It is well known that millions of elderly Americans are neglected at their most vulnerable time. Jewish law, however, requires multiple times and in multiple ways that we honor our parents (Exodus 20:11, Exodus 21:15, Exodus 21:17, Leviticus 19:3, Deuteronomy 27:16).
The ancient exhortations to honor one’s parents endure into our age. As of July 1, 2013, China has required that adult children take care of their parents. The amended Law for the Protection of the Rights and Interests of the Elderly states that adult children must visit their elderly relatives, and they are prohibited from insulting, mistreating, or abandoning them under pain of lawsuit. Wu Ming, the deputy department head in China’s Ministry of Civil Affairs said, “Family members should not ignore and isolate the elderly. And they should come often to visit.” Today, millions of Chinese workers live thousands of miles away from their parents, families are limited to one child per family, and the tradition values of filial piety have become more challenging to put into practice. But those who fail to take care of their parents will now be fined. This act may be in recognition of the aging of the Chinese population: There will be 221 million elderly (age 60 and older) in the country in 2015, and the percentage will reach about a third by 2050.
In Japan, another country with the longstanding value of filial piety, modern legislation assists families in paying for hired caregivers (although they cannot be family members). Elsewhere, many nations mandate some level of care for the elderly. While the Soviet Union no longer exists, some of its policies survive in the areas it used to control. For example, in much of the former Soviet bloc, the elderly can sue their children for child support, and siblings can sue each other to make sure the money is raised and the burden shared. In Western Europe, eldercare is typically ensured through social insurance programs. The most inclusive policy for the elderly can be found in Norway, where all of the elderly are guaranteed long-term care.
How does the United States, which has traditionally been reluctant in implementing social welfare policies taken for granted in Europe, compare with rest of the industrial world? Currently, nearly 10 million adults age 50 and older care for elderly parents, with little governmental assistance. This number has tripled in 15 years, so now about 1 in 4 adult children provide personal or financial care for their parents. A study conducted by a group of insurance, caregiving, and policy think tanks concluded that, taking into account wages and Social Security and pension money, the average adult who becomes a caregiver for an aging parent spends nearly $304,000. In addition, caregivers undergo tremendous stress, and suffer higher rates of cardiovascular disease and alcohol abuse, among other illnesses. On top of this, Social Security benefits here do not increase when personal care costs rise, as they do in some European nations.
One bright spot is that many adults can now take up to 12 weeks off from work to care for an ill parent (or any other family member) without losing their job under the Family and Medical Leave Act of 1993. Unfortunately, this does not go far enough, because this leave is without pay and therefore an unaffordable option for nearly all working Americans. Medicare may help pay for some short-term care, and Medicaid can cover expenses for those with in adequate resources, although these are dependent on individual state requirements, which are constantly under attack today. Currently, as the Medicare website notes, private funds are used for eldercare: “About half of all nursing home residents pay nursing home costs out of their own savings. After these savings and other resources are spent, many people who stay in nursing homes for long periods eventually become eligible for Medicaid.” In other words, if you want nursing care as an elderly person, be prepared to lose all your resources. Other programs, such as Meals on Wheels, are also dependent on state funding (with some federal aid that is also under attack), and we cannot assume that it will continue as is in the current atmosphere of austerity. Other options usually rely on independent insurance or health plans that require additional payments.
While the United States remains a wealthy nation, and many can afford their own care, we should heed Jewish law and truly honor our parents. The rabbis tell a story which is codified as law (Shulkhan Arukh YD 240:3).
They inquired of Rav Ula: “How far does honoring/dignifying parents extend?”
He said to them: “Go out and see what one [non-Jew] did in Ashkelon. His name was Dama ben Netinah. Once the Sages sought merchandise for a price of sixty myriads, but the key was resting under his father’s head, and he did not disturb him…. When Rav Dimi came, he said: Once he was wearing a gold diadem and sitting among the greats of Rome, when his mother came and tore it off him, and hit him over the head and spit in his face, but he did not humiliate her” (Kiddushin 31a).
Even when mistreated and shamed by a parent, many demands to honor parents still remain. To be sure, there are limits too!
One whose mother or father breaks down mentally – He must make the effort to behave with them in accordance with their condition until [Hashem] has mercy on them; but if he it is not possible for him to stand it, because they have become greatly insane – he may go and leave them behind, so long as he commands others to treat them properly (Shulchan Aruch, Yoreh Deah 240:10).
Jewish law wisely and prophetically notes the mental and physical strain that an elderly parent with Alzheimer’s or dementia can have on a family. However, the law also mandates that we provide some degree of proper care for them. We should not force families to go into bankruptcy in order to avoid placing their parents in virtual warehouses where their parents will be neglected and mistreated.
The thing is that this is not only an ossified, unrealistic demand based on an idealized or no longer extant religious society. We see models for contemporary implementation around the world today, in China, Norway, and beyond. Our parents sacrificed so much for our well-being throughout their lives, when we were not able to fend for ourselves. As a society, we must recognize this and provide for them when they are no longer physically independent themselves.
Rabbi Dr. Shmuly Yanklowitz