Preston Winning In The Last Inning

How to Grow Old, Stay Independent and Financially Solvent
1. Auflage 2012
ISBN: 978-1-62095-477-5
Verlag: BookBaby
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 309 Seiten

A helpful book for anyone involved in caregiving for the elderly or disabled. Long term care is an approaching tsunami which the country and most families/individuals can't afford. Disruption in the approaches and methodology of long term care will occur - understanding these changes and adapting to the new procedures will make the care of a loved one manageable and easier.

Autoren/Hrsg.

Preston, Robert

Leseproben

Chapter 1 – Aging
“To me, old age is fifteen years older than I am” – Bernard Baruch “Old age is the most unexpected of all the things that happen to a man.” – Leon Trotsky “The age factor means nothing to me. I’m old enough to know my limitations, and I’m young enough to exceed them.” – Marv Levy, 80, named General Manager of the NFL Buffalo Bills in 2005 Myth – Old age inevitably leads to deterioration and dependence. Institutional care will be necessary for a growing part of our elderly, with reimbursement from increased government funding and long term care insurance. A nurse, Phyllis McCormack, at Sunnyside Royal Hospital, Hillside, Montrose, Scotland summed up the process of aging in this simple, succinct verse entitled “Look closer, nurse”. “What do you see, nurses? What do you see? What are you thinking when you’re looking at me? A crabby old woman, not very wise, uncertain of habit, with faraway eyes? Who dribbles her food and makes no reply When you say in a loud voice, “I do wish you’d try!” Who seems not to notice the things that you do, And forever is losing a stocking or shoe…. Who, resisting or not, lets you do as you will, With bathing and feeding, the long day to fill…. Is that what you’re thinking? Is that what you see? Then open your eyes, nurse, you’re not looking at me. I’ll tell you who I am as I sit here so still, As I do your bidding, as I eat at your will. I’m a small child of ten… with a father and mother, Brothers and sisters, who love one another. A young girl of sixteen with wings on her feet Dreaming that soon now a lover she’ll meet. A bride soon at twenty, my heart gives a leap, Remembering the vows that I promised to keep. At twenty-five now, I have young of my own, Who need me to guide and a secure happy home. A woman of thirty, my young now grown fast, Bound to each other with ties that should last. At forty, my young sons have grown and are gone, But my man’s beside me to see I don’t mourn. At fifty once more, babies play round my knee, Again we know children, my loved one and me. Dark days are upon me, my husband is dead; I look at the future, I shudder with dread. For my young are all rearing young of their own, And I think of the years and the love that I’ve known. I’m now an old woman…and nature is cruel; ‘Tis jest to make old age look like a fool. The body, it crumbles, grace and vigor depart, There is now a stone where I once had a heart. But inside this old carcass a young girl still dwells, And now and again, my battered heart swells. I remember the joys, I remember the pain, And I’m loving and living life over again. I think of the years…all too few, gone too fast, And accept the stark fact that nothing can last. So open your eyes, people, open and see Not a crabby old woman; look closer. See ME!!” And growing old we are. During the past 100 years in America, the percentage of the population over 65 has tripled, while the actual number has increased eleven fold. The over 65 group is headed towards 20 percent of the population by 2030 – 70 million people (more than twice the number it is today, and ten times what it was 100 years ago).2 The over 85 part of our citizenry is the fastest growing segment of society (it’s predicted to be 8.5 million by 2030); by 2000 it had increased 28 times from what it was at the beginning of the last century. Singles comprise almost 50 percent of this category, which bodes ill for those that become incapacitated (the majority of singles living alone are women). The bulk of the rapid growth in seniors is just ahead, projected to occur between 2010 and 2030 – because of the boomers. As a precursor to demands on caregivers, it’s estimated about half of the 85 and older persons need some sort of assistance with daily living (bathing, eating, toileting, etc). And those over 85 absorb more than 20 times the NH costs as those 65-69.3 In over 20 states the over 65 population makes up more than 12 percent of the total population, and in Pennsylvania, West Virginia and Florida more than 15 percent. Some counties in Florida and other states, such as North Dakota, have an over 65 density rate of approximately 30 percent. We’ve got over 35 million seniors (65 and older) in the nation today, with projections of 87 million by 2050. As “demographics is destiny” this trend will alter the landscape in services, tax rates, real estate values and the cost of social programs. Just as the boomers have monopolized every national trend since entering kindergarten, they won’t disappoint with old age. In 1900 one in 25 Americans was over 65 (4 percent). In 1900 the average American lived to be 49 years old.4 Before the middle of this century, 20-25 percent of the populace will be over 65, with the majority (hopefully) supported through our entitlement network (Social Security, Medicare, Medicaid) – a huge responsibility for the working population. The Social Security Administration notes that the life expectancy for a male aged 65 in 1940 was 12.7 years; that’s expected to increase to approximately 18.6 years by 2040 – add another three years for females. The ratio of people of working age to those age 65 and above (the dependency ratio) may shrink from 4.7 today to 2.6 by 2040. 5 Although the problems of an aging society are gaining attention, until a situation attains “crisis mode”, solutions are not aggressively sought (when is a red light installed at an intersection? – after several accidents). “Quick fixes” to our dilemma will involve unimaginable pain to society. The antidote to major economic dislocations is intelligent advance planning (rare in Washington); in fairness to all segments of society, action sooner than later is relevant. And regardless of what our leaders in Washington do over the next decade to address these issues, you, as an individual, can (and should) prepare for the eventual changes sure to come. In the recent millennium census 12.4 percent of our populace was over age 65, while 21 percent was under age 15. Compare that to a country like Costa Rica where 34 percent of the population is under 15 and only 5 percent is over age 65. In many third world countries the population is exploding, causing other problems associated with the burden of too many people (of all ages). In chapter 11 we’ll discuss how the merging of these opposing trends could mitigate problems for both groups. Is modern medicine responsible for the increased longevity? Yes and no. People born in the recent past have a life expectancy, today, of around 77 years, 29 more years than those born at the turn of the 20th century. In 1900 75 percent of the population died before age 65; today 70 percent die after that number. Up to a few centuries ago, most of the world was “young” by today’s standards. For 99 percent of humanity’s life on this planet life expectancy was age 18.6 In the last century life expectancy increased by over 50 percent. Contrary to customary opinion, most of the increase in the averages occurred because of reduced mortality for the very young and young adults (thanks to vaccines and antibiotics eliminating infectious diseases which affect the young), and not high-tech medicine associated with old age. About six of those increased years are due to other factors such as better infrastructure – water, sewers, improved nutrition and more comfortable housing. Modern medicine can take credit for keeping us alive for short (2-3 years) periods as we approach death, but not for overall increased longevity. Society’s attitude towards longevity also plays a role which includes our acceptance or rejection of death. A large portion of total medical costs goes to people over 65 – about 40 percent of the pie; on top of that, Medicare spends 25 percent of its budget on individuals in the last year of life.7 The increase in medical expenses is not linear throughout life – it’s geometric as we age. As noted, we spend twenty times more on custodial funds for the frail over age 85 as compared to the younger elderly (65-69).8 Money well spent? A difficult question that will be debated and analyzed increasingly during the upcoming decades and where emotion, ethics and finance interact. Interestingly, all this money being spent on health care does not give Americans the longest average life expectancy – there are many countries ahead of us in the life expectancy game, including Canada, Japan (the longest) and Italy. Aging is not a disease – it’s a natural by-product of living long enough. Although our society is averse to natural aging (as evidenced by the cosmetic industry, both in personal beauty products and plastic surgery medicine), it’s a natural state of affairs. Live long enough, and the body’s resistance to deterioration and disease will eventually succumb – it’s a certainty. And if perchance one doesn’t succumb to one of the “gotchas” of old age (heart disease, cancer, stroke) then a gradual weakening will occur (entropy) which will eventually lead to an inability to function independently and a preponderance of time in bed. The study of why the...