Tag: seniors

General interest/Health/Politics & Causes/USA
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Justice Souter's Retirement Housing

by Fran Johns

It turns out not even Supreme Court justices are exempt from the dilemmas of senior housing. Too many steps? Too many books? What’s a retiree to do?

When he retired from the Supreme Court in June, it was expected that Justice David H. Souter would return to his beloved family farmhouse in Weare, N.H., a rustic abode with peeling brown paint, rotting beams and plenty of the solitude he desired. While the new home is only eight miles from his rustic farmhouse, the two could be worlds apart.

But Justice Souter, an individualist on and off the bench, decided to move.

On July 30, he bought a 3,448-square-foot Cape Cod-style home in neighboring Hopkinton listed at $549,000. The single-floor home, for which he paid a reported $510,000, sits on 2.36 well-manicured acres.

This is not going to work for the downsizers who don’t have access to a cheap, reliable lawn service. But it’s easy to pinpoint a few of Justice Souter’s upgrades in the downsize:

The farmhouse has no phone lines; the Hopkinton house has “multiple,” according to the real estate listing. The farmhouse’s lawn was spotted with brown; the Hopkinton house has a verdant lawn and neatly trimmed hedges. And for Justice Souter, 69, who is known to be a fitness buff, there is a home gym as well as a spa bath.

Or, he can just mow his own lawn. The core issue, however, is closer to those reported by hundreds who are opting for retirement apartments, urban condos and other housing choices mentioned in earlier columns.

Justice Souter told a Weare neighbor, Jimmy Gilman, that the two-story farmhouse was not structurally sound enough to support the thousands of books he owns, according to The Concord Monitor, and that he wished to live on one level.

Perhaps Justice Sotomayor will want to keep a lid on her library shelves.

Off the Bench, Souter Leaves Farmhouse Behind – NYTimes.com.

Health/Money/Politics & Causes
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Can We Hear It for Truth-Telling?

by Fran Johns

Although the They’re going to kill the grannies! campaign continues, some heavyweight voices of sanity are being heard above the roar. Sojourners founder/author/activist Jim Wallis weighed in Friday with a few choice words of wisdom:

I have said that one important moral principle for the health care debate is truth-telling. For decades, the physical health and well-being of our country has been a proxy battle for partisan politics. Industry interests and partisan fighting are once again threatening the current opportunity for a public dialogue about what is best for our health-care system. What we need is an honest and fair debate with good information, not sabotage of reform with half-truths and misinformation.

Yet in recent weeks, conservative radio ads have claimed that health-care reform will kill the elderly (it won’t), that it will include federal funding for abortion (it doesn’t), and that it is a socialist takeover of the health-care system (it isn’t). The organizations promoting these claims, including some Religious Right groups, are either badly misinformed, or they are deliberately distorting reality.

I think it’s all of the above. But what’s particularly frightening is the number of people who, hearing these messages over and over, are passing them along as presumed truth. My Inbox is having some dark days thanks to conservative friends wanting to know if I’m aware of one untruth or another. Because I have some conservative friends I like and respect, I try to listen, understand their points of view and keep lines of communication open — but it’s getting hard. Wallis cites one reason why:

A particularly egregious example is an ad that the Family Research Council has run in selected states. It depicts an elderly man and his wife sitting at their kitchen table. He turns to his wife and says, “They won’t pay for my surgery. What are we going to do?” He continues, “and to think that Planned Parenthood is included in the government-run health care plan and spending tax dollars on abortion. They won’t pay for my surgery, but we’re forced to pay for abortion.”

These kinds of ads should be stopped. They do not contribute to the debate that is needed to ensure that all Americans have access to quality, affordable health care. It is rather exactly the kind of misinformation campaign that could destroy needed reform.

It’s going to be a long, hard August.

Jim Wallis: Truth-telling and Responsibility in Health Care.

General interest/Health/Money/Politics & Causes/USA
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Ethical dilemmas for one and all

by Fran Johns

In case you don’t have enough medical/political/ethical dilemmas on your plate, William Saletan tossed out a hefty bunch, in last Sunday’s New York Times Book Review, to chew on:

The most powerful revolutions of our age aren’t happening in Washington, the Muslim world or the global economy. They’re happening in science and technology. At a pace our ancestors couldn’t have imagined, we’re decoding, replicating and transforming the human body. These revolutions are changing how we live, what we think and who we are.

Bodies used to be unalterably separate. Yours was yours; mine was mine. That isn’t true anymore. Organ transplantation has made human parts interchangeable. Thanks to aging and obesity, global demand for kidneys and liver tissue is increasing. Meanwhile, anti-rejection drugs and other innovations have turned more and more of us into potential donors. But supply isn’t keeping up with demand, so doctors, patients and governments are becoming more aggressive. Death is being declared more quickly so organs can be harvested. Rich people are buying kidneys from poor people. Governments are trying financial inducements to encourage donation. The latest proposals, outlined in Sally Satel’s “When Altruism Isn’t Enough: The Case for Compensating Kidney Donors” (2008), include tax credits, tuition vouchers and cash. As pressure grows from the left through socialized medicine, and from the right through free markets, organs will increasingly be treated either as a commodity or as a community resource.

The one that catches my eye (see Looking at One’s Own End-of-Life Choices, 7/30; Palliative Care: Rush Limbaugh vs the Grannies, 7/24, and a slew of other recent posts) is confronted in a reasonable, head-on fashion.

Beyond transplantation and mechanization looms the broader question of longevity. Over the last half-century, the age a 65-year-old American could expect to reach has increased by one year per decade. In 1960, it was 79. Today, it’s 84. Life expectancy at birth has passed 78 in the United States and 83 in Japan. We have no idea where these trends will end. It’s been just six years since we decoded the first human genome and less than two years since we learned how to make adult cells embryonic.

The cost of caring for old people will be enormous, but that’s just the beginning. We’re fixing and replacing worn-out body parts for older and older patients. How much life do we owe them?

The long-run solution, outlined by Robert N. Butler in “The Longevity Revolution” (2008), is to treat longer life as a resource, not just a goal. That means exploiting its benefits, like wisdom and equanimity, while focusing medicine and lifestyle changes on extending health and productivity rather than dragging out the last bedridden months.

It is well past time for us to stop looking at prolongation of life, regardless of quality, as the be-all-and-end-all of health care. Religious groups, right-wing factions and assorted others are screaming that even coverage of honest conversation with one’s physician about prognosis, treatment and options is going to shove people into early graves. But conversations of such sort, and civil discourse in general, are desperately needed.

OK, according to the above statistics this writer still has eight years before my projected demise; but I am definitely one of the grannies Mr. Limbaugh and his ilk profess to be protecting. Thanks very much; rather than drawn-out bed-ridden months I will take wisdom and equanimity any day, if our health care reformists will please focus on addressing health and productivity for all ages. Problem is, the voices of “protection” are drowning out the voices of reason. Which makes this not just a dilemma but a potential national tragedy.

Crossroads – You – The Updated Owner’s Manual – NYTimes.com.

General interest
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Brain Fitness: The New Best Thing

by Fran Johns

At a program on Assistive Technology for Seniors sponsored by the Commonwealth Club of California yesterday, four panelists at least one generation away from 50 themselves discussed the technological wonders being perfected by their contemporaries for the likes of boomers and beyonders. (Devices that tell your children across the country how many times you open the refrigerator; nifty machines to compute and address your every need…) But for some of us, the handsome twenty-something geek talking about brain fitness made the most newly-revealed sense. OK, maybe he’s 30-something, but not very something if so.

“Exercising your brain in very specific ways,” said Eric Mann, Vice President of Marketing for Posit Science, ” will be recognized within the years ahead as just as important as cardiovascular exercise.” The brain is not an organ condemned to progressive deterioration, he explained, but something evolving every day. Pointing out that mind and body are the two assets with which everyone comes equipped, Mann urged his largely gray-haired audience to understand that both need to be maximized through ongoing exercise.

To that end, his company has thus far created programs titled Brain Fitness, DriveSharp (brain/foot/hand fitness?) and InSight.

The program went back and forth between those sorts of brain-governed assists for our rapidly aging population — the percentage of Americans over 65 increases every day — to the computer-assisted living which is coming, ready-or-not, onto the scene. In what would surely have been proclaimed la-la land a decade or two ago, assistive technologies at one’s fingertips already include personal emergency response systems (esthetically improved over the “Help! I’ve fallen and I can’t get up!” necklace, cell phones with a button that alerts your five first choices), medication management systems (electronic pillboxes that do everything but pop the right dosage into your mouth) and senior-friendly e-mail options for the internet-averse.

The thought of all that technological wonder was enough to induce brain-weariness in some audience members who occasionally wish they had the “Number, please” telephone lady back. But because such an attitude might fall into a category Mr. Mann referenced in passing as  “maladaptive compensatory behavior,” most went home willing to hear it all as good news. And to ramp up the exercising of their brains.

More on those technological wonders in a following blog.

General interest/Health/Money
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Affordable Health Reform

by Fran Johns

It was actually spoken out loud on NewsHour Friday night: we could have a workable, affordable healthcare system if we would address the excessive costs that go into the last six months of life, particularly the last few days. The remark was immediately followed by the standard caveat: of course, no one is going to suggest doing this.

Good grief, why not? Everybody knows it, a few others have even said it out loud. Sure, it’s political suicide, but if someone were ever brave enough to fall on that particular sword there would be a lot of people around to pull out the sword, cleanse the wound and stand him or her back upright.

It could be done. If individual choice were encouraged and enabled. If physicians had to be honest about the quality of life (if any, usually for a few days or weeks) being bought with aggressive treatment at life’s end. If futile treatment were avoided. If protections were put in place for physicians and hospitals complying with the above, since fear of lawsuit is behind most of the mess. If all of us began to look at — and make clear — what extreme measures we would or would not want.

Big ifs. But the reward would be a workable, affordable system.

General interest
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Sir Edward's Choice

by Fran Johns

It is ironic that while some of us were offering mostly light-hearted comments about how we might choose to die, news circulated  that  Great Britain’s reknowned conductor Sir Edward Downes and his wife had just made that very real decision for themselves.

Sir Edward and his wife Joan, a ballerina before she gave up her own career in support of his and of their family, flew to a Swiss clinic sponsored by the Dignitas organization with their two grown children to end their lives together. He was 85, almost blind and losing his hearing; she was in the final stages of terminal cancer.

I strongly support the right of terminally ill, mentally comptetent adults to hasten their own death. While there is a very distinct line between hastened dying for the terminally ill and “suicide,” it would seem almost cruel to criticize Sir Edward’s choice. And the key word is choice.

What most of us would choose is precisely what Sir Edward and his wife did indeed have: a swift, peaceful end with loved ones at the bedside. Few of us would choose what actually happens too often in the U.S.: prolonged pain and indignity, often a death that follows extended, expensive, frequently futile treatment, in circumstances we would never have chosen for ourselves.

Physician aid in dying, now legal in Oregon and Washington, is one good way to put rational choice back in the hands of mentally competent adults.  The Oregon law has been in effect for over a decade and has proven that such legislation works. It offers comfort and compassion and has not been abused. Efforts to extend this humane law into other states have been vigorously fought by religious groups, but end-of-life choice is just as much a right as is reproductive choice; like other individual rights, it will eventually come.

Given the enormous financial cost of the universal healthcare system most of us want, and the enormous human cost of futile end-of-life treatments and denial of physician aid to terminally ill adults, the time has come for serious dialogue about the right to die.

Sir Edward Downes left a remarkable legacy in his music. A very private man throughout his long life, he nonetheless left another admirable legacy in his poignant death. Maybe those of us over here in the colonies can learn something. Maybe we could at least honor him with a little civilized discourse.

Health/Money
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The Joys (and Angst) of Housing Choices

by Fran Johns
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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.

General interest
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On Getting Started, and Re-started…

by Fran Johns

Front pages of the two east coast newspapers that arrive on our west coast doorstep every morning featured references to a few of the primary issues this column proposes to address: staying active and upbeat while confronting one’s mortality; the multiplicity of housing shifts in late generations; and whether one’s life experiences lead to rigidity or understanding.

 

Even the front page of today’s True/Slant, in Scott Bowen’s innovative take on Boston Globe books and publishing writer David Mehegan’s Over and Out, takes up the end-of-life choices question which has consumed much of my time and energies over the past decade and which I tackled (albeit anecdotally) in a 1999 book, Dying Unafraid.

 

Now. If life experience can be applied to mastery of T/S’s technological tools – which are not, after all, quite so daunting as the above – it will be great joy for Boomers &Beyond to explore these through headline grabs, riffs and commentaries and perhaps some lively reader responses. Stay tuned.

 

 

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