Life, Death, and the Struggle In Between

 
Jack Caputo

HST401

12 Feb 2026

Assignment 2

I pledge my Honor I have abided by the Stevens Honor System. x Jack Caputo

WITH THE FORTUNE of living a long life comes the misfortunate of the complications of age. Most seniors eventually find challenging the tasks which were once trivial – showering, taking the stairs, doing laundry. This happens at different times for different people, and in different forms, but if you stay on this planet long enough, you will certainly start to pay for that long life of yours.

I’ve been chewing on ideas of age and senior care for the past few months now. Allow me to set the scene: back in my hometown, my family lives across the street from a delightful older couple. Let’s call them Jim and Jane. They have had a great life together, travelling most of the world on excursions and cruises, and are generally just pleasant and polite in an old-timey sort of way. Genuine, pure souls. My family would see them only occasionally, maybe once a month. They were certainly getting up there in years – he was coming up on 90, and she 100. Though no one really likes to say it, when people are that old, you have to seriously consider what happens when they die, to be prepared. Although they were both still mentally sharp considering their ages, my family was concerned about Jim passing before her. Of course, any passing would be tragic and terrible, but tragedy would be much worse if Jane outlived him, because of their different mental attitudes, and Jane’s already inferior health. Despite this age difference, and Jim’s better health, tragedy indeed struck.

It's been a rough past few months for everyone. Neither Jim nor Jane had any family left – no siblings, no cousins, children, even friends – no one. My parents stepped up to help Jane, first with the logistics of the death – funeral, transfer of documents, finding a caretaker, figuring out what to do when she eventually passes – but they quickly assumed much more responsibility than they had first thought they would.

Jane had a day-time in-house nurse, but had to be driven to a good amount of doctors’ appointments and couldn’t make food for herself at night. With the passing of her husband of over 50 years, she quickly became severely depressed, accelerating her descent into dementia. There are good days, and there are bad days. Being at university, all I can do is call my parents to ask how they’re doing, how Jane is doing, and acting as an outlet for them.

My parents have been through senior care before, but this time was different. My mom’s own mother had dementia; I have some fuzzy memories of visiting her in the nursing home when I was only a few years old. My dad’s parents passed within a few years of one another, although they were both able to live out their final days in their home, thanks to frequent visits from my large family. Because Jane is not family, it is harder for my parents to help her, especially with paperwork, bills, bank accounts, and doctors. And because Jane has no family, she has no one to visit her, distract her, talk to her, give her some purpose in this dark time. It has become much harder for her to see light in her life.

I have a certain unique view I can bring to the discussion of senior care. During high school and college, I worked for a medical transportation company, driving around folks who couldn’t drive or even walk themselves, transporting them mostly to doctor’s or dialysis appointments. As one might imagine, most such folks were up there in age; as a result, I spent a considerable amount of time in nursing homes.

I want to avoid dramatizing my experiences, but the vast majority of nursing homes and rehab centers were disagreeable, to say the least. Many patients, more than you would expect, were severely mentally unstable, implying they were not getting the help or treatment they needed. Staff were overworked, underpaid, and underappreciated, making the caretakers of the patients stressed and irritable. By nature of my job, I had to get up close to patients to lift and assist them, who more often than not had the appearance and odor that they were overdue for a shower, further indicating that they were not being adequately cared for. There are many other descriptions I could give, and many singular stories, perhaps about a nude patient running through the halls, or a patient throwing punches at a nurse, but I think you get the idea.

A 2024 report by the American Health Care Association (AHCA)/National Center for Assisted Living (NCAL), the largest association representing nursing homes in the US, gives more official reasons than I, but agrees that nursing home care is not sufficiently dealing with the demand. It agrees that there is a labor shortage in nursing homes, causing them to downsize and decrease bedspaces, or even close down completely. Importantly, this change doesn’t agree with the demand: baby boomers are currently entering the age where they require such care, and so nursing home admissions should be increasing. However, admissions are not even stagnating but decreasing [1].

A different 2024 report, this time by the Inspector General, repeats much of what AHCA/NCAL says, reinforcing the severity and commonness of this situation. They also describe how nursing homes were particularly devastated by COVID-19, and through their investigation, uncovered fraud and abuse [2]. Though I never experienced anything so intense, I know without a doubt that fraud was happening against, and possibly by, some patients, and though the abuse may not have been physical, there was plenty of verbal and other less direct forms of abuse flying every which way.

While a lot of this job was crazy, it instilled deep in me a strong form of empathy and understanding – for people in general, but especially those in medical hardships. I am very glad I worked this job. Nonetheless, I learned that most nursing homes and rehab centers should be avoided, or at least scrutinized intensely. Naturally, the question arises: what other options do we have? If my mother gets in a terrible accident and I have to think of a plan, what can I do for her?

I mentioned earlier the possibility of a home nurse. A quick Google search will show you that this is a very popular option. And, from my limited knowledge of the profession, it is a good option, if you can find a nurse that meshes well with the patient. However, we have to keep in mind if the company you go through will take your insurance, and even if they do, how much it will ultimately cost you out-of-pocket. Jane is still helped in her own house by a day-nurse, in addition to the help she gets from my parents. And while I do not know how much the nurse costs, through the grapevine, I understand that it is closer to “a lot” than “a little”. And to tie off these more expensive solutions, there are some nicer senior communities or rehab centers – I myself have visited some for my job – but the financial barrier to entry is indeed usually quite steep.

What else, then? Well, really the only other option is to take care of the patient yourself. Many people go this route, because they cannot afford the other options. I have heard anecdotes from people in their 30s or 40s who have to halt their career, partially or completely, and become a nurse part- or full-time to take care of their loved one. Sometimes your job will compensate you for this, sometimes not.

So, then, is the solution to either be fortunate to have enough money to care for your loved one, or drop everything and care for them yourself? Ultimately, this is a very big, and very real, problem.

First, on the concern of cost. The Commonwealth Fund, a nonprofit conducting research and surveys to improve health care, surveyed seniors across several different countries, and found that those in the US were most likely, and sometimes considerably more likely, to forego their health care because of the cost. This might mean they forego refilling prescriptions, don’t see specific medical professions such as dentists, or even just skip seeing a doctor or following through on treatment [3]. Purely because of the costs.

But this is a deeper, more systemic issue. While I readily admit I don’t know much about Medicare and other social programs to assist seniors, I have heard others, from poor to not, complain that Medicare does not work for them. As part of their joint project with the New York Times, KFF Health News reported in 2023 on how long-term senior care differed in other countries. The unfortunate truth? Policy. A larger share of taxes would go towards caring for the nation’s seniors. Enrollment in social programs is required, and by starting them early, the citizen should have more money available to them when they are older and need it [4]. So yea, the boring stuff. But sometimes it’s the boring stuff that works.

To wrap up, I would like to return to empathy. All this talk of policy changes, unrealistic costs of health care, and the saddening state of senior care can make us feel depressed, as though things are out of our control. It’s a bit disheartening to say that we have to wait on policy changes to improve the state of health care, implying we don’t have the autonomy or power as ordinary people to do anything. But that’s wrong! The health care system acts just like that – a system. Systems are unfeeling, and this sentiment unfortunately spreads to those in the system: doctors, nurses, policymakers, etc. I implore you to please treat patients, but also those working in health care, for what they are – people. As hippie as it sounds, these small acts of kindness can help bring the humanity back to something as human as health care.

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[1] “Report: Access to Nursing Home Care Is Worsening.” Press Releases, www.ahcancal.org/News-and-Communications/Press-Releases/Pages/Report-Access-to-Nursing-Home-Care-is-Worsening-.aspx. 

[2] “Nursing Homes.” Office of Inspector General, U.S. Department of Health and Human Services, 5 Feb. 2025, oig.hhs.gov/reports/featured/nursing-homes/.

[3] Health Care Affordability for Older Adults: How the U.S. Compares to Other Countries, 4 Dec. 2024, www.commonwealthfund.org/publications/issue-briefs/2024/dec/health-care-affordability-older-adults-how-us-compares-other-countries.

[4] Rau, Jordan. “What Long-Term Care Looks like around the World.” KFF Health News, 14 Dec. 2023, kffhealthnews.org/news/article/dying-broke-long-term-care-other-countries/.