The Stoicism of the Caregiver

These are difficult realities without Hollywood cliche answers.

Caregivers and the costs of caregiving don't get much attention. They're not part of the news flow, and the day-to-day grind of caregiving doesn't lend itself to the self-promotional zeitgeist of social media. Look at me, helping Mom on her walker is not going to score big numbers online.

The burdens in human and financial terms are often crushing. These realities are generally obscured by taboos and Hollywood cliches: it's considered bad form to describe the burdens of caregiving, and anyone who dares to do so is quickly chided: "You're lucky your parent is still alive so you can spend quality time together."

Meanwhile, back in the real world, 4 in 10 family caregivers rarely or never feel relaxed, according to a 2023 AARP survey, as an integral part of caregiving is being on constant alert for something untoward happening to the elderly person in one's care.

The demographics are sobering: we're living longer, often much longer, than previous generations, and in greater numbers. This means 65-year olds are caring for 85-year olds and 70-year olds are caring for 90+-year olds. I've logged 8+ years of caregiving (5+ years here at home) from age 63 to 70 caring for my mom-in-law, so I have personal experience of being old enough to "retire" but retirement is a fantasy for caregivers. Our neighbors are 80+ years of age and they're caring for her 102-year old Mom. What's this retirement thing people talk about so cheerily?

All these realities are abstractions until they happen to you.

These burdens are seeping down to Gen X and the Millennial generation. 'It's a job, and a tough one': the pain and privilege of being a millennial caregiver.

The financial costs of care are staggering. A bed in private assisted living is around $75,000 and up a year, a private room in a nursing home is around $150,000 a year, and round-the-clock care at home costs from $150,000 to $250,000+ annually.

The Crushing Financial Burden of Aging at Home (WSJ.com)

"Christine Salhany spends about $240,000 a year for 24-hour in-home care for her husband who has Alzheimer's. In Illinois, Carolyn Brugioni's dad exhausted his savings and took out a home-equity line-of-credit to pay for home healthcare."

More than 11,000 people in the U.S. are turning 65 every day and the vast majority--77% of Americans age 50 and older according to an AARP survey--want to live as long as possible in their current home. At some point, many will need help. About one-fourth of those 65 and older will eventually require significant support and services for more than three years, according to the Center for Retirement Research at Boston College.

About one-third of retirees don't have resources to afford even a year of minimal care, according to the Boston College center.

"The new inheritance is not having enough money to give to kids but to have enough money to cover long-term care costs, says Liz O'Donnell, the Boston-based founder of Working Daughter, an online community of caregivers.

The costs of home care are so high that not just inheritances are exhausted; the home equity is also drained. $350,000 sounds like a lot of money but that might cover two years in a nursing home but not be enough to cover two years of round-the-clock care at home.

The cost of maintaining the home doesn't go away: property taxes, insurance and maintenance expenses must be paid, too.

Those without monumental financial resources make do by doing everything themselves. Depending on the resources available in the community, there may be some minimal assistance such as weekly visits by a nurse, meals delivered, and adult day-care facilities, but there are no guarantees any of these are available or that the family qualifies.

In other words, the idea that the retired generation will leave ample inheritances is increasingly detached from reality. As noted, the new inheritance is to get through the years of caregiving without acquiring debt.

The human costs are high, too. In the Hollywood cliche, everyone adapts and makes the best of it, and there's plenty of Hallmark moments that make it all worthwhile. Yes, there are Hallmark moments, but the elderly person misses their independence and may feel resentment that they no longer control how things are done. The caregivers are often exhausted--especially if they're 65 or older--and despite their best efforts may feel resentment at ending their careers early and sacrificing their own last best years caring for a decidedly unstellar parent who doesn't seem to appreciate the immense sacrifices being made on their behalf.

The indignities of extreme old age weigh on the elderly, and the 65+ caregivers worry that they can't pick Mom or Dad up now that they're so old that they have their own infirmities.

The responsible parent frets at the expense and feels bad they won't be able to pass on much to their grandkids. They may express guilt at being a burden, though that is beyond their control. The responsible adult child is burning out trying to juggle three generations and keep themselves glued together enough to keep functioning. They can't help but want their own life back, but to say this out loud is taboo because if life gives you lemons, make lemonade. In other words, tell us a happy story, repeat an acceptable cliche or say nothing.

Nobody wants to hear any of this, and so the caregiver develops a self-contained stoicism. Everyone with no experience of caregiving wants to hear the Hollywood version, and so conversations with other caregivers are the only moments where the truth can be expressed and heard. In the rest of "normal life," the caregiver quickly learns to say what's expected: "We're managing. Life's good."

This cultural taboo means the difficult realities that will multiply as 68 million Boomers age will come as an unwelcome surprise. Everyone wants to end their lives at home, we all understand this. While the fortunate elderly die peacefully at home after a brief illness, the less fortunate require levels of care that soon exhaust people and bank accounts.



The burdens of caring for the remaining Silent Generation are high, but what about the 60 million retiree tsunami of the Boomer generation? As the general health of the American public declines, how many people will be healthy enough to care for their very elderly parents or grandparents? Who will do the often thankless work of caring for the very elderly at home and in nursing homes?

These are difficult realities without Hollywood cliche answers. The fantasy is that 60 million very elderly will be tended by robots, All Watched Over by Machines of Loving Grace. But this isn't realistic, despite all the giddy claims.

The American zeitgeist rejects problems for which there is no facile technological solution. But reality isn't a narrative, and the elderly person who fell and can't get up wants a bit of caring and sympathy, and the aging child wants to help their parent. That it isn't easy to do so requires a stoicism worthy of Marcus Aurelius.

"You have power over your mind--not outside events. Realize this, and you will find strength."

"Accept the things to which fate binds you, and love the people with whom fate brings you together, but do so with all your heart."

"Never let the future disturb you. You will meet it, if you have to, with the same weapons of reason which today arm you against the present."

All Watched Over By Machines Of Loving Grace
by Richard Brautigan

I like to think (and
the sooner the better!)
of a cybernetic meadow
where mammals and computers
live together in mutually
programming harmony
like pure water
touching clear sky.

I like to think
(right now, please!)
of a cybernetic forest
filled with pines and electronics
where deer stroll peacefully
past computers
as if they were flowers
with spinning blossoms.

I like to think
(it has to be!)
of a cybernetic ecology
where we are free of our labors
and joined back to nature,
returned to our mammal
brothers and sisters,
and all watched over
by machines of loving grace.

---

My recent books:

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The Mythology of Progress, Anti-Progress and a Mythology for the 21st Century print $18, (Kindle $8.95, Hardcover $24 (215 pages, 2024) Read the Introduction and first chapter for free (PDF)

Self-Reliance in the 21st Century print $18, (Kindle $8.95, audiobook $13.08 (96 pages, 2022) Read the first chapter for free (PDF)

The Asian Heroine Who Seduced Me (Novel) print $10.95, Kindle $6.95 Read an excerpt for free (PDF)

When You Can't Go On: Burnout, Reckoning and Renewal $18 print, $8.95 Kindle ebook; audiobook Read the first section for free (PDF)

Global Crisis, National Renewal: A (Revolutionary) Grand Strategy for the United States (Kindle $9.95, print $24, audiobook) Read Chapter One for free (PDF).

A Hacker's Teleology: Sharing the Wealth of Our Shrinking Planet (Kindle $8.95, print $20, audiobook $17.46) Read the first section for free (PDF).

Will You Be Richer or Poorer?: Profit, Power, and AI in a Traumatized World
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The Adventures of the Consulting Philosopher: The Disappearance of Drake (Novel) $4.95 Kindle, $10.95 print); read the first chapters for free (PDF)

Money and Work Unchained $6.95 Kindle, $15 print) Read the first section for free


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If We Set Aside Ideology, Is There Anything We Can Agree On?

Just the experiment of setting aside ideological certainties for a moment would be instructive.

Humans are hard-wired to prefer simplicity over complexity, and this is the foundation of ideology, which like mythology takes a complex world and radically simplifies it to an easily digestible construct. (I tease all this apart in my book The Mythology of Progress.)

Being social animals, humans are also hard-wired to quickly form loyalties to groups and gravitate to one camp. Very few football fans (if any) have zero loyalty to any team and have zero emotional stake (i.e. there's no team they hope loses and none they hope will win).

Uncertainty generates anxiety, and so we settle the real world's many uncertainties with internal certainty: an ideology is a simple sketch of how the world works, and we will defend this emotionally powerful construct even as evidence piles up that it doesn't accurately map all of the world's complexities. We will deny, rationalize and cherry-pick examples to "prove" our ideological certainties map the real world.

The problem with radically simplified constructs like mythologies and ideologies is they cannot possibly map the world accurately as complex, interactive systems don't reduce down to a simplified construct. So every ideological construct ends up denying, rationalizing and cherry-picking examples to cover the inherent weaknesses of simplifying the world into bite-sized constructs.

Our intense drive to establish and nurture loyalties leads to emotionally satisfying but often counter-productive convolutions, such as any enemy of my enemy is my friend and any friend of my enemy is my enemy.

The problems with ideological constructs are magnified in tumultuous times as ideologies map a rapidly shrinking share of the real world. The internally coherent ideology drifts further into incoherence, and our natural defense is not to become more open-minded (i.e. actively embrace uncertainty and entertain new ideas) but to cling even harder to the simplified certainties that generate our internal sense of self and certainty.

Since the faithful of competing ideologies are pursuing the same strategy to reduce anxiety, our loyalties clash with increasing intensity. That possibility that all the ideologies claiming to map the real world are increasingly detached from real-world dynamics doesn't occur to any true believer in any camp, for each believer remains confident (and when pushed, becomes ever more adamant) that their ideology is the one true construct that faithfully maps all of the real world's immense complexity.

Such is the power of these internally coherent constructs that we don't see them as belief structures, we see them as the bedrock of truth. We don't recognize our ideological beliefs as beliefs open to question, and so when challenged, we respond defensively: Ideology? What ideology? What I'm saying is the truth. Yes, true to us, but an accurate account / map of all the world's complexity? No.

To each believer in an ideology, the problem isn't that their ideology is not mapping the real world with sufficient accuracy to successfully navigate increasingly stormy seas. The problem is the other ideologies are obstructing our solutions, which are guaranteed to work if pursued with absolute purity. Compromises introduce fatal impurities and so of course they fail to fix what's broken.

If only all those misguided souls abandoned their wrong-headed beliefs and joined our temple, then we'd clear up all the real-world problems in no time. But alas, the fools insist on clinging to their completely misguided faith in false gods.

In this increasingly bitter environment, up becomes down and vice versa. Common sense--by definition, an attempt to map real world complexities based on practicalities rather than internally coherent constructs and loyalties--is tossed aside in favor of doubling down on the simplified precepts of the ideology.

We end up arguing about internally coherent simplifications, none of which do a productive job of mapping the real world, and accusations and raw emotions replace rationality. We are raging, spittle flying, demanding everyone agree with us that 100 angels can dance on the head of pin, not 10 and not 1,000.

How can we trust anyone who so adamantly clings to such wrong-headed ideas? We can't, so social trust plummets accordingly.



Those without any ideological faith watch the emotional fireworks with stunned amazement. So you think Dallas should be nuked because you hate the Cowboys? Um, okay.... But does nuking the Cowboys really clear your team's path to the Super Bowl?

The more the real world unravels into complex uncertainties, the greater our need to cling to certainties as the source of our internal security and hope. Rather than see the failure of all internally coherent but increasingly incoherent constructs to map the real world as the core problem, we see those with different ideological beliefs as the problem.

If we managed to set all ideological beliefs and constructs aside for a brief moment, is there anything we might agree on? As a thought experiment, imagine an AI project tasked with providing solutions to the core threats to our future stability and security. Is there anything the program might suggest that we could agree on?

How about accountability and transparency? Can we agree on the practical value of making those wielding power accountable for their actions and decisions? Can anyone contest the practicality of demanding an honest, transparent, accurate accounting of public funds and publicly traded private-sector enterprises? Can anyone contest that transparency is the foundation of sound decision-making?

Just the experiment of setting aside ideological certainties for a moment would be instructive. The irony here is the more the real world changes in ways that don't map simplistic ideologies, the greater our urgency to cling even harder to the simplicities we've invested with our identity and loyalty, and the stronger our instinct to lash out at anyone who disagrees with us, as if their disagreement is the problem, rather than the real-world complexities that no simple construct can map with any functional utility.

Rather than nuking Dallas, maybe finding some sort of practical, common-sense middle ground might be the wiser course, even though it goes against every fiber of our hard-wired instincts to circle the wagons to defend the one true construct and declare those who disagree as the problem.

---

My recent books:

Disclosure: As an Amazon Associate I earn from qualifying purchases originated via links to Amazon products on this site.

The Mythology of Progress, Anti-Progress and a Mythology for the 21st Century print $18, (Kindle $8.95, Hardcover $24 (215 pages, 2024) Read the Introduction and first chapter for free (PDF)

Self-Reliance in the 21st Century print $18, (Kindle $8.95, audiobook $13.08 (96 pages, 2022) Read the first chapter for free (PDF)

The Asian Heroine Who Seduced Me (Novel) print $10.95, Kindle $6.95 Read an excerpt for free (PDF)

When You Can't Go On: Burnout, Reckoning and Renewal $18 print, $8.95 Kindle ebook; audiobook Read the first section for free (PDF)

Global Crisis, National Renewal: A (Revolutionary) Grand Strategy for the United States (Kindle $9.95, print $24, audiobook) Read Chapter One for free (PDF).

A Hacker's Teleology: Sharing the Wealth of Our Shrinking Planet (Kindle $8.95, print $20, audiobook $17.46) Read the first section for free (PDF).

Will You Be Richer or Poorer?: Profit, Power, and AI in a Traumatized World
(Kindle $5, print $10, audiobook) Read the first section for free (PDF).

The Adventures of the Consulting Philosopher: The Disappearance of Drake (Novel) $4.95 Kindle, $10.95 print); read the first chapters for free (PDF)

Money and Work Unchained $6.95 Kindle, $15 print) Read the first section for free


Become a $3/month patron of my work via patreon.com.

Subscribe to my Substack for free

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NOTE: Contributions/subscriptions are acknowledged in the order received. Your name and email remain confidential and will not be given to any other individual, company or agency.

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