Parent Care: Floor, Not Favor
About this audiobook
On the second Wednesday of every month, a widow's Social Security deposit arrives without an application, an interview, or a means test. It is the one piece of American old age that has never made anyone kneel. Everything else — the home aide, the day program, the memory care, the hospice night — must be begged for, waited for, and paid for down to the last two thousand dollars.
Parent Care is a psychiatrist's account of what that architecture does to families, told through the patients of forty years, rendered as composites: Diane, who counted her caregiving hours on a legal pad and apologized for counting; her mother Margaret, whose careful savings had to be spent to nothing before help could arrive; Marcus, who kept parking receipts in his car like a diary; Lourdes, whose hands are the most skilled and least protected in American health care; Walter, whose closest companion is a machine that cannot be disappointed in him; and Gene, who had nobody — and met the system as it truly is.
From these lives, Dr. Bhalla builds the national accounting: the trillion-dollar invoice of unpaid family labor; the two denials — of death, and of arithmetic — that keep the country from building what every family needs; the countries that looked straight and built floors; the machines now arriving in eldercare, for better and worse; and a fair path for the age of AI abundance: let the machines take the paperwork, let the humans take the presence, and let the windfall pay for it.
The book closes with the tools families need now — the Appendix maps the ten doors of American eldercare, from Medicare's enrollment windows to the five-year Medicaid clock to the letter that comes after — and with a promise kept: the voices of real caregivers, who told a newspaper's comment field what this life is like, given back their years at last.
For readers of Being Mortal and Elderhood: a clinical, humane, and finally hopeful argument that care must become a floor — guaranteed, universal, unbegged-for — before it reaches your door.
About the author
Ravinder Nath Bhalla, MD, has practiced psychiatry for four decades in New Jersey, sitting with families through the long illnesses and longer bureaucracies of American aging. He is the author of Before the Birth of Hope and Despair, an account of caregiving and disability at the beginning of life; the What Does It Mean To Be Human trilogy, on artificial intelligence and the human record; and Wisdom We Cannot Hold. The father of an adult son with severe autism, he writes from both sides of the consulting-room desk: as the clinician families bring their exhaustion to, and as a family member who has filled out the eleven-page applications himself.