As I was waiting for a bus in the outer-edges of Brooklyn, a particularly fragrant homeless man steered his wheelchair aggressively into the crowd. The crowd parted like the Red Sea, only to realize he was staking his claim to be first on the bus. There was a moment of panic as people checked the bus schedule and confirmed the next bus was another 25 minutes away and there was no other route home. I was torn between feeling empathy for this man, who was trying to get himself from the free clinic to his home unaided, and the thought of a long, stomach-churning ride home.

a homeless man stands in a doorway wrapped in blankets and carrying his things in a trash bagHe stepped up from his wheelchair for a moment, carefully adjusting the rags he had soiled himself into, before the bus driver helped him into the bus. He politely reminded the driver to lock his wheelchair brakes. When another bus pulled up, the crowd rushed it and a few people pleaded with that driver to skip his break. No such luck – he couldn’t go off schedule. As one of the more vocal women got on the bus in front of me, I heard the driver apologize to her, sighing that it was discrimination to not let him ride the bus.

We know that caregivers are important. We can rattle off statistics about how much money we save the insurance companies – a figure I don’t feel particularly good about. But our importance is even more apparent when ‘informal’ caregivers and private insurance are taken out of the picture. Then you’re left with people like this man, who was in such dire need of additional care.

The other day I was reading about George Hodgman, who moved in with his mother after realizing she needed around-the-clock care and there was no one else to provide it. What happens to the 90-year-old women who don’t have children, or have children who aren’t able to uproot themselves from their lives to re-enter the lives of their parents? Are they left to keep driving off the road as they struggle to get to the doctor’s office and the grocery store? Are they destined to be skeletons discovered when the property tax bill goes unpaid too long?

In Manitoba, public insurance will now provide ongoing payments to people whose unpaid caregivers die in car accidents, rather than just paying a one-time death benefit. It appears that this is the only public insurance scheme in Canada that provides such coverage and recognizes the role of family caregivers.

Nearly a quarter of America’s 43 million seniors are at risk of becoming ‘elder orphans.’ If they qualify for public programs – and someone assists them with applying and fulfilling the requirements – they can receive basic support. As many of us know, people fall through the cracks as they struggle with the application or find that there’s a very long waiting list for service. It shows up in the news occasionally when someone is forgotten, others never get the help they need.

What happens to the people who need care but have no friends or family to take them in at their own expense? If they’re lucky they end up in a nursing home. If they’re not, they end up on the streets.

Featured image: Robert Hoetink /

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