Never Say Die

[Focus]

Almost done reading “Never Say Die: The Myth and Marketing of the New Old Age,” a very interesting but highly depressing book by Susan Jacoby. It’s got a definite political slant (left), which might bother some, but its myth-busting findings have some bearing on those of us who are planning to retire early or have already done so.

On the one hand, you might think it supports the view of most of us here that it’s best to pull the trigger as early as possible in order to enjoy as many remaining years of good health (mental and physical) as possible. Yet, it doesn’t buy into the idea that expenses are lower later in life and paints such a depressing financial picture that you might find yourself encouraged to work as long as possible.

Here are a few of the book’s main points, as I see them, with some quotes:

1. The idea that baby boomers will be able to make “90 the new 50” by eating right and staying physically and mentally active is bunk. “We cannot continue to base our image of old age on the extraordinary person, blessed by a combination of affluence and physiological hardiness, who remains ‘as sharp as a tack’ and takes up a new, youthful hobby – say, skydiving – in her nineties.”

2. The writer distinguishes between the “young old” (or “new old”) and the “old old.” The media like to focus on the young old and extrapolate their experience into the old old, but that’s not accurate. “In real old age, as opposed to fantasyland, most people who live beyond their mid-eighties can expect a period of extended frailty and disability before they die.” Alzheimer’s may only affect 10% of those over 65, but it affects nearly 50% of those over 85. Only 5% of Americans over 65 are confined to institutions, but after 85 the chances of ending up in a nursing home become 50-50.

3. If we succeed in lengthening life spans further through medical intervention, we’ll only be extending what is likely to be the most difficult and expensive period in a person’s life. “Longevity enthusiasts, especially in the boomer generation, never ask whether a longer life will necessarily be a gift; most are convinced that they can bend old age to their will through their own good behavior, reinforced by a little help from Big Pharma.” It’s a vain (in both senses of the word) hope. As is the idea that we'll die swiftly and gently in our sleep at home. “In the United States today, only about 20 percent of us die at home, although public opinion surveys repeatedly have shown that 90 percent of Americans – whether or not they subscribe to the hope of immortality – would prefer to end their lives in their own beds.”

Depressed yet? If you want to read more, here’s an excerpt from her preface.

 

[Silver]

This does sound like an interesting read. Thanks for posting. I read the preface and some of the reviews, and they peaked my interest even more. In the book, does the author attempt to make any suggestions for societal acceptance and practical changes related to end-of-life choices?

Betty Davis had it spot-on when she said "Growing old is not for sissys".

 

[MasterBlaster]

Yet, it doesn’t buy into the idea that expenses are lower later in life and paints such a depressing financial picture that you might find yourself encouraged to work as long as possible.

What is the reason to keep on working "as long as possible". Do they site inflation, higher taxes, and higher medical/senior care expenses ?

What (exactly) is the rational to keep working ?

 

[Sue]

This description of the quality of life after the mid-eighties is pretty similar to what I've observed in my own family. People live well into their 90's and even to 100, but they all seem to end up in nursing homes with horrible quality of life, i.e., blind and tied up in wheel chairs, bedridden with hip fractures, or having significant dementia. My mother escaped that fate. She lived independently until her mid nineties when almost complete loss of vision, hearing and onset of some significant dementia forced her to agree to an assisted living situtation. She was very unhappy with that decision. She died after a short illness before entering assisted living.

After observing all this, I've come to realize that the quality of life can become unacceptable after a certain age. It may not be possible to override the genetics of aging with nutrition, supplements and exercise. All the more reason to enjoy life to its fullest when you are healthy and pray for a quick exit when you are not.

 

[samclem]

After observing all this, I've come to realize that the quality of life can become unacceptable after a certain age.

But, apparently, one of the other things that changes with age is our perception of an "unacceptable" quality of life. Many of us who are young and spry look at frail old folks who can't do much and say "that's unacceptable--I'd never want to live like that." But, apparently, something changes as we get older, since these oldsters overwhelmingly choose to continue living. Despite the pain, aches, disability, cost, and diminution in what we can do, most of us will vote each day for one more day.

 

[REWahoo]

But, apparently, one of the other things that changes with age is our perception of an "unacceptable" quality of life. Many of us who are young and spry look at frail old folks who can't do much and say "that's unacceptable--I'd never want to live like that." But, apparently, something changes as we get older, since these oldsters overwhelmingly choose to continue living. Despite the pain, aches, disability, cost, and diminution in what we can do, most of us will vote each day for one more day.

+1

The will to live is a basic part of human nature. Those who think it will decline with age should spend some time talking with the elderly.

 

[Runner]

I truly don't understand the mindset of making retirement plans on the basis that I might live to be 97 (36 years from now in my case). In the first place, what the world in general and American society in particular are going to look like in 36 years is so uncertain that any attempt at planning seems to me to be futile. Secondly, the likelihood that I will live to be 97, or be in a condition to even care what my living circumstances are at that age, seems almost nil. I'm probably fitter than 98% of the people my age, but the only plan that makes sense to me is to aim at a horizon about ten years out (70-75), make sure I have enough to last that long, and then expand my planning in five-year increments if and when I approach the first horizon. If society has to figure out what to do with me when I'm a doddering, Alzheimer's-riddled 83-year-old, or if I have to pull the plug on myself before I'm unable to do so, so be it. But the whole idea of postponing the enjoyment of life now because I might run out of money when I'm 87 or 97 strikes me as quite weird and the sort of thing that would be promoted only by those who stand to gain if I keep working.

 

[Focus]

In the book, does the author attempt to make any suggestions for societal acceptance and practical changes related to end-of-life choices?

Yes, there's a whole chapter on this. A quote from it: "Let us be honest with the old, and with their relatives, about what can and cannot reasonably be expected from medical treatment near the end of life. Let us offer palliative care liberally in nonhospital settings, so that people who do not want to die hooked up to machines are not forced to do so. But let us also respect the wishes of the few old people who have had enough and want to end their own lives on their own terms. Let us not insult them by dismissing their justified fear of lingering too long as a mental disorder."

 

[Nords]

But let us also respect the wishes of the few old people who have had enough and want to end their own lives on their own terms. Let us not insult them by dismissing their justified fear of lingering too long as a mental disorder."

A whole book to say "Legalize euthanasia"? What are the authorities going to do to someone if they break the law by killing themselves?!?

I sure hope she doesn't ruin a good deal by calling undue attention to all the people who've already been stockpiling Percocet.

Or at least that's what my spouse blurted out...

 

[samclem]

But let us also respect the wishes of the few old people who have had enough and want to end their own lives on their own terms. Let us not insult them by dismissing their justified fear of lingering too long as a mental disorder."

Yes, this is all true, and it should be said. But it's not the most vexing issue, is it? What about :

But let us also respect the wishes of the [-]few[/-] old people who [-]have had enough and want to end their own lives on their own terms[/-] aren't ready to give up, who want to take advantage of technology to have a chance to keep living. Let us not insult them by dismissing their justified fear of [-]lingering too long[/-]giving up too soon as a mental disorder."

Of course--who pays the bill? If the entity paying the medical bill is also the one charged with convincing Granny to stop being selfish and throw in the towel, then we might have a conflict of interest here. It's probably better to dispense with all pretense of persuasion and just establish a hard policy that honestly tells everyone what resources they can expect to be able to use. Nothing personal--and if you don't like it or want to insure against the risk, that's a personal/family decision.

 

[Focus]

What is the reason to keep on working "as long as possible". Do they site inflation, higher taxes, and higher medical/senior care expenses ? What (exactly) is the rational to keep working ?

I'm not sure she's actually advising that everyone work as long as possible. I think it's more that she thinks it might be the only option for most people due to the need to count on the costs of an unhealthy old age, those costs continuing to go higher, the likelihood that boomers will have to pay a larger share of those costs than the elderly do now, the current younger generations' resistance to supporting older generations, the possibility of reduced Social Security benefits, the lack of retirement savings among boomers, etc. These last two are probably not so much of an issue for those belonging to this forum.

 

[Martha]

Does she address the issue that many people start taking social security at 62 and retire "early" because their health isn't good? There are two issues with working longer. One is the ability to work full time. The other is finding a job when you are older. Who was hurt in the jobless recovery? Older people who can't find work. As this article calls it, in your 50s you hit the "gray wall" of unemployment: Unemployment for 55 And Older Worse than National Average | Over 50 Website So, if you want to change jobs to a part time or other lower stress job there may very well be no jobs for you.

 

[Khan]

But, apparently, one of the other things that changes with age is our perception of an "unacceptable" quality of life. Many of us who are young and spry look at frail old folks who can't do much and say "that's unacceptable--I'd never want to live like that." But, apparently, something changes as we get older, since these oldsters overwhelmingly choose to continue living. Despite the pain, aches, disability, cost, and diminution in what we can do, most of us will vote each day for one more day.

Go right ahead.

Some of us are horrified of all that stuff and are trying to figure out how not to live too long.

 

[GregLee]

... but the only plan that makes sense to me is to aim at a horizon about ten years out (70-75), ...

70 may seem pretty old to you, but I'll be 69 in two weeks. It doesn't seem old to me. I'm still mentally and physically vigorous, so maybe you should revise that time horizon upwards a little, unless you're already sickly.

 

[DangerMouse]

70 may seem pretty old to you, but I'll be 69 in two weeks. It doesn't seem old to me. I'm still mentally and physically vigorous, so maybe you should revise that time horizon upwards a little, unless you're already sickly.

Problem with aging is the deterioration sets in quickly. My in-laws were quite spritely at 70. However, my MIL is 88 and can barely walk without a walker. Her hearing is all but gone, sight is terrible and memory is not what it used to be.

 

[GregLee]

Problem with aging is the deterioration sets in quickly. My in-laws were quite spritely at 70. However, my MIL is 88 and can barely walk without a walker. Her hearing is all but gone, sight is terrible and memory is not what it used to be.

Yes, I know, from watching my mother's rapid deterioration in old age, starting around 85 until her death at 89. Still 85 is substantially older than the 70-75 that was mentioned. And I think I have a shot at doing better than my mother's 85, because, though she did some things right, she never took any steps against osteoporosis or macular degeneration. At any rate, I sure am not planning on checking out in the next 6 years.

 

[Focus]

Still 85 is substantially older than the 70-75 that was mentioned.

Right. That's why one of Jacoby's main points is the need to distinguish between the "young old" and the very different "old old" (80s and above).

Does she address the issue that many people start taking social security at 62 and retire "early" because their health isn't good? There are two issues with working longer. One is the ability to work full time. The other is finding a job when you are older.

Yes. Another quote from the book: "There are people -- many, many people -- who need to retire because their bodies can no longer bear the strain of what they do for a living. We cannot 'fix' Social Security by deciding that all people ought to work into their seventies or eighties and if they can't, well, they must have done something wrong to be in such bad shape. ... The notion that all old people are capable of working longer -- much longer -- to earn their keep encourages procrastination about the difficult political decisions that must be made in order to preserve Social Security and Medicare for Americans living today as well as for generations yet unborn."

 

[haha]

Problem with aging is the deterioration sets in quickly. My in-laws were quite spritely at 70. However, my MIL is 88 and can barely walk without a walker. Her hearing is all but gone, sight is terrible and memory is not what it used to be.

But that is 18 years, a long time. The same time it takes to go from the womb to a full grown, battle ready sexually mature 18 year old. Or a unrealistic 18 year old to a 36 year old mother or father, holding down a job or 2 and caring for a family.

Ha

 

[DangerMouse]

True 18 years is a long time. However it has taken 18 years to get to the final results, the breakdown of bits and pieces commenced probably in the mid 70s, it was one thing after another and it leaves MIL at 88 living in a situation where she really is nothing more than a broken shell.

 

[haha]

I don't see a lot of choices. Look forward confidently, and plan on and prepare for a long life because you may get one; or make suicide plans. I know too many old men and women, currently and in the past who were relatively hale and hearty in their mid 80s, including my own father, my former FIL, and my maternal grandfather and paternal great grandfather, plus neighbors in my old neighborhood. My FIL is just starting to lose ground at 96, although he is still able to live with his wife in their same old house of the past 30 years, drive, go alone into downtown, etc.

The idea that one should spend early because that is the only time you will enjoy it is seriously off from several points of view.

Ha

 

[DAYDREAMER]

The movie "Logons Run" had a solution to the dying old issue. The philosophy of the movie (being exterminated at a young age) would help in many ways. We would never have to plan for retirment, we would not need long term care insurance. We would die healthy, and not be decrepid and we would die fast. Would also solve the social security issue, and most of the healthcare budgeting problems.

Crap, my palm button just turned red!!!!!

 

[Runner]

70 may seem pretty old to you, but I'll be 69 in two weeks. It doesn't seem old to me. I'm still mentally and physically vigorous, so maybe you should revise that time horizon upwards a little, unless you're already sickly.

No, actually quite the opposite -- I'm in a near-Olympic state of health and fitness at 61 and have been for many, many years. My statement is not based on 70 seeming old, or even 80 seeming particularly old. My statement is based on the fact that I believe that, in today's world, people who think they can project what the world will look like and the economy will look like more than ten years from now are living in a fantasy-land. If the world and the economy remain reasonably stable, I will be fine economically at 70 and will simply set a new horizon -- but I doubt very seriously that they will. I am by no means a survivalist wacko, but I would certainly give odds that the next 10-15 years will see near-cataclysmic changes that will make conventional retirement-planning assumptions look laughable.

 

[Focus]

For those who couldn't get enough of this thread, the New York Times just posted a review of the book.

 

[flyfishnevada]

1. The idea that baby boomers will be able to make “90 the new 50” by eating right and staying physically and mentally active is bunk. “We cannot continue to base our image of old age on the extraordinary person, blessed by a combination of affluence and physiological hardiness, who remains ‘as sharp as a tack’ and takes up a new, youthful hobby – say, skydiving – in her nineties.”

2. The writer distinguishes between the “young old” (or “new old”) and the “old old.” The media like to focus on the young old and extrapolate their experience into the old old, but that’s not accurate. “In real old age, as opposed to fantasyland, most people who live beyond their mid-eighties can expect a period of extended frailty and disability before they die.” Alzheimer’s may only affect 10% of those over 65, but it affects nearly 50% of those over 85. Only 5% of Americans over 65 are confined to institutions, but after 85 the chances of ending up in a nursing home become 50-50.

3. If we succeed in lengthening life spans further through medical intervention, we’ll only be extending what is likely to be the most difficult and expensive period in a person’s life. “Longevity enthusiasts, especially in the boomer generation, never ask whether a longer life will necessarily be a gift; most are convinced that they can bend old age to their will through their own good behavior, reinforced by a little help from Big Pharma.” It’s a vain (in both senses of the word) hope. As is the idea that we'll die swiftly and gently in our sleep at home. “In the United States today, only about 20 percent of us die at home, although public opinion surveys repeatedly have shown that 90 percent of Americans – whether or not they subscribe to the hope of immortality – would prefer to end their lives in their own beds.”

Sounds like there is a sweet spot, all things being equal, between 75 and 85 to kick the bucket. You're best years are behind you, but statistically the worst is yet to come. My plan of eating bacon morning noon and night once I hit about 70 and hoping for a massive heart attack around 80 isn't far off.

 

[Eagle43]

A comparison. My father died at 67; lay down at 1 pm and was declared dead by 4 pm. My mother currently resides in a nursing home, age 90, eats, takes medicine, will never walk again, and barely remembers me. I read part of that book in bookstore and currently have it on library reserve. The author is accurate, but damn negative and decidedly left-wing. I have a goal of living until 100, but not to live in the conditions I see every day in the nursing home. Absolutely no quality of life. BTW: My mother saw her mother in a nursing home and swore she would never spend one day in one. When you lose control, the game is over.