Ken Dychtwald, Age Power, 1999.

List of questions on page xvii-xviii sets a tone and should hook readers.

Although most Americans have ignored elders in the last few decades, we’re about to be engulfed by them – a new social paradigm.

Certain: we’ll live longer, assume economic and political power, have to change ideas about how to spend the extra years, and it will be the biggest challenge we’ve faced personally.

Modern industrial nations’ fertility rates a dropping so that growth is mostly dependent on immigrants. [JR: maybe GAIA is controlling damage to her ecosystems by having the most damaging folks reproduce the least.]

When Old Was In

Colonial times: aged were "elect; powerful through bequeathing the land"; fashion leaders (gray wigs and wide hipped gowns).

But industrialism favored the young and mobile and strong, and experience and wisdom were less valuable. Germ theory helped extended life expectation. Fashions shifted to thin and energetic, see the flappers (1^st generation of this).

Elders got poor: 30% in poverty in 1930.

Reversal of Fortune: Elders’ Growing Financial Power

Aug. 14, 1935 – Social Security act passed; and underdogs are becoming bulldogs. Much details on how much $$$ elders now control.

Also elders are growing in political influence, because nearly 70% >65 vote (vs. 30% under 20).

A long screed on AARP – its wealth and its power: with 33 million members it’s twice the size of any other such organization.

The Longevity Revolution: A Long Time Coming

Various ways to extend and enhance life, through history:

Taoist practices; alchemy; promoting hygiene; semen and animal testicle implants

Modern Approaches

Predicted Anti-aging Sciences:

Super nutrition – few calories and rich nutrients the ONLY proven life extender: nutraceutricals; phytochemicals and micronutrients that occur naturally and often killed by food processing;

Hormone Replacement: estrogen; testosterone; melatonin and DHEA; human growth hormone – but we don’t know the potential side-effects of any of these

Gene Therapy and the Manipulation of Cellular Aging

"telomeres" may help cells double the number of divisions they can do before wearing out – risks unknown

Bionics: Toward Cyborg Humans

From dumb (Teflon hips) to smart bionics (nanotech etc.)

Cyborg limbs: already developing prosthetics that can sense, feel, adapt

Bionic hearts, lungs, and other organs – the new thumb sized Jarvik 2000 heart

Cyborg sight and sound:

Bio-orchestrators – implantable health monitors

Organ Cloning and Other Novel Approaches to Spare Parts

Chimera parts – transgenic pigs bred for parts (but new viral epidemics?)

Human organ cloning

Enhanced humans – volunteer experimental subjects looking for longer and prettier and younger

The boomers will be a tsunami age wave.

Boom times: boomers parents thought duty before pleasure, but gave the boomers all the advantages and stuff they could. Proliferation of products for the emerging boomers – diapers, toys, TV sets (which shaped the consciousness of the new generation – they saw diversity of lifestyles [??])

New neighborhoods, new schools – public system unprepared for all the new students. Blue jeans transformed fashion. R&R became teen-agers music (and rebellion)

The times they were a-changing—boomers knew they were young, free and in charge. Number of college students tripled 1965-75. As they moved into adulthood in the 70s, issues of self-discovery, self-esteem and experimentation dominated society and the market place.

Trading love beads for stock options: they overwhelmed the housing market, birthed the echo boom and focused on careers and families

Is there life After Youth?

Family life: front and center: now 75% boomers say equal marriage better than traditional model. They’re transforming traditional roles.

Dual income families: 85% of all boomers have jobs. Rising salaries lave led to investing by many. One expert says they’ll drive the Dow to 21,500 by 2010 or so.

Like a Pig moving through a python: list of institutions they’ve transformed on page 69. While the group has been powerful, individuals have faced increased competition for housing, school seats, etc.

The Emerging "Silver" Market

As boomers age, five factors will reshape supply and demand:

1. Desire to postpone physical aging
2. Increasing amounts of discretionary dollars
3. New adult lifestyles and stages (JR see Sheehy)
4. Desire to buy good experiences
5. Absence of disposable time due to complex lifestyles

50 Major areas of change (a 50 trends like list)

Healthcare

Anti-aging/Human enhancement

Technology

Financial services

Work/leisure

Lifestyle support

Housing/transportation

Death and dying

The Baby Boom Was Born to Become an Age Wave

We’re not prepared for them to get old. Record taxes boomers now pay is giving today’s elders a robust boost. But when boomers get old, there won’t be such a crowd to support them.

The Five Social Train Wrecks We Need to Prevent

(subsequent chapters on these are coming)

1. Using 65 as marker of old age – life expectancy is now 76 and dependency ratio today is 3.3 to 1.
2. Epidemics unless we reform healthcare skills and priorities
3. A caregiving crunch – average 21^st century American will spend more time caring for parents than for children
4. Boomers headed for poverty in old age
5. Will need a new purpose for old age (now 40 million retirees average 43 hours a week watching TV) where’s the meaning?

65 as gateway to old age no longer makes sense. (arbitrarily set by Bismarck in 1881 when establishing his social security system)

From 60s, it now takes about 10 more years to grow up: young adulthood now more like 18 to 40.

Adolescence as term invented 1904. Prior to then there was no such stage. Then in 1940s Eirkson promoted young adulthood as a stage. Now we’re seeing middlescence emerge -- 40 to 60 -- as a period of growth and ascension, not retreat and decline.Boomers beginning to accept revised versions of success, scaled down American dream. But boomers middle years will be good, involved, reflective.

In 1965, 57% folks over 55 worked. Today, it’s 38%. 70 opt for Social Seccrity before 65.

Adjusting: Four solutions

1. Unhinge old age from the obsolete marker of 65 and index entitlements to rising longevity

The problem is demographic, but politicians cast it as political: seniors fear being cut off somehow.

So we need to decide what % is a reasonable time for retirement (if life expectancy is 80, 10% retirement places the age at 72.)

2. Let people choose to retire when they are ready and can afford to, instead of holding everyone to uniform standards

Prior to 20^th century, retirement didn’t exist. Now 70% Americans see good retirement as part of American dream. But if life expectancy continues to rise, only a small fraction of boomers can afford to retire as young as their parents did.

"Boomerangers" [Monsanto] retire for a few months, then bounce back often with limited and lighter responsibilities. Don’t need training, thus cheaper than temps.]

 

 

 

 

 

 

3. Smash the "silver ceiling" and make it easier for people to pursue meaningful employment in maturity

Age discrimination is pervasive though illegal. But now

1. we have skilled worker shortage
2. older people are healthier than ever before, and youthful strength is less important than knowledge and maturity
3. the portion of life spent working has plummeted and may bneed to be readjusted.
4. Replace the "linear" life pattern with a new "cyclic" one

We will cycle in and out of several careers, interspersed with periods of rest, reflection and retraining. Formal sabbaticals and informal work-leaves.

Adult ed and non-trad students increasing and thriving. 22% of all college students are 35 or older.

1. Plan to live very long, 80-90 years and take steps to guarantee intellectual and social stimulation you’ll want.
2. Adjust psychologically to a cyclic life plan
3. Envision new career goals and challenges
4. Prepare to reinvent yourself several times in adulthood.

Today’s average adult will spend 10% of his life sick.

1960: healthcare expenditures 5.2% GNP; in 1996 13.6%. At that pace, 2020 it will be 31.5% unsustainable.

USA is 35^th in life expectancy in industrial world.

Most of our research and resources go into curing, not prevention. Doctors and nurses aren’t trained in geriatrics. 80% of 65+ population have one or more chronic diseases.

Alzheimer’s: elderly AIDS. 25-30% of those over 80 have it; 47% of over 85. Average duration of Alzeimer’s before death is now 8-10 years, and can easily double. If could postpone onset, could reduce cases by 50%

Five part solution:

1. Promote research needed to delay or eliminate the diseases of aging.

Much promising research is going on.

Over 65 use one-third of healthcare costs -- $342 Billion. Yet today’s seniors want tax dollars applied to today, not to prevention. Politicians therefore votes for the short term fix because seniors vote.

2. Needed: Aging-ready healthcare professionals

Millions of mistakes every day because physicians don’t know about geriatrics. Less than 2% are trained in it.

Yet average professional will spend 50% time with mature patients.

AMA, AARP etc. should require professionals to acquire geriatric competence.

3. Make disease prevention and self-care a national priority

Some boomers are responding, but most of us should do what we know we should do.

4. Orient economic incentives toward health aging.

Current system offers economic incentives for disease.

Early HMOs had two goals:

a.better manage healthcare costs

b.provide doctors and medical institutions with incentives to keep patients healthy.

We’ve done ok with the first, but awful with the 2d.

5. A humane approach to death

Medicare spends 28% of budget on patients in their last year of life. Hospice, right to die issues are important.

Tips to age proof your life:

1. Make sure your primary care physician has geriatric training
2. Buy insurance from companies committed to preventive medicine and wellness programs
3. Take responsibility for your own health
4. Create a living will

The sandwich problem: caring for kids and parents at the same time. Now more than 22 million households avtively provide some kind of eldercare, 3X a decade ago. 80% of all long term care is by family and frieds outside of hospitals and nursing homes.

If this trend continues, with associated responsibilities, sacrifices and suffering, it could become the economic sinkhole of the 21^st century.

1. Increasing longevity of the chronically ill

Co-morbidities: multiple chronic conditions increasing

Estimate: 2040 5.5M in nursing homes and 12M needing ongoing homecare

2. Worsening strain on sandwiched generations

Average boomers have more parents than children (counting both of a couple) and will spend more time caring for parents than for children. And will have fewer kids to care for them in their old age.

Burden falls more on women. 1999 only 4% of fo;lks over 65 lived with an adult child (40% in 1960).

As eldercare increases, many "unresolved issues" will flare up to add to the strains.

3. Insufficient financing for long-term care

1995: $470B spent on medical services for chronic conditions, mostly folks over 65. 76%, $360B, went to nursing homes, but only 5% (2M) of elderly are in such homes.

Medicare doesn’t pay for nursing homes (20 days, skilled care). But anyone who wants to run the scam, with a lawyer, can now get Medicaid for nursing homes (but govt must close loopholes).

Neither of the federal programs – Medicare or Medicaid- are anything like a solution for long-term care mostly because of institutional biases, that cost more than homecare. 1999 nursing homes averaged $3200 monthly.

4. The absence of integrated, accessible long-term care services

available services are confusing, fragmented and hard to obtain. Of those with long-term needs 47% don’t know what they’re eligible for, 38% don’t know who provides the services, and 30% found services confusing or inaccessible.

5. The premature death of men

Women outlive men by about 10 years, leaving lots of women alone and less likely to remarry and more likely to need help

1. Finance long-term care through private pay insurance or reverse mortgages

Most believe wrongly that Medicare will cover long-term costs. Look for a boom in long-term care insurance (LTC) based now on fear of living too long. Many proposals now floating around, but nothing in place yet.

2. Establish new eldercare-oriented employee benefits

Such programs are now barely on the screen, though analogous to childcare in the 70s. Studies show it pays off for companies in productivity and fewer absences.

3. Expand and integrate long-term care programs and services

Socialized countries like Denmark and Sweden have effective programs.

We don’t, though many pieces are in place.

 

 

 

 

 

 

 

4. Develop health-related "affirmative action" programs for men

If men live longer, couples can care for each other. Probably men’s self-consciousness that prevents them from getting adequate help for helath problems.

1. increase research into physical and psychological factors that influence male mortality
2. increase education on men’s issues (like prostate cancer)
3. motivate men to take better care of themselves
4. encourage docs and insurance companies to be more responsive to men’s needs and styles of communication
5. enlist public figures to help raise awareness

1. Talk with your parents about their preparedness, and take steps..
2. Expect to need long-term care and find good insurance for it
3. Familiarize yourself with services in your and your parents’ communities before you need them
4. Focus on your men’s health especially

Excluding pension contributions, UA average savings rate is 1-2%, negligible.

If the current trend continues, 1/3boomers will do fine,1/3 will have to work 5 more years to retire ok, and 1/3 (mostly female) will have little or nothing to retire on ever. (And don’t forget healthcare expenses). Money from top 2/3 will have to be diverted to save the bottom 1/3.

1. Economics of old-age entitlements just don’t add up

2010-2030 65+ population will increase 75%, tax-paying population by only 5%. Without corrective action, SS trust funds will be depleted by 2029 and revenues will provide on 70-77% of benefits.

Ratio of workers to retirees today is only 3.3; by 2040 projections show it at 1.6-2 to 1.

FICA today: 12.4% of first $72,600 plus 2.9% of all wages for medicare.

If both members of a couple max out, their Social Security tax is $18,000.

Current plan is a pyramid scheme, and gov’t uses proceeds to finance deficit spending. But pyramids require continual stream of new players, and that won’t happen.

2. Many boomers are in state of financial paralysis

Most boomers know only a little about finance, and nothng about the entitlements. But 90% think gov’t won’t be able to keep its financial promises.

1. Increase personal savings rates

18% disposable income now goes to debt service in US. Average boomer carries $4000 in unsecured debt. 1.1M declare bankruptcy each year, but we let credit card companies continue to seduce folks.

Tax support for college is likely to decrease given other pressures on gov’t money.

We need "massive, multiyear public education campaign to get folks to save, to act sensibly.

2. Make pensions more portable and flexible to match boomers’ mobile lifestyles.

Pensions are increasingly irrelevant for 4 reasons:

1. about half of all workers aren’t covered (53M)
2. shift from defined benefits to defined contribution plans makes employees’ mistakes costly
3. vesting hurdles and absence of pension portability – most vesting is 5-10 years, but average boomer changes jobs every 3 or 4 years
4. 401k leakage: 40% workers offered 401k and 30% participate, but millions divert the funds for immediate needs. Many countries have promising models and US should check them out: Australia, Chile, Switzerland

1. Affluence-test and target entitlements to match the diverse needs of tomorrow’s elders

¾ to 1M elders are now millionaires

1997: $48.1B SS benefits go to households with incomes between $50-100k, and $15.5B more to those over $100k – and this comes from heavily taxed young workers

"Affluence testing" better than means testing as term.

2. Privatize portions of SS to generate better returns

Argues for "a controlled and limited government investment in carefully selected and regulated mutual funds" based on broad based indexes.

Precedents: Texas Employees Retirement System-$116.3B, with $56.9B in equities – and many other states.

But do not privatize the whole system – keep it diversified

Lesson: don’t expect tax-supported entitlements to be a significant part of boomers retirement income.

1.Pay down high interest rate debt asap

1. Save at least 10% of income
2. Maximize all tax-protected savings programs
3. Plan for the day when you’re a sandwiched caregiver.

From Smith and Clurman, Rocking the Ages, a chart on generational identities on page 205.

Average 65 year-old will live 18 more years.

• Teamwork, sacrifice, trust authority (govt, doctors, big companies etc.)
• Most concerned about security: personal safety, health.
• 89% white, 8.3% black, 2.3% asian, 5.2% Hispanic
• Politically wired: the 800 lb gorilla of modern democracy

• Boomers realizing their size will be disadvantage as they line up for entitlements.
• Distrust gov’t, employers, authority
• Intellectually and socially individualistic; measure achievement as personal fulfillment
• 83% white, 12% black, 4% asian, 9% Hispanic
• Politically more involved with causes than parties, especially local concerns and workplace dynamics

• Raised with information and technology as fundamental to work and play
• Security: job stability and avoid debt
• Diversity: are "samplers" no real generational identify
• 78% white, 16% black, 5% asian, 13% Hispanic
• Politics are weak, fragmented, run by small clannish groups with no clout

Boomers and Xers have nothing like AARP to fight their battles

Since 1965 spending on over-65ers from 16% to 33% of federal budget. With 13% of population, get 4X federal money as those under 18, who are 26% of population. For every $1 of tax revenues…spent on seniors, only $.11

to each child.

Lester Thurow: successful societies must invest long-term in but our elderly voting bloc know they won’t benefit from such investments.

In past 20 years education, infrastructure and r&d spending fell from 24% to 15% of federal budget, while spending for elderly’s entitlements grew by 253% in real dollars.

Age wars: both elders and Xers annoyed with boomers. Xers will inherit divorce, homelessness, ozone depletion, drugs, downsizing, gangs, debt, violence. Xers will be outraged at the new old boomers.

Four adjustments to make:

1. Wisdom and generativity: a new purpose for elderhood

Average retiree watches 43 hours of TV a week – we need new roles for the old. Freud to Jung to Erikson’s stages of life chart on 218. The old age stage provides opportunity to contribute learning and experience back to society. But as independence and control are challenged, self-esteem and confidence are weakened. Joan Erikson wrote about gero-transcendence –shift to spiritual from materialistic – as the final stage possibly.

Kids and elders are not much connected today.

Two wrongs: [1] growing wasteland of elders sitting idle [2] 20+M young people at risk and without enough funding.

Bring these two wrongs together into a big right: a national ElderCorps – he provides lots of current examples of such programs, but we need to get them all together somehow.

[Elderhostel, Sierra Club offer stuff for grandparents and grandkids]

Jimmy Carter: elders often are too timid to take the risky step to a bigger life

32 million members, but only 15% join for the politicing and lobbying.

AARPthink is his term for how the leadership dominates the debates.

Split the lobbying and politics from the marketing giant (and make it pay taxes)

4.The need for elderheroes

Jimmy Carter is his hero and he tells a powerful story about working with Carter in Habitat for Humanity. JC: "It’s an expansion of life."

Tips to age-proof your life:

1. Think carefully about who you want to be in your elder years
2. Before joining AARP, think about where your dues will go.
3. Learn how to make use of yourself in your community
4. Don’t’ think of retirement as an extended vacation but a a time of continued growth, generosity, learning, wisdom and love

1. more of us will live longer than previous generations
2. epicenter of economic and political power will shift from the young to the old
3. need to change minds about how to spend the extra years of life
4. how we decide to behave as elders will be the most important challenge in our lives