I have paid attention to the career of New York State Comptroller Alan Hevesi,a Democrat, who resigned today as part of a plea bargain that will give him a criminal conviction but keep him out of prison, because I served with him as an officer of the National Association of Jewish Legislators during the late 1980's. Hevesi brought an unprecedented amount of energy and creativity to that organization.
Hevesi resigned today because he used state comptroller's office staff to regularly provide services--day care, transportation, housekeeping--to his ailing wife. As comptroller, he had 2400 employees working for him, and he evidently figured that one or two would not be missed. When this scandal became public due to the diligence of his long-shot Republican opponent, Hevesi lost ground in the polls, but still won by a landslide 57%-43% margin. Democratic Attorney General and Governor-elect Elliot Spritzer made clear in the campaign that he favored Hevesi's removal.
Hevesi was able to win convincingly despite the scandal because his underlying problem of taking care of an ill spouse with a long term serious illness was something that likely millions of New Yorkers could identify with. The chaotic system of elder care in the United States is heavily privatized, chaotic, impenetrable for many, and extremely expensive.
It is something that those with elderly dependents--dependents at least in the sense of needing regular help in order to function effectively and sometimes financially as well--must face a variety of obstacles in order to confront effectively.
The science and medical knowledge now exist for many, many Americans to live well into their 80's or 90's. But, to do that, they often must be able to see a bewildering variety of medical specialists on a regular basis, keep track of regular doses of prescriptions and how they interact with each other, do exercises to keep physically fit, and ward off the infirmities of age such as hearing and vision problems, heart and liver failure, diabetes, depression, etc.
Old age, the saying goes, is not for sissies. At the very time in which they are most mentally stressed, they have the most decisions to make. At the very time in which their bodies are the weakest, they have the most need for exercise. At the time in which their incomes are almost invariably fixed, they have the most demand for money from an ever-growing number of service providers.
The first thing Hevesi should have done is admitted that his wife's long-term illnesses presented him with a serious series of long-term problems. He should have moved in with her to a high quality continuing care facility, where she could have the companionship, housekeeping services, and some or all of the transportation services she needed to get to her many, many medical appointments. To the degree that her needs were beyond what the continuing care facility offered, he should have reached out to staff social workers, relatives, and friends to fill in the gaps where he personally could not do so because of his work schedule.
Hevesi and his wife are typical of millions of American families where two spouses, of roughly equal age, have vastly different physical capabilities as they age. One spouse can be living for all practical purposes in extended middle age into his or her seventies or eighties, while the other spouse spends the same years as a visibly ailing obviously very senior citizen. This is because some diseases and conditions have cures or successful treatment protocols, while others do not.
The caretaker spouse can be horrified at the prospects of spending decades in that role. The most common scandal in this situation is the full or partial abandonment of the dependent spouse.
The cost of a high quality continuing care center is beyond the financial means of most Americans. Homecare, attendance at local senior citizens centers, and adult day care are more affordable options, but still financially difficult for many, many Americans. And the understanding of how to navigate the patchwork, crazy-quilt system of senior citizens services is beyond the capability of even many who can afford to pay for whatever services and treatments are needed.
My good friend Dennis J. Piermattie consults for fees for family members of New Jersey senior citizens about how best to navigate the numerous governmental and private systems set up to help. He has a thriving business with a good record of success. But the essential problem is that help is only available to a fraction of the people who need help due to shortages of public funds and shortages of private resources.
How we treat senior citizens is one of the tests of ourselves as a nation. I am proud that Pennsylvania spends more per capita on senior citizens programs than any other state in the nation. But even in Pennsylvania, we have a long, long way to go to meet the challenges of aging baby boomers and other citizens.
The Hevesi case does not appear to be one of greed. Rather, it appears to be one of shame that he could not solve his wife's problems, and he did not want others to know about that.
All across the nation, the sense of personal shame at the diabilities of loved ones must end. At the very least, governments must work to make the provision of senior citizens programs more transparent. More than that, governments should be working to boost the number of people eligible for senior citizens services, boosting the quality of services provided, and tearing down the wall of fear that keeps all too many ignorant of family needs and public and private remedies.