Marian Snabe drove from her South Pasadena home to visit her 100-year-old mother in Gardena once a week, tagging her recent mornings to talk about the crippling costs of elder care.
Snabe, a retired school psychologist, said her mother has an independent heart, loves the comfort of her own home, and does not want to move in with Snabe or her siblings. For the past four years, Reiko of Kobata had a daytime caregiver. However, there have been some recent additions to night caregivers after falling and becoming ill with pneumonia.
Daytime tabs for 13.5 hours shifts cost $320. The 11-hour night shift costs just under $300, bringing the daily total to $620.
100-year-old Reiko Kobata enjoys a visit from her daughter, Marian Snabe.
(Genaro Molina / Los Angeles Times)
This makes it a staggering $18,600 a month. If you don't need a night shift caregiver, that amount is about half.
“Most people can't afford this, but there are no many options other than putting them on board or nursing homes,” Snabe said in an email. “I know people who had to quit their jobs… to look after their aging parents. It can easily drain all your savings and assets – not a good system.”
In fact, it is a national crisis, with the United States lagging behind many developed countries when the world's population is rapidly aging.
“Americans aren't prepared for the challenges of caregiving,” said Paul Irving, a senior adviser at the Milken Institute, in his new PBS documentary, “Care.” Families ultimately learn that essential care is not covered by health insurance.
And it may not be that long, given the Trump administration and Congress's work on Medicaid hatch.
As Snabe and I drove south, I told her about her friend Molly Markov, who lived in 110 people. He was fortunate enough to save him for $14,000 a month at home care. But he and Snabe's mother are not the norm. I also wrote about World War II veterinarian Paul Hart, who was about 102 years old.
Sunabe had neat pencil pillars on sheets of paper lined up for me and outlined the mathematics of caring for my mother. Kobata covered $18,600 a month bills for Social Security, income from rental properties owned by her and her late husband, pensions, long-term care insurance and retirement savings.
100-year-old Reiko Kobata takes a photo of herself at her Gardena home at age 29.
(Genaro Molina / Los Angeles Times)
Kobata pays institutions that provide caregivers and compensate them. Such an arrangement will cost the agency half the total. This could leave people close to the minimum wage for caregivers, making it difficult to employ many employers in the industry with a critical labor shortage.
As a result, many caregivers are undocumented and are working on books. Saves clients money because there is no division with the agency. And while many caregivers get free rooms and boards while they work, they sacrifice their own privacy and time with their family.
Filipino women – those with legal status, some of them make up a significant portion of the California workforce. As I reported, some of them share barracks-style housing, and many have lived for the moment in fear of deportation, thanks to the Trump administration's immigrant raids.
So, what we are witnessing is a huge public policy failure and that the wave of age – creeping up for decades – may have been a surprise. The California Institute of Public Policy predicts that in 2040, Californians are over 65 years old, reaching 9 million, accounting for 22% of the population, up from 14% in 2020.
Inevitably, more and more families rely on a rather common approach in immigration culture. They look after themselves, live together, juggle a lot, and hope that medical care will not go bankrupt when a need arises.
Snabe left the 110 highway and passed through Gardena Street, where he went to school. As we approach the family home, she says her mother still likes to pay her bills to write a check personally, but does not track the total cost of her own care.
“Sometimes she asks, 'What does this money do?'” Snabe said.
Snabe parked in the driveway of the house where she grew up. Her parents bought it for $13,000 about 65 years ago.
Kobata entered the living room with the help of a pedestrian, but otherwise miraculously appeared to be in a healthy and even better spirit. Her grandson, who was with her grandmother while working as a sushi chef at a nearby restaurant, was leaving for his shift.
Reiko Kobata is looking at a booklet of photographs her family made for her 100th birthday in her living room in Gardena.
(Genaro Molina / Los Angeles Times)
Kobata settled on a comfortable sofa against the walls of family photos. She told me she enjoyed her morning walks around the neighborhood and likes to spread out the LA Times every day and read the whole paper from the front to the back. She tends to go to the garden, plays solitaire on her computer, follows the Dodgers, and has her favorite player, Shohei ohtani.
I told Kobata that she hadn't seen 100.
“How are you feeling?” I asked.
“I don't know,” she said. “What do you think?”
She thought about it and said she felt about 90.
We had a lovely visit and it was 2 hours but I didn't want to keep Kobata from my nap. Back in South Pasadena, Snabe said her mother's situation would be sustainable for the time being, but she wonders about the broader social challenges.
“If you've been at home for a long time, you'll probably have a fair share of property for so long that you don't want to leave it,” she said. “And if you reduce or move into a more communal environment, you will solve the issue of isolation and care by gaining that equity.”
This is an option for some people along with state programs that provide unpaid help from relatives and friends, as well as limited care for low-income and seniors.
However, according to Irving and UCLA professor Fernando Torres Gill, there are no easy or cheap solutions.
In the middle of the last century, Torres Gill said the United States invested heavily in institutional care, “enableing a huge for-profit industry to take hold.” Instead, they invested in public funding for community-based and home-centered care, including Singapore, Japan, Taiwan and South Korea.
“We're behind the curve,” Irving said. “We are the only developed country. We don't have a universal health care system, leading to a high rate of chronic diseases and a shorter health span and life expectancy.
Ironically, the only hope may be the age wave itself. As more and more people are wiped out, policymakers may discover the cost of ignoring cries for help.
steve.lopez@latimes.com
