Recently, I had lunch with an older American friend who mentioned that his wife has to take care of her 60 year old brother who is fundamentally incapable of looking after himself.
My friend’s brother-in-law was being cared for by his parents until they passed away and now the onus has fallen on his sister. This man has not held a steady job for years, and blames everyone else for his problems. He has had misfortune related to health and finance over the years. Not wanting to abandon her brother, my friend’s wife expends an enormous amount of psychological, physical, and financial effort to take care of him.
He is one of the lucky ones.
My friend remarked that he can now understand homelessness. Exhausted by the demands of taking care of a helpless adult who cannot even take care of personal finance, find and hold on to a job, look after their well-being and invest for the future, relatives can give up. If such a person is prone to addiction, the situation gets worse. Their loved ones have to also invest in their own future and perhaps, their children and not sacrifice their well-being for the sake of the helpless person.
As the Cleveland Clinic website notes:
Dependent personality disorder (DPD) is a mental health condition that involves an excessive need to be taken care of by others. A person with DPD relies on people close to them for their emotional or physical needs. Others may describe them as needy or clingy.
People with DPD believe they can’t take care of themselves. They may have trouble making everyday decisions, like what to wear or what food to eat, without others’ reassurance. They usually don’t realize that their thoughts and behaviors are problematic.
How does one frame public policy for such persons?
Even libertarian economists such as Nobel Prize winner Friedrich Hayek felt that the government should play a role in health-care. In ‘The road to serfdom’, he wrote;
"There is no reason why in a society that has reached the general level of wealth which ours has attained, the first kind of security should not be guaranteed to all without endangering general freedom. There are difficult questions about the precise standard which should thus be assured; there is particularly the important question whether those who thus rely on the community should indefinitely enjoy all the same liberties as the rest. An incautious handling of these questions might well cause serious and perhaps even dangerous political problems; but there can be no doubt that some minimum of food, shelter, and clothing, sufficient to preserve health and the capacity to work, can be assured to everybody. Indeed, for a considerable part of the population of this country this sort of security has long been achieved.
Nor is there any reason why the state should not assist the individuals in providing for those common hazards of life against which, because of their uncertainty, few individuals can make adequate provision. Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance, where, in short, we deal with genuinely insurable risks, the case for the state helping to organ- ise a comprehensive system of social insurance is very strong. There are many points of detail where those wishing to preserve the competitive system and those wishing to supersede it by something different will disagree on the details of such schemes; and it is possible under the name of social insurance to introduce measures which tend to make competition more or less ineffective. But there is no incompatibility in principle between the state providing greater security in this way and the preservation of individual freedom. To the same category belongs also the increase of security through the state rendering assistance to the victims of such "acts of God" as earthquakes and floods. Wher- ever communal action can mitigate disasters against which the individual can neither attempt to guard himself, nor make provision for the consequences, such communal action should undoubtedly be taken."
The United States saw a dramatic rise in homelessness this year according to the Department of Housing and Urban Development.
In 2024, more than one of every four people experiencing homelessness was a child under the age of 18
(19%) or a young adult between the ages of 18 and 24 (8%). Demographics differ depending on the type
of homelessness experienced, with few children experiencing unsheltered homelessness and more middle
aged adults making up the unsheltered population. People between the ages of 35 and 54 make up almost
half of the total number of people experiencing unsheltered homelessness.
The spread of homelessness to less populated states is also a shock - whoa, Alaska?. That being said, the coastal states that are rather prosperous have high numbers of homeless people. Some of this is due to bad policy fueled by wealthy progressive voters.
Not sure what the new year will bring to these unfortunate citizens of this country, but I hope and pray that we’re able to do better.