Pope Benedict delivered an important message today: There comes a time for most of us when our bodies and minds weaken and we must change the way we live our lives. As with the Pontiff, it may mean giving up a demanding job. But for others, it may mean much more: Getting help with those activities we once took for granted.
This does not mean giving up life, of course. For many elders, retiring from a day job makes time for new interests and challenges. In our culture, that’s a choice that is made more acceptable by age (if you leave your job at 40, you’re a deadbeat or going through a mid-life crisis. If you leave at 70, you’re retiring).
And entire industries have grown up around the idea of productive aging, the third age, or all the other marketing euphemisms out there. Dr. Bill Thomas has a nice perspective on the choices we can make as elders.
But for most of us, the time will come when we need more help with life than we’ve been used to. For those elders suffering from chronic diseases, independence slowly takes on a new, and more limited, meaning.
As with Benedict, who is 85, this often happens in our 80s. On average, men at about 80 will face a year and a half of severe disability. Women can expect about three years of severe disability starting at about 82.
It is that period when many of us will need long-term services or supports. It may be help bathing or dressing, cooking or going to the doctor. And it may require the assistance of a family member or a paid aide, or perhaps require a move to a residential care facility or even a nursing home.
Two-thirds of those 65 or older will need some assistance before they die, according to a landmark 2005 study by Peter Kemper, Harriet Komisar, and Lisa Alecxih. One-third will need it for a year or two, but one out of five will require care for five years or more. Half of those 65 or older will spend no money on personal care, though that is often thanks to the help they get from family members who may make substantial personal and financial sacrifices. But one in six will need to set aside more than $100,000 (present value of 2005 dollars) for long-term care.
Pope Benedict will get the help he needs. But many of us will not have the resources for this care. We don’t have the community surrounding us that the Pope enjoys. Increasingly, we don’t have children, or our children live at a distance or are estranged. Few of us have the money to purchase aid. Half of Americans age 65-74 have financial assets of less than $65,000, though they’ll need nearly twice that on average just to pay for medical care in old age.
We think that Medicare will pay for our long-term care, but it won’t. Medicaid, which does pay (if you are impoverished and very frail), is under enormous financial stress. And private long-term care insurance is expensive and increasingly difficult to buy.
Thanks to Pope Benedict for reminding us that while old age can bring great joy, it can also bring frailty. With good diet and exercise, we may be able to delay the day disability comes, but short of sudden death we can’t stop it.
We can prepare for it though. And Benedict’s story is a reminder that we need to–as individuals, families, communities, and as a society.