What are we going to do when the old folks are us?
By Marvin Schachter 12/07/2006
The good news is that people are living longer today than ever before. Today, as the first wave of baby-boomers (people born between 1946 and 1960) begin reaching seniority, we are witnessing an explosion in the number of aging Americans. More and more people are living past their 60th birthday, but the especially significant fact is that what the demographers call the “cohort” of people over 85, the “old, old,” is the fastest growing sector.
In California, the projections show that the 425,657 Californians over 85 counted in the 2000 Census will grow to 630,000 in 2010, and to about 1,300,000 by 2040. That is a 205 percent increase over the last census.
The question is: What will we do with all these old folks? And these old folks will be either you or your parents. The fact is that our society is just beginning to consider what we must do and what we must plan for when nearly one out of every five people will be over 60 and about 10 percent of that number will be over 85.
If one is rich or at least economically secure, as well as moderately healthy, the so-called “golden years” can be pleasurable and rewarding, but time does take its toll. As the years roll by, physical capabilities inevitably decline. In California, losing the ability to drive can force a change in lifestyle. Friends move away. Relatives and neighbors of one's own generation pass away. Health problems, major or minor, are inevitable. In a mobile society offspring and relatives may live long distances away. A growing isolation can lead to severe depression.
At some point, especially for those in the over-85 population, living independently becomes more difficult, even if there are no health problems, but especially so if disabilities develop. “Aging in place,” remaining in one's own home and in one's own neighborhood, is overwhelmingly what seniors want, but they cannot afford the $20 or more per hour cost of private assistance, and unless they have poverty-level incomes, they cannot qualify for government-financed home care. Often, the home requires some degree of modification or remodeling.
If seniors can no longer live independently, they face costs of $4,000 or more per month in Los Angeles area assisted-living facilities.
For the small minority of the very rich, the costs of care, whether in one's own home or in a “retirement community,” are of no consequence. For perhaps the 25 percent or so low-income elderly, there are government programs available. The vast majority of seniors of moderate incomes are dependent on their own resources, which are too often disastrously inadequate. Where do they go? What can they do?
In past generations, a relatively small percentage of the population lived much beyond their working years. Those who did depended largely on family care. In the 21st century, such care is less likely: The latest surveys show for the first time that the United States has a majority of single-person households; family connections are often less close in a geographically dispersed society. People growing older far too often can only depend on their own resources.
I am not suggesting that long-term care for an aging society takes precedence over other urgent challenges facing the American people. Second only to the growth in the proportion of the elderly is the increase in the number of children. Certainly, support for education is a priority, as is health care for all children and for all families. At the December 2005 White House Conference on Aging, to which I was a delegate, I picked up a campaign button that put the issue properly: “No child left behind, no senior overlooked.”
But senior issues must be on the agenda because they affect us all. It is not that we do not know what to do about long-term care. To meet the clearly evident need now existing, and that will increase as the aging population increases, we must build a system that strengthens community-based services to enable the elderly to remain in their own homes as long as possible. For those who, perhaps inevitably, reach a stage where independence is no longer possible, we must plan and begin to build a national network of affordable assisted-living resident communities.
Can we afford such programs? Can a nation as rich as the United States meet the needs of the American people? What are the choices? What are we going to do with all the old folks and the children?
Perhaps the real question is: What kind of America do we want to have?
The senior writing this article also suggests: REMEMBER, YOU TOO — IF YOU ARE LUCKY —WILL BE A SENIOR.
Marvin Schachter, chair of the Senior Advocacy Council of Pasadena, has just completed two terms as a member of the California Commission on Aging.