Shay Jacobson, RN, MA, NMG, LNCC, CNLCP
Martha Kern


Think of advanced age as a foreign country.

If we’re lucky, we will all eventually live there.  Many of our clients and loved ones have moved there and had remarkably mixed experiences.  And yet we tend to do very little to learn about this foreign land to which they’ve gone, and where we may also contend with mixed experiences.

What is it like in this strange place?  How can we understand those who have undergone this journey?  Are there things we can do now to improve our own experiences later?

Expectation versus Reality
A number of studies have been carried out to help gain insight into what we suspect advanced age might offer in terms of activity, expenses, and quality of life, and what the reality may, in fact, be.  Here are some of the more interesting findings:

  • Respondents between the ages of 19 and 29 say old age begins at 60. People aged 65 and older say it begins at 74.
  • Two-thirds of those over 75 report that they don’t feel “old”. Thirty percent of respondents between the ages of 65 and 74 say they feel 10-19 years younger than they actually are.  This may well fuel the overall denial of any need for care.
  • Respondents are prone to overestimating how long they will work. Only 27% expect to retire before age 64. Twenty-two percent expect to retire at 70 or later. In reality, a full 67% retire before 64 and only 9% continue to work at 70 and beyond.
  • Often, those retiring earlier than expected did so for health-related reasons (61%). Eighteen percent retired earlier than anticipated to be a caregiver for someone else.  The remainder retired earlier due to work-related reasons, such as downsizing or a change in the skills requirement for the job.  This clash of expectation and reality may be somewhat bruising to a senior’s sense of purpose and “belonging” in the world.
  • Sixty-five percent of respondents expect to work for pay after they retire from their main career. Only 27% were actually paid for work after retirement.  Part-time or reduced hours often translate to minimum wage jobs in retail or hospitality.
  • The retirement years may offer more expenses than are generally anticipated. Credit card debt and leisure spending were both 20% higher than respondents believed they would be.  Also showing a 25% increase over expectations were expenses related to “supporting others”.  Care is expensive, even when our clients provide the care themselves – being a caregiver and/or financial support to a disabled loved one often precludes work altogether.

The Company We Keep and the Care We Need
The past 30 years or so have seen a 50% increase in the number of mid-life adults who are single.  There has also been a 10% increase in the number of mid-life women who are childless.  As of 2010, 12.1 million seniors lived alone.  This number is expected to rise as 76 million Baby Boomers age into their senior years.  Few people contemplate the fact that they, too, may wind up alone and without support or companionship.

Social isolation is now recognized as a serious public health issue.  People who are “orphaned” or isolated in later life do less well across many measures.  They are likelier to struggle with activities of daily living, to experience cognitive decline, to be at risk for medical complications, mental illness and mobility issues.  Shockingly, the loneliest adults are nearly twice as likely to die within six years.

Many people assume their spouses and/or adult children will be available to help them.  One spouse will outlive the other in most instances, and it’s not at all uncommon to be geographically separated from adult children who are in the midst of their careers and unable to drop everything to tend to a parent’s needs.

Despite the inevitability of aging and the decline it can bring, only 37% of respondents believe they will need care in their senior years.  In reality, 69% will receive formal care.

How Can We Improve the Senior Experience?
Whether you are thinking of a client or loved one in the context of aging, or contemplating your own future, there are a number of ways we can help others (and ourselves) achieve better outcomes in the later chapters of life:

Talk about it.  Discuss concerns, possible challenges, and how to prepare for a number of contingencies.  A move to Arizona might help to eliminate the risks associated with cold, icy weather, but could relocating to a new place lead to social isolation?  Seek professional advice and then weigh the options with greater insight.

Start early.  If there are medical histories in the family that feature particular patterns, encourage routine medical care and preventative measures.  Urge your clients to develop a nest egg – having more financial resources typically leads to having more choices.

Forge, Renew and Maintain Social Connections.  As clients and loved ones age, help them establish connections and ties that will sustain them in the future. Having friends enables more activity and stimulation, and staves off depression.  It’s particularly useful to befriend younger people who are not only active and engaging, but who may be around and able to offer support in the years ahead.

Be interested and interesting.  Keeping up with the world and maintaining an outward focus help our clients stimulate their minds, sustain social connections, and generally be the kind of people others like to be around.  Assist them in finding people who share their interests, whether through clubs, park district classes or other community offerings that bring like-minded people together.

Name agents and tell them. Be assured that clients/family members have done their legal work and formally named agents under the Powers of Attorney (and successor agents) to make decisions for them should a medical reversal prevent them from making choices for themselves.  Urge them to inform their named agents they have been chosen, and to tell them how they want for them to act on their behalf.  If they have no one to name and/or no successor agent candidates, connect them with a company like Lifecare Innovations or another corporate entity that can act as agent for them.

Build a team. Explore the world of senior services and identify preferred types of facilities, caregiver companies, care management entities, attorneys, and financial advisors. Build a team of professionals to surround and support the client, even if nothing is needed just yet.  If the client is an “elder orphan” with no adult children, the team they choose will be essential in providing support and averting disaster should a medical calamity occur.

Find purpose. Seniors who have the ability to remain productive and engaged should seize every opportunity to do so.  Whether a part-time job, a hobby, a class or volunteer work, having a place to go and people to be with is vital to continued wellbeing and functionality.  Cognitive skills remain sharper when we use them, and social connection is pivotal to the avoidance of depression and postponement of decline.

Be optimistic.  Studies seem to show that expectation can create reality when it comes to aging. A focus on the positive elements of agedness (leisure time to spend with family, an appreciation of the smaller blessings in life, pursuit of hobbies and interests, etc.) will help generate a more positive experience.  We should speak of our abilities in a positive manner, and focus on those things we can do versus those we can’t.

Providing travel agency services to clients and loved ones embarking on the journey to older age could be one of the most valuable endeavors we undertake.  Help them study this foreign land, its customs, its challenges and its many choices and opportunities.  We shouldn’t travel unprepared and without the proper papers, and we most certainly should not travel alone.  It takes a team to manage the many facets of older life, and it is far better to choose one’s own team for this very personal trek.

Resources:

https://www.apa.org/pi/aging/lifespan.pdf

http://www.theretirementmanifesto.com/retirement-reality-vs-expectations/

http://www.timegoesby.net/weblog/2016/05/expectations-versus-reality-about-old-age.html

http://health.usnews.com/health-news/health-wellness/articles/2015/10/26/no-spouse-no-kids-no-caregiver-how-to-prepare-to-age-alone

http://www.seniors.gc.ca/eng/working/fptf/paip-cl.shtml

http://help4srs.org/seniortruth/?p=1222

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