Chuck Lauer: Do your homework on the effects of aging

"What a drag it is getting old." That was Mick Jagger's scorching remark at age 23. But the truth of the matter is we all get old, even a 72-year-old rock superstar. All of us have to grapple with getting old — and with death that lurks on the other side.

Like many Americans, I've been able to ward off the aging process a little bit. In the mornings, I work out at a fitness center near my home, and then I walk the dog. It's one of the high points of my day. The dog used to be Yodie, my Alaskan Malamute, but Yodie passed away about two years ago, and now I walk Renny, a bulldog owned by my son and daughter-in-law, who live nearby.

It's nice having my son and his wife nearby and my wife at home with me. But not everyone has family around them as they get older. On our morning walk, Renny and I pass by a large house along the way where a very agreeable elderly woman has lived on her own for many years.

As we pass by, I usually grab her paper and fling it up toward her door so she doesn't have to walk down her long driveway to pick it up. If she's outside, she waves to me, and sometimes we have a brief chat. It's always very pleasant.

A few days ago, I caught a glimpse of her as she picked up her paper and went back inside. A moment later, she came back out again and gestured for me to come up the driveway. She had something to tell me. "As soon as I can get things organized," he said, "I'm going to sell the house and move." She told me she planned to go to an assisted living center several miles away.  

Then she got very frank with me. "I've been living alone for some time now," she said. "It gets very lonely." I muttered something that I hoped was comforting, but she looked at me and said, "I'm afraid that one of these mornings, they'll find me dead on the floor. I don't want things to end up that way."

I said I was sorry she'd be leaving the neighborhood, but she was making the right decision. Moving into an assisted living center can open up the world again for someone who has been living on her own. It even makes sense for many elderly couples. You can make friends and take part in a lot of activities without having to go outside.

I asked her how old she was. Eighty-nine. And when did her husband die? Twenty-three years ago! She seemed amazed at the stretch of time that had passed since then — all on her own. I told her that I'd be glad to help her in any way, and then Renny and I moved on.

Since then, I've been thinking about all the elderly people there are in my area who are living all alone. They've lost their husbands or wives and can't afford a live-in companion. Many people can stay quite active into their nineties, but their life isn't the same. Often their spouses have passed on, and their kids have moved far away.

Aging gets all the more challenging for people who have dementia. I read in the paper the other day that dementia is one of the three leading killers of Americans, along with heart disease and cancer. All three involve many years of decline. The other two require expensive drugs, surgeries and hospitalizations, but to a large extent these costs are covered by health insurance. Dementia, on the other hand, has no effective treatments. But according to a new study, it's even more expensive than cancer and heart disease, partly because much of the cost isn't covered by Medicare or other insurance.

The study, in the new issue of the Annals of Internal Medicine, found that the average out-of-pocket cost for a person with dementia was $61,522 over five years — more than 80 percent more than for people with other diseases. There is no effective treatment to slow down dementia, but patients need continual supervision. They need help with simple activities like eating, dressing and bathing. And if you turn away for a moment, they could wander off or fall. The costs of dementia often have to be paid by the children of these patients.

I got a taste of the seriousness of this problem the other day, when George, a good friend of mine, met me for lunch to discuss something that has been nagging at him, and is just getting worse. His mother is in the first stages of dementia. She lives alone and has been able to take care of herself, except that she can't drive any more. She was beginning to get lost when she went out driving, and one time a state trooper had to drive her home. Then her driver's license was taken away from her.

George is concerned about what happens next. "My sister and I don't know what to do," he said. The issue is complicated by the fact that his mother never learned to speak English well, and now his father has left her. "My dad got fed up and went back to the old country two weeks ago," he said. "He refuses to come back and take care of her."

"She's stubborn," he said. "I'm always worried that she'll get back in her car and get caught without a valid driver's license. And I worry about her taking care of herself. We've talked about paying someone to come by from time to time, but it's hard to find anyone who can speak her language."

"We've been thinking of selling her house and putting her into an apartment, but she can't be alone," he continued. He's priced out assisted living facilities for people with dementia. "I had no idea how expensive they are," he said. "We can't afford it."

To say George was anguished and distraught would be an understatement. He was in urgent need of advice. I recommended that he should read The Caregivers Toolbox, which is a superb resource for anyone dealing with a loved-one who has a serious illness.

I had just finished reading the book. One of the authors is Carolyn P. Hartley who has written nearly 20 books on health published by the American Medical Association, American Dental Association and the American Society of Clinical Oncology. Her co-author is Peter Wong who has advised senior-level management on healthcare and financial services for the past 25 years.

There are 36.5 million people in the United States who have been thrust into the role of amateur caregiver. In their introduction, the authors start on an upbeat note. "Thank God for you!" they say. "Your care contributes more than $572 billion per year in unpaid clinical support. That number is rising because of people living longer (hat off to the Boomers) but there are fewer people to manage care."

It's very demanding work. "If you are like the average caregiver, you spend about 22 hours a week providing support," the authors write. But there is help, if you look for it. Those hours can be minimized a little through "medications, exercise, access to care, long-term care insurance for home-based care or the rapid expansion of the home health agencies," they write.

Even families who have not dealt with the problems of aging spouses and parents can benefit from this book. Time passes too quickly, and no one is immune from the process of aging. One message of The Caregivers Toolbox is to plan in advance, before things become desperate. Take a little time to do your homework. Think about what you'll need to do, and organize for it. Believe me, you won't regret it.

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