185 Commonwealth Road
(Route 30)
Wayland, MA 01778



My last blog post generated a number of comments, mostly on the websites where I posted links, such as LinkedIn.com. Unfortunately, most commenters – all, in fact – did not also post to this blog website. Whenever possible, please comment here so that other readers can see what you think. That blog discussed the frustration of being the first person someone talks to about care for seniors since it is almost always a lot more expensive than people expect. Those prior comments fell into two categories. One group had been in my position before and understood my perspective . The other group felt I was thumbing my nose at people who could not afford home care and worse, that I had no patience for them. I apologize to the latter group. What I was trying to say, apparently not so well, was that care is not cheap but people usually expect it to be far cheaper than it is. Why? My theory is that people do not have prior knowledge of what it should cost. When we stop for a cup of coffee at Dunkin’ Donuts and the cashier asks for a $1.50 we don’t bat an eye; if he asks for $4.00 we stop in our tracks. Why? Because we have a general sense of what a cup of coffee should cost. The same goes for many other things we purchase on a daily, weekly, or monthly basis including our cell phone bill, a sandwich at the deli, or even a gallon of gasoline. But when it comes to home care, most people have no experience with it and therefore no frame of reference. As with any business, a consumer sees only the tip of the iceberg of what goes into the service. In the case of that deli sandwich, we can add up the costs involved: Bread, deli meats, condiments, the ovens or other equipment used, wages for the counter staff, rent, cleaning the store, etc. So we can accept that buying a sandwich at a deli costs more than if we were to make it for ourselves at home. And most people understand why good sandwiches cost more than lousy ones. This is not the case for home care or other support for elders. Many adult children who have taken dad to the doctor or the grocery store or spend a Saturday putting away porch furniture and otherwise maintaining their parent’s home do not see the costs as concretely because time and patience is the most valuable raw material and there is no clear value for these. They also often do not realize how long each task actually takes. These tasks don’t cost these adult children anything out-of-pocket so they have no frame of reference for how much is reasonable to pay someone else to do it. If they sat down and figured out what they give up in income by taking half a day off and then factor in the emotional stress from the activity they can start to see why paying someone else is a good value! But when they make that first call for support they haven’t done this math yet. There is more to providing care than paying the caregiver/employee a decent wage. Having someone step in quickly if a regular caregiver calls in sick leads to bonuses paid for last-minute fill-ins and there is often overtime that isn’t passed along to the client. And aside from the overhead associated with running any business, senior support is very labor intensive and requires several different and significant insurance coverages. Workers compensation, unemployment, liability and commercial policies are all required. I could go on but that would not only be uninteresting but also sound like I am whining, which I am not. I am simply pointing out that when people first look for care for a senior it is often their first experience with the industry and the lack of realistic cost expectations leads to sticker shock. There is significant value added by having someone besides a close relative providing care. Those are worth talking about in a different entry. Please add comments on the blog website so anyone else reading it will see them. And thanks for reading!