This as-told-to essay is based on a conversation with Brenda Eicher-Beard, in her 70s and living in Virginia. The following has been edited for length and clarity.
I spent most of my career life in Maryland, but I moved to Virginia a decade ago because my daughter lives and works there.
We kept our home in Maryland because we intended to return after helping with childcare. However, we ended up staying due to my husband’s health declining, to be near my daughter for her assistance, and for the medical facilities and physicians.
When my grandson was in kindergarten, my husband was in good health and helped with childcare while I continued to work. He picked him up from school and things like that. His health started to decline a bit in 2021, and we were trying to figure out a diagnosis. After seeing several different neurologists, the doctors said that he had atypical Parkinson’s.
He also had blood pressure issues that we were dealing with, and then he had a hemorrhagic stroke in January 2023, just a few months after the Parkinson’s diagnosis, and I quit working. This fall I went back to work full time as a reading specialist to afford keeping him at home with private paid care.
He never really took a day off work
My husband was a very healthy person. He never really took any time off from work. He was an athlete, went to college on a basketball scholarship, and was a teacher. He taught US history for decades and coached football and basketball. He was placed in the Maryland High School Coaches Hall of Fame for his football coaching.
His stroke a few years ago has impaired him health-wise. They medevaced him from the local hospital to another. He was in intensive care for a month. Then he was in their stroke ward for several days before being in a rehabilitation hospital for a month.
He came home, but went back into rehab a few months after. He had some other issues, but he’s been home since then. Medicare was covering home healthcare for the first few months. It also covered occupational and physical therapy, but that ended in June 2025 based on the progress he had made. So I’ve been paying for home health and physical therapy; my husband no longer needs occupational therapy.
We did speech therapy as an outpatient, but he was released from that. I paid privately for a speech therapist, but they’re very limited, so it’s hard to find. If Medicare does cover it, sometimes it’s through an online call, which doesn’t work for everybody, certainly not for older adults.
We used money from selling our home because Medicare only covered so much
We sold our home in Maryland in 2021, and we had some of those financial resources to use, but Medicare only covered so much. It covered a lot, don’t get me wrong, but it stopped covering once he was out of the rehab hospital, and he did a little bit of therapy. To have more therapy, I had to pay individually. I was somewhat astounded that Medicare would stop paying, but they did.
I guess I had the false conception of — my husband and I worked for school systems, we have a decent pension, we have Social Security, we have Medicare — Medicare would kind of come in and cover those things that we didn’t. I worked for Baltimore County Public Schools for 30 years, and when I retired, they covered my health benefits until I reached Social Security and Medicare age. I just had no concept that Medicare wouldn’t cover his nursing home care other than the initial 30 days of the rehab.
We spend about $5,000 a month
I pay at least $240 a month for a private certified nursing assistant to come and assist with his showers. I was paying $140 an hour for physical therapy twice a week, but now paying $110 an hour for three times a week with a different company for an exercise physiotherapist. My husband can do limited walking with a walker and assistance. Working with the exercise physiotherapist allows my husband to stay home, because if he gets to the point where he’s totally bedfast, I won’t be able to take care of him by myself.
Now that I work again in the education system, I’m basically there with him from 4:30 p.m. until I leave at 7:30 a.m. or 8 a.m. to come to school. I employ multiple caregivers, but only one would come for a day; the pay is from $20 an hour to $29 an hour for home healthcare in this area.
We spent about $5,000 a month, with over $1,000 coming from physical therapy and the rest from other expenses, including the shower assistance and eight to nine hours a day for multiple caregivers. Since school was out in June, I paid very little for caregiving since I wasn’t working. I’ll be paying for more care again in July since I’ll be getting surgery and need the help. I’ll be working full time again in August.
It’s cheaper than assisted living memory care units. It’s what I can afford at this point in time without going bankrupt, so I can still have money for expenses and other things. I can keep and maintain my car. If I need to buy clothing or decide I want to buy a gift for my grandchildren, I’m not at the bare-bones broke, which I would be if he were in assisted living.
I don’t know if assisted living would meet his needs
I feel better about doing care this way because I don’t know that assisted living or a nursing home would actually meet his needs at this point in time.
He doesn’t speak as much as he used to, but he still reads and maintains an interest in sports and history. At a lot of the places I visited, I didn’t see things that would actually keep him entertained.
I just feel more comfortable with him at home because he can go to plays or we can go to things that he’s interested in, even though his mobility is limited. He still requires a lot of care, but there are also important things for his quality of life.
We’ve gone to football games. We went to the University of Maryland in April because my husband got an award for his high school coaching, and a lot of his former players and people associated with his coaching career were there. The local university does a lot of summer theater and plays. My daughter usually takes us, and we usually go to at least one or two of those during the summer. We watch football games or lectures or things through my Chromebook online. He’s very interested in that. He likes to read. A couple of them, nursing homes and rehab centers, really don’t have anything for people to read.
I like working
I retired from Baltimore County after 30 years, and then I worked in Pennsylvania in literacy for a period of time, and I actually had enough time there to meet the qualifications to retire from them. So I had two retirement things going on, and then we moved to Virginia. I was still working, so I worked here in the school systems. I did retire briefly, and we did a bit of traveling and other things.
When he started to have some issues with Parkinson’s, I left the school system. I did a little tutoring and some work at a preschool. When he had a stroke, I was scheduled to work with another school system, but that kind of shut everything down because that was a full-time job.
Then I went back to work full-time with the school system again, and they were incredibly generous, giving me all my years of experience. So I went in at the top of the pay scale, which made it conceivable for me to hire people to stay with my husband because someone has to be with him all of the time. He is in a wheelchair or in his lift chair. He can’t move on his own without assistance, and he needs someone to prepare his meals.
I’m a reading specialist. I like my job and don’t mind working. I’m going to be working probably for a long time. I recently renewed my teaching certificate, so I’m good until I’m 80.
I’m sure I’ll be working until then because that’s the only way we’ll be able to manage all the things we’re doing for my husband’s care. If he declines more, because he does have atypical Parkinson’s, and if that leads to more decline and he does require more help, either in-home or a nursing home situation, then definitely I’ll be working.
I’m not really concerned about future caregiving needs for myself. I’m fairly healthy. My father lived until his late 80s. I have a grandmother who lived well into her 90s, so I hope I have some long-winded genes in there. I have a good family practice person here. We have good medical care here, so I keep up with that. I’m trying to stay healthy myself so that I can swing all this that we’re doing.
I know that if push came to shove, my daughter and son would be helpful, and they have helped with their dad in a lot of different ways, but I don’t really look ahead. I look at it as one season at a time.
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