Prohibitive costs

For most of the 20th century, aging policies were designed with a youthful society in mind. When Medicare and Medicaid were created, few people thought about the strain that would be put on the funding system when 76 million baby boomers retired.

Cheryl Jones laughs with her client Margaret Bass while folding Bass' laundry.

There was no need for someone like Cheryl Jones to come in and vacuum the house or organize grandma’s pill bottles because typically the daughter who lived with her, or across the street, took care of such things.

But that daughter may now live in Kansas, and it’s likely that she’s busy taking care of her own family and working full time, too.

Nationwide, many private companies have emerged to fill the gap — more than a dozen in the Roanoke area alone. But home-care services are expensive and plagued by a nationwide worker shortage, advocates for the elderly say.

They are especially hard to come by for modest-income families in Virginia.

“The problem is, people are really needing custodial care, somebody to come in and make sure mom doesn’t stick a fork in the microwave and help her with a bath,” said Shannon Abell, director of senior resources for the LOA Area Agency on Aging.

“These agencies will do it ... but the average family simply can’t afford it,” Abell said.

In Roanoke, home care averages $14 an hour. For 20 hours a week, that amounts to a minimum weekly bill of $280, or $14,560 a year.

The cost is well beyond the reach of average Roanoke seniors, whose median household income is $28,542 a year. Yet it’s cheaper than a nursing home by half.

But for seniors whose children live out of state, home care is well worth the cost, according to Martha Anderson, who recommends the service frequently. The Monday after Thanksgiving, her phone at the Carilion Center for Healthy Aging rings all day long with adult children who have just returned from visiting their parents over the holidays.

They’re calling, many of them frantic, to say: Mom forgot to put the turkey in the oven. Dad isn’t taking his medicine the way he should.

“A lot of the patients we see have a little bit of money, and if they’re lucky the kids are pitching in to pay for home care,” said Anderson, clinical consultant. “I tell the patients, ‘This is the time you should be spending those pennies you’ve been hanging onto. Turn those lights on so you won’t fall! Pay for someone to come organize your meds!’ ”

At the LOA office, ombudsman Pam McAdams worries about the callers — typically wives, many of them caring for husbands with dementia — who don’t have family members who can help, and who have just enough income not to qualify for state-funded help.

“I’ve had people call me and say, ‘I haven’t slept in three weeks because my husband gets out at night and I don’t dare fall asleep.’ ” McAdams said. “When they can’t afford home health and have no other resources, sometimes the only decision they have left is to place a person in a facility.”