On Tuesday night Seth and I went to the John F. Kennedy Presidential Library and Museum for a presentation sponsored by UBS on Planning for Longevity: Aging and its financial implications. UBS developed the presentation in collaboration with Johns Hopkins and their Center for Innovative Care in Aging.
The hors-d’oeuvres and wine were excellent and the presentation was fascinating. Kathleen M. Pritchard, head of business development for Legg Mason Global Asset Management spoke knowledgeably and fluently about a subject that she knows from both a personal and professional perspective.
She was standing on a stage in Massachusetts but much of the audience sat in another state–the state of denial—until she explained how the real world works.
At the start Ms. Pritchard asked the audience how many people wanted to remain in their homes through their retirement and until “end of life.” A majority raised their hands. We were not among them, of course, having ditched the family house two years ago for a condo in a retirement community.
In the State of Denial
The State of Denial is populated by people who plan to remain active and mobile, in full possession of their faculties and engaged both mentally and physically with the world around them until they die suddenly—and happily—in their sleep. If only. Denial is a very comfortable state in which to live as long as the real world does not intrude.
The real world is, of course, a very different place that includes unpleasant illnesses like dementia, heart attack, stroke, and cancer. Also broken bones, glaucoma, osteoporosis, arthritis and other maladies that affect one’s visibility and mobility. These conditions require medical care as well as assistance with the daily tasks of living.
The flip side of planning to remain in your home is believing that your children will take care of you. When, however, Ms.Pritchard asked how many people wanted their children to bathe them and take them to the bathroom no hands went up.
In the State of Denial it is possible to say, “That won’t happen to me” and believe it. Ms. Pritchard pointed out that this attitude flies in the face of both common sense and experience. Often that experience with our own parental units is painful enough that the adult children say, as we did, “I’m not going to do this to my kids.”
Grey Gardens
I have never understood the desire to remain in one’s home no matter what. The term for this is “aging in place” and to me that sounds like being petrified. I would much rather be with people in a secure environment with lots of social interaction and activity. Give me Auntie Mame in Manhattan over Edie Beale in Grey Gardens any day.
You Can’t Go Home Again
My dad was different. We lived in the home where he grew up and he stayed there alone after Mom passed away. He had aortic stenosis, a condition he accepted in comfortable denial that it would truly have a real impact. When it began to affect his mobility and caused him to black out he opted for valve replacement surgery–years after he should have done it. Sometime during the operation he suffered a stroke. He went to sleep fully ambulatory and woke up with the left side of his body paralyzed. He spent the rest of his life in a wheelchair.
As he recovered Dad moved from hospital to rehabilitation center to nursing home but all he wanted was to return to the house in Somerset again. We knew that couldn’t happen because his house was not wheelchair accessible and could not be renovated to accommodate a wheelchair. This, however, was something Dad had to experience for himself. So one day we gathered two sons in law and three grandsons to take him home for a visit.
The house has no garage and there’s no sidewalk on the street. Together the five men hauled him and his chair out of the car and up the stairs into the house. It was a major effort. Once there he could not go into his bedroom because the doorway wasn’t wide enough. He also could not go to the bathroom because the hall was too narrow. And climbing over the bathtub for a shower would have been impossible. We spent some time in the house there and then the men hauled him out to the car. Once returned to the nursing home he had to face the reality that he would never go back to the house where he had grown up.
Eventually we moved Dad to an assisted living facility where he had a wheelchair-accessible unit and lots of company. The staff at Sunrise of Wayland took very good care of Dad but he continued to deteriorate, going into and out of a rehab facility until he finally passed away.
You see, there’s nothing neat and dignified about this process and sticking your head in the sand is not a strategy for dealing with it.
Plan Ahead
@LeggMason’s Ms. Pritchard went through the six housing options: aging in place, 55+ independent living community, continuing care retirement communities, assisted living facilities, skilled nursing facilities, and sub-acute rehabilitation. She discussed the requirements,benefits, drawbacks, and cost of each. Once again she asked the audience how many people still wanted to stay in their homes. No hands went up.
If you have thought about retirement, whether in the near or distant future, and how you’re going to deal with the housing component, do some research on Legg Mason’s Literature Library. Download the booklet on “Aging and Its Financial Implications: Planning for Housing.” It contains a wealth of information including options, tools and resources like worksheets and cost calculators, steps to take today and a list of references—websites that help with a wide variety of issues. Do the math yourself.
Ms. Pritchard concluded, appropriately, with a quote from John F. Kennedy: “The time to repair your roof is when the sun is shining.” President Kennedy never grew old enough to face these issues but most of us will. Make a plan when you’re able and functional and you won’t have to live unhappily in the State of Denial. Nor will your kids have to deal with the consequences.
Wow! This paints a rather dismal picture! I took care of both my parents and had help from hospice so their wishes could be met as much as possible. I believe there are alternatives available to help most folks live out their time here with dignity and loving care.
I am a hospice volunteer and take such joy in helping families as they cope with the difficulties of aging parents and spouses. It is a gift to be part of a person’s final days and know they are comfortable. Too many times I hear from friends whose families decide Mom or Dad can’t live alone anymore so they are relocated to a facility. Though their intentions are for what is best, often the parent is so distraught by the change they give up and die sooner than perhaps they would have had they been cared for by family. I think we need to rethink family and aging in general. All these “alternatives” were not available to previous generations and families managed.
Martha: you have done great work with hospice care and I admire it tremendously. They key is planning, based on knowledge, instead of just waiting and hoping that everything will turn out all right. Your parents were lucky to have you to care for them and you were fortunate to have hospice to support you. Not everyone has either or both. Our experience with assisted living for both my dad and my mother in law was just the opposite of what you describe. They were happy to be in a place where they were well cared for, where they weren’t a burden to their children, and where they had company around them. My mother in law had a short orientation period in which her Alzheimer’s grew worse but after that she got much better knowing that she was safe and cared for. Tuesday’s speaker had exactly the same experience: a mother who fought going into assisted living and then loved being with other people. Assisted living is very different from a nursing home. I’ve told my kids that, when it’s time for me to move into one, just say the word and I’m ready to go.