The Blessings of Flight, Part One
What arranging my father's care in a new country has taught me about the United States of America (our old country)
It has been an exhausting ten days, moving all the pieces of our lives around so we can safely escape the escalating harassment and threats my family and I now face in the United States because of my work as an independent journalist. So many pieces, all falling out of my hands like sand. I can’t push my fingers together tight enough, fast enough, to hold these little castles of ours all together. The bureaucracy. The paperwork apostilled and re-apostilled. The money — holy shit, the money. Banks that hold you hostage. Begging for your own money back. The logistics, the language, the leaving behind of thirteen generations of roots in soil I have loved my whole life. The crying friends. The family you might never see again. Those things are hard. They are real. They have kept me up at night in borrowed rooms in the days since I had to flee my home. My hands shake now. I am typing anyway.
The hardest thing in all of this has been something I did not anticipate. And it has turned out to be, unexpectedly, the most compelling validation for leaving that I have found — more clarifying than the fear, more convincing than the politics of a nation intent upon silencing me one way or another.
The hardest thing has been figuring out what to do with my father.
My father has Alzheimer’s disease. Mid-to-late stage. He is a scholar, a teacher, a man of tremendous intellectual distinction. He does not always know where he is now. He does not always know who I am. And he is coming with me — because the alternative was leaving him in a system that would like to eat him alive. A system of monsters salivating to revoke the naturalized citizenship of men like my dad. Men who ran, as children, to get here because here was thought to be safer. Men who must now run again, in the painful fog of old age. I hold power of attorney to manage his affairs. All of them. Medical, financial. So it’s not just me I am moving. It is also my father. His house. His bank accounts. His memory care. His medical care. His files and writings. His. Entire. Life. If not for this, I’d have been gone in an instant. Instead,
I have been making these arrangements for two weeks, from safe houses and hotel rooms and borrowed rooms, displaced from my own house. I emptied the house when the threats escalated to physical attacks in my home. Things in storage. Me, in motion ever since.
I’ve been on burners phone after burner phone. With doctors, neurologists, geriatric specialists, memory care facility staff, nurses, social workers, Medicaid representatives, retirement specialists, bankers, accountants — in both hemispheres. Aqui. Alla. The one becomes the other. Leaving a trail of broken sandcastles in my wake. Trying to solve, in days, a logistical puzzle that most families have years to work through. How to get to safety in a digital world where the corporations own every part of you.
What I found broke my heart. And then it set me free.
Every professional I spoke with on the American side said the same thing, in their own words, with the quiet urgency of people who have been watching a slow catastrophe and waiting for someone to ask.
Get out while you can. This place is broken.
I’ve heard the same story from doctors and social workers and care home administrators and Medicaid representatives and investment brokers and government workers and real estate agents — the quiet infrastructure of American aging, the people who show up every day to manage the distance between what this country promises its elders and what it actually delivers. Every one of them had a story. A parent or grandparent warehoused in a facility little better than an urban animal shelter. A spouse medicated past recognition because a heavily sedated patient is easier to manage and, not incidentally, more profitable to keep. A sibling who quit their job to provide care no one else would provide, and lost years of earnings and retirement savings, and never financially recovered and when it was their time to get care, had no one left to help. A family that fell apart under the weight of a disease no one was prepared for and a system designed, it sometimes seems, to punish the unprepared for their unpreparedness.
They said these things in a sort of stunned disbelief. How is it possible that in the richest country in the world, this is how we treat the elderly? Exhausted tenderness with relief. People who believed they were the only ones facing this. The shame they’ve taken on. Believing they missed some preparation they should have done, some form they should have filed, some conversation they should have had before it was too late. They arrive ashamed of their confusion and hollowed out by grief and the system that daily tells millions of us to pay for things we can’t afford, or die.
This is the crisis beneath all our other crises, the one we do not talk about because it frightens us too much. An estimated 7.4 million Americans age 65 and older are currently living with Alzheimer’s disease. By 2050, that number is projected to rise to nearly 13 million. One in three older adults dies with Alzheimer’s or another dementia — it kills more people than breast cancer and prostate cancer combined. And our country does not care what happens to them. As my dad’s broker told me, “You either have to be destitute or very rich now, to get into a memory care home. If you’re broke, it’s horrible. If you’re rich, it’s also horrible, but luxurious.”
There is nothing for the middle.
Nearly 13 million Americans are providing unpaid care for a family member or friend with dementia right now. In 2025 alone, those caregivers provided more than 19 billion hours of care — valued at more than $446 billion. That is more than seventeen times the total annual revenue of McDonald’s. It is also invisible, uncompensated, and structurally expected — particularly of women, particularly of daughters, particularly of the daughters of immigrants who were raised to believe that family takes care of its own and have discovered, here, that the belief was not reciprocal.
The total lifetime cost of caregiving for someone with dementia exceeds $400,000, and seventy percent of it is borne by family members through out-of-pocket expenses and unpaid care. Life savings. Retirement. My dad’s entire pension is going towards his care now, but even that is not enough. His pension plus money I pay. This is the money that was supposed to exist on the other side of a working life, now consumed by a disease no one chose and a system that offers the family almost nothing in return. The system is so evil it will continue to eat his home and savings to pay for medical bills, even after he is dead.
Here is what that system actually looks like, from the inside.
If you are very poor — poor enough to qualify for Medicaid, with assets under $2,000 and income under roughly $2,500 a month — the state will place your parent somewhere. You will likely have limited say in where. The facility will likely have high staff turnover, because memory care work is grueling and the wages at Medicaid-funded facilities are often not enough to retain skilled and compassionate people. Abuse and neglect in these facilities is not rare. It is documented, recurring, and catastrophically underreported.
If you are wealthy, you will pay for a private memory care facility. The national average is now $7,645 per month — more than $91,000 per year. We are at $8,400 a month now, headed towards $12,000 if we stay. A typical two-to-three-year stay runs between $183,000 and $275,000. At the higher end of the market, the facilities are beautiful. Gardens. Music therapy. Carefully trained staff. They are also, in many cases, profit-maximizing enterprises that have discovered something useful: the worse a patient gets, the more expensive their care tier becomes. Decline is revenue. There is a financial incentive — not always acted upon, but structurally present — to accelerate the very deterioration you are billing for.
If you are in the middle — the vast middle of American life, the people who worked and saved and did what they were told and still do not have $91,000 a year in liquid assets to spend on a parent’s care but have more than $2000 in assets — you are largely on your own. You will be told to rely on family, even if you have no family. You will be handed brochures. You will be wished well.
And now, in the middle of all of this, Trump’s government has made it worse.
On July 4, 2025 — Independence Day, with whatever bitter irony you care to assign to that — the Budget Reconciliation Act was signed into law. It cut more than a trillion dollars from Medicaid, Medicare, and the Affordable Care Act. It represented the largest cuts in history to Medicaid and nutrition assistance — all to expand tax cuts for the wealthy. It broke a promise to everyone in America that we can depend on assistance as we age. Because the law increases the deficit, it triggered automatic cuts to Medicare beginning in fiscal year 2026 — cuts that could only be stopped by an act of Congress.
It is now May 2026. Congress has not acted.
They say it takes a village to raise a child. It also takes one to give our elders the dignified last years they deserve. America no longer has a village. It has a market. And the market has decided that the confused and the frail and the slowly vanishing are, depending on your asset level, either a burden to be warehoused or a revenue stream to be optimized. The village was pillaged by the village idiots who run this Godforsaken country.
Now let me tell you what I found when I started making calls in our new continent.
In most of Latin America, caring for elders is understood as deber: duty and love made inseparable, extending beyond the immediate family into the community, to the neighbor, to the stranger who reminds you of your grandmother. In Latin America, an elder is not a problem to be solved or a cost to be managed. They are the memory of the family, and when their own memory fails, the family remembers for them.
Care for the elderly is yet one more compassion that America dismantled under the name of individualism and profit, under the delusion that empathy is a weakness rather than that which makes us whole and holy.
In our new country on our new continent, the memory care homes do not charge more per month as the dementia gets worse, as they do here. No bait and switch. No “make them dependent, then gouge them.” Dementia care in our new country is one-quarter the cost and of superior quality. It’s subsidized for the people who live there. The home we’ve found for my father is not incentivized towards quicker deterioration and demise, but towards genuine care. The conversations I have had — with administrators, with doctors, with social workers — have had a different texture than the ones I’ve had here. Warm. Decent. Sincere. Kind. I believe this reflects a society that has not yet fully severed the connection between its institutions and its stated values. It’s early days yet, but promising ones. More soon.
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Oh Alisa, I have been waiting for an update. I am so sorry about eveything that you and your family are going through, I can't even imagine. Stay strong, we are cheering you on! Sending you all my love 🩷 you and your family come first, please don't feel obligated to post if you are struggling too much!
Next time don’t telegraph your movements in advance. Just sayin’.
As for your SubStack it was featured twice on episode 2503 of the Joe Rogan Experience with guest Eric Weinstein, a theoretical astrophysicist with deep knowledge of the inner workings of the secret doings out there in New Mexico. At the 1hr 35min and 1hr 59min mark. Stay safe.