A personal and intense story by a NYT columnist dealing with her aging parents. Article link is unlocked but altho you may have to register, NYT does not spam or sell your email.
‘We Had No Idea What Was Coming’: Caring for My Aging Father
NYT Opinion by Michelle Cottle
https://www.nytimes.com/2025/11/24/...e_code=1.7E8.Pkxq.5DkmfYhA_uie&smid=url-share
(Excerpt)
… At this point we should address the 800-pound caregiving gorilla in the room: money. As challenging as caregiving can be for anyone, families with limited financial resources face next-level stress. Even for families not employing professional aides, the costs quickly pile up. Family caregivers spend on average over a quarter of their annual income on caregiving, factoring in housing and medical costs. On top of such direct expenses, add the cost of taking time away from their paying jobs to handle caregiving duties like running errands, taking loved ones to the doctor and so on.
With my mother in a rehab facility and Dad receiving 24-7 care, the bills started rolling in. And they stung. Mom’s expenses were largely covered by Medicare — until she stayed beyond what the program allowed. The cost of Dad’s aides, around $3,500 a week, was out of pocket from the get-go, since neither Medicare nor private health insurance typically covers most long-term care costs.
… Worse, many family caregivers themselves are on Medicaid and will be subject to the new work requirements put in place by Mr. Trump’s domestic policy law. Caregivers looking after young children or loved ones with disabilities are exempt, but those looking after seniors were not granted a specific exemption.
… Even the most devoted family caregivers may occasionally need outside help, if only a few hours of respite care a week. When that happens, many wind up relying on America’s newcomers. Foreign-born workers are the lifeblood of paid caregiving in the United States. More than 820,000 immigrants provide long-term care services in the direct-care work force (defined as including aides and nurses), according to KFF. Overrepresented in their fields, foreign-born workers account for 28 percent of personal care workers and 40 percent of home health aides, according to the Bureau of Labor Statistics.
High demand for such workers is already causing shortages in home-based and institutional care alike, with the situation on track to get worse. The Bureau of Labor Statistics projects that the demand for care aides will rise 17 percent over the next decade, making it one of the occupations with the most growth.
As Mr. Trump throttles the flow of immigrants into the United States, families are likely to have more and more difficulty finding help. Already, the cancellation of the temporary protected status of hundreds of thousands of migrants is causing upheaval. “We’re seeing a jarring, sudden loss of workers, of people who are being sent back” to their home countries, said Katie Smith Sloan, the head of LeadingAge, an association of community-based organizations that provide services for seniors. In addition to creating gaps in staffing, “the relationships that they’ve built with the residents and clients that they’re serving are just broken,” she said.
Further disruptions loom. For instance, the administration has put new barriers on a type of visa that “brought in a lot of nurses from the Philippines,” said Ms. Smith Sloan. Facing access barriers and a hostile climate in the United States, those nurses are likely to head for more welcoming countries, such as Canada, Germany and Australia, she said. “The more restrictive we are, the more it’s going to hurt us in the long run.”
‘We Had No Idea What Was Coming’: Caring for My Aging Father
NYT Opinion by Michelle Cottle
https://www.nytimes.com/2025/11/24/...e_code=1.7E8.Pkxq.5DkmfYhA_uie&smid=url-share
(Excerpt)
… At this point we should address the 800-pound caregiving gorilla in the room: money. As challenging as caregiving can be for anyone, families with limited financial resources face next-level stress. Even for families not employing professional aides, the costs quickly pile up. Family caregivers spend on average over a quarter of their annual income on caregiving, factoring in housing and medical costs. On top of such direct expenses, add the cost of taking time away from their paying jobs to handle caregiving duties like running errands, taking loved ones to the doctor and so on.
With my mother in a rehab facility and Dad receiving 24-7 care, the bills started rolling in. And they stung. Mom’s expenses were largely covered by Medicare — until she stayed beyond what the program allowed. The cost of Dad’s aides, around $3,500 a week, was out of pocket from the get-go, since neither Medicare nor private health insurance typically covers most long-term care costs.
… Worse, many family caregivers themselves are on Medicaid and will be subject to the new work requirements put in place by Mr. Trump’s domestic policy law. Caregivers looking after young children or loved ones with disabilities are exempt, but those looking after seniors were not granted a specific exemption.
… Even the most devoted family caregivers may occasionally need outside help, if only a few hours of respite care a week. When that happens, many wind up relying on America’s newcomers. Foreign-born workers are the lifeblood of paid caregiving in the United States. More than 820,000 immigrants provide long-term care services in the direct-care work force (defined as including aides and nurses), according to KFF. Overrepresented in their fields, foreign-born workers account for 28 percent of personal care workers and 40 percent of home health aides, according to the Bureau of Labor Statistics.
High demand for such workers is already causing shortages in home-based and institutional care alike, with the situation on track to get worse. The Bureau of Labor Statistics projects that the demand for care aides will rise 17 percent over the next decade, making it one of the occupations with the most growth.
As Mr. Trump throttles the flow of immigrants into the United States, families are likely to have more and more difficulty finding help. Already, the cancellation of the temporary protected status of hundreds of thousands of migrants is causing upheaval. “We’re seeing a jarring, sudden loss of workers, of people who are being sent back” to their home countries, said Katie Smith Sloan, the head of LeadingAge, an association of community-based organizations that provide services for seniors. In addition to creating gaps in staffing, “the relationships that they’ve built with the residents and clients that they’re serving are just broken,” she said.
Further disruptions loom. For instance, the administration has put new barriers on a type of visa that “brought in a lot of nurses from the Philippines,” said Ms. Smith Sloan. Facing access barriers and a hostile climate in the United States, those nurses are likely to head for more welcoming countries, such as Canada, Germany and Australia, she said. “The more restrictive we are, the more it’s going to hurt us in the long run.”
