Death wish for boomers & elders?

Reaching for the hemlock in order not to be a burden…. this seems a little farther than most of us want to go. But the idea is crossing more than a few aging minds, reports CNN intern Sachin Seth on a recent blog.

Rather than burden their children with the daunting task of caring for them as they age, some baby boomers may be considering an extreme form of “relief.” Suicide.

Psychiatrist Mark Goulston says he’s been approached by some middle-aged patients who say they’d rather “take a bottle of pills” than inconvenience their children.

Dr. Goulston blames the problem on the impatient nature of “millennials” – the offspring of baby boomers – a trait he says was passed down from the boomers themselves.

Adding to their angst is their own experience of taking care of elderly parents, which sometimes leads to feelings of resentment. Baby boomers don’t want their own children to grow to resent and begrudge them when they get old and feeble.

There’s a video exchange between Goulston and CNN’s Don Lemon that’s worth watching, but won’t lift your spirits much.

Add to this don’t-be-a-burden dilemma — and it IS a dilemma that crosses the mind of everyone over 60 and most folks who have a parent over 60 — the bizarre situation of estate taxes right now and the whole business of dying gets seriously complicated. It was okay last year, when you knew estate taxes were magically going to disappear on January 1, 2010, so the focus was on staying alive until then.

Moving Mom and Dad

The folks are getting on in years, the old house needs work, the Stuff is piling up everywhere — it’s time to look at moving. But the big question is, where to? Urban condo? Assisted living? Retirement village? LifeCare facility? Co-housing? Maybe even the dreaded Nursing home or dementia facility?

Making the decision to move into what is likely the last residence on this side of the hereafter can be daunting, sometimes devastating. Whether it involves oneself or one’s older family members, the Final Move often exhausts patience, finances and family resources. But good choices are out there, and good help (sometimes free, more often adding to the growing costs of this life event) can be found. In previous posts this space has offered glimpses of these choices and experiences: Helping Mom Die (10/16); Hanging in the ‘Hood (9/29); Justice Souter’s Retirement Housing (8/10.) What follows is a look into the LifeCare option. I should first insert a grateful nod to the source of this headline, a great book by Sarah Morse and Donna Quinn Robbins.

I have just returned from a visit with my sister Helen and her husband, newly installed in a spacious two-bedroom cottage at Kendal at Ithaca (NY), a Continuing Care Retirement Community. To do this necessitated cleaning out and selling (of course, the sale fell through when everything was on the moving vans, but last-minute calamity is to be expected) the far more spacious four-bedroom plus roof deck 1920s condominium in Boston they have called home for nearly 40 years. It was not pretty. Despite my earlier Boston visits to whittle down the Stuff factor and later urgings to connect Helen with the National Study Group on Chronic Disorganization, the job tested the limits of patience and strength of their four extraordinarily loving children.

Nonetheless the deed did get done, and Kendal at Ithaca is perfect for Helen and Clare, thanks to a confluence of happy circumstances: their physician daughter has relocated from Seattle to Ithaca; Manhattan is a comfortable Cornell bus trip away; desired features are in place. KAI includes a community center with a dining room in which their monthly fees entitle them to one meal per day, a fitness center, a large library, a van to take residents to doctors’ appointments etc. Best of all, says Clare, who has Parkinson’s, “they can’t throw me out.” The major appeal of LifeCare, or Continuing Care communities, for many seniors, is the inclusion of facilities for different levels of care which one may require in the future. (Worst of all, Clare adds, is the fact that “we have a lot of Parkinson’s, so I see myself 3 years down the road… 6 years down the road.”)

Continuing Care communities do not come cheap. But for seniors who have a chunk of change from a home sale or other source and a comfortable retirement income, they fortunately exist in growing numbers across the country.

For my own part, and I am certainly very senior, I was suffering anxieties and depression after one day. I need regular infusions of 30-somethings and 40-somethings for basic survival. Again, from what I’ve heard about co-housing — the perfect choice for many others as they age — that arrangement would feel crowded and disorderly. But there is the growing aging-in-place “Village” movement, which many would not choose but seems perfect to me.

Thank heaven for choices. It is seldom too early for Boomers, or Beyonders, to start considering them — and while you’re at it, you may want to clean out the attic.

Hanging in the 'hood – a good option for boomers and beyonders and the economy

Say you’re happy in your ‘hood. The sights are familiar, the neighbors are okay, the comfort level is high. Now say you’re 70-something or 80-something and you need a little help now and then, bringing in the papers, getting to doctors’ appointments, changing light bulbs. Do you really want to pull up roots and move to a totally new environment, re-learn where everything is, make new friends among people who never knew your children (or your parents)? The latter is being chosen every day for or by seniors in America; the former is spurring a movement with an interesting variety of formats under the general heading of Aging in Place. I really want an umbrella acronym for this category, but I don’t really want to be an AIP.

On her New Old Age blog for the New York Times a few days ago Paula Span wrote about her dad’s life in a NORC.

In my father’s apartment building in South Jersey, the older tenants start drifting into the small lobby each day around 1 p.m., taking up positions on chairs and couches. The ostensible reason: The mail is about to arrive. The real reason: They relish a chance to schmooze.

“There’s a lot of discussion about the economy,” Dad reports. “And what the president said about the police and that fellow in Massachusetts.” Lesser issues arise, too. Whose daughter is coming to visit. What is on sale at the ShopRite supermarket.

Twenty-five years ago, a University of Wisconsin professor coined a great term for this kind of residence. It is a naturally occurring retirement community, or NORC. The place wasn’t built for seniors; its tenants are all ages, infants through nonagenarians. But a substantial number of residents have been there long enough to grow old together.

Since he still drives, my father heads out each morning to buy the papers, which get passed from one apartment to another. (God forbid you should squander 50 cents for your own copy and read the headlines before suppertime.) He ferries friends to doctors’ appointments. He benefits, too: his pal Manny comes by several times a day to check on him, and neighbors stock his fridge with soup and strudel.

NORCs exist all over; probably half of Miami Beach, Fla., was a NORC at one time. Watching this little community cope with shopping and banking and constant medical visits, I have wondered why services can’t be brought to these residents. Wouldn’t it be more efficient to have a nurse visit weekly, instead of each person making a laborious trip to a doctor’s office? For the senior van to schedule regular excursions to ShopRite? For the high school orchestra to give concerts in the community room, since so few older residents go out after dark?

A number of NORCs do offer this kind of help. Twenty-five states have NORC supportive service programs, according to the queen of NORCs, Fredda Vladeck, who runs the United Hospital Fund’s Aging in Place Initiative. New York leads the list with 54 NORC programs operating in high-rises, garden apartment complexes and neighborhoods of single-family homes; Indiana comes in second. The common mission of the programs, Ms. Vladeck said, is “transforming communities into good places to grow old.”

NORC’s and their cousins the Village aging-in-place concepts are multiplying, but they’re nothing new. They’ve been around for more than a quarter of a century (if you discount the automatic NORCs that small towns and Native American communities offered in ancient America afforded. And they’re proven effective. “Numerous studies have documented the benefits and potential of NORCs, including a Senate report (PDF), a foundation grant report and a graduate thesis,” Span writes.

So why, after 25 years’ experience, are there not more support programs for the millions of older Americans already living in NORCs, and the millions more to come?

Ms. Vladeck, accustomed to lobbying and testifying and organizing, sounded philosophical. “It’s incubating,” she said. “Sometimes, innovation takes a long time.”

If you want to keep your parents out of nursing homes, or want to stay out of a nursing home yourself, learning about how these alternatives work isn’t a bad way to start the plan.  There may not be a long time left, at the rate America’s getting older.

When the Neighborhood Is the Retirement Village – The New Old Age Blog – NYTimes.com.

The Joys (and Angst) of Housing Choices

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What is it about the term “adult living” that seems so, well, one-foot-in-the-grave to me? Being surely one foot in the grave myself, if one chooses to look at actuarial tables which I do not, you’d think my opinionated mind might be pried slightly more open.

It’s a dilemma. Not whether one is polite and knowledgeable about adult living communities urban or suburban, but how to differentiate — and ultimately make choices among — the often bewildering assortment of housing communities and choices targeting everyone over 50 (and increasingly even below.)

I gave a talk at Rossmoor earlier today, a serene and bucolic adult living/retirement community about 25 miles and 40 degrees from San Francisco. This is no lie; it was 58 in the fog when I left home, 98 in the sun when I arrived. Rossmoor is full of recreational amenities: golf and tennis, choirs and bridge clubs and book groups. You cannot live there unless you are (or are formally attached to someone who is) 55 or older, and if you’re 18 or under you can’t hang around for more than 3 weeks. Rossmoor has its own mildly bewildering housing choices: congregate living, condos, co-ops and big houses on lush lots. It is ranked among the top such senior adult communities in the country and they are everywhere.

Add to these the growing varieties of aging-in-place groups (think Beacon Hill Village in Boston) and the truly bewildering assortment of assisted living facilities. The latter include simple rentals, detached cottages and elegant high rises; you can pay fixed or varying fees, or you can turn over your total estate (if it’s a large one) in return for a promise that you’ll be cared for in style throughout whatever infirmity or affliction arises and unto the grave.

Our friend Berta, widowed not many years ago, made the (possible) mistake of mentioning to her children that the responsibilities of maintaining her tidy, comfortable home were becoming onerous at times. This set off a frenzy of activity among her very active progeny, 3/4 of whom live in far-flung states. In addition to tackling the task of clearing out (“I had to grab a few things I wanted that were about to get thrown away…”) they came up with an assortment of possibilities for the mother whose comfort and well being they value above all else: condos and co-ops and a variety of retirement homes near their own homes, most at price tags more than daunting to someone who grew up in the Depression. Berta hopes to stay put. Most of us do, many of us can’t, and there’s the rub.