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 Who Can Afford Homecare and Care Management?

afford homecare and care management

Yes, both truck drivers and narcissistic, entitled elders can afford home care and care management. Older people who can pay for private homecare and care management- long-term- can do so because they have the financial resources. These resources are usually over a million dollars in assets or having a defined pension. Part of this is drawn from Claudia Fine and Nick Newcombe’s excellent chapter ” Entitlement in the Aging Family”, Care Managers Working With the Aging Family, Jones and Bartlett) 

Narcissistic-Entitled Families can afford homecare and care management:

Entitlement in these families usually develops from a specific kind of “not good enough parenting”.In these narcissistic entitled families, the parents themselves have struggled with personality disorders, most frequently narcissistic borderline personality  (example President Trump). They grappled with a borderline personality that went undiagnosed or was formally diagnosed and untreated.

The narcissistic or borderline parent essentially does not experience the child/children as separate and discreet from themselves and, moreover, uses the child/children to serve parental needs.  This parent-child relationship is characterized by severe boundary issues in which seduction and abandonment are ever-present dynamics and where emotional unpredictability and instability are constant.  ( Fine and Newcombe- Entitlement in the Aging Family, Care Managers Working With the Aging Family)

Rich and Famous-Entitled Families Can Afford Homecare and care management

These families are identified by the parents’ socioeconomic, financial, and political prominence.  ( example President Reagan)They are families in which all basic needs, services, resources, and creature comforts are obtained via income, assets, abundant discretionary cash flow, and/or come from the political position, station, or power.  Once again, the entitlement of the family is passed from the parent to the child who in turn brings these behaviors and actions to the caregiving milieu and care management relationship.  In this category, the entitlement arises from a family that is accustomed to purchasing everything.  They look to pay others to meet their needs (as opposed to families who must themselves find and orchestrate ways to meet basic and complex needs themselves or with the help of the extra-familial system).  Often these families have household staff, i.e., nannies, butlers, drivers, private pilots, cooks, and maids.  They may have available to the business and family lawyers and accountants, as well as, teams of medical professionals and concierge physicians.  Consequently, in almost all situations they are uninvolved in processes, especially those that are difficult, stressful, and time-consuming.  ( Fine and Newcombe- Entitlement in the Aging Family, Care Managers Working With the Aging Family)

Well-heeled Seniors can Afford Homecare and Care Management,

According to the New York Times,  middle-class retirees who buy shoes from Payless but have a defined pension can afford homecare and care management when they need it. They rode the post-war economy, held jobs long term,   through that defined pension (no 401K) face a very healthy financial picture in aging.  They worked for city, county, and state governments are teachers, truck drivers, social workers, and subway drivers, or were union members in all trades. They had a career at Xerox, IBM, Campbell Soup, and big Fortune 500 companies.

Professionals- Physician, Attorneys, CPAs can afford homecare and care management

This group made a very healthy living during the late 20^th Century, probably had a defined pension, and have very lucrative investments that allow them to afford home care and care management. They usually come from nearly normal families and have been well parented although you will find a mixture of dysfunctional aging families. Their adult children tend to be supportive of their parents, although again you will find a mixture of dysfunctional families in this category.

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