Harry R. Jackson, Jr.

Recently, I have experienced first hand the issues of Elder Care as my mother’s health began to decline. I have been subjected to the maze of red tape with Medicare and Medicaid, and the difficulties caregivers endure to provide adequate care with the associated financial strain.

Indeed, life has changed drastically for senior citizens in America during the past few decades. For centuries elder care was not much of an issue. The wealthy might have hired a personal staff to care for them, and the destitute might have died alone. But when the overwhelming majority of aging seniors were no longer able to care for themselves, they were cared for by their families.

Then things began to change. More and more Americans left rural areas for cities and suburbs, often splitting up extended families. (According to US Census data, the majority of Americans lived in rural areas until about 1920.) Yet well into the mid-twentieth century, there were still enough homemakers and other relatives to care for the elderly as needed.

In the second half of the twentieth century, several changes converged to make elder care a growing challenge. More and more wives went to work, and an increasing number of women didn’t marry at all. Understandably, the large scale entrance of women into the fulltime workforce has been greeted as a sign of tremendous progress; however, the lack of a fulltime homemaker also affects the options for grandparents who begin to need help and care.

Another positive change with challenging consequences was the dramatic rise in life expectancy. Both economic prosperity and tremendous advancements in medical care have allowed many Americans to live to ages that were rare just a few decades earlier. In 1900, for example, the average life expectancy for Americans was just 46 for men and 48 for women. By the time Social Security was created in 1937, it had risen to 58 and 62; today it is 76 and 81. Caring for these older individuals often involves more complex and expensive medical care as well.

The growing prosperity of the twentieth century also brought about cultural changes. More and more senior citizens wanted to live independently as long as possible; at the same time, an increasing number of Americans grew reluctant to care for their aging parents in their own homes. This led to an explosion in nursing homes and assisted living facilities which seemed to answer both problems: they gave the elderly professional care and their adult children peace of mind.


Harry R. Jackson, Jr.

Bishop Harry Jackson is chairman of the High Impact Leadership Coalition and senior pastor of Hope Christian Church in Beltsville, MD, and co-authored, Personal Faith, Public Policy [FrontLine; March 2008] with Tony Perkins, president of the Family Research Council.