The future of home care

New Options (and Risks) in Home Care for Elderly
By JANE GROSS, The New York Times, March 1, 2007

Dr. Diane E. Meier, a geriatrician at Mount Sinai Medical Center in New York, is an expert on end-of-life care. So when her elderly parents needed long-term help at home with bathing, dressing and cooking after her father’s stroke, she knew where to find assistance.

It was not through agencies in Manhattan that provide home health aides who are bonded, insured and certified. A year of custodial care from such an agency would cost her family $150,000, and in short order exhaust its savings because aides are not covered by government assistance unless patients are poor or fresh from a hospital stay.

Instead Dr. Meier turned to “a little list” of aides from the so-called gray market, an over-the-back-fence network of women. They are usually untrained, unscreened and unsupervised, but more affordable without an agency’s fee, less constrained by regulations and hired through personal recommendation.

With 4.2 million Americans currently over 85 — a number expected to grow to 5.9 million by 2014 and then accelerate with the baby boom generation — the exploding need for long-term care is remaking the home-care industry, driving more of it underground. Gray-market hiring, fraught with risks, is a solution that middle-class families are turning to as they face the crushing burden of indefinite home-care expenses. But it is hardly the only one, as businesses rush to meet the needs of these families, the fastest-growing segment of the marketplace, who are intent on keeping their loved ones out of nursing homes.
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Schlesinger

Arthur Schlesinger, Historian of Power, Dies at 89
By DOUGLAS MARTIN, The New York Times, March 1, 2007

Arthur M. Schlesinger Jr., the historian whose more than 20 books shaped discussions for two generations about America’s past and who himself was a provocative, unabashedly liberal partisan, most notably in serving in the Kennedy White House, died last night in Manhattan. He was 89.

The cause was a heart attack, said Mr. Schlesinger’s son Stephen. He died at New York Downtown Hospital after being stricken in a restaurant.

Twice awarded the Pulitzer Prize and the National Book Award, Mr. Schlesinger exhaustively examined the administrations of two prominent presidents, Andrew Jackson and Franklin Delano Roosevelt, against a vast background of regional and economic rivalries. He strongly argued that strong individuals like Jackson and Roosevelt could bend history.
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