Social Security: Don’t ‘scrap the cap’

By I fancy that I stay abreast of what’s happening in the Social Security policy arena, so I was taken aback during a trip to Washington, D.C. to learn that a whole movement has developed to eliminate the bulk of Social Security’s 75-year deficit by scrapping the cap – that is, eliminating the earnings cap used for tax and benefit calculations ($113,700 in 2013).  Estimates from the Social Security actuaries indicate that this change alone – if no benefits were provided in exchange for the higher taxes – would close about 90 percent of the 75-year gap.  This proposal even has its own rap video, “Just Scrap The Cap (We’re Movin’ In),” in which a hilarious older couple warns their son that he should pull out the couch and get more towels if Social Security does not scrap the cap. Continue reading…

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A New Direction for Geriatric Psychiatry: Wellness

In his farewell address in May as the outgoing president of the American Psychiatric Association, Dr. Dilip Jeste emphasized the need for a “positive psychiatry of aging.” Until recently, psychiatry has largely conceptualized health and well-being as the absence of illness and symptoms. In Jeste’s view, “quality of life and psychosocial functioning depend less on physical health and more on positive psychological traits like resilience, optimism, social engagement, and wisdom.” He predicted that in the future psychiatry will go beyond treating psychiatric symptoms to “seek to enhance the well-being of people with mental or physical illness.”

This isn’t simply feel-good rhetoric. There are currently 40 million Americans over the age of 65. By 2030 the predicted number is 72 million. The U.S. needs us over 65ers to be as healthy as possible for our own well-being, but also so we can contribute to society in accord with our capacities and place less of an economic strain on younger generations. In place of the feared “silver tsunami,” Jeste wants the elderly to be – and be seen as – a “golden boom.” Continue reading…

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Retirement and Dementia

On Monday, July 15, at 4:00 PM at the Alzheimer’s Association International Conference in Boston, Carole Dufouil, director of research in neuroepidemiology at the Institut National de la santé et de la recherché médicale at the Bordeaux School of Public Health in France, presented her research on the relationship between retirement and dementia. In less than 24 hours her report on the research, which has not yet been published, was all over the media and the blogosphere. Continue reading…

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Two Zorbas on Aging

Summer reading recommendations are a feature of many publications. I have two for readers of Over65.

For some reason, I didn’t read the novel Zorba the Greek when I was younger. Nor did I see the popular movie or musical based on the book. Fortunately, our book club chose it recently. In retrospect, perhaps it was a blessing to wait until I was older, for Zorba presents an intriguing vision of aging.

For those who are unfamiliar with either the book (1952), movie (1964), or musical (1968), Zorba the Greek is the story of a reserved and timid English writer who hires a stranger name Zorba to lead the work in a mine the writer has inherited on the island of Crete. Among other adventures, Zorba chases women, plays music to sooth and seduce, enjoys nature, cooks soup, faces perils in the mines, and defies a large group of men bent on revenge on a young widow who rejects their advances. In watching and interacting with Zorba, the writer, who narrates the story, becomes more active and daring himself, ultimately spending a climactic night with the widow herself. Though much more subtle, there seemed to be some sense that Zorba becomes more thoughtful in response to the English writer’s ways. Continue reading…

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Honor Thy Mother and Father

The Japanese have the right idea. Their Prime Minister recently announced his government would invest in the development of “nursing care robots” that help older people with everyday tasks. With just over 20% of its people over age 65, Japan has the largest proportion of elders of any country in the world–the corresponding number for the US is 12%, but we can expect to reach the 20% level by 2030. The Japanese also live longer than other peoples: at birth, life expectancy is 84 years (compared to 79 in the US) and at age 60, life expectancy is 26 years (compared to 23 in the US). But in Japan, the “old age dependency ratio,” or the number of older people as a share of those of working age, is a stunning 39, compared to 21 in the US (for anyone wondering how these numbers could possibly be 39 and 21, the actual formula used is the number of people 65 and older divided by the number of people age 20-64, times 100).  That means there simply aren’t enough caregivers for the burgeoning elderly population—hence the interest in robots. Continue reading…

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Aging, Weight Gain, and Weight Loss

Overweight, obesity, and physical inactivity are smoking’s close cousins in preventable causes of mortality, leading to over 300,000 deaths annually.  The societal costs of these conditions* may be as high as $400 billion per year.  Therefore, upon reading the May 6 blog post from Sissela Bok and the May 20 post from Steven Schroeder, it seemed appropriate to address two questions that came to mind from their posts:  1) Do people over the age of 65 continue to fall prey to overeating, physical inactivity and weight gain?, and 2) Is 65 too late to tackle overweight, obesity, and physical inactivity?  Continue reading…

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Aging, Stereotypes, and Reality

I have heard for many years, informally and in scholarly journals, that ageism reigns in our society, and in particular that employers are biased against older workers. That last point is frequently made by many observers, who can cite a good bit of data showing that those over 50 who have lost jobs in the current recession have a much harder time finding new ones than younger workers.  The situation is worse the longer the unemployed person is out of the workplace. A critical ingredient in that trend is the judgment of employers, the ones who have the power to hire. Continue reading…

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How can we fix long-term care insurance?

This post extends the discussion of long-term care insurance recently initiated by Kenneth  Deitch.

The prospective costs for long-term care are a big problem.  First, nursing home care is really expensive for those who end up needing it.  Second, the prospect of such an expense is likely to prevent people from making the best use of their meager 401(k) assets, much less their more substantial home equity.  Therefore, I am a big fan of products or approaches that can define and limit the magnitude of long-term care costs.

 It would be nice if people had access to good long-term care insurance and bought the product.  But despite the fact that over one-quarter of men and over two-fifths of women will enter a nursing home at some point after 65 and that a semi-private room costs about $80,000 a year, only about 10% of households purchase long-term care insurance.  Continue reading…

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More are retiring with mortgages and credit card debt

Alicia H. Munnell

 With a contracting retirement income system, rapidly rising health-care costs, and the prospect of long-term care expenses, one would have thought that people approaching retirement would be paying off their credit card debt and closing out their mortgages.  But surveys suggest that people are entering retirement with more debt than ever before and relying on borrowing to cover expenses in retirement. Continue reading…

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Return of the Hero

Blanched by anemia, Mary rested quietly in the hospital bed. Her pallor made her barely visible amid the bleached bed linens–she seemed a mere  shock of white hair against the pillowcase.

Age 93, she’d visited the hospital a half-dozen times in as many months, shuttling between nursing home and hospital as many elders unwittingly do in their last year of life. She may have preferred to stay put, but no one knew for sure: as a person with dementia, she was presumably unable to speak for herself. 

I was a palliative-care nurse practitioner in the hospital. Until about two decades ago, whenever someone neared the end of life the details of care were discussed with his or her doctor; nowadays, that intimate discussion often takes place in the hospital, with a total stranger. For Mary, I was that stranger.  Continue reading…

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