Importing caregivers to look after the oldest old?

“Listening to the current bitter debates over immigration, I wonder whether those so eager to rid our nation of these immigrants have thought about what that will mean for the growing number of elderly in our nation.

"As one of four siblings who shared the burden of looking after my mother when she became too weak to care for herself in her late 80s, I worry about the heavier burden I will put on my two children, and panic at the thought of what the future may hold for them when they are very old, for neither of them has children. What makes their future care so problematic is that they are part of a growing trend—people who will live much longer and who are likely to have no or few children to care for them. “

This thought-provoking comment comes from Beverly Goldberg, a scholar with the Century Foundation and author of the new report Facing the Problems of Providing Long-Term Care for the Oldest Old.

The report “examines the demographic realities facing our nation as the boomers continue to age, the special needs of the oldest old, the costs of the long-term care necessary to meet those needs, and the challenge of developing a large enough cadre of health care workers who are trained in gerontology.”

Policy recommendations to “improve the care of the elderly while
containing costs for government and families include some creative and controversial workforce recommendations, including issuing visas for caregivers.

Among the recommendation are:

• establishing programs to train primary-care doctors, nurse practitioners, and others who provide nursing care in geriatrics;

• ensuring that drug trials include the elderly; that possible interactions between drugs used by the elderly are reported, studied, and information about them made available;

• covering long-term care through a social insurance mechanism like Medicare;

• encouraging the use of, and payments for, alternatives to nursing home placement;

• expanding the available tax credit for family caregivers or passing legislation providing direct cash payments to family members who provide such care;

• creating a civilian health service corps that will train people to provide basic home health care in return for funds for vocational training or community college education after a given term of service is completed;

• providing forgiveness for loans taken out to cover college tuition for nurses who work for a certain mandated time in nursing homes;

• increasing the pool of available home health care workers by increasing the number of visas for low-skilled workers; and

• encouraging businesses to provide programs aimed at easing the care-giving problem for workers, which would aid in retention, decrease absenteeism, and improve the
productivity of workers carrying such burdens.

Which recommendations strike you as most intriguing?