My father-in-law was the happiest person I’ve ever known. Jon Lee Wray was a simple man — a farmer and cowboy — who spent his whole life within eight miles of his Weiser home.
After a heart attack in 2001, my husband and I began supporting his care and had tough conversations about end-of-life planning. Jon Lee wanted his final time to be spent as he’d lived — surrounded by his friends, family and home in Weiser. In that, he aligned with 87 percent of seniors who want to stay in their home as they age. We promised to do our best to honor his wishes.
We became an “activated family,” securing power of attorney and taking over household and health care management. We used this time to research and prepare for when Jon Lee needed more care.
Some thought: “Medicare must cover long term care, right?” Wrong. Medicare only covers long-term care following a qualifying three-day hospital stay, with limits per benefit period. Once this benefit is maxed-out, or you need care to assist with daily living, the care costs become your responsibility. Based on income and needs, we knew he’d probably end up on Medicaid and started squirreling away money in case we’d need to pay out-of-pocket.
When Jon Lee had a second heart attack in December 2022, he’d saved almost $40,000. We brought him home on hospice and quickly realized he needed hands-on, round-the-clock support. Home hospice was a wonderful resource, but only provided six hours of weekly care. It was up to the family to help him for the remaining 162 hours of the week including meals, medication management, grooming, moving around, and using the facilities.
Preparation is irrelevant
I felt prepared for home-based care. We had conducted interviews, checked certifications and saved. But it never occurred to me that we’d have $40,000 saved for care and there would be no caregivers available.
Resources didn’t exist. We explored hiring a neighbor or friend, but those who had time and willingness didn’t have the physical strength to assist a 200-pound man. There were times we considered giving up on our goal of keeping him home, but no nursing home beds were available.
When we finally found an agency with staffing to support him, the $35 hourly cost was inadequate to consistently attract quality caregivers. After overhead costs, direct care workers earn about $15 hourly for physically and emotionally difficult work — lifting, feeding, grooming and helping people in the bathroom. The low hourly rate and limited choices resulted in Dad not feeling confident about or comfortable with some of his caregivers.
And there was nothing we could do except put our own lives on hold and our livelihoods at risk by taking time off work to support his daily needs.
The fear of ‘what if?’
Jon Lee did all the right things. He spent his life paying taxes, never missed a day of work and lived modestly on Social Security. He never earned $35 an hour. How could he save enough to pay someone more than he ever made?
Dad passed after the family spent four weeks with him full-time supplementing available direct care services. In that time, we spent nearly half his savings on part-time care. His life savings would have only paid for two months of full-time care.
Employers at HP, Inc. were exceptionally supportive and allowed me to work remotely for over a month. His son left his business for weeks to help with care. But we often wondered what would happen if we had site-required jobs. What if we hadn’t had 20 years to prepare? What if we ran out of savings? What if we just had to depend on Medicaid?
Let’s make change
People think “it will never be me.” The U.S. Department of Health and Human Services found more than half of Americans turning 65 will develop a disability requiring long-term support services and average $138,000 in long-term care costs. Families pay about half of that with the remainder covered by public programs and private insurance.
It’s time for Idaho’s Legislature to find sustainable solutions for direct care Medicaid reimbursement rates. If we maintain today’s paltry pay, this problem will grow. As our population ages, more leave for careers with better pay.
The Office of Performance Evaluations issued a report with five simple recommendations to address this crisis and stabilize Idaho’s long-term direct care workforce. One way: increase wages.
I am proud we found a way to keep Dad home with family, community and direct care support. From the first day he came home from the hospital, 18 lifetime friends came to check on, talk, laugh and reminisce with him so he could enjoy his final days. Those men wouldn’t have been able to drive to a facility in Boise to visit or have been allowed to bring meals or have extended visits in a hospital. But their time together helped Jon Lee find peace on his journey.
When he passed, Jon Lee was in his home, his bedroom, with family at his side. And he is still the happiest person I’ve ever known.
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