Facing the Future
An essay
Sandra Martin
Aging in Canada
Neena Chappell and Marcus Hollander
208 pages, softcover
The New Old: How the Boomers Are Changing Everything ... Again
David Cravit
ECW Press
You Could Live A Long Time: Are You Ready?
Lyndsay Green
Thomas Allen Publishers
The Perfect Home for a Long Life: Choosing the Right Retirement Lifestyle for You
Last November, three days before I was set to celebrate a significant birthday, I had a freak fall—aren't they all—and broke my pelvis in two places. I was hurtling through city streets dodging vehicles and pedestrians, composing random sentences in my head, when I tripped on uneven pavement. I landed in an intersection on my right side, still clutching two heavy bags of books and shoes. I was lucky. I was not run over by a car; I shattered a bracelet instead of my right wrist; I did not break a hip (as I insist on reminding all of those well meaning friends who continue to enquire about my bone density—just fine, thank you) and good Samaritans rushed to my aid, cell phones unleashed, eager to dial 911 for emergency services.
A foolish combination of pride and shock compelled me to refuse an ambulance. With the aid of a passerby, I reclaimed my feet and slowly stumbled the three blocks to my destination. There, adrenalin spent, I collapsed and gratefully accepted whatever medical services could be summoned. My mishap was neither life-threatening nor permanent, but there is nothing like hobbling about with a walker, feeling your bones crunch together with each hesitant step, to propel you over the precipice into the rocky terrain of the elderly and the infirm. I spent a couple of months contemplating the inevitable and it was not pretty. And that was before I read the four books under consideration in this essay. As a society we are aging rapidly—no surprise there. What we do about it on personal, corporate and public policy levels is ultimately up to luck, finances, politicians and our own resourcefulness. That is the short takeaway. The longer version offers a multiplicity of warnings, directives and opportunities to plan for the future—a very long one.
I am surely not the only one surprised at how old everybody looks suddenly. I scrolled through photographs posted on my high school reunion website earlier this year. Who were those people with the grey hair and the pot bellies and the wrinkles, I wondered, until I caught a glimpse of myself in the bathroom mirror. When I was in my early twenties—in the late 1960s and early '70s—everybody seemed young, thanks to the baby boom. Now the opposite is true.
Statistics Canada defines the baby boom as the dramatic increase in the birthrate in the two decades between 1946 and 1965. More than 8.2 million children were born for an average of 3.7 per woman. The oldest of that cohort turns 67 this year as the baby bulge works its way through the human lifespan. In 2010, 15.3 percent of Canadians (or 4,386,906 people) were over 65; by 2030 that figure will rise to 24.1 percent (or 7,844,309 people), according to statistics quoted by sociologist Neena Chappell of the University of Victoria and analyst Marcus Hollander, a former director of Health Network, in Aging in Canada.
Image by Olivia Mew
Not only are we getting older, but we are also living longer. Life expectancy is soaring. In 1981, the average Canadian died at age 76; by 2006 it was 81, an increase of five years in 25 years. According to recent figures from the Canadian Institute of Actuaries, life expectancy is escalating rather than stabilizing. A 60-year-old man in 2013 will live another 27.3 years, long enough to celebrate his 87th birthday. His female counterpart should live an additional 29.4 years, or long enough to plan festivities for her 90th birthday. That is a life span increase of at least seven years in as many calendar years.
For anybody juggling kids, jobs and mortgages, there never seems enough time to catch a breath, let alone contemplate old age. But the kids grow up—although some could argue that never really happens—and then what do you do with the bonus time? That is the question that David Cravit, adman and executive vice-president of ZoomerMedia Ltd., poses in The New Old: How Boomers Are Changing Everything…Again. In his breezy treatise, which often reads like a testimonial to his boss, Moses Znaimer, the innovator and czar of all things zoomer, Cravit argues that boomers have destroyed the traditional concept of aging. Relegate the word "seniors" to the compost, he commands, and replace it with "zoomer," a word Znaimer coined to define boomers with zip.
Cravit believes zoomers represent a huge and untapped potential and he is determined to harness it. Boomers, he argues, "grew up determined to experience new things, break new ground, get what they wanted. They see no reason to let their chronological age determine their mental or emotional age."
Instead of shunning boomers as doddery and irrelevant slow pokes, employers need to recognize the wisdom, experience and institutional memory they can bring to the workplace as mentors, project managers and consultants. Unfortunately, the advertising and media worlds are dominated by young people who have little or no awareness of the buying power of boomers.
Arguing that there is "a shocking disconnect between the actual influence of Boomers in the marketplace, and the perception of that influence by marketers and their ad agencies," he quotes a series of polls in which boomers complain about being ignored and cites comments by Neil Gabler, a senior fellow at the Norman Lear Center at the Annenberg School for Communication at University of Southern California. In an article aptly named "The Tyranny of 18–49: American Culture Held Hostage," Gabler says that while "the culture has been fixated on youth, it has also been hiring the young to service its constituents, creating a self-perpetuating system." This is foolish, says Gabler, because "Americans over 50 years of age control 55 percent of the discretionary income in America."
Instead of punching a clock until the magic retirement age of 65, many boomers are refusing to call it quits. Even governments agree that 65 is too young to retire, hence the abolition of mandatory retirement in most jurisdictions in Canada. But it is not as easy as that. If you do not have to retire—ever—why would you, if the working conditions are cushy? I know several tenured professors who are hanging on to their offices and their coterie of graduate students while pulling down a lucrative defined benefit pension for life. How do universities force these people to move over and make room for younger, fresher academics? Hard to say, unless the working conditions become unpalatable enough to encourage septuagenarians and octogenarians to call it a day and do research and write books in their home offices. How about revising the curriculum to have them lecture in back-to-back survey courses for first-year undergraduates—and hold the teaching assistants?
I am all for working past retirement. I thrive on deadline pressure and being forced to learn something new every day. Still, the older I get, the more I long to work differently. Let others chase fires. I want to share my skills and experience with younger journalists and work on long and complex projects that demand more than filing copy to fill the daily news hole. I no longer want to work 24/7, 365 days a year. Coincidentally, my employer, driven by economics more than altruism, has started offering unpaid leave in the summer, which is a great opportunity for me to slow down, think about creative projects, reconnect with friends and family, and recharge for the back-to-work frenzy in September.
As much as Cravit trumpets the resilience, creativity and spending power of boomers with zip, 90 is not the new 65, no matter how optimistically he trumpets an end to aging. That might be true for some of us, but most people really do not have the energy or the desire to work full time in their seventies and eighties. On a practical level, 70 is probably the new 65—at least in this decade.
Growing older would be fine if it simply meant celebrating birthdays. Alas, that is not the way it works. The more candles on the cake, the fewer friends who are still around to congratulate us, and the less lung power we have to blow them out. That is the sober message sociologist and communications specialist Lyndsay Green imparts in her bestseller, You Could Live a Long Time: Are You Ready?, and its sequel, The Perfect Home for a Long Life: Choosing the Right Retirement Lifestyle for You.
In researching her book, Green formed a network of 40 people between the ages of 75 and 100 living in different parts of Canada and asked them for advice on many aspects of their lives, including finances, housing, companionship, physical and mental impairments, and keeping engaged. She also drew on her own frustrating experience dealing with her elderly parents, a couple who lived in a different city and who refused to move out of the home they had shared for 35 years.
Eventually, her mother fell out of bed, broke her collarbone and was taken by ambulance to the emergency ward of the nearest hospital. She never saw her cherished home again. Instead, she resided in six different institutions over the next two years before Green and her siblings found suitable accommodation for both their parents. By refusing to make a timely and necessary decision to downsize, "they gave up control of their future," Green writes about her parents.
If that is what happened to the Greens, a well-educated, affluent couple, with connected and committed children, what fate awaits the poor and the disadvantaged? That point was underscored by Green's father during a visit to his wife in one of those interim facilities. He looked around at the rows of elderly people waiting for somebody to help them to the toilet and to feed them dinner and observed: "We're not living longer, we're dying longer."
We like to imagine that we will be perfectly healthy until we die in our sleep or have a massive and deadly heart attack on the golf course, but we are far more likely to have protracted deaths after several years of infirmity and ill health. Longevity runs in Green's family, but even she got a shock when she consulted an online predictor and discovered she is likely to live until she is 98, but will only be healthy until she is 90. That kind of statistic should concentrate the mind.
Some of us are better at aging than others. My mother-in-law, who was widowed at 90 after 65 years of marriage, was desperately lonely, but too independent (or stubborn) to move into a retirement home. Her two children and their families lived on the other side of the country. We phoned every day, but we only visited a couple of times a year. So she hired a roster of university students to visit her two or three evenings a week. Because she was intellectually curious and genuinely interested in hearing about other people, she developed a coterie of substitute grandchildren.
Earlier this summer, I attended a funeral in Toronto for a 99-year-old woman I will call Joan. The church was packed with people of all ages. One of the eulogists said of the deceased: "Joan not only asked questions; she listened to the answers." That reminded me of my mother-in-law. The two women had vastly different personalities—my mother-in-law was shy and reserved, while Joan was a grande dame and a socialite—but they shared an interest in people and the world around them and it was paid back in affection and stimulating company of all ages till they died.
Green has drawn similar life lessons from her group of elders. A lot of what she says is common sense, but it bears repeating because most of us cannot force ourselves to plan ahead or to confront the inevitable. Perhaps her most important lesson is do not procrastinate. If you want an active and engaged old age, start preparing for it now. Inertia is the bane of advanced care planning.
Concentrate on the inner self as much as the outer, she advises; consider old age your last career. Develop younger friends, exercise, stretch your grey matter, volunteer. Do not neglect your finances, but remember that money can buy people to care for you, but that does not mean they will care about you. That is why you should ensure that your emotional circle is as robust as your RRSP portfolio. And for heaven's sake de-clutter, clear out the stuff you have not looked at in years and the clothes that are taking up space in the back of your closet, and organize your papers and books. Delay, and your children—or strangers—will be forced to disperse your precious belongings.
Speaking of children, they are the ones who will shoulder the burden of caring for us—whether that means hiring and managing others, finding retirement facilities or taking us into their own homes. Many of us despair that our grown children will never leave home—indeed, I know some couples who have downsized partly to force their kids to move out of the family nest—so the idea of living with them when we are too decrepit or too impoverished to manage on our own is alarming. Green has researched a number of alternatives in The Perfect Home for a Long Life, including co-op living—the thought of negotiating fridge rights makes me quake—granny flats, condos and high-rise apartments as a means of staving off the final move into a nursing home.
Hedging your bets, if you can afford it, is another piece of housing advice Green received from her elders. A woman Green calls Virginia stayed as a guest in the retirement home she had chosen before putting her condo on the market. She was happy with the experience and moved in permanently. Gordon, another elder, made a similar arrangement and discovered it was not to his taste. At 101, he found the retirement home "too depressing" because the other residents were "too old," so he moved happily back into his apartment.
As we get older, our living arrangements may seem as arcane to others as they did when we were 20-somethings living out of backpacks and sleeping on strangers' floors. For example, novelist Martin Amis and his brother devised an unusual eldercare arrangement for their father, Kingsley Amis, after his second wife left him. They proposed that their father move back in with their mother—his first wife—and her third husband. "Everyone else … considered the idea both bizarre and impracticable. 'Like an Iris Murdoch novel,'" Martin Amis wrote in his memoir, Experience. But the arrangement worked for the Amis family for 15 years until Kingsley died from Alzheimer's disease—and that, rather than other people's opinion, is what counts.
As much as Cravit extols the resilience, creativity and spending power of boomers with zip, and Green plots strategies and delivers timely and practical advice about how we can navigate elderland with the utmost dignity and independence, neither author truly confronts the public policy issue of how we as a society should provide care for the elderly among us.
Green knows full well that it is primarily children who take care of their aged parents. That is what happened with her parents and she hopes she will have managed her old age so smoothly that her daughters will not face the same burden when she and her husband need care. But she does not go into much detail about the missing piece in that equation. Not everybody manages their lives or their finances astutely. In a report on Canada's credit status released late this summer, Equifax Canada reported that the year-over-year debt level for people over 65 had leapt by 6.5 percent, the largest increase for any age group. Some authorities suggest that retirees have only themselves to blame because they are leading profligate lifestyles by continuing to spend and borrow as they did when their bank accounts were replenished with regular paycheques, but others warn that seniors are going into debt because they are depleting their retirement savings to help support both their elderly parents and their underemployed offspring.
If these debt levels cannot be curtailed, caring for the elderly will turn into a crisis because there is a yawning gap in our social service and healthcare umbrella, as Neena L. Chappell and Marcus J. Hollander argue in Aging in Canada.
They cite alarming figures about aging populations in Canada and to an even larger degree in Germany, Italy, the United Kingdom and, especially, Japan where 23.1 percent of the population was 65+ in 2010, amounting to 29.3 million people. Unlike some experts who warn of the "grey tsunami" and the "grey wave" that can potentially "bankrupt" our healthcare system, Chappell and Hollander argue that simply throwing money at the system is not the solution.
Healthcare funding, as a percentage of gross domestic product, only increased from 10 percent to 10.5 percent from 1992 to 2007, they say, quoting 2011 figures from the Canadian Institute for Health Information. While those figures do not take into account the economic meltdown of 2008, the authors present a cogent case that the healthcare problem presented by the bulge in elderly people needs structural rather than economic solutions. "Past choices got us into our current predicament. Better choices, more sophisticated analyses and political will can get us out of it."
The Canada Health Act (1982) established the five major principles of our healthcare system: accessibility, comprehensiveness, portability, universality and public administration. The act also imposed penalties for extra billing by doctors and user fees for hospital care. But these principles and prohibitions do not apply to extended healthcare services such as integrated long-term residential care and homecare services. That is why these services are not protected from user fees and are not portable from one province to another. Unless you fall below the poverty line and are eligible for social assistance under the Canada Assistance Plan, you either pay for a place in a seniors' home or you rely on family members—many of them stretched physically, emotionally and financially—to organize or deliver care for you.
The seniors needing help now are the parents of the baby boom generation. Typically the husband/father worked outside of the home and the wife/mother was a homemaker who raised several children—all of them ideally sharing the duties involved in caring for their parents. That situation will change drastically because boomers will live longer than their parents and have fewer children to provide care. Given current economic realities, many of those adult children are not finding lucrative or steady employment and will not be able to support their parents financially. Consequently, the early boomers will barge their way toward death, but the middle and late boomers may once again find themselves in the nasty shadows of the older members of their cohort.
Chappell and Hollander argue that adult children are already providing far more care for seniors than government and they predict this can only increase as the population ages. "Soon we can expect to spend more time providing care for our parents than childrearing," they say. So what is the answer, if we believe that access to health care is a fundamental right in Canada? Do we continue to insist that home care for elders, with their myriad medical, physical and mental problems, can be offset simply by tax credits and piecemeal provincial programs?
Our state-supported universal healthcare system has not expanded beyond its physician and acute care hospital origins. Meanwhile more and more people are living with chronic conditions. That is why, Chappell and Hollander argue, recognizing continuing care as a major component of our healthcare system is a critical first step in caring for older Canadians.
They do not offer a definitive blueprint. Instead they review how care is currently being provided, make suggestions for further research and policy development, and call upon political leaders to initiate a public debate offering Canadians clear choices with transparent funding models so that we can all be part of the conversation about one of the most pressing issues of our time.
Developing a comprehensive and integrated seniors' strategy was the overriding message from the annual meeting of the Canadian Medical Association in Calgary this past August. The organization released the results of a national poll in which three out of five respondents said they believed that there would not be enough hospital beds, long-term care and homecare services to meet future demands. "The anxiety Canadians have about health care in their so-called golden years is both real and well-founded," said Anna Reid, outgoing president of the CMA.
More than 90 percent of those polled agreed that governments should get together to develop a comprehensive seniors strategy and that the federal government (and not just the provinces) should play a significant role. "Let there be no doubt that a national strategy for seniors' health care should be a federal priority," Reid told delegates.
We should all do our part to be productive members of our social, cultural and economic environment. Keep working as long as you can; develop new friendships while maintaining old ones; plan your future so that you can control where and how you live, and who cares for you. But at some point—and I hope it happens before another generation of elders is warehoused in nursing homes—society has to pitch in.
Sandra Martin is the author of A Good Death: Making the Most of Our Final Choices.
Related Letters and Responses
Sandra Martin's review of recent books on the fate of aging Canadians poses more questions than it answers. Martin describes a range of responses to our shared prospect of "not living longer, but dying longer," but all of them serve only to amplify our collective worry. On the other hand, there is real hope for innovative solutions to our national demographic challenges. Not surprisingly, evidence shows that social isolation is the most dire predictor of poor health outcomes in older people. Canadian social innovations that take direct aim at isolation and the need for a family/professional team approach to care are attracting international interest and investment. The Canadian...
Life in the Afternoon
A review of Stayin' Alive: How Canadian Baby Boomers Will Work, Play and Find Meaning in the Second Half of Their Adult Lives, by Michael Adams
The Care in Health Care
A review of Love, Fear and Health: How Our Attachments to Others Shape Health and Health Care, by Robert Maunder and Jonathan Hunter
Keith Oatley
Saving Medicare
Michael Decter
A review of Cleaning Up: How Hospital Outsourcing Is Hurting Workers and Endangering Patients, by Dan Zuberi
Katherine Fierlbeck