My grandmother died from the Spanish Flu in 1920. She was 28 years old and had a young child. 100 years later, I am in danger of dying from another deadly virus. I am 68 years old and have no family. According to several public figures, her death was a tragedy. Mine would not be. Conservative commentator, Ben Shapiro, believes in an “obvious truth”. He says, “If someone who is 81 dies of COVID-19, that is not the same thing as somebody of 30 dying of COVID-19. If grandma dies in a nursing home at age 81, that’s tragic and it is terrible; also, the life expectancy in the United States is 80”. Gee, thanks, Ben.
The idea that older people are intrinsically less valuable than folks in younger cohorts is more prevalent than one would think. The problem with that belief is that most of us will make it to 65 and beyond. We should all consider how we are going to be viewed when we are 81. Will we still be relevant and living significant lives? It appears that the answer to that question is yes. For goodness sake, our President-elect is 78. Now we have a new problem: surviving to ages we never have before, surviving forever.
“How terribly strange to be 70.” – Paul Simon
America is aging at an unprecedented rate. In the mid-20th century, the average lifespan was 49.2 years. In 2003 it was 77.5 years. White females’ average life span is currently over 80 years old. The Population Reference Bureau cites aging data from the U.S Census Bureau showing the number of Americans age 65 and older is projected to nearly double from 52 million to 95 million by 2060. So, if you are 35 now, you can plan to be part of a huge cohort.
The demographics will change as well during this time frame. Non-Hispanic whites are currently about 77 percent of the older population. This is expected to drop to 55 percent. We are aging rapidly and in large numbers. That’s not all. As people reach upper levels of longevity their income and resources are reduced. Retirement savings that would have been adequate if one lived to be 60 or 70 are stretched thin if one reaches 80 or older. “We are simply going to live longer than we may have expected. It would be good if people just planned on living until 100.,” says James (name changed to protect privacy), a local financial planner, “You can always change that plan if circumstances change”.
We are all aging and we are all going to die…eventually. We may not expect to live to 100, but it certainly is a possibility. “Every day I get up with a new pain and think, ‘what now?’,” says Mark, who is 62 years old, “Then I think about how lucky I am to be alive”. Sometimes that is the hard part to remember. As our bodies age, it sometimes seems that it’s just one thing after the other. Joint arthritis is almost a guarantee. More people over 65 and people well into their 80s are getting knee replacement according to the Mayo Clinic. 13.9 percent of the population over 71 develops dementia. If you are over 90, your chances increase to 37.4 percent. By age 65, over 90 percent of people have a cataract. And these are just the most impactful things.
“It ain’t necessarily so” – Bronski Beat
According to the Aging Services Foundation there are 63,000 Boulder County residents over the age of 60. Ninety percent of these seniors want to remain in their own homes. Over 17,000 of these folks live alone. These facts may make aging comfortably a problem since 54.29 percent of those aged 45-54 have no savings. This shocking statistic published by the SpendMeNot blog, coupled with increased longevity, paints a grim picture of life after 65.
There is some good news. Elders are better educated now than they were in 1950. “Age specific mortality” (dying just because you are old) is decreasing. The gender gap in dying is reducing. The poverty rate of the elderly has dropped sharply from 30 percent in 1966 to a current 9 percent rate. People over 90 make up 4.7 percent of people 65 and older. This has increased from 2.8 percent in 1980 and could reach 10 percent by 2050.
Seniors are and will be a force to be reckoned with. Just living longer is not the goal for the seniors I spoke with. (Some names have been changed to protect privacy). John is 74. He is a vegetarian, an avid skier, and a personal trainer. “I don’t think too much about being old”, he says, “I’ve gotten used to the aches and pains and concentrate on the joy of every day”. John’s life isn’t without challenges. He has had cancer, two torn rotator cuffs and several ski injuries. He believes aging isn’t about what issues you have but what you can do.
The things that bring joy into our lives are under our control. Arthur is 90 years old. He lives alone. That is not exactly true. He lives with a lovely, affectionate cat who provides him with company, love and a reason to get up in the morning. That is, she sits on his chest batting his nose until he gets up. Grace has her two dogs to hike with in the mountains. Her pups are a strong motivator to get outside. Jane volunteers at Luvin’ Arms, the farm animal sanctuary. She has found a spiritual connection with animals that most people eat. Her understanding of the intrinsic value of their lives and the fact that this understanding has led her to a vegan lifestyle will, most likely, increase her longevity. We shouldn’t discount connections to nature as a luxury or privilege. They are a necessity to meaningful aging. These are especially important when we are faced with limited interactions with other people.
Seniors appear to be eminently more sensible about public health concerns than other age cohorts. Most seniors do wear masks and social distance in public. In a study done by Marquette University (Who is Wearing a Mask? 2019; Haischer, et,al.) only 41 percent of people observed in shopping locations wore a mask. Seniors were the exception. Mask wearing substantially increased with age, presumably because the media pointed out that seniors were at heightened risk. This is good news. Unfortunately, the sad fact is that seniors in care facilities have died disproportionally to the rest of us. These people don’t have control over their health precautions. Contrary to what Dr. Atlas predicted, we have not been able to protect this vulnerable population. Maybe we can do better next time. Because there will be a next time. Experts agree that Disease X is going to happen, maybe soon. People now in their 30s will most likely be facing another zoonotic virus.
“If I had a hammer” – Pete Seeger
Meaningful aging, the striving for purpose and meaning in life – what is called generativity, creating a life well lived and leaving a legacy for the future, is the goal of increasing numbers of elders. Finding and pursuing a purpose plays an important role in maintaining physical function, according to a study from Harvard T.H. School of Public Health. The study was published August 16, 2017 in JAMA Psychiatry. Purpose makes life worth living. A higher purpose gives us a reason to live.
Peter Yarrow, a member of the iconic group Peter, Paul and Mary, is a prime example. “I want to share with people of all ages that the joy of giving to others is a happy secret to staying young at heart”, said Yarrow. The group was a social force in the 60s and 70s. They sang about social justice, were at the forefront of protests against the war in Vietnam, and spread a progressive message of the power of love and compassion in politics. “I was sitting in a rowboat with Eugene McCarthy after his failed Presidential bid in 1968. He said to me ‘We almost did it’ and what he meant was not that he almost won the Presidency, but that we had almost made an evolutionary leap toward creating institutions that put people first,” Peter remembers. “The issues we sang about 40 years ago are still plaguing America – racial and social injustice, violence, and economic unfairness”.
Peter is the founder of Operation Respect, which began in the fall of 2000, providing classroom curricula and professional development workshops for education professionals. This part of his journey began when his daughter, Bethany, took him to hear the song, “Don’t Laugh at Me”. The song is about how it feels to be bullied. Getting Operation Respect started was complicated work. It required stamina and collaboration. Peter was a senior when he started it. Currently 185,000 copies of the song have been distributed worldwide. The organization has provided lessons worldwide as well. These lessons embody the concepts of kindness, compassion and empathy aimed at creating a caring learning environment.
Involvement in this effort and others has gotten Peter through some tough physical challenges. His Jewish faith has been a rock that he has built on. He has remained focused on his purpose – providing inspiration to a younger generation that will carry this torch into the future. Talking of the challenges of aging, he says that getting people to respond to him is more difficult. “Everyone would take my calls during PP&M’s heyday. Now I have to explain who I am,” he says with a chuckle. Peter is 82.
You don’t need to be famous or wealthy to find a greater purpose in life. Joanne has lived in Boulder since 1977. She retired from teaching in the early 2000s and turned her life-long love of art into providing art classes for unhoused folks. She also teaches Sunday school for her church. Over the years she and her husband have helped people transition into housing. Currently, they are providing housing for a no-longer-unhoused person who assists them in caring for their pets and helping with heavier chores around the house. “It makes me feel happy to help provide for good people experiencing homelessness. It gives my life meaning. We get a lot out of it,” she says, petting Molly, a blind Chihuahua-Pug adopted from Colorado Pug Rescue. Being actively engaged in giving expands your circle of compassion.
The joy of giving that Peter Yarrow talks about usually finds ways of helping a variety of causes. More and more social welfare causes are reaching out to the older members of society. Political and environmental causes especially need to focus on the senior population. Getting younger people in these movements to engage and respect the participation of people over 65 can be difficult. “It seems that we lose our intrinsic value when we hit 65,” says Kathy, an active volunteer for the Democratic Party. “Many young people have forgotten that we protested in the streets against racism and war. Many people in their 60s risked their lives and their futures in the anti-war movement. They have valuable experience that could be used to avoid mis-steps in the future. It can be an uphill battle getting young people to believe that you are relevant when you are old”.
Planning for purpose is like planning your financial future. Finding out what is most important to you and being able to do something about is one of the luxuries of aging. Elders have more time to dedicate to their causes. The majority of all charitable gifts are made by those over 55, with most coming from those over 65 (Bekkers and Weipking 2011; IRS 2007). However, volunteering for a cause declines as people age. Because of the positive effects of having a purpose, older folks should seriously consider making themselves heard by getting out and giving of their time and expertise. Volunteers live longer, more fulfilling lives (Luoh and Herzog, 2002). A study conducted by the National Institutes of Mental Health in 2010 found that volunteers over 60 reported lower disability and higher levels of well-being relative to non-volunteers. The positive effects of volunteering were greater than any other factors.
“It’s money that matters” – Randy Newman
Planning for a financially secure future is more important now than ever. One of the greatest fears of people reaching 65 is the insecurity of Social Security. It is pretty certain that Social Security will be gone or look very different by 2034. If I live to my expected age of 81, my last year may find me without the social safety net. Younger people may have to live without it entirely, even though they have paid into it. Medicare, Medicaid and Social Security are maligned by right wing politicians as “entitlement program”. They don’t seem to realize that we paid for these programs, so, yes, we are entitled to them. Politicians have also raided funds from these programs to support other areas, and refused to pay it back. The decline of social safety nets is a self-fulfilling prophecy.
Financial planners warn that people need to start now planning for their old age. This can be extremely difficult, if not impossible, for the working poor and people living below the poverty line. “I try to save, and believe me I don’t buy a lot of stuff I don’t need. I work at a minimum wage job. I have heart trouble and can barely afford my doctor’s bills. I’m going to work as long as I can, but I’ll be depending on Social Security to survive,” says Theresa, a 63-year-old Hispanic woman.
Seniors are also prime victims of fraud. 1 out of 18 seniors are victims of financial fraud or scams each year in the United States (NIH). Seniors tend to be trusting and polite. They also tend to be lonely. Fraudsters are adept at gaining their trust. This had led to a $3B yearly criminal industry in America. It will get worse in the future (FBI).
Experts say that reverting to the old-fashioned values of saving and thrift when possible could save the next generation of seniors. “Don’t buy things on credit and save 10-20 percent of your income. If you want something, save for it,” says Allen, a Boulder banker. This may seem harsh to a generation raised to expect immediate gratification. But, really, do you remember the presents you got last holiday season? Given that you will be paying 18 – 34 percent interest on these items, it may be best to buy what you can afford.
American culture glorifies excess. The “got to have it” mentality has been fostered by the ubiquitous sounds and images of things that people equate with happiness, ideas built up by the current senior population, Boomers, and seeded since the rebound of the Great Depression as America turned towards consumption as a primary economic function. It is not an accident that we see so many dogs in commercials. Dogs really do bring happiness, so showing them with a product is a good advertising strategy. Advisors warn about being sucked in by the warm fuzzies, bright colors, and catchy tunes. “Being an educated consumer is important. Try putting things you ‘have to have’ on a wish list. You’ll be surprised that when you visit it again, you may not want it,” says Allen.
“Will you still need me, will you still feed me, when I’m 64” – The Beatles
As you age, the need to be actively involved in your own future is imperative. Healthcare is a huge issue in the United States. As the only wealthy country that does not consider healthcare a right, navigating insurance, medical care, and medications is complicated. Deciding on a Medicare program can be a nightmare. It is important to remember that insurance companies do not exist to benefit the client, but to make money for their stockholders. Anecdotally, the best place to get information is the government, not the insurance “helplines,” (Medicare.gov).
Caveat Emptor (buyer beware) goes for medication and procedures. According to the seniors I interviewed, doctors tend to prescribe medication for seniors without a complete review of how it works and what the side effects are. Seniors need to learn to ask the right questions of their doctors and pharmacists, or bring an advocate with them who can assist. Recently, a friend was told she needed cataract surgery. She began researching Medicare supplement plans to see if they or regular Medicare would be best. No one could tell her the actual cost of the surgery. There was the surgery center, the surgeon, the nurse and the anesthesiologist charges. There would be extra charges that no one was willing to give an estimate for. She finally gave up and stuck with basic Medicare.
Members of target groups (people of color, immigrants, and the poor) have a different experience of growing old in America. Emily Barnak, a physician’s assistant at Clinica, a low-cost healthcare provider, says, “My experience of aging clients is different from the mainstream of Boulder residents. I see a few really old clients, but most die much younger than the statistical average”. There is a huge mortality gap between the rich and the poor. Poor people live shorter lives. MIT researchers (Chetty, Stepner and, Abraham) have conducted a study showing that the richest 1 percent of men live 14.6 years longer than the poorest 1 percent. This was not a small study. It used income tax information from 1.4 billion people.
Maintaining your health by exercise and nutrition is really a no brainer. My cardiologist told me that if I went on a plant-based diet, I could eliminate most of my heart medications. Attention to diet is vital to healthy aging. Many things elders grew up on are not good for us. The ooey-gooey treats high in sugar and fat that entice us from the television screen are dangerous to our health.
Sedentary lifestyles increase all causes of mortality (WHO). Walking a half-hour a day can significantly improve your health. Exercise makes you feel good, improves mood, and makes you happy. Although it is not a guarantee of long life, an active old age is fulfilling. We are fully in the throes of active living communities, where past generations had senior homes.
“I hope I die before I get old” – The Who
Let’s talk about that pesky elephant – death. As one ages death becomes less of a concept and more of a reality. To worry about something inevitable seems counter-productive; to accept and plan for the inevitable seems sensible. People close to death and their families are active in changing public policies. They are demanding their rights.
The government tries to regulate our approach to death. Two examples are Right to Try laws and Right to Die Laws. Right to Try and Right to Die laws are controversial, to say the least. The Federal Right to Try Law allows terminally ill patients to request experimental drugs from pharmaceutical companies. It does not mandate companies to provide these drugs, doctors to prescribe them, or insurance companies to cover them. Colorado passed a similar law in 2014. Although touted by Donald Trump saying “a lot of people have been saved,” the FDA has no records of the number of people using the law.
The New York University School of Medicine cites less than 10 people using the Right to Try law to try to obtain treatment. 41 states have passed right-to-try laws. Critics say that the Federal and State laws give families false hope. The laws provide for less paperwork but give no guarantees. In several cases individuals have had to pay for treatment and have had difficulty getting manufacturers to allow access.
In contrast, in the five states reporting, 3,174 people have been prescribed Right to Die drugs. Only nine states have these laws on the books. In 2016 Colorado voters approved Proposition 106 (Access to Medical Aid in Dying). It amends Colorado statutes to include the Colorado End-of-Life Options Act. This allows eligible terminally ill individuals with less than 6 months to live to request and have administered medical aid in dying. It also allows physicians to prescribe these medications and provides penalties for tampering with the person’s request, including coercing a person to request the aid.
These two types of legislation appear to stem from the same theory of individual freedom and government interference in health decisions. One allows people an easier path in their attempt to live longer and more productive lives. The other allows people to make probably their most significant decision of when and how to die. In the era of COVID-19 it is becoming increasingly clear that a substantial portion of the population believes that any government interference with personal liberties is wrongheaded. Government decisions have a deep and lasting impact on how we lead our lives.
“When the Autumn weather turns leaves to flame, one hasn’t got time for the waiting game” – Willie Nelson
Graceful, meaningful, comfortable aging takes perseverance and a healthy ego. It takes the recognition that time is precious. Mind over matter begins to really mean something. During my youth, nobody talked about the realities of getting old. People just got older. Then they died. We really didn’t pay much attention. Now that we are aware of the pitfalls and pleasures of aging, we can do something about them. The keys to aging well are finding a higher purpose and dedicating yourself to it, understanding and planning for financial and health security, and making connections with positive people and the natural world. A simple prescription that should begin now, wherever you are on your path toward mortality.