A recent profile in the New York Times of the marriage between President Barack Obama and First Lady Michelle had a great deal to say about how the Obamas have balanced their desire for public influence and personal privacy. The article had nothing to say about one of the most simple and remarkable facts about the first family: for the first time in recent memory, the family in the White House is not a nuclear family.
The White House has played host to its share of unusual marriages, but the Obamas have broken new ground by bringing in Michelle’s mother, Marilyn Robinson, to help care for their children. The Obamas’ stated reason for inviting Robinson to live in the White House was so that she could assist in the care of Sasha and Malia, the Obamas daughters. As baby boomers age and America becomes what the President’s Council on Bioethics called the “mass geriatric society,” more and more elderly Americans may begin to live with their adult children. As with the Obamas, the desire for improved care-giving will be the main motivation. But in this case, the elders, not the children, will be the ones receiving the care.
Our society has not always been very clear about what obligations grown children have toward their aging parents. But in the case of the Boomers, the question becomes exceedingly complex. Taking advantage of the rise of no-fault divorce laws, they sought flexibility and happiness through more negotiable romantic and sexual attachments. They had fewer children than their parents’ generation, but those they did have were buffeted by the chaos of divorce, remarriage, custody battles, and multiple Christmases.
Now, the balance of dependence is tipping. As boomers enter their second childhood, we may witness the historical irony of aged parents experiencing some of the chaos and uncertainty felt by their children. What responsibilities of care does one have toward a stepfather? Toward a parent with more than one set of children? It’s no longer a question of who gets to keep the kids but rather of who gets stuck with the grandparents.
In such an environment it is easy to see why the public provision of medicine and end-of-life care is becoming especially important. Complicated family arrangements matter less when the main caregiver for the elderly is the government. A recent survey from the Pew Research Center found that only 12% of parents age 65 and older report depending more on their children than their children do on them.
In another sense, America’s seniors are as dependent on their children as ever. Instead of direct child-to-parent support, government programs such as Medicare and Social Security formalize and standardize intergenerational support. The average person retiring at age 65 relies on Social Security for approximately 40% of their pre-tax income. Behind the illusion of independence there are painful fiscal liabilities. A May report from the trustees of the Social Security Administration reported that Social Security will no longer be able to pay full benefits by 2037. Things are even more dire in the case of Medicare, which is predicted to be bankrupt by 2017.
The budgetary shortfalls of Medicare and Social Security will require difficult political and economic choices. The main priority guiding those choices should be protecting the dignity of the elderly. We must remove any incentives for caregivers to hasten death. Here the principle of subsidiarity, of local care and family knowledge becomes evident. There will, of course, be exceptions, but in general family members are the most likely to understand the will and protect the interests of those entering senescence. Just as the family is necessary for the raising of children, it should be central to the process of aging and death. In the absence of easy budgetary answers, one potentially significant way to see to the care of our rapidly aging population is to make it easier for parents to live with or near their grown children.
If families are to play a greater role in the care and support of aging grandparents, we will need good laws and economic policies. We will need to promote strong and stable marriages that can support vulnerable children and care for aging elders. It will also be necessary to have neighborhoods built in order to accommodate a variety of living arrangements, including extended families. Aging parents will not want to yield all of their independence and privacy. The single-family middle-class dwelling in an auto-oriented suburb doesn’t do a good job of accommodating for aging parents or an extended family, no doubt because it was never designed to do so. People who already drive their children to soccer practice don’t want to drive their aging parents to the bingo parlor as well.
The Obama family has the benefit of a large mansion in which they can live close to an older parent while still preserving privacy. While moving into the White House is not an option for most Americans, a way to increase choice is to promote neighborhoods with a mixture of housing that includes smaller, single-person dwellings and walkable streets. Cities can also allow families to build so called “backyard cottages,” detached units that are well suited for semi-independent, aging parents, as Seattle has recently done. In some areas today, one is hard-pressed to find any old people at all other than the gentleman who welcomes you as you enter the local Walmart. He’s nice, but where are all his friends?
Opposition to euthanasia, expressed most recently in anxiety over “death panels,” should begin with a stand against the elimination of old folks from our everyday experience. The segregation of the young and the old should be a more alarming sign of how our country will deal with aging Boomers than any health-care proposal in Congress. Today, the use of nursing homes and assisted-living facilities is, of course, often necessary. But their widespread success indicates a culture that is troublingly comfortable with the absence of the old from the world of those who are young and healthy.
As we seek out broad, long-term solutions to dealing with a graying society, it will be important to keep in mind the ways that neighborhood and home design can encourage local, subsidiary, and family-friendly solutions to end-of-life care. Of course, no one type of family arrangement fits all, but it may be time to recognize that if we are to be less dependent on government interventions we may have to become more dependent on each other.
Matthew Schmitz is the managing editor of Public Discourse.