LTC Bullet: And Thou Shalt Honor

Monday, September 23, 2002


*** New book on LTC planning: LTC speaker and trainer Marilee Driscoll's "The Complete Idiot's Guide to Long-Term Care Planning" (Alpha Books, Indianapolis, 2003) is out. You can find it in bookstores for $19.95 or on for $13.97. We're reading the volume now (with gritted teeth as we like the author but rebel at the title) and we'll provide a critical review sometime soon. ***

*** We've been getting wonderful feedback from some of the leading LTC trainers in the country about THE LTC GRADUATE SEMINAR. Don't miss any opportunity to attend this advanced training program. LAST CHANCE to register for the Center's Dallas LTC Graduate Seminar to be held this Wednesday, September 25, 2002, 9 AM to 5 PM, at the Holiday Inn Select Dallas-Fort Worth Airport, 4441 Highway 114 at Esters Blvd., Irving (Dallas), Texas. Phone 972-929-8181 for directions. Please call or email Amy Marohn-McDougall to reserve a place: or 425-377-9500. SEVEN TEXAS CONTINUING EDUCATION CREDITS. Tuition is $225. For all the details on this advanced LTC training program, see ***

*** New content added to the donor-only zone today is listed below. If you already qualify for The Zone, you can jump to this link , enter your user name and password, and read the new items immediately.

The LTC Reader #33--Rural LTC Poses Special Challenge and Opportunity
The LTC Reader #34--The More Medicaid Cuts, the Greater the Need for LTCI

The LTC Data Base #33--Medicare Spending Anomalies
The LTC Data Base #34--Good News, Bad News on Longevity

To enter The Zone ( ), contribute $100 or more to the Center for Long-Term Care Financing (tax deductible) and email your preferred user name and password to . You'll be Zoned In before your check arrives. Mail to 2212 Queen Anne Avenue North, #110, Seattle, WA 98109 or contribute online at . ***


LTC Comment: If you care about long-term care, the October 9, 2002 PBS special "And Thou Shalt Honor" is a must-watch. Tickle your calendar now and program your VCR just in case. (Check local listings for exact times.) Below you'll find the press release for this two-hour program celebrating America's overworked and underpaid (or unpaid) long-term caregivers.

We've previewed the show and recommend it with only one qualification. Watching story after story of saintly people giving of themselves to disabled loved ones in every imaginable situation and venue begins to evoke compassion fatigue. One starts to wonder about the seamy side of long-term care such as burned out caregivers who inflict an epidemic of physical elder abuse in America, 100-percent-Medicaid nursing home mills with their serious quality problems, abusive Medicaid estate planning (artificial impoverishment of the infirm elderly) by greedy heirs enabled by scheming lawyers, and the seemingly irrational denial of LTC risk by the baby boom generation, just to name a few difficult problems. "And Thou Shalt Honor" laments the absence of more community-based programs and encourages responsible long-term care financial planning, but it does not spotlight the truly desperate condition of America's long-term care service delivery and financing system. Unless we confront those realities, the burden of long-term care will never be lifted from the shoulders of the wonderful people showcased so movingly in this program.

By the way, keep an eye out in this special for appearances by four good friends of the Center: LTCI trainers Phyllis Shelton and Nancy Morith, researcher Marc Cohen, and LTC visionary Dr. Bill Thomas of the Eden Alternative. The Center for Long-Term Care Financing was pleased to provide consultation and advice to Wiland-Bell Productions, producers of "And Thou Shalt Honor."

Here's the August 2002 press release announcing the show:


Two-Hour PBS Documentary Celebrates and Explores The Emerging Healthcare Issue of Long-Term Caregiving in America

Award-winning Actor Joe Mantegna to Host Special

Premiering Wednesday, October 9 at 9PM on PBS

"Will there be any of me left?" -- Caregiver Ethelinn Block

"I don't have three arms," says Lorraine Watson. "I only have two arms. And I can only take so many people on my arms."

Watson is the sole caregiver for her aging parents and her blind, mentally-retarded sister. While most of America's caregivers are responsible for the well-being of fewer loved ones, Watson's daily demonstrations of love and quiet heroism are typical of the estimated 30 million men and women who currently provide care for the elderly and the disabled.

Their stories are told in AND THOU SHALT HONOR . . . Caring for Our Aging Parents, Spouses, and Friends, a groundbreaking two-hour documentary hosted by award-winning actor Joe Mantegna, set to premiere on Wednesday, October 9 at 9PM on PBS (check local listings). The film and its accompanying nationwide outreach program is the first major PBS initiative on caregiving, an emerging healthcare issue of staggering proportions.

Filmed all over America, the program makes it clear that today's longer life-spans come at a cost, and that a disproportionate amount of that cost is borne by those who step up to assume responsibility for their loved ones. Not everything about long-term caregiving is dark, however; this commitment can be a spiritual journey that expands the boundaries of love. AND THOU SHALT HONOR is a Wiland-Bell Production in association with OPB and ITVS who are co-presenting the project. Executive producers and directors Harry Wiland and Dale Bell, have each personally experienced the challenges of caregiving.

"Family is here to take care of family," says Milton Boykin of Atlanta. "Nobody can look after our Mama better than we can." When Boykin's mother suffered a stroke he and his two siblings resolved to share her care; now she spends four months of every year with each child. It is not a perfect system, but it divides the work - and the cost.

Virtually no government assistance is available to those who prefer to keep their ailing elders at home. Jerry Cohen is watching his life savings dwindle to nothing as he cares for his wife, Harriet. If he put her into a nursing home, Medicaid would cover much of the expense, but as long as she remains home they get nothing. "It just doesn't make any sense." Cohen says. "Any rational person can realize a home environment with a caregiver is best." Despite all he has been through - financially and emotionally - Jerry Cohen shares the experience of many caregivers when he says, "I love her now more than when I first met her."

Ethelinn Block's father, Arthur, is one of four million Americans who suffer from Alzheimer's disease. Physically active, Arthur needs to be watched 24/7. Ethelinn's children help, but the majority of the stress falls on her shoulders, and she worries about the impact it is having on her and her ability to care for the rest of her family. "There [are] two victims in this," she says. "The ailing person and the caregiver, and that scares me, but I wouldn't have it any other way. I can't even conceive of any other way." Three-quarters of the nation's Alzheimer's patients are cared for at home.

The reluctance of many people to put their loved ones in a professional care environment is understandable. Professional caregivers are often underpaid and overworked. On the national average, each professional caregiver today has to tend to the needs of 11 patients - and these patients can be demanding and difficult.

"You've got to love this work because nobody else is gonna do it," says Mary Alice Wadley. "We do things that... nobody else would want to do this job." Wadley, a nursing home caregiver for 28 years, still does not earn ten dollars per hour. In a system that does not allow her to give her patients the time and attention they need, she does the best she can, day in and day out. "If you didn't care," she says, "you would say, 'I'm walking out of here now and I ain't coming back.'"

"We've got millions of fantastic caregivers who are willing to work and to give their time and effort to the care of the elders," says Dr. Bill Thomas, "but they're being made to do it in a really fouled up, left over, antiquated factory system." Thomas has founded The Eden Alternative, a radically different approach to elder care that provides a stimulating environment full of children, animals, and constructive, engaging ways to spend time. "I believe that every elder should have a chance to live in a garden," Thomas says. Since Dr. Thomas first published his ideas, in 1996, 237 nursing facilities have adopted his approach.

Other innovative programs are being put into effect in communities around the country, and petitioners representing caregivers have received a sympathetic ear in Congress. Although some national legislation has been enacted, its impact has been minimal. In the meantime, for millions of people, home care will continue to be the right choice. Despite its sometimes overwhelming financial and emotional cost, it honors one of our most fundamental compacts, our commitment to our loved ones.

"Caregiving is calling each other into life, isn't it?" says writer Nancy Smith Mairs, who was stricken with Multiple Sclerosis. "To be as helpless as I am, means it would be easier for everybody if I just died. Having [my husband] George participate in my care calls me into life, says, 'despite your limitations, you belong here with us, and we're willing to participate in the labor that it takes.'"

Joe Mantegna was most recently seen on the CBS series First Mondays. An accomplished stage actor, he was awarded the Tony and Joseph Jefferson Awards for his performance in David Mamet's Pulitzer Prize-winning play Glengarry Glen Ross. Among his film credits are Woody Allen's Alice and Celebrity, Francis Ford Coppola's The Godfather III, and Barry Levinson's Liberty Heights and Bugsy. Additionally he narrated the Oscar-nominated documentary films Crack USA: Country Under Siege and Death on the Job.

The PBS broadcast AND THOU SHALT HONOR will be extended by a national outreach campaign, an extensive searchable Web site already in operation at, and a resource book The Caregiver's Companion, with a foreword by Rosalynn Carter, published by Rodale Inc. and PREVENTION magazine. AND THOU SHALT HONOR is underwritten by AXA Foundation, Atlantic Philanthropies, The Jacob and Valeria Langeloth Foundation, FJC, Service Employees International Union, Administration on Aging, Northwest Health Foundation, Joseph Drown Foundation, Care There Inc., Mt. Sinai Health Care Foundation, Jewish Healthcare Foundation, Grotta Foundation, Mellon Financial Corporation Foundation, John Vestri and CPB. Local/regional underwriting is provided by The Ahmanson Foundation (for So. California), Grotta Foundation (for New Jersey), JHF (for Pittsburgh and Western Pennsylvania), Mt. Sinai Health Care (for Cleveland), Northwest Health (for Oregon), and Atlantic Philanthropies (for Bermuda).

AND THOU SHALT HONOR is produced by Wiland-Bell Productions, LLC. Executive Producers: Harry Wiland and Dale Bell; Producers: Dale Bell, Harry Wiland, Teresa Modnick and Beverly Baroff; Directed by: Harry Wiland and Dale Bell; Editor: Beverly Baroff; Written by Beverly Baroff, Harry Wiland and Dale Bell; Host: Joe Mantegna. Gail Gibson Hunt, Executive Director of the National Alliance for Caregiving, is the project's Technical Advisor.


Press Contacts:

Adina Barnett, Kelly & Salerno Communications, 203-863-1008,

Diane Domondon, Kelly & Salerno Communications, 203-863-1006,