Financial and emotional costs of providing long-term care for a loved one can be devastating. Helping meet them would help Hawaii.

Originally published by Honolulu Civil Beat. Read it there.
By Moya Gray  / October 24, 2016

We in Hawaii place enormous importance on family and on caring for our parents, our children, and the most vulnerable among us. Yet, economic realities often force people to put a parent in a nursing home, in an environment many of us would not want for ourselves, so that they do not have to leave the workforce and can keep working to provide for their families.

As someone who was faced with the need to opt out of the workforce prematurely to care for family members, I have felt the financial and emotional cost of cutting short my career years.

I would like to add my voice to those of the thousands of silent caregivers who have experienced what I have been through.

When my husband had a bicycle accident, his resulting quadraplegia left us with few choices for his ongoing care: I could place him in a nursing home, I could hire caregivers or I could stop working and care for him.

We tried to hire caregivers but few were reliable — so I stopped working to provide the care he needed. I was young enough and strong enough to provide the physical care that he needed. We were also very fortunate that we were able to reduce our cost of living so that we could live on long term disability income. But at this point both of us had stopped our careers at the height of our earning power with one child in college and one still in high school.

Just last year, my mother suffered a severe stroke and required significant round-the-clock care while in the hospital. Family members took turns being with her throughout the day and night, taking off hours upon hours from their jobs. Unfortunately, there was only one nursing home on Oahu that could manage her care upon discharge from the hospital.

But even with a decent nursing home, the care simply wasn’t adequate, and within a few days of entering the nursing home, she was returned to the hospital with complications. At this point, the doctors advised us that mom’s only choice was hospice. Eventually, the family decided to move mom into my home so that I could manage her 24-hour care; we had caregivers around the clock for another five months before she passed.

For members of the family, mom’s move into my house meant that they could all return to work on a regular basis and know that she was getting good care in our home, with the family around her.

Some families have insurance policies that help pay for the nursing home. Medicare does provide some assistance when a parent is placed in a facility, but there is virtually no help that people can tap into if they choose to let a parent age in their own home.

Clearly, not having policies to take care of our aging parents in a state where people over 60 will make up about 27 percent of the population by 2030 is potentially disastrous.
Therefore, the family that wants to keep a parent or disabled loved one at home has to somehow pay for the cost of hiring home aides or quit their own jobs to provide the care themselves. Either way, the working family suffers in more ways than one.

Currently, if you hire a home health aide through a company, the average caregiver (not a nurse) will cost a family $26 – $35 per hour. As I understand it, the caregiver is paid $12-$20 per hour by the company. To hire someone eight hours a day for a year, a family would have to earn $52,000 over and above their own needs – so paying for full-time home care is almost impossible for the majority of individuals and families.

But, if one member of the family quits his or her job to take care of the parent, there is an economic loss to the family, and to the employer as well. It’s a gut-wrenching situation to be in. It places one in a position to have to choose between earning an income for the family and giving our loved ones the care they deserve and need.

The cost to society of this choice reverberates beyond the actual immediate impact on the family. As the person who stays at home to take care of the parent is not working, their future retirement is likely endangered by the lack of earnings at a time when those earnings would probably be at their highest. Thus when it comes time for them to retire, they, too, have fewer resources, and their children must wrestle with the same emotional and economic challenges as they did.

Clearly, not having policies to take care of our aging parents in a state where people over 60 will make up about 27 percent of the population by 2030 is potentially disastrous. The escalation of this challenge through successive generations has a real impact on the wellbeing of Hawaii’s people and the state.

Earlier this year, I participated in a town hall with legislators and other members of the community to offer my perspective on the need to enact legislation that will allow for public long-term care insurance for all.

The proposed legislation would have given families a modest stipend to help pay for the cost of hiring a caregiver in the home. This would allow the working family members to continue in their jobs and build up savings for their own retirement. Such a policy benefits employers, as they do not lose experienced employees prematurely. This is a win for the employer, the employee and for working families.

My hope, as we look to the next legislative session, is that taking care of our families will rank as a number one priority. There are few things more important than ensuring the health and wellbeing of our families, from our keiki to our kupuna.

About the Author

Moya Gray

Moya Gray

A former practicing attorney, Moya Gray led the Office of Information Practices under Gov. Ben Cayetano and was more recently head of Volunteer Legal Services Hawaii. She continues to meet the challenge of serving as a caregiver for loved ones.

Community Voices aims to encourage broad discussion on many topics of community interest. It’s kind of a cross between Letters to the Editor and op-eds. This is your space to talk about important issues or interesting people who are making a difference in our world. Columns generally run about 800 words (yes, they can be shorter or longer) and we need a photo of the author and a bio. We welcome video commentary and other multimedia formats. Send to