Dear Gov. Rauner: Trust Is Key In Providing Senior Services

Cutting the Illinois Community Care Program by outsourcing care providers to Uber drivers and other free-lance workers will end up costing Illinoisans far more than it might save in the short run. In-home care providers save the state money by avoiding costly medical interventions. Avoiding crisis care requires a consistent relationship of trust and care between the care provider and senior citizen.

Recent coverage of the proposed Illinois state budget cuts notes, “there’s not much reason to trust him (Gov. Rauner).” The word trust caught my eye as the one word missing from this debate over how best to provide in-home support to aging and, often frail, senior citizens.

Serving in end of life care for more than a decade taught me that trust between care providers and those receiving services is key. For some families, trust is not an issue because a spouse or grown child is able and willing to assist with transportation, shopping, and even personal care needs, should those arise. But today’s modern families are changing. Forty percent of Americans include a step-relative in their family and these connections are often tenuous and are untried in a crisis.

Today’s seniors may call a clergy member, a neighbor, an ex-spouse, a friend, a paid sitter, and even the Community Care Program worker, “family.” These people become “fictive kin” or para-family, as we (my co-author Naomi Cahn) call them, and they help fill in the gap between private family-provided care and the half-trillion dollar cost of paid care . Para-families are formed because of geographical proximity and frequency and reliability of visits. The care providers in Illinois are para-family members. They don’t necessarily replace family but walk alongside them, providing support to older people and their caregivers.

For an elderly individual and their family members, having a consistent nurse or aide visit each day builds trust and saves the system money. Part of the cost savings that comes from a program like the Community Care Program is based on relationship. The aide will notice nuanced changes in speech or mobility that can be then addressed before a crisis like a fall leads to an expensive Emergency Room visit that leads to $40,000 hip replacement surgery that leads to a 30-day stay at a skilled nursing home for rehabilitation services. Trust keeps disasters at bay. The consistent care and attention of a home care provider can help reduce the risk of potential suffering for the individual while saving the overall healthcare system money.

87 percent of those ages 65 and older wish to stay home as they age. The number of those aged 65 and older is sky-rocketing and will continue to do so as 76 million American Baby Boomers become our next generation of elders. Gov. Rauner should not cut programs that foster trusting care and support for some of the most vulnerable citizens of our state.

Rev. Amy Ziettlow serves as a Lutheran minister in Decatur, Illinois and is the former COO of The Hospice of Baton Rouge. She is the co-author, with Naomi Cahn, a Law Professor at George Washington University, of Homeward Bound: Modern Families, Elder Care & Loss (Oxford, 2017).