Role reversal: Baby Boomers juggling financial needs with caring for aging parents

Kimberley McGee

Thursday, March 7, 2002 | 8:22 a.m.

Growing up, Lamar Marchese's mom was always there for him.

Now it's his turn.

"There's a point where you have to take responsibility and take care of your parents the way they took care of you," Marchese, 58, said.

Marchese, general manager of Las Vegas public radio station KNPR 89.5-FM, is one of millions of Baby Boomers nationwide who are taking charge of their parents' long-term care.

The Boomers are grappling with serious decisions, such as whether to care for their parents at home or place them in assisted-living facilities.

Boomers are also facing their own mortality as they prepare for retirement.

After months of talks with his mother, Marchese moved her from her home in Texas (where she lived with her daughter, Sheila) to an assisted-care facility in Las Vegas.

A recent cornea operation had left 83-year-old Catherine Marchese blind in her right eye. Marchese's sister's busy schedule and the location of her suburban home meant that his mother was left alone for hours during the day, with nowhere to go.

"She needed to move somewhere where she could be with people," Marchese said. "It was a tough decision for all of us at the time."

The Baby Boom generation -- classified as those born between 1946-1964 -- is uniquely affected by the growing dilemma of long-term health care, said Tom Burke, spokesperson for the American Health Care Association in Washington, D.C. The association represents assisted-living facilities and nursing homes nationwide.

Figures from the 2000 U.S. Census show that there are 77 million Boomers in the United States.

No other generation has been in such a position, where its members are taking care of their parents while putting their children through college and preparing for their own retirement, Burke said.

Are they ready to take on the financial and emotional burden of caring for their parents?

"Absolutely not," Burke said.

The trend will probably continue as the average life span increases, Burke said. The National Center for Health Statistics in Maryland has tabulated that the average life expectancy for Americans is 78, up from 68 in 1950.

Americans aged 85 and older are the fastest-growing segment of the population, Burke said, and the most dependent on long-term health-care services. Many rely on Medicare to see them through their long-term health care needs.

But that may not be a good idea.

"Medicare has strings attached, which people don't understand," Burke said.

Long-term health care can churn through savings pretty quickly, at about $4,000 a month, Burke said. That steep figure includes the assistance of Medicare.

The average range for continuing care for the elderly is $13,000-$21,000 per year. That number doubles for nursing-home care at $50,000 annually. The AHCA reported the average nursing home stay in 1995 was 2.3 years. Meanwhile assisted-living facilities charge around $22,000 annually.

Locally there are more housing options for the aged than ever, said Charles Perry, executive director for the Nevada Health Care Association in Las Vegas.

But housing isn't always affordable, Perry said. Neither health insurance nor government programs cover the climbing costs.

"The elderly portion of our population is growing and has grown dramatically in the last 20 years," Perry said. "Assisted-living facilities are booming here."

By being prepared for the inevitable, Burke said families could enjoy each other rather than maneuver through the emotional and expensive bureaucracy of health-care insurance.

"We encourage families to have the talk," Burke said. "Otherwise something happens and suddenly they find themselves in care-giver situations that aren't easy for anyone."

Boomers in charge

For Marchese and his mother, the "talk" was difficult at first.

She wasn't hesitant to move at her age. She discussed the living situation for months with her son and daughter.

"I kind of bullied her into it," Lamar Marchese said. "I knew she valued her independence, but she couldn't live there anymore."

The Marchese family searched for a pleasing facility in Las Vegas, of which they found many, but were put off by the $3,000-plus monthly costs. They eventually located a facility that was affordable and close to Lamar Marchese's Las Vegas home.

"There was a lot to choose from, but they were really expensive," Marchese said. "We wanted something where she would be happy, but that didn't put us in serious debt."

Marchese and his mother split the cost of the facility, which includes meals, cleaning services, social events and laundry.

"I thought (paying the monthly $1,000 fee) would have been beyond her capacity without my help," Marchese said.

Catherine Marchese is settling into her new home with aplomb.

Her 500-square-foot room, with an oversized attached bathroom, is equipped with a small refrigerator and microwave for her nightly coffee.

She has moved her own furniture into the room and added some new bookcases, which her son assembled for her, to hold her porcelain-animal figurine collection.

She takes daily walks to nearby stores, lunches with other residents and recently received a haircut from the stylist who visits the facility weekly.

"I have more independence here than I did at my daughter's," Catherine Marchese said.

"I can fix my cup of coffee in my room and sit on the floor and watch TV or whatever."

Health care hurdles

Making such life-altering decisions for their parents has also forced Boomers to confront their financial limitations.

Tony Rino, 42, has split his time between his life in Las Vegas with his wife, Jennifer, 41, and their 9-year-old daughter, Emily, and his aging parents who live near Denver.

"I'm trying to do everything right now," Rino said. "I don't know how long that will last."

When his 75-year-old father fell and broke a hip three years ago, Rino, a Las Vegas defense contractor employee, flew to Colorado to care for his mother, 82, while his father recovered.

That's when Rino began to notice changes in his parents. They regularly ate fast food because his mother could no longer cook. She occasionally appeared confused. They were not themselves.

Rino set out to ensure they could live at home as long as possible. He contacted a Colorado Meals on Wheels group to deliver nutritional meals to his parents' home. He also asked neighbors to help out a little.

He was met at each turn with resistance from his parents.

"It was hard," Rino said. "They (come from a) very stubborn generation and they don't want to admit they need help."

After a series of misfortunes late last year, it was made clear to all involved that the family's dynamics had changed. The son had become the caregiver and financial planner.

Rino's mother became ill in October and he returned for a monthlong stay at his parents' house to install safety railing in the bathroom and prepare the house for her return from the hospital.

He wasn't prepared for what came next.

While in the hospital the doctors determined Rino's mother's mental state was diminishing and she would need around-the-clock care.

Last month Rino was forced to place his 84-year-old mother in a nursing home. Meanwhile his 75-year-old father is lost at home without his 40-year companion.

Rino's father's financial assets were more than were allowed for him to qualify for federally funded Medicaid. His father is bitter and depressed that he has had to cash in some of his retirement assets to afford the medical situation he has suddenly been thrust into.

The move of Rino's mother has deeply affected his father's mental and physical well-being, Rino said.

"He said that his married life was over because he knew she was never coming home," Rino said. "He said, 'I'm just surviving here.' "

Friends ask Rino why he doesn't move his parents to Las Vegas, or move his own family to Colorado. Financially, Rino said, both options are difficult.

"Frustration is my biggest problem," Rino said. "We're just taking it day by day."

Similar to many in his situation, Rino said, he and his wife are squeezing future funds -- earmarked for their daughter's college education and their retirement, as well for as the possibility that they may need to care for each of their parents -- from their modest two-salary annual income.

They have begun a living trust and estate planning.

"This has definitely been a lesson learned for us," Rino said. "You need to evaluate your estate and where you are in life so that you don't get to the point where my parents are."