Forgetting to Remember: America’s Eldercare Crisis

By Jacqueline Zanders

Anyone familiar with the penal system of the Ancient Romans knows that they were particularly gifted at concocting death sentences. Executions were devised with the inventiveness of an artist at his easel, with punishments ranging from the well-known sentence of crucifixion to more unexpected penalties like live burials, public maulings by wild beasts, or the particularly ghastly verdict of being sewn into a goatskin and thrown into a river. But in contrast to the nature of other penalties, there was one Roman punishment whose reach extended past the grave. The famed damnatio memoriae, or, literally, “damnation of memory,” was a particularly shameful sentence in which the Roman Senate sought to destroy all records that a person ever existed. Usually reserved for government officials who had fallen from grace or those who had committed crimes like treason, the damnatio memoriae saw statues, headstones, writings, and even conversations stripped of all mention of the transgressor.

Of course, erasing all proof that someone ever lived is much easier said than done, and the damnatio memoriae wasn’t always successful. But the effort that the Romans put into such a seemingly impossible task still illuminates a concealed wisdom. Even in light of all the violence, Roman lawmakers knew that the heights of punishment didn’t rest with a transgressor’s demise; it was the memory of one’s life that held the truest value. To be forgotten was literally a fate worse than death.

Forgetfulness has, admittedly, been on my mind quite a lot lately. My maternal grandfather, who’s been diagnosed with Alzheimer’s, recently arrived in my hometown for the holidays, and though he is only in the early stages of the disease, I do find myself watching out for signs of memory lapses. Presently, he’s doing pretty well for a 92-year-old. But with college starting again soon, I’m trying to make sure that I extend as much time and watchfulness towards my grandfather as possible, especially because the next time I’ll see him is uncertain. See, he might return to Delaware soon, where he’d enter a nursing facility. But if he decides to stay, he’ll become Permanent Occupant #5, causing my family to join the estimated 18 million people in the U.S.  who care for a relative over 65 at home. Thankfully, my brother and I are both old enough to help out when not in school, and my parents are prepared to handle expenses. But for many, at-home elder care is too stressful or too time-consuming to cope with, while care in a nursing facility costs $92,000 a year on average. And with the number of seniors in the U.S. climbing faster than any other group, the amount of caregivers and services available for families is becoming scarce.

In other words, we may be heading towards a national crisis—thousands upon thousands of seniors with compromised care. In some cases, these seniors will be subject to neglect, exploitation, maltreatment, or the alternative of life confined in a hospital ward where the majority of Americans will forget that they exist. So what’s being done? We’d like to think of ourselves as more merciful than the Ancient Romans, but as we dissolve into partisan arguments or out-of-sight, out-of-mind mentalities, are we becoming complacent about the prospect of millions of people being shut away and neglected by the public?

A little research reveals that the answer isn’t quite so simplistic. For one thing, it’s not as if the problem has gone completely unaddressed. There are government programs in place to assist elders with low funds during end-of-life care, such as Medicare and Medicaid. The market also boasts a plethora of insurance policies for seniors, supposedly designed to pay for short-term care and long-term end-of-life care. But the system is falling apart.

One aspect of this lies in the huge financial gap between the exorbitant price tag for comfortable, independently-paid care and the wage bracket necessary to qualify for financial aid. With prices for lodging in retirement homes escalating to thousands of dollars a month and medical expenses arcing even higher, the average American family can’t hope to meet these costs for very long. An increasing number of families, even those who did plan and save ahead, end up spending through all of the senior’s assets (sometimes just to qualify for Medicaid). This then inundates federal programs with needy people, which experts say could eventually lead to these programs’ collapse. In the meantime, a lot of insurance plans are also expensive, so they aren’t a reasonable choice for most consumers who try to plan ahead. For example, according to one study, while only 10% of consumers hold a long-term care insurance policy, a hypothetical insurance product with fixed premiums “set at an actuarially fair level, based on each individual’s age, gender, and health,” would attract 60% of consumers. The market simply hasn’t provided a product that the public actually wants to buy. And in other cases, it comes down to too-little, too-late planning, where discussions about how to take care of Mom or Dad don’t get serious until a surprise phone call.

What it really comes down to is proper allotment of responsibility. America can’t put all of the weight on families, because many simply can’t pay for services all on their own. We also can’t put all of the weight on the government, because to be honest, Medicaid and Medicare simply can’t bear such a strain (and neither can taxpayer dollars). And we certainly can’t just ignore the problem because it doesn’t seem to affect us personally or because it hasn’t reached its peak. We have to make plans now. On a social level, that means educating ourselves about what tools are available, where these tools are failing, and where we can put our votes and our money to catalyze effective policies, ideas, and action. But on a local, personal level, that means having significant conversations with our loved ones about the future—and that’s something that we all can do. Every small step is an advancement.

That’s the nice thing about caring for the seniors in our lives. Sure, each person we support poses a set of challenges, but they also give us someone tangible to fight for. The numbers become less abstract. We start to see faces, hear voices, remember stories, gain motivations. So even though it might be too difficult to commit to remembering a formless mass of people that we’ll never know—in that way, such a group was doomed to the damnatio memoriae from the start—all of us can still remember those we love.

Jacqueline Zanders is a freshman at Harvard University. She plans to major in History and Literature and aspires to become an oncologist.


To learn more the Elder Care Crisis and to take action:

What’s Behind America’s Elder Care Crisis

The Crisis Facing America's Working Daughters

Why Long-Term Care for U.S. Seniors is Headed for ‘Crisis’

More Americans Care for Elderly Relatives, But Who Will Care for the Caregivers?

Damnatio Memoriae: When the Romans Purposely Erased People from History

The Extremely Cruel Edges of Roman Justice