Wisdom is the sum of the reflective and reflexive understandings that settle deep in one’s soul after a long journey — a life adventure peppered with laughter, tears, fear, foolishness, joy, doubt, amazement and wonder. Pay attention to those who have traveled before you. Ask questions and listen with your whole being. Like echoes in a canyon, the lessons will continue whispering their meaning.
What follows is the Summary of this essay on health and wellness for seniors.
The Chronologically Superior: Part V – VIDEO Summary (So What?)
We’ve all done it. Certainly, I have. You know what I mean: spoken a little louder, perhaps a little slower, maybe, with the same affect used when talking to small children. We somehow-for some reason—assume that as the hair lightens/thins/disappears, and the shoulders stoop, cognitive thinking is slowly washed out by the inevitable bright light that holds vigil at the end of the tunnel. Oh, it’s done with the best of intentions. We want to show respect, show deference, reduce the load and clear a path to green pastures. “Take it easy,” “Can I get you anything?” “Oh, Sweetie, I’ll get that,” “Have a seat, Honey…you’ve earned.”
“I said, HAVE A SEAT…YOU’VE EARNED IT.”
Nice. Polite. Moms all over are proud. Right? I mean that’s how we were taught to treat our elders. Remove responsibilities, assume control, open the door and help them in and out of the backseat. Nice. Polite. Moms all over are proud. Right?
Not so fast. I like the intent, truly I do, but we need to rethink our assumptions regarding “old age.”
Old Age Isn’t What it Used to Be
In 1935, when President F.D. Roosevelt sent his “Economic Security Bill” to Capital Hill, a white male child born in that year could expect to celebrate his 63rd birthday, and a male person of color had a life-expectancy of around 52 years. A white woman was expected to live until 67, and a non-white female, about 55 years. Renamed, “The Social Security Act,” the title was amended so as to read:
“An act to provide for the general welfare by establishing a system of Federal old-age benefits, and…”
Given that—in 1935—life expectancy was somewhere between 52 and 67, “old” seems like an appropriate descriptor for someone in this age range. However, a child born today, in general, can expect to live somewhere between 71 – 81 years. On the high side, this is a 14 year, or a >20%, gain in longevity.
One of the dangers of advancing outdated notions of what it means to be 65 and older is that these lowered expectations are quickly assimilated. Older people are the same as everyone else; if you set the bar lower than their ability, they will pick up on your cues and tend to underachieve. Conversely, set a stretch-goal and people—of all ages—tend to reach or exceed the mark. Psychologists refer to this as, “Priming Behavior.” We prime behavior in a variety of ways including signals we send with our physical posture, gestures, vocabulary, facial expressions, and the tenor, tone and volume of our speech. When it comes to the senior population, if we are not careful, we will transform our otherwise sharp, productive, energetic, and engaged senior population into shuffle-board-playing, slow-moving, disengaged, crabby, self-absorbed, sickly, afternoon-matinee-attending, 5’o’clock Denny’s Dinner Special-eating “old” folks. AND they will stay that way for a long, long, time!
The More Senior You Become…The More Senior We Become
There are a number of factors contributing to expanded life expectancy. Reduced infant mortality, improved disease prevention, and better medical treatment for all age groups are key, well-known, factors. The one factor we’ve neglected to consider and plan for is, aging. The older we get, the older we get.
When my great grandfather Jeremiah Madden was born in 1846, his life expectancy was just over 38 years. When he reached 10 years of age, his life expectancy jumped all the way to 58 (the impact of infant and childhood mortality). When he made it to 20, his predicted age at death was pushed out another two years to 60. At 30, he was looking at 64 and, when he reached 40 years of age, statistics projected my great grandfather out for another four years to 68. When he reached his Jubilee year, he was given three more years to the age of 71. At 60, he could look forward to seeing his 75th birthday and, when he reached 70, the stone mason made the statistical folks look real smart when, chisel in hand, he finished the bookend dates on either side of my great grandfather’s tombstone dash with the year “1926.” Jeremiah Madden died at the age of 80. The older he got…the older he got.
To put it another way, when my great grandfather turned 65 in 1910, his 65+ cohort represented 4.3% of the total population. When my grandfather turned 65 in 1947, he and his buddies were 8.1% of the total. When my dad turned 65 in 1974, his group made up 10% of the population. Should I make it to 65 in 2013, my baby boomer friends and I will consume more than 13% of the population pie. Our children begin turning 65 in 2041 and they and their group will represent 21% of the total population, and our grandchildren in the year 2075, will represent 23%. As you can see by the graph below, starting with my grandchildren’s generation—the Echo Boom progeny—it’s projected to start leveling out.
However, in the meantime…
Are you (we) ready for an older population? Who will benefit? Who will suffer? How so?
The 5 Ws
Years ago I realized that the only way I could attack an issue—an opportunity— was to break it down using what I call, “The 5 Ws Model.” ™
- What’s Happening? – Current Status
- So What? – Trends & Consequences
- What Now? – Triage & Emergency Action Plan
- What Next? – Strategic Plan & Intent
- What Difference Does it And Will it Make? – Personal/Organizational ROI
Let’s apply this model to the question at hand:
Our Aging Population
(a.k.a., “What Are We Going to Do About Grandma and Grandpa?”)
What’s Happening (Current Status)
- In 2010 the top three federal spending categories were:
- Social Security
- Since the turn of the 20th century, the percentage of the US resident population, 65 years of age and older, has grown three-fold, from 4% to 13%.
- The current unfunded debt obligation for Medicare is $24.8 trillion. Let me write that out for you:
So What? (Trends & Consequences)
- In 1962, 13% of the federal budget was spent on Social Security and Medicare. According to the OMB, by 2020 these two programs will account for 36% of the total spend.
- From 2000 – 2010, Medicare spending jumped 81% (OMB data).
- The high cost of Medicare pulls dollars away from other needed programs. As seniors age, we must find a way—healthwise— to keep them younger as they grow older.
- Overall, the top-heavy spend on unnecessary medical treatment, error, and redundancy has drained away much-needed primary prevention dollars. Dollars that could advance and ensure affordable, full access to the social determinants of health. These include health literacy, general education, basic nutrition, neonatal care, early childhood development, healthy infrastructure, screenings and early intervention.
- According to the 2010 Trustees Report, the year that Social Security will begin to spend more in benefits than it receives in payroll taxes is 2015—one year sooner than predicted in last year’s report. In the year 2037 “trust funds” will be exhausted.
What Now? (Triage and Emergency Action Plan)
- Pull your head out of the sand. Begin facing the hopes and fears, obstacles and opportunities that come with aging. It is the quintessential approach/avoidance dilemma.
- As a relief-reaction to the horrible and historical mismanagement of your tax dollars, go to a window, open it, stick your head out and echo the cry of Howard Beal: “I’m mad as hell and I’m not going to take it anymore!”
- Look in the mirror and ask yourself, “Down the road, who’s going to have to pay for my lifestyle-related health issues? My children? My grandchildren?” Take steps, today, to reduce future economic and emotional debt for your (and our) loved ones.
- Intellectually, emotionally, spiritually and economically embrace the concept and value of compressed morbidity.
What Next? (Strategic Plan and Intent)
- Write your representatives in DC and demand administrative reform at CMS and SSA. It doesn’t matter if you don’t have a plan…it does matter that, they (House and Senate), know that you hold them accountable and that you VOTE. Do the same when it comes to state and local issues that impact senior populations.
- As Steve Jobs would say, “Think Different” when it comes to seniors. Treat them with respect, not deference. Our seniors want/need to feel relevant and engaged. Encourage activities, include them in your discussions, ask for their advice and pay attention to the life lessons they have to share. Sense of purpose is a beautiful thing.
- If you are an employer, consider phased retirement for key people. Thirty years that ends with a cardboard box and a pat on the back hurts everyone. Consider such things as mentoring positions, advisory boards, focus groups, open ended consulting relationships, and confidential no-oblique-speak lunch and learns with senior workers and senior staff. Mine the treasure wrapped in gray. You don’t even have to dig…it’s sitting right in front of you begging to be noticed!
- If you are a vendor of products and services, don’t miss the senior market opportunity. They are a large group with significant discretionary dollars to spend and they expect to be around for decades to come.
- When you turn 60 and—assuming you’re in good health—the odds are very strong that you will be around for your 75th birthday. If good health finds you turning 75, 85 looks good to go. And, if you’re doing okay at 85, welcome to your 90s! Can Willard Scott be far behind?! Is this good news or bad? Will the years ahead bring gold or rust?
- When it comes to aging, PLAN FOR THRIVAL NOT SURVIVAL!
- Plan on spending less time at Denny’s.
What Difference Does It and Will It Make? (Personal/Organizational ROI)
- It’s not enough to simply—or, not so simply—increase awareness, education and action. Without measuring effectiveness and personal meaning (passion), we are doomed to repeat history. We need to monitor both the objective as well as subjective impact of our interest and energy.
- Stay informed by reading and studying both sides of an issue and listening to the interpretations and evaluations of both vested and disinterested parties. Depending upon who is in the White House and who is controlling Congress, Republicans and Democrats will tell you that things are getting better or that Chicken Little was right. Libertarians will simply tell you and everyone else to just leave this, and virtually every other issue, alone. Get involved and stay involved.
I’m just starting this CS journey, but as it progresses—and God willing it will be a long and healthy journey—you can call me “Honey,” “Dear,” and “Sweetie.” You can open every door, offer to carry every heavy package and even speak a little louder and slower if it makes you feel better to do so. These are nice things to do, well-intended, and I’m sure your mother would be proud. I appreciate it, I really do. But, please—and, I speak for all those with light/thinning/transparent hair and stooping shoulders—please respect my dignity and intelligence, support my independence, ask for my advice, benefit from my experience… including my mistakes, let me drive my car for as long as it’s safe to do so, share your time (the most precious gift you can give me) and don’t, I beg of you, feel a need tell me about the early-bird dinner specials at Denny’s. 😉