Wednesday, December 26, 2018

New INC Blog Post: Family Holidays Can Be Fraught. Here's One Way to Make Them Productive


Family Holidays Can Be Fraught. Here's One Way to Make Them Productive
Rather than settling scores with your siblings, or overeating, use this time to get serious about how you're going to take care of your aging parents, a problem made more difficult by our broken-down healthcare system.

Executive director, Ed Kaplan Family Institute for Innovation and Tech Entrepreneurship, Illinois Institute of Technology

   The holidays are always a very complicated time for families. Most of us look forward to the annual gatherings and grudgingly try to forget the imagined affronts, drunken insults, petty squabbles and painful debacles of the past. I realize that this sounds a lot like most of the office parties we've all recently suffered through. The big difference, though,  is that you can't really bail early when you're stuck at your parents' home for the evening, trying to hide out in your old bedroom and staring at decades-old debate trophies gathering dust on shelves you ineptly installed sometime in the 60s or 70s.

This wave of mass selective memory that carefully edits unfortunate prior episodes blankets the country at this time of year as we try to be of good cheer. It's one of the greatest examples of how fantasy and fiction, along with abundant optimism, continue to triumph over memory and bitter experience. That doesn't include politics, where everything remains a bitter experience.

So, we soldier on each year and hope for the best. Certain delights and dilemmas are recurring. Seeing distant, but not distant enough, relatives once a year is as much a regular December ritual as avoiding Uncle Arnold's questionable creme brûlée, which he serves in an old Folger's coffee can. And don't get me started on Frieda's fruit cake which, if inadvertently dropped, would easily crack concrete never mind the dentures of anyone foolhardy enough to bite the beast.

But these trials and tribulations pale in comparison to the newest and toughest Christmas conversation, which is no fun for anyone. This happens when the brothers and sisters of a certain age who are lucky enough to have living parents gather to have "the talk" about Mom and/or Dad's health, happiness, financial condition, and, most of all, their future care. This is tough because the subject is so difficult to address (with or without your parents in the room) and very timely because we are the very first generation that is discovering in mass that we're going to have to become our parents' parents. Millions of us are going to be required to unexpectedly comfort and care for our parents for many years at the very same time when we're facing the financial challenges of getting our kids into and out of college/grad school and launched into the working world-- so we can keep them from moving back home. Others, a little older, may have thought they were on the cusp of a blissful and stress-free retirement, only to realize that they're about to confront a bundle of new responsibilities.

Caring for our folks for a decade or so may not have been foreseen or properly prepared for and, in some respects, this responsibility is far from fair. But it's a fact today and one which more and more families will need to deal with. And truthfully, most of us aren't prepared for the prospect that our parents are living one misstep away from misery and the near certainty that their care, problems and concerns will then become ours as well.

If this dawning realization wasn't frightening and painful enough, it's compounded by the fact that their trials and tribulations are merely a glimpse into the futures that we too can all expect. All the more reason, by the way, to begin right now being exceedingly nice to your own kids. And to consider three very disturbing lessons that our parents never bothered to share with us; lessons you will learn quickly as you attempt to assist them in navigating their golden, if somewhat tarnished, days.

(1) Hospitals aren't places you go to get well. Get out ASAP.
Hospitals don't make you feel better. They're insensitive and unfeeling factories focused on figuring out how quickly they can get you out the door. The sooner, the better. And actually, that's the only real favor they do for you because the whole process is a game of Russian roulette, where limited, overworked and under-trained staffs try to keep you from getting the newest staph infection before they send you home with a pile of papers, incomprehensible discharge instructions, and a hearty slap on the back.

 Leaving your loved ones at the mercy (hopefully not MRSA) of one of these medical bureaucracies is heartbreaking for all concerned. But there's not much choice, unless you move into their room  and try to act as their advocate.  Needless to say, no one in the hospital likes that notion, in part because you might quickly see that the call buttons are placebos-- no one really comes when you call-- and that, because of severe personnel shortages, there's a new duty nurse almost every day who knows practically nothing about your Mom or Dad. It's not that they don't care -- the good ones clearly do. The problem is that they're just prisoners along with their patients in a system that optimizes everything but caring and curing.

 (2) Insurance "benefits" benefit the insurers, not the insureds.
The "can't-be-bothered" clerks and sloth-like cretins who work for the nation's insurers are similarly mis-incented.  They get paid to first say "No" all day long and hope that (after waiting an hour to speak to an alleged human) you'll take their word for it, so they can get you off the phone.  When you squeal and appeal, you often get paid, but they still make it as slow and painful as possible because they know  time is on their side and that you're probably tired, in pain, and on drugs.  

 And, by the way, they do the same scummy things to your doctors. Some useless creep in Omaha decides what tests and procedures your insurer will pay for and dictates the acceptable diagnoses to the doctor-- not the other way around. Even the best physicians face barriers to helping you get well when these people won't pay for the proper tests to determine what's wrong with you in the first place.  This is the kind of support and these are the "benefits" for which you paid premiums religiously for most of your life. You've become lost in the land of loopholes, shabby excuses, clever clauses, and everything short of the simple truth.  If there's an industry with more scumbags per capita than health insurance, I can't imagine what it would be.

 (3) Social Security is neither social nor secure, but it's unsettling for sure.
 Parents planning to rely on Social Security for much of anything will be shocked to find what a pittance they'll be paid after a lifetime of work and contributions.  Don't think of it so much as a question of imminent insolvency--that will be our kids' concern. Instead, with Social Security the greater insult is to be offered peanuts with a straight face by a bureaucracy and a bunch of useless politicians still set on squandering our financial future while lining their own pockets at the same time.  They don't need to depend on Social Security, so what do they really care?

 Trying to understand what you and your spouse should be paid each month is an invitation to recurring torment, jumbled jargon, and double-talk by people who can't even seem to read the mechanical scripts set in front of them. This mess is made even worse (if that were possible) by an immediate and unstoppable deluge of written notices, indecipherable calculations, after-the-fact adjustments and everything but a simple explanation or an answered phone call. This seems to be a plan to further punish you for the audacity you initially exhibited by being so brash as to ask a question. And the Social Security swamp is only a poor cousin to the utter morass of Medicare or "Mini-care" as we like to call it, since anything of importance to your health and every material cost seems to be mysteriously uncovered.

 So, be forewarned.  This is not a journey to be lightly undertaken or traversed by the faint-of-heart. Nevertheless, it's a journey we will all need to navigate for our parents and thereafter for ourselves and there's no better time than now to get the conversations started.