Some Of Us Will Live Too Long

Can we live too long? How is that possible? A recent editorial in the Washington Post hinted at the problem:

“Wait,” you may say. “I thought life expectancy was decreasing.”There are two trends happening in the US. Yes, life expectancy is getting shorter overall. But, this is also a classic case of the “haves and the have nots.” Some people are dying sooner. But others are living a lot longer.

In my geriatric practice, I’m amazed at the number of people living into their late 90s. Most express surprise at living so long. Some are in amazing health. In fact, I have many patients who still work, well into their 80s.

We are making amazing strides in prolonging life.TAVR is such an example. In TAVR, a stenotic aortic valve is easily replaced in someone as old as 95, magically improving health for the recipient. Initially, I was a skeptic. But, I’ve found the results to be amazing. Someone 95 years old may now live another five or ten years. It sounds ridiculous, but I’m seeing it happen.

This creates problems.

How do you cover living expenses? Who is your caretaker when you become confused or debilitated? Your “kids” may literally be dying of old age. I am often astonished at the age and poor condition of the “children” who bring in their elderly parents.

Your support group and friends may all be dead. Do we really want to live “forever?”Even people with really bad health habits seem to be easily surviving into their late 80s. They may be on dialysis and a ton of medicines, but they are still getting around. Unfortunately, many need a lot of assistance at home. Most lack the financial reserves to afford such help.

It can be a catastrophe for the families tasked with such care.

The problem is going to dramatically worsen. Most of my elderly patients have something we younger workers can only imagine: A defined pension plan. Unfortunately, defined pension plans are vanishing. A defined pension plan is where you receive a check each month until you die.

Unless you work for the government, you need something else. You have to set aside a big pile of money and hope it lasts long enough until you die

.I recently sat with a financial planner. In his scenarios, he told me he assumes death at age 90. I stopped him: “You may want to rethink that calculation. I saw seven people today 93 or older.”If you retire at age 65, can you live for 30 years on savings alone? Probably, not! There are expenses you cannot imagine.

Medical care expenses and drug costs will surprise you.

Most people have no long term care insurance. Every week, I have to tell the shocked family of an elderly debilitated patient: “Yes, your family member needs assisted living or in-home care. No, Medicare does not cover that. You have to cover that. Plan on $6000 per month. Sorry. It’s just the way it is.”Tech founders are branching into healthcare and promising to make us all “live forever!”Can we survive it?

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