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  • Writer's pictureDr. Ilene Nathanson

Caregiving Confidential: The Retirement Plan Afterthought

I wrote Caregiving Confidential: Path of Meaning to respond to a gap in people’s retirement planning that especially impacts women (of all ages). It was my intent to reach as many women as possible with a message that comes crashing home sooner or later and thereby avoid some of the more challenging implications of failure to plan for caregiving. The book is intended to amuse as well as soothe, not scare. To open eyes and minds to what I have experienced as an afterthought in people’s retirement planning.

The experience of caring for an aging spouse or parent can best be described as bittersweet, reflecting a range of often conflicting experiences — sometimes deeply rewarding, other times deeply disturbing. Many of the more disturbing issues I have encountered could have been mitigated by more careful planning.

Continuity of care planning has never achieved the same centrality as financial or estate planning in our culture. Why is that?

I have asked myself that question so many times. What has been particularly distressing to me, is the general resistance I have encountered to planning for retirement and beyond, not only among members of my parents’ generation but also among members of my own age group.

Considering the findings of a 2019 study undertaken for the (U.S.) federal Department of Health and Human Services this trend becomes even more troubling. These data suggest that about 70 percent of older adults will need help from family caregivers or paid aides or some combination of both. So, what’s the reluctance?

Some of it has to do with human nature. Who wants to think about being old and frail when you are young or youngish and strong? Much of the resistance has to do with societal denial of the issues associated with an aging population with inevitable and widespread custodial needs. We are not much into social planning in North America until the problem becomes so grave that avoidance is no longer an option.

Much of caregiving planning avoidance has to do with over-reliance on women as a naturally renewable resource.

This misguided assumption is leading to a Caregiving Crisis. Maybe not as sexy as Climate or Covid, but a crisis nonetheless!

So that brings us to the book, Caregiving Confidential: Path of Meaning. Maybe you feel you should have done a better job of preparing for the demands, including expense, of caregiving. I say join the crowd! This book is designed to grab your interest with first-hand accounts of caregivers and some honest facts about aging and caregiving. I limited the focus to caring for the aged. The chapters are constructed to provide support and safeguards to counteract the effects of anticipated failures.

I consider some common issues that cause fireworks to go off when dealing with aging parents and spouses: Broaching the idea of Taking Away the Car Keys; Broaching the idea of Clearing out the House; Broaching the idea of Selling the House; Caregiving up Close, Caregiving at a Distance; Challenges of Navigating Medical Care; Broaching the idea of Moving to Assisted Living; The Challenges of Nursing Home Care; The Challenges of finding Paid Caregivers; Show me the Money: Paying for it; What Happens to Caregivers when the Elder goes off the Rails?; Who is going to take Care of Me?

The title, Caregiving Confidential: Path of Meaning aptly characterizes the book’s dual focus on (1) the Caregiving Journey and (2) the Caregiver’s Journey. In addition to highlighting common challenges encountered along the typical caregiving timeline, the narrative seeks to provide some insight into the intra-psychic challenges encountered by the principal caregiver a/k/a the Designated Informal Caregiver or, DIC.

The book avoids the use of platitudes and reflects the experiences of a range of subjects. It is both anecdotal and factual, and information is woven into the narrative to enrich the discussion - but with a light hand. I would like to believe the book offers some amusement as well as support and inspires people to take action to better prepare for or cope with an unfolding situation.

I draw upon the many caregiving experiences in my various roles, e.g., health proxy with parents and other older adult dependents, caring professional helping my clients and patients manage personal challenges, and friend and confidante to many others who have experienced the stresses of managing the needs of older adults.

Caregiving is a women’s issue and a cultural phenomenon.

One of the major takeaways for me has been a heightened awareness of the significance of caregiving as a woman’s Issue. I discovered that more and more young women in their thirties and forties (as well as older women who themselves are past the age of sixty-five) are being summoned to caregiver duty than ever before. Women are being challenged on so many fronts at the present time and caregiving is as politically and socially charged an issue as Climate and Covid.

LEANING OUT has been a sterling example of a platform aimed to enhance career opportunities for women, without shying away from the brutal realities facing women today.

This book is meant to amuse its way into the public consciousness of the significance of caregiving as a critical women’s issue. I hope it serves as a catalyst for bringing attention to what is becoming an entrenched cultural phenomenon mainly impacting women: the advancing influence of an aging population on the role of women in society.

Order your copy of Caregiving Confidential: Path of Meaning here:



Ilene Nathanson just retired from full time employment as Co-Founder and Chief Administrator of the Long Island University Collaborative MSW Program where she served as a Full Professor, Social Work. Her specialties include gerontology, clinical social work and health policy. Ilene has been a pioneer in promoting multidisciplinary practice with older adults, as evidenced in the publication, Elder Practice: A Multidisciplinary Approach. She received her “induction into gerontology” at the Brookdale Center on Aging of Hunter College. She is also recognized for her contributions to the development of the Nathanson-Giffords ethics scale for the social work profession. Her newest book, Caregiving Confidential: Path of Meaning provides answers to some common challenges faced by caregivers of older adults.


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