The monthly tab for her in-home elder care: $18,000. She can cover it, but how many others can?

Marian Sunabe goes from her house to the south of Pasadena to visit her mother of Gardena, aged 100, once a week, and I marked a recent morning to talk about the cost of care for the elderly.

Sunabe, a retired psychologist from the school, said her mother was independent, likes the comfort of her own house and does not want to move with Sunabe or her brother. Over the past four years, Reiko Kobata has received a caregiver. But in recent times, after falling and fell ill from pneumonia, there are times when a night caregiver has been added.

The diurnal tab, for a quarter of a half and a half, is $ 320. The 11 -hour night change costs a little less than $ 300, which brings the total daily to $ 620.

Reiko Kobata, 100, benefits from a visit to her daughter, Marian Sunabe.

(Genaro Molina / Los Angeles Times)

This increases $ 18,600 per month. When the nursing caregiver is not necessary, the amount is about half of this.

“Most people would not be able to afford it. But there are not many options other than admitting them to a board of directors and care,” said Sunabe in an email, and even it can run several thousand dollars a month. “I have known people who had to leave their work … to take care of their aging parent. It can easily empty all your savings and assets – not a good system. ”

In fact, it is a national crisis, and the United States is lagging behind many developed countries at a time when the world population is growing quickly.

“The Americans are not prepared for the challenges of the service provision,” explains Paul Irving, principal advisor at the Milken Institute, in “Caregiving”, a new PBS documentary. Families finally learn, he says, that essential care is not covered by health insurance, “therefore incredibly, more and more American-class Americans are forced to repay poverty so that they can qualify for Medicaid. It is a crazy system for them and for our federal government. ”

And it may not be a much longer option, given the ax work on Medicaid by the Trump administration and the Congress.

While Sunabe and I led south, I told her about my friend Morrie Markoffwho lived at 110. He was lucky to have saved enough for home care that cost $ 14,000 per month. But he and Sunabe’s mother are not the norm. I also wrote on Veterinarian of the Second World War 102 years Paul Hult, who quickly burned his savings after taking a fall and needing home care.

Sunabe had columns of numbers carefully in pencil for me on a sheet of bordered paper, describing the mathematics of her mother’s care. KOBATA pools social security, the income of a rental property that she and her late husband had, pensions, long -term care insurance and retirement savings to cover the monthly invoice of $ 18,600.

Reiko Kobata, 100, takes a photo of her at 29 in her house in Gardena.

(Genaro Molina / Los Angeles Times)

Kobata pays an agency that provides and, in turn, compensates for the caregiver. In such arrangements, agencies take up to half the total. This can leave something close to the minimum wage for the caregiver, which makes it difficult to recruit more of them in an industry with a shortage of essential labor.

As a result, many caregivers are undocumented and work on books. This saves money to customers because there is no separation with an agency. And many caregivers get a free room and pension in service, but sacrifice their own privacy and their time with the family.

The women of the Philippines – Some having legal status, some without – constitute an important part of the workforce in California. As I have reported, some of them share barracks in barracks, and many are Live in fear of deportation Currently thanks to the immigration raids of the Trump administration.

So what we are witnessing is a colossal failure of public policy, and it is not as if the age wave – escaping for decades – could have surprised. The California public policy institute provides that in 2040, the number of Californians aged 65 and over will reach 9 millionrepresenting 22% of the population, against 14% in 2020.

By necessity, more and more families will use a fairly common approach in immigrant cultures. They will take care of their own, will live together, will do a lot of juggling and hope that when the need will result, they will not be bankrupt by medical care.

Sunabe left the 110 highway and crossed the Gardena streets where she went to school. While we are approaching the family home, she told me that her mother always liked to write checks personally to pay her bills, but do not keep the total cost of her own care.

“Sometimes she will ask:” What is all this money? “” Said Sunabe.

Sunabe parked in the aisle of the house in which she grew up. His parents bought him about 65 years ago for $ 13,000, when Harold Kobata worked as a chemical engineer and his wife was assistant assistant and school office.

Kobata entered the living room using a walker, but seemed to be in good health miraculously and even better. His grandson, who remains with his grandmother when he works as a sucki chef in a neighboring restaurant, left for his quarter of work.

Reiko Kobata looks at a photo booklet that his family made for his 100th anniversary in the living room of his house in Gardena.

(Genaro Molina / Los Angeles Times)

KOBATA moved to a comfortable sofa against a wall of family photos. She told me that she liked a morning walk in the neighborhood and likes to spread the Times every day and read all the paper, from front to back. She takes care of her garden, plays lonely on her computer, follows the dodgers and has a favorite player – Shohei Ohtani.

I told Kobata that she didn’t look 100.

“How do you feel?” I asked.

“I don’t know,” she said. “How are you supposed to feel?”

She thought about it and said that she felt about 90 years.

We had a great visit, spending two hours, but I didn’t want to keep Kobata from his nap. On the return to South Pasadena, Sunabe said that her mother’s situation is sustainable for the moment, but she wonders the wider societal challenge.

“If you have been in a house for a long time, so long that you don’t want to get out because it’s so comfortable and familiar, then you probably have a capital in equity,” she said. “And if you were to reduce or go into a more common framework, you were solving the problem of isolation and the care problem by taking these equity.”

It is an option for some people, as well as the unpaid help of relatives or friends, and a State program offering limited care For low -income and elderly residents.

But there are no easy or inexpensive solutions, according to Irving and Professor Emeritus of UCLA Fernando Torres-GilWho also appears in “Caregiving” and says that when he asked for advice on the care of the elderly, he has a response of two words: “You are fucked up.”

In the middle of the last century, Torres-Gil said that the United States invested massively in institutional care, allowing “a huge profit industry to settle”. Other countries have rather invested in public funding for community care and centered on the house, notably Singapore, Japan, Taiwan and South Korea.

“We are behind the curve,” said Irving. “We are the only developed country … Without universal health care system, leading to high levels of chronic diseases and shorter health spans and life expectancy … and that the system – if you can call it a system – fails our elders. Assisted life communities and nursing homes are unaffordable for most Americans. ”

The only hope, ironically, can be the wave of age itself. As more and more people are trying, decision -makers could discover the cost of ignoring their cries to get help.

Steve.lopez@latimes.com