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This New Land of Old Age

Since 1900, average life expectancy in the U.S. has increased by 30 years to 77. Expanded life expectancy is a global phenomenon and in some western countries, the number is even higher. This was accomplished through eradication of some diseases, management and prevention of others, advances in medical science, redistribution of wealth during the industrial revolution, public education and social programs.

Butlerbookam2 The result today is a burgeoning population of people older than 65 that will nearly double in number by 2025, just 17 years from now. Dr. Robert N. Butler calls this historically unprecedented shift in age distribution The Longevity Revolution, which is the title of his new book, subtitled, “The Benefits and Challenges of Living a Long Life.”

Dr. Butler says he wrote the book “for a thoughtful public” to describe “the origins, challenges and adjustments” necessary to accommodate the new longevity and “to question contemporary assumptions about late life.” The range and detail of the book are extraordinary without being pedantic and in the heart of the book, he lays out both common-sense and radical solutions he believes are required to meet the needs of elders and society in general.

“We have the tools to take advantage of this exceptional demographic shift,” writes Dr. Butler. “But it will require nothing less than a total transformation of both the personal experience of aging and of cultural attitudes.”

Dr. Butler takes on the big questions of which a few are:

  • Can we afford old people?

  • How can resources be fairly distributed among generations?

  • How will an aging population affect the economy?

  • Will power be concentrated in the hands of old people?

  • Will increased longevity worsen overpopulation?

  • How can we reorganize the healthcare system to be fair and affordable?

Dr. Butler debunks the widely-held belief that healthcare and pension costs presage a crisis as the aging population increases. In fact, he shows, old people create wealth.

“Older people constitute a powerful and growing market, variously called the silver industries, the mature market and the senior market, which are all as significant as the youth market of the baby boom 1960s. Indeed, they are more so. Longevity affects the entire live course, including the amount people spend on health and in the financial services industries. Optimism about the future encourages people to save and invest.”

For the longevity revolution to succeed, Dr. Butler warns that ageism, a term he invented in the 1960s, will need to be overcome in all areas of the culture – social, economic, healthcare, and more - that are frequently based on myth and misinformation. As he notes in regard to age discrimination in the workplace:

“The stereotype equates aging workers with nonproductive drains on society, but, ironically, older workers who remain productively employed are most likely to remain healthy and able to contribute to society than those who retire…

“Learning ability, intelligence, memory, and motivation do not decline with age in the absence of disease, dementia, and depression and if one keeps active. Healthy older workers have fewer accidents than younger workers and often a stronger work ethic. Admittedly, perhaps one of the reasons studies of older workers are so positive is that only the most committed remain in the workforce.”

One of the few issues I take with Dr. Butler (a small one, to be sure) is that last statement. It could be that the studies would find even higher positive results if more of us were allowed to remain in the workforce by corporate America which continues to rid itself of elders in favor of less experienced and lower-wage young people.

Some other readers will take issue with Dr. Butler’s advocacy of population control. As he states throughout the book, longevity is desirable only when accompanied by high quality of life, and there are only so many earthly resources.

“Those interested in a longer life for themselves and their progeny had best support family planning and population reduction and stabilization.”

For those whose religion precludes types of birth control, Dr. Butler suggests an international priority for developing a method to predict the time of ovulation. And for those who say there is already not enough work to employ everyone, let alone a healthy, aging population, he states what should be obvious to the naysayers:

“Certainly , there is no shortage of work to be done to maintain and expand the quality of our lives – better housing, cleaner environments, and improved educational programs are examples.”

The middle of The Longevity Revolution is an extensive examination of current financing of old age with suggestions and prescriptions for the changes needed to pay for the future of it, including the politics and public policy changes required. Dr. Butler is cautiously optimistic that the necessary adjustments can be made, but warns of the enormous threats that must be addressed worldwide:

  • Industrial pollution

  • Global warming

  • Nuclear, chemical and biological warfare

  • Terrorism

  • Population growth

  • Infectious diseases

  • Poverty and malnutrition

(Providing, it seems to me, even more productive employment to fight those scourges.)

Dr. Butler covers so much ground in this remarkable book, it should be required reading for everyone. It is nothing less than a blueprint on how to save the world. Now, you and I must get to work to do our part. As he says,

“We need guides that help us live out our lives, enjoy longevity, and contribute responsibility to others in our later years…

“Perhaps in old age, there can be a return to the more elemental, powerful forces, the freedom that comes from having to obey a boss, a social structure, or even the scholarship of a lifetime. Perhaps it is old people who can point out the guideposts for others to follow in this new land of old age.”

Tomorrow: A Time Goes By Interview with Dr. Robert N. Butler.

[At The Elder Storytelling Place today, Grannymar tells a poignant story of grief and bewilderment overcome in Marcia.]



Elderblogging on Television

This isn’t one of those rites of passage birthdays like 18, when you can vote in the U.S. or 65 when you become eligible for Medicare. It’s not even one of those big, round, decade birthdays with a zero at the end we all like to celebrate. It’s just 67, of no particular significance, except that it feels like yesterday I turned 66.

You may know I appeared on the Brian Lehrer Live television show in New York City on CUNY-TV last Wednesday to discuss elderblogging. I was particularly pleased to be invited because I listened to Brian’s radio show when I lived in New York, more frequently in recent years when I worked from home a lot.

So I know first-hand that he deserves to have won a prestigious Peabody Award for 2007. Brian is always intelligent, always informed and always entertaining - what a talk show host ought to be, particularly compared to the shouters and instigators. The award citation reads:

“Lehrer's talk show is a wide open yet shrewdly managed forum in which every sort of political, social and cultural issue is considered and where New Yorkers, in all their diversity, can get to know each other.”

And so it is. And now I’m happy to discover that I can listen right here on my computer at WNYC.org.

The weekly television show emulates the daily radio program, but through the prism of technology and the web. One of the things we discussed is the importance of community to elderblogging, the give and take in the comments not unlike the call-ins on radio shows.

It’s not that there aren’t comments on younger people’s blogs. And on political blogs, the number of comments can sometimes reach hundreds depending on the controversy of the topic. But on our elderblogs, there is rarely the vitriol found often on the others; there is usually a discussion of the day's issue that is as smart and relevant as Brian's.

It’s that two-way street that has become important to me and that there is a variety of opinion and disagreement without snark or name-calling. Maybe we elders are just older and wiser (she said with a grin).

So instead of celebrating my innocuous-sounding birthday, let’s celebrate elderblogging – with Brian Lehrer. Some of you had difficulty accessing the feed online last Wednesday, so here now is the video (15:22).

A good interview is at least as dependent on the host and producers as it is on the guest. Brian and his producers, Derek Tutschulte, Alan Smith and Marty Goldensohn had done the homework (which isn't always the case), read TGB and researched elderblogging. They made it easy and a pleasure for me.

[At The Elder Storytelling Place today, Nancy Leitz tells the story of the uncommonly loving Walker Family.]



This Week in Elder News: 5 April 2008

In this regular weekend feature you will find links to news items from the preceding week related to elders and aging, along with whatever else catches my fancy that I think you might like to know. Suggestions are welcome with, however, no promises of publication.

Christian Renaud responded quite thoughtfully when Crabby Old Lady called him out last week for his ageist post about elders and technology. Now there is an enlightening report about elder participation in Web 2.0 technology. According to a panel of experts, the number one contributor to the intelligence community’s Intellipedia wiki is a 69-year-old. In the same story, a college professor says most of his students hardly know what a blog or a podcast is. Hat tip to Mary Jamison.

All the old women wanted to do in 2004, was help some other old people who are mostly housebound to vote by mail. Now they face criminal prosecution for voter fraud and if convicted, could be sentenced to six months in jail and a $2000 fine. It’s happening in Texas to citizens who are old, minorities and not Republicans, according to this story at alternet.org.

Some may think it is macabre, but I am fascinated with this photo exhibit of 22 people taken just before or just after their deaths. The black-and-white images are by German photographer, Walter Schels and his partner Beate Lakotta. They go on exhibit at the Wellcome Collection in London next week. Hat tip to Nikki of Nikki’s Place.

Some of you may not know about a TGB feature, Where Elders Blog, a collection of photos of elderbloggers’ computer workspaces. Some new ones have been added and it would terrific to see some other new ones – from Y.O.U.

Yeah, yeah, I thought, when Guy Kawasaki emailed about his company’s new website aggregator service. Human-powered search engines, aggregators, whatever fail for me because the quality depends on the humans doing the selecting and who knows if their taste and criteria match my own - usually not.

But this one is different. Alltop.com is a human-powered single-page aggregation site “organized by topics such as Fashion, Celebrities, Sports, Gaming, Macintosh, Science, Green, and Autos.” A big difference from other aggregators is the snippet (popurl) showing enough from a site’s recent pages to get the idea so that you don’t waste time clicking on something that doesn't interest you.

The human site selections are excellent; I haven't followed a link yet that wasn't worth the effort and I’m not saying that just because Time Goes By is listed in the Living > Life section.

Although they may be the only way to save some animals from extinction, zoos make me sad; I don’t like seeing animals penned. But this is a jaw-dropping video that in 8:29 minutes will fill you with wonder and awe, and a new appreciation for how close we are connected to our friends, the animals. That’s all I’m going to tell you; watch the video. Hat tip to Norm Jenson of One Good Move.

Quote of the week: I’ve received this from so many readers that I’ve lost track of whom, so with apologies to all for lacking a hat tip, here are the lyrics 72-year-old Julie Andrews sang at Radio City Music Hall to the tune of My Favorite Things. It’s even better if you sing aloud. Go ahead. No one will care if, like me, you’re off-key.

Maalox and nose drops and
Needles for knitting,
Walkers and handrails and
New dental fittings,
Bundles of magazines tied up in string,
These are a few of my favorite things.

Cadillacs and cataracts and
Hearing aids and glasses,
Polident and Fixodent and
False teeth in glasses,
Pacemakers, golf carts and
Porches with swings,
These are a few of my favorite things.

When the pipes leak
When the bones creak,
When the knees go bad,
I simply remember my favorite things,
And then I don't feel so bad.

Hot tea and crumpets and
Corn pads for bunions,
No spicy hot food or
Food cooked with onions,
Bathrobes and heating pads and
Hot meals they bring,
These are a few of my favorite things.

Back pain, confused brains and
No need for sinnin',
Thin bones and fractures and
Hair that is thinnin',
And we won't mention
Our short shrunken frames,
When we remember our favorite things.

When the joints ache,
When the hips break,
When the eyes grow dim,
Then I remember the
Great life I've had,
And then I don't feel so bad.



A New York Minute

category_bug_journal2.gif I was there only 16 hours and indoors for 13 of them, but New York City was as familiar as if I hadn’t left in June 2006. It felt like home.

Walking the few blocks from Penn Station to Fifth Avenue and 35th Street on Wednesday afternoon, I heard four languages that were not English being spoken. I passed people whose skin was every color in the human spectrum. A homeless man explained how he was getting his life back together as he sold me a copy of The Onion. A few hours later, in Greenwich Village, another man asked me where Charles Street is and I was pleased to be taken, after nearly two years away, as a native.

You can take the girl out of the city, but you can’t the city out of the girl. It all felt right – the crowded sidewalks, the noise, the rude business people banging their briefcases into my shins as they scurried past, eyes focused on the middle distance, cell phones permanently attached to their ears. You don't see much of that here in Portland, Maine.

Before catching my return train yesterday morning, I walked my old neighborhood. My building, my beautiful, little, brick townhouse on Bedford Street, is boarded up, street trash collecting at the stoop. It’s empty. No one lives there now – Drew Barrymore, who owned the top apartment, is gone too - but it’s clear that no renovation is in progress or, maybe, has been halted for some reason.

The plexiglass on the front of the box on a wall down the street, mounted there to post announcements from the Bedford-Downing Block Association, which I started 15 years ago, is smashed, the postings curled and tattered. It looks abandoned, although the association will probably fix it during the annual spring cleanup.

It was early morning, 7AM, and the few people on the block were hurrying off to work. No one I recognized. The two guys who run the corner deli came out from behind the counter to hug me, big smiles on their faces. I bought a cup of coffee for old times’ sake and got some cash from the ATM. I must have done that a thousand times over the years; it felt familiar.

I was sorry the laundry, where all the best block gossip is exchanged, wasn’t open yet and I had no time to wait.

I wasn’t born in New York City, but it was home for almost 40 years and I will always miss it. The noise, the hubbub, the street energy fit me like a second skin. As the train pulled out of the tunnel in Queens, I looked back at the skyline and my eyes got misty. If I could afford it, I'd move back in a New York minute.

(I want to thank Naomi Dagen Bloom of A Little Red Hen for writing such a nice report about my appearance on the Brian Lehrer Live show on Wednesday evening.)

[At The Elder Storytelling Place today, Nikki Stern tells about letting off steam in The Beast Within.]



Are You Elderly?

[EDITORIAL NOTE: The TGB Interview with elder comedian Mrs. Hughes is still one of the most popular pages on this blog. She is appearing on the Craig Ferguson television show tonight on CBS-TV. Check your local listings.]

I ask that question in the headline because the media think you are. Reporters consistently and continually refer to old people as “elderly” even though the newsletter of the Journalists Exchange on Aging [pdf] (an organization for reporters who cover the age beat) wisely advises the following:

“Use only as a modifier (e.g., elderly people, elderly patients) in referring to people who are discernibly old and frail.” [emphasis added]

The meaning of elderly has alway included lacking in or declining strength, and when the word is used as a synonym for old people in general, it implies that everyone whose appearance is old-looking is no longer capable of caring for themselves, helpless or near death. The citations below were collected during the month of March 2008, without my having made more than a casual effort to notice them. There are undoubtedly many others.

The New York Times:
“You need not be elderly to remember when we had no choice…” (about our too-busy lives)

The New York Time again:
“Addiction specialists and organizations for the elderly anticipate a tidal wave of baby boomers…” (about aging addicts)

A subhead in the Washington Post:
“Officials, Schools Prod Doctors to Focus on Elderly Care” (about the dwindling supply of geriatricians)

alternet.org:
“And in Japan…more than 40 percent of the population will be elderly by the middle of this century.” (about global aging)

Headline on a medical news website:
“Baltimore Sun Examines Medicine Mismanagement Among Elderly U.S. Residents” (about prescription drug safety)

Even a professional medical writer at the Washington Post:
“Merck…wanted a broader market than just elderly fracture patients” (about causes of health anxiety)

And, The New York Times again:
“…one of three storefront hubs for the elderly here…” (about new kinds of senior centers)

All the reporters responsible for these stories were writing about old people in general, not those who are frail. Apparently, they and their editors did not get the Journalists Exchange on Aging memo.

It is not only reporters who consign all old people to the category of frail. That kind of disrespect infects departments of transportation too, as these signs indicate:

Elderlysigns

Just as near schoolyards we remind motorists there are children around who might chase a ball into the street, it’s a good idea to warn drivers to watch for slow-moving adults. More old people than young do move slowly, but slow doesn’t necessarily mean frail and the word “elder” would do the traffic alert job while preserving elders’ dignity.

When we consistently identify a group of people with prejudicial descriptions, it not only demeans them, but gives other people permission to do so and reinforces pre-conceived, negative notions picked up from all the other cultural cues to the old-is-bad school of thought.

Surveys show that most old people don’t like the phrase “senior citizen” and I agree. It has a dusty, institutional feel. Some old folks are fine with “senior,” but it too feels inadequate and for several years Time Goes By has been promoting “elder” as a replacement.

Elderlaw has been the word for that career specialty for many years. Elderblogging and elderblogger are becoming so common now, that they flow trippingly off the tongue of every journalist, television and radio producer who contacts me leaving me to wonder why they don't make the linguistic leap to elder.

Elderly is a good and useful word for describing frail elders. But the majority of old people lead healthy lives, contributing to their communities into their seventies, eighties and even nineties. Most of us are not frail and therefore, not elderly.

[At The Elder Storytelling Place today, Richard Mims takes us back to the heyday of hippies, rock 'n' roll and the Vietnam War in May 1971 - Washington, D.C.]



How Medicare Funds are Wasted

[EDITORIAL NOTE: I am in New York City today for an appearance on the Brian Lehrer Live show at 7:30PM ET to discuss elderblogging. New Yorkers can watch on Time Warner CUNY-TV channel 75. Everyone else who is interested can catch the live, online, video feed here. There is a list of television rebroadcast times on the website where the program video will also be archived.]

category_bug_journal2.gif For a fee of $5, the City of Portland, Maine, where I live, annually provides flu shots available over several days in different locations throughout the city. On 8 November 2007, I went to City Hall where tables were provided on one side of a room for paperwork, and on the other side for technicians to administer the vaccine.

One form requested my Medicare number. When I turned in the forms, I asked where to pay the $5.

VOLUNTEER: Oh, Medicare will pay that.

ME: But I have a five dollar bill right here. It will save a lot of paperwork if I just give you the $5.

VOLUNTEER: Why use your money when Medicare will pay?

ME: It’s only five dollars and like I said, it will save paperwork and mailings.

VOLUNTEER: You save your money for something you need. Medicare will pay.

She defeated me. The line of people was at a standstill and there was no point in arguing further. I took a seat to await my turn for the shot.

A few days ago, paper – of course, paper – arrived in the mail from the Centers for Medicare and Medicaid Services. Here is the accounting for my November flu shot:

$13.21 - 1 Flu vaccine
$19.37 - 1 Admin influenza virus vac

$32.58 - TOTAL

According to the Medicare accounting, this amount was paid to the City of Portland, Health Division. I had no idea the City would bill Medicare for more than the $5 charge, and now I’m wondering what the $5 is for and who does pay it.

It likely offsets the price a little for people who are not yet old enough for Medicare (although I didn’t notice money changing hands even among the young), and I would have been happy to contribute $5. Hell, I’d have paid the entire $32.58. It’s a bargain not to be down and out for three or four weeks which is how long I was sick last time I had the flu a decade ago. And according to stories in the local paper, budgets are tight here, as they are in most municipal governments.

But one item in that accounting nags me – nearly $20 to administer the shot.

The technicians were moving us through their vaccine assembly line at the rate of one person every five minutes. Do they earn $240 an hour? (If so, I’ll take the job.) Even subtracting the price of one cotton ball, a few drops of alcohol, a pair of latex gloves and a little round Band-Aid per person, someone’s overcharging Medicare for this operation. Multiply that by millions of people throughout the U.S…

Well, you get my point. And if the charge is being padded to Medicare on something as inexpensive as flu vaccine, how much is being added to more costly procedures?

Some other items to ponder:

• Hardly a week goes by without at least one news story about someone or some organization accused of Medicare fraud. It is not sensible to believe all are caught.

• No doubt you saw last week’s grim report on the future of Medicare. Spending is expected to outstrip contributions by 2019.

• In accordance with the prescription drug benefit (Part D) legislation, Medicare is prevented from negotiating prices with pharmaceutical companies.

• Medicare subsidizes Medicare Advantage plans (private Medicare) by paying the private insurance companies that operate them up to 18 percent of costs.

Preventing price padding, fighting fraud, allowing (nay, requiring) drug price negotiation and abolishing private Medicare (or, at least, the subsidies) wouldn't solve all the Medicare woes, but many millions of dollars would be returned to the kitty.

Of course, what is really needed is Medicare for everyone – universal coverage that all pay into and all benefit from.

[At The Elder Storytelling Place today, David Wolfe gives us a story that will make everyone smile, My First Kiss.]



The End of Myths About Older Workers?

[EDITORIAL NOTE NO. 1: I will be in New York City tomorrow, 2 April, for an appearance on the Brian Lehrer Live show at 7:30PM ET to discuss elderblogging. New Yorkers can watch on Time Warner CUNY-TV channel 75. Everyone else who is interested can catch the live, online, video feed here. There is a list of television rebroadcast times on the website where the program video will also be archived.]

[EDITORIAL NOTE NO. 2: Tonight at 10PM ET on ABC-TV, there is a Barbara Walters Special titled “Live To Be 150 – Can You Do It?” Find out more here.]

Listen to this young, technology worker in his self-assured assessment of boomer and elder workers as he discusses the shift from office-based employment to increased telecommuting within communities and among far-flung corners of the world:

“Having recently ‘pitched’ a room full of senior citizens on new technology trends, I can assure you that they are disinclined to buy a computer (if they do not already have one), much less create an avatar. They are comfortable with the traditional workplace metaphor...with autonomous-work/shared-environment, so any tools that are developed for them must be painfully easy-to-use and consistent with their ingrained habits.”
- Christian Renaud’s Weblog, 28 March 2008

Apparently, Mr. Renaud is unaware that most boomers are still active in the workforce (the oldest are 62, youngest 44) with a probable majority familiar with computers and the distances they cover. He probably doesn’t know, either, that people 65 and older are going online in record numbers which does, necessarily, involve use of a computer.

As to creating an avatar, when did that minor technique, hardly difficult, become a benchmark of technology competency?

Some questions come to mind from Renaud’s commentary: How old were these “senior citizens” – 50, 70, 80? How long have they been retired? How many of them were there – 10, 20, 100? – for Mr. Renaud to be so certain they are representative?

Elder workers are regularly admonished by career counselors to be patient with inexperienced young managers to whom they report and to not be know-it-alls. Good advice. But a functioning and successful workplace also requires that young workers shed their prejudices and learn the value of elders:

  • Elders take fewer sick days than younger workers
  • Productivity does not decline with age
  • Elders are more loyal, dedicated and quality-conscious than younger workers
  • Motivation often increases with age
  • Old workers are at least as creative as young ones. Eighty percent of the most workable and worthwhile new production ideas are produced by employees older than 40.
  • Old workers are just as flexible as young workers when they understand the reasons, although they are more likely to ask why.

[Sources supplied upon request]

“Think you are a good presenter?" twittered Mr. Renaud. "Try a room full of Senior Citizens. Harder than my last keynote x 10."

Maybe he was annoyed that those senior citizens were asking why?

Certainly, there are elders who are stuck in their ways, but if Mr. Renaud is as representative of his age group as he believes his room full of senior citizens is, then he too is inflexible.

The good news is that all of the above may become moot with the growth of telecommuting. No one knows your age from an email message or your avatar.

[At The Elder Storytelling Place today, in A Bad Ending, Marvin Wildman tells of a conversation with his father that includes a surprise that if not quite an April Fool's joke, is still in the spirit of the day.]