Who Will Protect the Baby Boomers?
The Case of Masumi Murasaki Should Cause All to Revisit This Age Old Question
By W. Chun, 11/30/2004 8:26:57 AM
From: www.hawaiireporter.com
In Hawaii and across the United States, a number of baby boomers are aging and the question becomes who will take care of them when they need elderly care, will the caregivers do an adequate job and will they be trustworthy?
Statistics show that the baby boomers will represent a major portion of the population. According to a report by Paul Hodge, JD, MBA, MPA Chairperson, Global Generations Policy Initiative Director, Harvard Generations Policy Program, "In 2006, the baby boomers will begin to turn 60 and in 2011, 65. In the coming decades, there will be a significant increase in the number of elder boomers and in their proportion to the total population. By 2030, the boomers’ proportion will increase to 20 percent of the population up from a current 13 percent, and the number of elderly will double. (3) Put in different terms, from 2010 to 2030, the 65+ population is projected to 'spike' by 75 percent to over 69 million people.(4) Then from 2030 to 2050, the growth rate is projected to grow about 14 percent with the number of elderly totaling about 79 million."
These numbers are staggering and mean big money for those involved in the care of the elderly.
The Healthcare industry continues to show a distinct profit and an egotistical commonality throughout the last 40 years. Baby boomers must act now to prepare for the future retirement and care of the millions of people in the future.
"In the near future, the baby boomers will be the recipients of the largest intergenerational transfer of wealth in the history of this country if not the world. More than ten trillion dollars will be transferred from the boomers’ aging parents. While this transfer bodes well for the finances of a number of boomers, a significant number of less well off boomers will be unaffected and the wealth differentials, which exist today, will follow the baby boomer generation. These 'wealth disparities' will determine the life style options for many aging boomers and will limit the choices of millions of Americans (especially women and minorities) in quality of health care, housing and numerous other areas," Hodge said.
The Hawaii Reporter.com story about 85-year-old Masumi Murasaki and the outrageous treatment and alleged theft of his lifetime savings by his "caregiver," Jennifer Alonso-Toma, is only the "tip of the iceberg."
Why have we not heard of similar or other cases like Masumi Murasaki?
The answer is simply there are no regulations, or agency responsible for the oversight of the Health Care industry when it comes to home or personal care.
Would it surprise you that the cost of a caregiver can run $4,000 per month or more? This cost is above and beyond the provisions of any medical insurance. The caregiver is governed or regulated by no one and has a free reign in the determination of the last days or years on this earth.
Any baby boomer can look forward to the disability of a heart attack, stroke, dementia, paralysis, diabetes, etc. Once rendered disabled the patient is helpless and must rely on the "ethics" of the industry, i.e., home healthcare. The cost of hospitalization or rest homes is not the answer and often the family is burdened with the health care duties. Nurses Aides, Registered Nurses, and others can provide assistance and help. This is the industry that is unregulated, and many of the problems go unreported.
Consider the conditions of a helpless elderly person who is incapacitated. Only one person controls their food, cleanliness, loneliness and events of their day. The psychological dependency increases with each day and the completion of each task by the Caregiver. How long will it take to coerce someone into signing a new will, or title to his or her house, or car, or bank account? Family, friends, neighbors, and others closely related to the elderly person are without a means to stop the onslaught or the thievery. Where would one go to complain?
I’ve toured many of the home healthcare locations, private duty nursing sites, and some of the rest homes in Hawaii. Some of these areas are horrible at best and can give an insight to the plight of the baby boomers. The state of Hawaii’s Department of Health rules for home healthcare are insignificant at best and unmonitored.
We are watching the increase of businesses in this industry and the loss of millions of dollars to the unethical, and unmonitored businesses.
The Masumi Murasaki case should be a benchmark for the establishment of rules and regulations for this industry. Here are some considerations in that regard:
The establishment of a business relationship between the caregiver and the patient.
Specific rates, insurance, tax reporting, and other legal requirements must be met prior to engaging into this relationship. Did Jennifer Alonso-Toma have a legitimate business? Did she report the income and changes in income? Did she pay the General Excise Taxes? Did she insure her patient?
The protection of the patient’s belongings must be established up front.
Professional liability insurance, or other similar liability insurance naming the patient as the insured is a must. The family did not have much recourse once the "bleeding" of Masumi Murasaki’s life savings started. At any point in time, the legality and the ethics of the transfer and increase in funds was not checked.
Prohibition or limitation of visitors to the patient is inconceivable, especially from the family members.
Masumi Murasaki, who once fed the birds outside every morning, went regularly to the beach to sing to the turtles, and spent countless hours with his many friends and family members, was suddenly not allowed to have these freedoms, according to friends and family members. Masumi Murasaki had no one to go to and no one to ensure his rights were preserved. At no time should any caregiver restrict open access of a patient to their family and friends. How could this family or anyone ensure the patient was receiving the care needed? What about the psychological control being exerted by the caregiver?
Changes in the caregiver’s monthly stipend from $350 per month to $2,500 per month without a major reason and permission from the family that hired the caregiver, are indicators of something gone wrong.
Large drains in the elderly person’s financial accounts is another indicator something bad is happening. While the financial institution involved recognized the situation and alerted the family, the family was already isolated. Changes in the will and other similar unethical behavior are commonplace in the home healthcare industry and we have not been able to stop or control it.
Theft from someone being cared for by the caretaker in the last days of life is an unspeakable crime. As a baby boomer myself, I can say that my last days is a culmination of life represented by my family and would like to spend the time with them. Masumi Murasaki was robbed of his basic right to die with the full freedom of this country, according to his family members. It is a cruel irony that today’s generation is fighting to protect our rights to freedom and democracy, yet the elderly are being robbed right in our country of the basic right to life and the freedoms that Americans die to protect overseas.
The circumstances surrounding Masumi Murasaki’s death also are questionable and the treatment of the Murasaki family, who were pressed several times by the caregiver to give up custody of their father’s body after he died, also was extremely odd.
Caregivers are responsible for their patient. The treatment of an elderly person prior to death is critical in the assurance of care. It is the ultimate measure of their performance and obligation to the quality of care. The goal and obligation of a caregiver is to ensure that the patient’s death is handled with the utmost respect to their wishes, concerns, and in plain view of the family.
What elements of this industry should be controlled?
· Professional liability insurance naming the patient and family as the insured should be regulated. Some protection of the patient’s resources is needed. The establishment of the requirement for professional insurance will ensure the relationship between patient and caregiver is established.
· Any time a limitation of freedom is placed on anyone some rules must be engaged. The prohibition of visitors, friends and neighbors must be controlled. Laws and regulations must be established to ensure this freedom is not taken without sufficient cause.
· Specific regulations are needed to ensure the standard of care for home healthcare are established and maintained. Rules and regulations are needed for the transfer of property, monies, etc. by a patient to the caregiver to ensure the highest level of ethics.
· An agency or extension of an existing agency is needed to thoroughly investigate the cases like Masumi Murasaki. The full arm of the law should be used to investigate and prosecute offenders.
· Standards for the home healthcare industry must be established. We cannot rely on the professional ethics code as the standard. The present rules from the Department of Health are insignificant and unmonitored. Standards prescribing the nature of the healthcare, specific needs for life safety, training and education for emergencies, specific activities for the elderly to promote health and longevity, and specific assurances to protect the quality of life. Laws and regulations to ensure the inspection and observation by third parties or family are not limited but open.
While I have been privileged and honored to work with nurses of the highest quality and ethics -- nurses observed in hospital or office settings -- my observations of Certified Nurse Aides and nurses in the home healthcare industry have been the opposite.
The challenge to everyone with baby boomer parents or relatives is to visit the home healthcare facilities in Hawaii or the state in which they live. Call and talk to home healthcare providers and visit them.
My prediction is that observers will find the standards of care are varied or lacking and that elderly are left sitting in their rooms or at the television or in isolated areas. Most people would not want to be in settings like these. Finally there are few, if any, protections in place for the patient’s belongings, or their quality of life.
Dennis Murasaki wanted to tell the story of his father and the events up to his death. He wanted to bring forward the theft of his father fortune and desire to pass on his hard working estate to his grandchildren. Unfortunately, his desire to openly discuss the injustice and the hurt of the family was turned into a political dilemma for Duke Bainum, who married the caretaker, Jennifer Alonso-Toma, in February 2004, before this case was made public.
In the political muck and mire, the original intent and the point of the story were lost.
The outrage of our community was not allowed by the media to be seen.
This story should have been in every newspaper, on every television news station, on every radio show, and must be on everyone’s mind today.
We cannot close our eyes to the dilemma of the baby boomers and the future of our elderly.
Our politicians and lawmakers must address the future of the elderly and they must do it now.
W. Chun is a resident of Honolulu.