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tv   Book TV After Words  CSPAN  February 26, 2011 10:00pm-10:59pm EST

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>> host: susan jacoby, welcome. you're the author inouye but "never say die" with the subtitle of the myth of marketing of the new old age. so what is the myth of marketing of the new old age? >> guest: the new old age is that we are all -- and by weak i really mean people who are not old now. the age of people who are in their 50s and 60s now and their 40's. but our old age is going to be lived in a way that is totally different from the way old age has been lived in the past, that we are going to all the sky and diving i like to think of it. but we are simply going to get
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older, but not actually old. >> host: why do you think the culture likes sugarcoating old age? >> guest: it's very interesting. when i was growing up like the oldest boomers in the 1950's, i would say that attitudes toward old age were negative in a particular age. old age started the minute amana retired and returned home to bother his wife. her only role was to be their grandmother to her grandchildren, and that was the whole idea not just of old age but of anybody that was retired in their 60s. now i think we have had a great corrective to that in which the aarp has had the role we now understand people over 65 can do a lot of things and their only role isn't just lying around the house watching tv and working after the grand kids and the new
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age's that's taken over is this, it's great to be old as long as you don't exhibit any of the typical problems of old age, and old age is also very much redefined in terms of the young old age which sociologists and doctors call people in their sixties and seventies who are basically pretty healthy even if they have had all kinds of diseases like cancer and heart disease and old old age in the late 80's and 90's of who so many older boomers are going to live to the era the typical problems of people in the old old age or downplayed if you decide to write the book you write to a panel of the world science the title 90's the new 50 does anybody really believe that, and the answer is there are a lot of people in their 40's, 50's and 60's who do believe that.
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so it's a new kind of subtle form of ages and it's great to be old as long as you don't have any of the typical problems of people who are really old. we use the phrase old old. what is that? >> guest: it's a phrase used by doctors and sociologists and it is used basically for people in their late 80s and 90s as opposed to those in their 60's and 70's and its right to make that distinction because people in their 90s in terms of health and abilities, i'm not talking about exceptions i'm talking about the majority of people to talk about them as though they were the same as the people in the 60's to talk about people in the 60's as they appear in the 30's. other people in their 60s like to think they are in their 30s but they are diluted. >> host: you see the overwhelming so old old age are health overtime which is
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inevitable and the tendency for most people to get poor, and use it just there's some collective action we should take in response to that. what are those two points? >> guest: health there is not much we can do about and there are people who don't -- whose health doesn't constantly worry over time but those of us who have parents that have survived into their 90s as i have no that the typical person has to deal with many more health problems over time. this by the way the problems have to be looked at as not entirely but there are a huge women's issue because right now the vast majority of people over 85 or women, and everybody gets poor over time except people like say warren buffett. i am sure he is going to be well fixed at 92, but women in particular get poor because there's lots of things that happen to the total income with the death of a husband.
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this is true with women today most of whom didn't work outside their home in their 90s, but it's also going to be true to some degree of the boomer women because they have more interrupted work patterns than the men do which reduces the total amount of either penchant or social security income of a lifetime to people that poor as they get older and more over this is also connected with worse health because people need more services as they get older that cost money. most of which none of our social service programs which the republicans are eager to cut and certain democrats as well pay for it already so people's needs in terms of the systems they need if they would like to one of living independently become greater and the time their income becomes less. >> host: he mentioned in the book you had a friend who when you told her you are writing a book about aging and old age your writing a book about women
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for the expect reason you say statistically the women live longer and have a more problematic -- >> right. people in this age group among the women in their nineties, social security makes up about 90% of their income. there's not a lot of money laughter round by then. i would like to see something i forget in interviews. i think that one of the problems here in thinking about this rationally is we do live in a society in which the idea that people ought to be able to save enough, to finance a 30 year retirement there is something wrong with you if you can't do that. and this is ridiculous. the social security act was signed in 1935. the average life expectancy was 62 and people were not able to save enough for their old age, that's why social security was enacted, but no one foresaw a
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time when right now all of the baby boomers turning 65 in 20 years they are going to be 85 or 8.5 billion of them. a saving enough money to finance it in your retirement and 30 retirement if you have an average income if you're not rich or two different things. it is not a matter of moral turpitude of the average family in this country can not save enough to finance the retirement and furthermore there is the question do we want a society in which let's say 45 orie 50-year-old parent sister their kid in college i can't help you i'm putting aside money for long-term care. is that a healthy society? i don't think so >> host: some of the consequences perhaps of growing up as i did come as you did come in the age of medical miracles, i was just a little girl when the polio vaccine came along. there's always been antibiotics.
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we had fake hips and knees and organ transplants. that is the medical norm now. people who have taken a vantage or have not been disadvantaged because they have had access to this kind of care would i think assume that that is a good thing, but you need a sort of overall picture in your book that these things do have consequences because the prolonged life beyond what our social network safety network was able to provide or was created to provide. >> guest: that's true, but i think they have other consequences in antibiotics. people who would have died of pneumonia at 65 or if they got a bad case of pneumonia don't get any more because there are antibiotics talking about the older age group. but i think there is something else about medical miracles that
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creates a problem in thinking realistically about old age is things like my first medical memory spanning the length of the vaccine, too. i am just old enough to remember life in the summer before this fall's vaccine when your parents would never let you go out to go swimming because they were so terrified of polio. the was eradicated overnight. i think because we have grown up amidst these medical miracles we don't realize some of the things that kill people and old age inevitably, alzheimer's disease, for a simple, or forms of cancer that hit in old age, if they don't fit in old age your immune system becomes too weak to overcome them but these things are far more complicated will require if they are ever to be ameliorated they require research at the basic biomedical level which is now going on, and they are very connected.
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the more alzheimer's research is being done the would assume when they started it that a disease that's common and nearly half of all people over 85 have it, something else nobody likes to hear. don't shoot the messenger. [laughter] but these things are not easy to find an answer to, not that anything like polio seemed easy before they found the vaccine either, but they are far more complex. most of the scientists i've talked to, far from the 90's, the new 50 crowd feel that the solution to these things or are even let's say something the would deily alzheimer's which would be a wonderful thing. utter much likely to be there for our children or grandchildren or people who are now in their 50s and early 60's to count on this, to give them a new old age is really not being realistic. i like to quote my good friend, dr. robert butler, who in sure
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you know died at age 82 last year of leukemia and he invented the field of gerontology and was the first director of the national institute on aging and was the only voice of irrationality on that that 90 is the new 50 panel and i asked him a few months before he died, i interviewed him for the book and i said you know, what do you think about the prospect for, say, a cure for alzheimer's and he said i may scientist and nobody believes in science more than a scientist and i would like nothing better than to weaken tomorrow morning and see in the newspaper that there is a cure for alzheimer's. he said realistically the reason we need to invest more in the research now is that it's still a long way away. and furthermore, you can always hope for something like that, but you can't base a strategy for dealing with old age on the assumption that this is going to have been for you and magically whisk it away and that is my view. we can always hope for a medical
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miracle but co-pays and a plan of action. hope is just hope. >> host: i thought your chapter on alzheimer's was the most passionate in the book or maybe i was bringing my own experiences to that. talk to us a little bit about how you develop that chapter and the personal experiences that you have that may be shaped that chapter. >> guest: well, alzheimer's, not in my family, my mother and my grandmother -- by grandmother lived to be 99 with a body and sound mind and i never personally experience with alzheimer's until my partner, who was 15 years older than i got it, and mercifully he died three years of cancer before the last remnants of his mind went. one thing this experience is helping to care for some with
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alzheimer's changed my thinking about one thing first of all it changed my magical thinking about it. i know that intelligent and educated people get alzheimer's too. i fought my way of thinking will come if you're smart and engaged with life and work hard and do intellectual work and exercise and eat your vegetables you're not going to get alzheimer's. this is nonsense as the institute of health found out in a major review and exercise and it's in to protect them from alzheimer's. those are people themselves from the exercise, the greens and intellectual work are not a letter to become magical but clinton cannot get alzheimer's. but one of the thing about it that is so tragic and when you think the risk of it doubles and a free fight your period over 65
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and that half of people who are over 85 have dementia of which alzheimer's is a leading cause. my partner when he was sort of in the middle stages when he could still do some things but not others i remember him turning to me on the crosstown bus and say i feel it somewhere inside me is the person i really am. the person i was before, but he said i can't find. i can't talk to him. if there was ever a definition of what happened in the dying brain of a person with alzheimer's that is it. and you understand what this means and also understand how tragic this false hope is and i have to say one of the things that particularly enrages me for
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the ads for the so-called memory pills. i won't mention the brand names but you know what they are, helping dad be more like himself, which by the way we also found to be basically to have affected all and the national institutes of health one daughter turns to the other and says help that be more like himself. but it doesn't show is that taking the pill, walking out of the house, getting lost and not being found for seven hours, and i will just close with one more personal thing. my partner took them, but i know when he was still able to think things through he had no faith in them. i can remember taking the memory pill on one day and singing in yiddish [inaudible] , which means basically nothing will help. this was the punch line of a lot of old jewish jokes he used to tell in the days he could tell jokes, and i cut this false idea that there are all sorts of ways
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right now we can armored ourselves against, this is not good for people. it's great to hope you'll never get it but to think that you are living right things are going to turn out right for you. >> host: do you think the boomers are particularly susceptible to that kind of wishful thinking or if so, which comes first? the products that you mentioned that are advertised and the leaking pipes, the viagra come all these sorts of things -- >> guest: viagra works. [laughter] different from the memory tells it actually works. >> host: products and that the baby boomers, to make us think that if we take them or use them i would change as i become 80 or 85. >> guest: i think that there is a lot of -- there's a lot in our history and our social history that makes us have a lot of faith in the idea of self
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transformation that you are the master of your faith and of yourself, and i don't for one minute want to denigrate the value of good health hazards. these habits, things like exercise and so on have been shown to meet you healthier while you are healthy. they may make you healthy year in old age than you would have been otherwise they probably will. they are good things in themselves because they make your life better. they are not and anti-ageing hill. they are something that is good for their own sake, but they are not any more than transcendental meditation was or all of the -- we can all remember the self-help movement of the 70's. some of them were good, some of them were -- but they don't or were you against something which is inevitable, which is getting older and the realities of disease and economic problems
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that now a company getting older. there are some things that are not within our control. we can make the best of what life handsaws and part of that is the genetic hand that we are dealt, but i like to say that we are all capable of aging successfully until we aren't. >> host: what do you mean by that aging successfully? >> guest: aging successfully, what i mean is making the best of your health at any given point. but what i think society means by it is not seen in old at all. now my mother is now 90. if you had asked me, she would have been a prime example of success preaching for years ago. she did 25 hours of volunteer work at the critical care unit of her local hospital and a huge job. if you ask me about her you would know that she was really on top of her game, but again, like my grandmother, she has a fully functioning brain in a body that has led her down and
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is now mostly confined to her room and an assisted living facilities. so, she was capable of aging successfully until some diseases she had had because as you get older, your immune system ability to fight off things that when you are 60 and 70 you can live with a lot more easily. so what i mean by aging successfully is doing everything you can at that moment year to be cut. but there is a point at which there is this very till we all have, i'm going to drop dead at the age of 95 in the middle of making love or para gura -- para gliding or skydiving. with no pain, nothing leading up to it, and in fact you don't get to choose the manner of your own death in that way. my mother, who is very frank and has a living will and a health care proxy for years, her children don't need to wonder what she wants done.
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my mother says frankly she doesn't -- the life she is living now she doesn't consider life she would have liked to have dropped a bit of a heart attack while she was doing volunteer work but that isn't what happened. >> host: what does she think of your book? >> guest: she les my book and it's interesting. i've had a number of females and response to various articles in various places. the older people are the better they like my book. i've had a lot of responses from computer savvy people in their 80s saying you've said what i would like to say but i don't dare say and i find these interesting. you asked about successful aging. what they mean by the don't dare to say them is one of the ways in which yo get viewed as a hip older person by younger people is you never complain about your health because nobody that is in good health wants to hear, and i don't think anybody who's in
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good health really understands what it is to get up every morning and fight to deal with, you know, very d'aspin and things like that that you don't feel the way a 30-year-old or a 50-year-old does when you're 85 or in a relatively healthy 85 year old person, so you don't talk about bad health. you don't talk about losses and if you are grieving for a partner, a longtime partner who died, yes, it were allowed a month or two of tears, but i saw this ridiculous piece in "the new york times" a few days ago, and op-ed piece about some social scientist has done a study, you know, that basically most people are supposed to get with it after about six months and yes, they may still grieve for their partner, but tears or thinking about the partner all the time or a constant feeling of sadness may be a sign of depression or something more, and that is another thing.
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so you have to project a positive attitude. frankly i don't understand anybody who six months after the death of a partner of 30 years feels okay and doesn't think about them all the time. but i think that is one of the -- positive thinking business is something our society imposes on everybody, but with no group is more coerced by that than the old. because if you express sorrow or dissatisfaction when he or 85 with something a 45-year-old would be considered a normal right, at 85 it is o.k. he's just a cranky old geezer, she's just a mean old crone. what people express when they are older is put down to old age rather than the legitimate response to a loss which anybody would have if they had it at any age except old people had more of them, and i suspect --
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>> host: i suspect old people are reluctant to express those genuine emotions because of another point to make in the book which is the factor that when people get old, may be their partner died so they don't have the primary person to love or maybe there is not a child in the picture, and the social circle has shrunk, so i would think that what you're saying is that the society coerces people not to be that a grumpy old man because it pushes people even further away. some talk about that loneliness, and in particular affects the oldest old, i think one of the reasons it may well be true is that women do better as widows than men as we grow worse is to have more women friends and this is true. win in relief to other women more closely throughout the lives at least now. that may not be true in a generation from now. but still, the men do but when a
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woman lives to be really old into her 90s, then because she is the oldest of the old survivors she begins to lose her female friends, too. my grandmother who did live to be 99i talked to quite a lot about this and one of the things she said to me is and she's a person who always made anybody who had as gold of old age they could she did. but she said one of the hardest things about being in her mind these days she outlived anyone who didn't see her as this old woman but remembered her as she was, the young and vibrant growth and woman but those people were all gone and will of course you can have canceled all ages and good friends there is a special thing to friends of your own generation, and for the people who live the longest, they have to cope with not just one loss of the primary person
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in their life, but a succession of losses of the people who are not as hardy as they are dhaka off before them. >> host: my father who is 86 lives right in the area where he grew up, and his high school class still has a reunion once a year and is just such a highlight of his year to go to this and see people he probably doesn't see from year to year. but i think that element of having been children to get there, it reminds them of themselves at that age. >> guest: even thought mrs. early children, but just somebody you knew when you were young adults. all of the people, you know, that my grandmother and my grandfather used to do things with and so on, she outlived them all. and even a loving child to not make up for the absence of your contemporaries. >> host: you mentioned aarp in your book a few times and say
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that the organization hasn't really helped the american society have a full picture of the realities of the old old. what is that organization to? >> guest: i do believe that and i should say that i am not just criticizing aarp, i wrote for the aarp publications for years, so why am criticizing is myself. but my thinking about age has changed since i was writing for the with him and the magazine. i think that one of the things that aarp needs to do is it needs to first of all stop concentrating which i think it does in its publications on the 50 and 60 and early 70's something and start presenting the full picture of older people as well. if you look at any of the aarp features on people we love, almost all of them will be in their 50s and 60s. i know that's where the business is, that is where the boomers are, and there will be one
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person in their 80s, and this was always the case in the aarp publications, because articles about people who are really sick and how they cope with it, i think they ought to be doing more of that. but they are also down articles that's hard to do them well. the story i told on myself in this book was this was many years ago and the editors were not the editors then. but i was asked to do a story about people who after a serious illness had made big changes in their health habits and had greatly improved their lives, and the first person i thought of was a high school classmate who had a form of cancer in her 50s that she was supposed to die from and she didn't, and when it became clear she wasn't going to die she responded by giving up smoking and losing 50 pounds and they ran a picture of her. she was 56 then. i swear, she was so gorgeous she
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looked not really -- anybody would have recognized her as a high school cheerleader she was. i didn't interview anybody over 64 for that article because i couldn't find these triumphant stories and people who were in the late 70's and 80's. now they exist, but i think that simply by featuring a number of people in these publications so constantly and not older people, they are suggesting that people in their eighties can expect the same results and the fight aging in the same way people in their 50s can come and by the way it's fine, people over 50, i've been a member of aarp since i was over 50, but people in their 50s comparing them to people in their 80s is also ridiculous, but i think mostly the aarp publications present in their personal with samples the suns by the old age, always come and i don't think given that the aarp represents all seen years
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and has a huge battle on its hands and is going to for the next ten years to maintain medicare and social security in ways that old people need, but it needs to start featuring more of the worst problems as well as the best case out comes. >> host: is there any aspect of popular culture that does, in your mind, present the accurate view of greedy old age? do we have any tv shows, do we have any -- >> guest: in popular culture? >> host: in popular culture. >> guest: of course you know how few television shows are on the feature older characters, but the fact that we keep coming back to betty white -- how few of them there or because anybody asks about that, the only person you can think of is that the white -- betty white, the most
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wanted talk-show host. by the way this wasn't about people who were old, really they were the young old, i really the old series "the golden girls," i thought was completely unrealistic about life for women in their 50s and 60s. host could have a lot of dates. >> guest: the only concern was getting another man. the only realistic problems that real women in their 50s and 60s face. so why don't think that there is anything in the popular culture because popular culture doesn't -- what it likes to look at is the rare old person like betty white who doesn't seem old. i mean, i couldn't move my hips and dance like betty white when i was 30. danny white is one of those unusual people, but i don't think there is anything in the popular culture that accurately reflect the lives of old people because it is a downer, and even not in popular culture, the hbo
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production "alzheimer's project," which is the first real tv series to really examine alzheimer's and produced by maria shriver, who's author of course recently died. one of the things wrong with that series was it presented only nice long-term care facilities for people -- it was horrifying enough it didn't show -- did should people in the last stage was like there was always a caretaker, home, there was nothing about the people who have no caretakers in the late stages of alzheimer's, people who are not in the mice nursing home whose life savings have run out and are in nursing homes on medicaid and i've done articles of nursing homes when i work number and they are not nice places. so it did not -- in a way it should the worst case individual
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scenario. there was always a caretaker. there was always a woman. there was a woman who had given up her job in minneapolis to care for her mother. who's going to care for that woman? the years that she lost caretaking. that is a very, very serious issue -- >> host: [inaudible] >> guest: let's just say a woman is willing to quit her job in her 50s to take care of her mother well, that woman is going to need to be taken care of in one way or another when she's older and the fact that she quit her job, we don't have anything really that provides for long-term care in homes even for people in the middle stages of alzheimer's who can do a lot. when my partner was in the middle stages of alzheimer's, and i emphasize he did not reach, cancer mercifully took him before then, but there were a lot of people involved in his care, and he had something i felt was stupid and devoted
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children and people who subbed for each other, he had a big network and for when there couldn't be somebody there because he did reach a point he really couldn't be left unsupervised even though he could still do things light enjoy old movies and things like that, but he couldn't be trusted not to turn the stove on and burn the house down. he had taken -- when he retired he took a lot of medical benefits that provided for some home care. we needed that. most people can't afford that. and we are talking about cutting down when interest to provide home benefits for families who are willing and able and eager to help care for a person cost so much less than to put people's life savings run out and put them in a nursing home. >> host: you make a number of criticisms on the medicare program, particularly that assistance for the home caregiver isn't covered. why don't you talk more about
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that. >> guest: this is a hard thing to talk about because nobody is talking about expanding services. now all people are talking about in medicare is ways to cut them and in fact i think there are a number of things we are going to have to do to reduce end of life care would only prolong staff and i will talk about that in a bid. it is a great criticism of medicare that you cannot -- with say you have a husband at home in the middle stages of alzheimer's, but you cannot care for him 24 hours a day. you have the job yourself, and in come you very much need. medicare will not pay for people to come in for eight hours a day, the eight hours you need to work which would be so much cheaper in the long run, but we are a country that doesn't do long run thinking. but having people lose their assets and having to put somebody into a nursing home when there is someone who is willing and eager to provide care at home if only they had
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some help. >> host: nursing homes cost maybe three times as much -- >> guest: that's right. and there are people who need nursing homes, make no mistake about it. but there are people who could stay at home longer. there are howls the old people who could live independently longer if they could have nursing homes. if they could have some kind of home care, not necessarily medicare, which our society doesn't pay for unless you have completely exhausted all of your assets. this is going to be an urgent issue as boomers live to be over 85. and of course now there certainly isn't going to be any discussion of it right now because all we are talking about is about how to cut the cost of medicare. well, now i will talk about that. i can tell you -- i can tell you one thing that would cut the cost of in that life care and it's not death panels. it is the thing that out of the
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political power has been retreated from which is paying for voluntary consultations between older people when they are healthy. it doesn't have to be when they are sick infected is much better if it isn't. talking with their doctors about what are their feelings about in that life care. do the -- would they like for instance do they want -- to things which means as long as the heart is being whether you are in a coma or not, and that is what we spend a huge proportion of the medicare budget on in the last month of life. i think if people were encouraged to discuss this with their doctors, and by the way, doctors who are as scared of death and a daunting as anybody else need this discussion as much as their patients would encourage them to go home, talk to the people they loved, investigate the legal issues. only one-third of americans have living wills and also what you need which is someone legally appointed to make decisions for
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you if you can't take care of yourself. if only half of the 70% of americans who don't have any end of life care instructions would make those decisions for themselves, it is uncountable how much, since we spend so much in the last month of care, and this isn't death panels it is people being encouraged to think about what the 90 per cent of americans say they would like to buy a home. i will definitely use my mother as an ex sable. schmidle her living away and planted my brother and me as her legal representatives 30 years ago, and we are in no doubt about what she wants, and in fact, she has rejected all kinds of care already. we don't have to make decisions for her now because she is of sound mind. if she ever is not, then we will do exactly what she said. we would be afraid not to. laughter, but the point is, she's taken care of. my mother is not going to cost one-third of the medicare budget
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in the last year of her life. she understands and accepts the difference between care that can only prolong her dying and care could return her to a good quality-of-life and there isn't much of that for her any more. she made these decisions when she was healthy. i'm not saying anybody is as strong minded as my mother, but a lot of people are. if they are encouraged to do it. that is a way, without having a death panels or even talking about assisted suicide, we can encourage people who want to make plans for their own end of life here to do it instead of avoiding the subject and eating it. >> host: if somebody wants to have a living will, tell us what that means. what steps somebody has to go through, what questions they have to ask themselves and answer. >> guest: first of all, a living will, not every state but we recognize is living wills. first of all, you have to find out what your state law is about this. and this is something -- aarp is
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full of information. if you can't use the internet you can call the appropriate office of aarp and they will tell you exactly what your state law is about this, and even those people who can't use the internet, which i think more of the boomers will be able to use the internet, but even if you can't, you can call up aarp, you can call with your local citizen's council and they will tell you what the state of law is. it is -- if you are not rich and there are financial issues involved with your regular will come in you need to have a lawyer for that. by understand there are people who want the do-it-yourself willes, but they're all kind of senior centers that offer aid at a fairly moderate rate. but for a living will, a living will sort of states your wishes saying a living will state's coffers example, a new york state that if there is no chance of my returning to -- recovering to life being able to speak
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again i do not want to be hooked up to ventilators, i do not want to be force fed by tubes. it spells it out quite explicitly. and any -- any legal -- any lawyer will draw up one of those if the states allow. the living will was not all you need. you must discuss this with whoever and appoint a legal representative to act for you if you cannot act for yourself. because many people, by the time these issues arise they can't act for themselves. your children, your spouse or your friend if you are not married. this is going to be a bigger issue for boomers because many more who are divorced, boomers have smaller families. the assumption that there is going to be someone, and by the way, the person you a point may not necessarily your child. it will be if you don't like anyone, and it may be a child who doesn't agree with your ideas about that at all. people need to appoint legally it representative, and you
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actually do need a lawyer and a notary to do it, but it doesn't cost a great deal in most places. if you call aarp or a senior organization they will tell you how to find legal health witnesses for not very much money. but you have to have a will that spells out what you don't want done to you if you cannot recover, and somebody to sign the papers for you if you cannot assign them for yourself. the people who criticize this and talk about these as death penalties -- panels, as far as i'm concerned, the year idiots. the one was the chair of president bush's counseling bioethics, president bush the younger. he is opposed to living wills because he writes that no one can possibly imagine what they would do in all future contingencies and there is no substitute for a loving partner. good for him. he's got a loving partner and
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wife but there are a lot people particularly women who won't have a loving partner even if the had a loving partner for most of their lives. and while it is certainly true that you cannot know what you would do in every circumstance, i can't know whether it might me gets worse i am willing to go through a knee replacement or whether there would rather call boehler around on a leaf from 20 years ago, i don't know the answer to that. but i do know that if my brain, if my high your brain functioning as are done but i do not want to be force fed to keep my body alive, that i do not want to be hooked up to an artificial been a leader if i am 85-years-old and cannot breathe on my own, that i don't know -- i can't answer what i would do in every situation doesn't mean that i can't know what i would do in the most common situation. and i think whatever anyone says
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about this i do think the objections to this or a particular kind of highly conservative religion. i was raised catholic. i'm an atheist but i was raised catholic and i know the catholic church has no objection to saying you don't want, you know, to be on a ventilator if you can't get better. that is not considered suicide. it's considered you don't have an obligation to have everything to keep your body alive as long as possible. but there is a particular kind of i would say very antiindividualistic religion which says everything is in god's hands, we don't have the right to make any decisions for ourselves and i think that is where the opposition on the far right is coming to the whole idea of living wills because the mainstream religions do not object to these things at all. many of them do object in suicide but that is a different thing. assistant suicide is a very different thing from saying i
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don't want extreme things done just to keep my heart artificially pumping when i am not going to be me again. >> host: you do to say the suicide or assisted suicide can be a rational choice, and you go on to make the point that in medicine at least what practiced in this country tends to view anybody that reaches that decision that that is the option that they want to take has either lost their marbles or is depressed and can be cured by pills. >> guest: the fact that -- the fact that suicide is rare under any circumstance is borne out by states like organ that have had assisted suicide for ten years. very few people use them to read a number of people who use them are people who work terminal within six months and numbered in the hundreds. many who went through the process of applying for this didn't do it. most people are not going to commit suicide under any circumstances.
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but i believe that for people who are an unbearable pain, it is a rational choice. and i don't agree at all that everybody who wants to commit suicide is irrational or depressed, and i think this is part of patronizing. i don't deny for a minute that there are some people who are depressed, it for a simple, i will give you an example of people who are depressed. there are people who -- people and their sixties or seventies or when they receive a diagnosis of something like see multiple sclerosis or parkinson's, which doherty eventually going to die of, but unlike, say alzheimer's or some various forms of cancer, they are manageable and treatable and you can have a meaningful life for a long time. they are not a death sentence. but there are people who will treat that kind of the diagnosis as if it were an immediate death sentence. those are people whose thinking is distorted, and many of them might not need only to be on the anti-depressant, but to have
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therapy and to have their disease explained to them better so that they don't. a lot of people who treat something that isn't a death sentence as a death sentence are depressed and irrational in their thinking about what is always, who likes to put the cat ms or parkinson's? nobody. we can cite huge numbers of examples of people who live meaningful lives long years, decades after these diagnosis you can live with it unlike some of the worst diseases of old, old age. some people who are not terminal and everybody that has said i have had a good life and have had enough is depressed. one example use in my book is this 100 two-year-old man in st. louis, very well known in st. louis, i'm sure the shrinks would have just loved to have gotten their hands on him, he was a leader in the jewish community, he built half of st. louis. when st. louis was very much still the southern town and its racial attitudes the unions on
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the construction projects and african-americans. he was a huge civic figure philanthropist and builder in st. louis and was just fine until he was about 99 when he fell and broke his hip. any bid, again, a great example of someone who can age successfully until you can't. then he had to have a companion, which for a man like this heated. there was nothing wrong with his mind. two weeks before he committed suicide he had given a from memory speech at a synagogue about what a great life he had. he outlived to wives and lift some of his children, has grandchildren. well, what he did one morning, and he took living with a companion, well i'm sure that there are a lot of the people, people who commit suicide are all crazy, thank god the helping professions didn't get their hands on him. he, one morning, stole the keys to his companion's car. he had been a champion swimmer in high school and college.
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he drove it from his lifelong -- he had all the money in the world. he would have died at home, but he didn't want his every move monitored by another person obviously. he drove his car to the missouri river, got up on the bridge and drove off of and committed suicide. now i am not advocating people do this. i'm saying i don't think this man was crazy in the letters that he left for his grandchildren said please don't grieve for me or think i was out of my mind. he said i don't want to live until i have no control over my own death. i can't do any of the things really that have given my life meaning, and i'm not -- - this is a case of a man who said enough, i have had a great life. it's downhill from here, and again, i don't advocate this, but i don't think he was crazy, and i am glad that some psychiatrists with anti-depressant and xanax didn't get him in his hands before he took his own.
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>> host: well, i don't want to get away from this before i ask you what the two or three or four public policy decisions or what needs to be done in order to start addressing the issues that you raised in your book. >> guest: you mean everything that's being talked about in washington right now. we need social security it's not in desperate straits now. but we need not to reduce social security benefits. >> host: not increase the retirement age. >> guest: no, actually i think we can increase the retirement age. i think we can increase it a few years. but it has to be with an understanding that's not an absolute requirement. i hate the idea of retirement. until someone fires me i'm not retiring, which could happen. but until that happens, and as long as i have my mind, i intend to be working. but there are people who have spent a whole lifetime of
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physical labor, and i don't just mean working in coal mines. i also mean physically on the body, having stood behind the retail counter on my feet for 40 years for more physical taxing than having been a writer. there are people who need to retire before age 70. firefighters, and not just that, there are a lot of low-income jobs that are relentless physical work, and i think that to say for instance that everyone made their living say as a health care aide in the hospital can't retire until they are 70 is wrong, so i think that there has to be a lot of exceptions, raise the retirement age, yeah, but also build a lot of physical the exceptions, you know, into that law. the hardest thing in the world to do. we have to raise the retirement age for a lot of people the retirement age could be raised to 70. for a lot of people that can't.
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there is no one-size-fits-all. i don't think we need to cut social security benefits at all. i think we must not, because they are not generous now. three-quarters over 75 live on $34,000 a year or less including social security. does that sound like rich greedy geezers to you? first of all, we need to tax, we need to raise social security withholding tax and apply it to everyone. >> host: even the rich people? >> guest: yes, but even people, you know, right now i think the ceiling is $109,000. and there aren't too many people who make more than $109,000, but everybody should pay social security withholding is on every date that they've made, whether they make $109,000 or $100 million. that said, you can do that. they're still probably has to be an increase in taxes as well.
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cutting the retirement age and taxing all incomes will do part of it, but there will have to be probably how your tax. i don't think that higher taxes, and i am not in that fortunate billionaires' category, high your taxes on the understand or a dirty word, and what we have written or politicians encouraging the public and the reality about this. the polls show the majority of people are totally opposed to cutting either medicare or social security benefits. they also totally opposed to paying more taxes for it. that cannot be. there are not politicians of either party that have the courage to tell people either we cannot cut social security benefits. people need that. i think also yes, you could also have a means test in the people who make $1 billion a year who are 80-years-old don't need social security. but that, that is such a small percentage of it that inevitably
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it reforms social security is going to mean raising the retirement age in a sensible way, taxing everybody on all of their income for social security and probably raising it. if we don't do that, if we don't do that we are going to undo the most stellar achievements of the american 20th century which is the reduction of old age poverty. medicare is harder. the medicare system, again, i'm talking policy in the sky because nobody is talking right. every morning on morning joe i hear the talk constantly about the need to cut entitlements, medicare, medicaid, medicare really does need a fix, but it's the kind of fix that has to come the way that it's come the equivalent of the medical care doesn't cost the european countries the proportion of their gross national product that it does to us. why? first of all, there are real
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tight government ceilings on certain procedures, and if you have government cost controls, for instance, the bush prescription drug plan, which passed the prescription drug plan is a great thing but without passing the cost controls at which the government demands certain concessions for big forma which can still make money, you know, charging a lot less for those drugs, if the government is going to be your biggest customer, it has the right to demand a ceiling on drugs, which costs the same drugs which cost so much less than every other country in the developed world. there is no solution to providing universal health care for the old without more government cost controls. but i believe also there really is no solution to the problems of medicare for the old, the financial ones without a solution to the rising cost of health care and health insurance for the young. i write in my book when i started working at "the
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washington post" in 1965, social security seemed a lot bigger on $105 a week salary than it did leader, but i didn't resent it. that was for my grandparents. however, i had good health insurance from the "washington post" and health care didn't cost that much. now, for the last 20 years i have been spending 15% of my after-tax income for that private health insurance plan. the next generation below the boomers of whom there are fewer than last is not going to so easily accept those texas for medicare and social security if the cost of their own bad health insurance keeps rising i don't believe the one problem can be solved without the other. and by the way, i am not very impressed by the stands of old people over 65 on the last health care reform bill which
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whatever you think of that bill was the first attempt to address this issue. the majority of people over 65 are opposed to universal health care for anybody who has themselves have better things. the aarp knows that a lot of people resign because they supported health care bill. there is no solution for the jongh are not going to support the old if the old don't recognize the financial stresses of the young as well. >> host: one reviewer called your book or called you a reality instructor and says it isn't a cheerful book. [laughter] are people buying it? >> guest: i don't know actually. i mean, i am booked to our land where you hardly know but i will tell you people either love or they hate this book. the people who hate eight hate it because they say it is too pessimistic. i call it realistic. the older people are the better they like it. the floods of e-mail i've had on my author website or people in
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their seventies and eighties who spend you know, this is what i wanted to say but didn't feel i could see it. people either love this book and considered it singing something that they have wanted to say, or they consider it an absolute diatribe. >> host: use of your friends and fellow writers encourage you to end the book on happy note. >> guest: i tried to get [laughter] >> host: do you think it comes of happy? >> guest: no, i tried to -- welcome they wanted me to and the note on what good advice to my have for people to solve these problems. >> host: of old age? >> guest: and one of the things i say in this book is that old age itself is not ultimately definable. the practical piece of advice i have caught it would work for everyone -- first of all, i think people need to stop thinking about retirement unless their whole purpose in life is looking the sunny clime which i admit after this winter seems more attractive, but the best
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place is with public transportation systems. there aren't a lot of them, but there are some. because one of the things that is so bad about a lot of this country is the minute you can no longer jul if you can no longer have a life. people can be an excellent mental state wanting to go to the theater, wanting to go out, wanting to go shopping, wanting to do all of these things they are perfectly capable of doing but not for let's say reasons of vision or something like that, they are unable to drive safely. well, in new york i see it everyday. i see people pushing their walkers on to the left of the buses and going all kinds of places. i see people with a little more money getting taxes, but you do not need a car to live in only a few cities in this country. so, we have a country without public transportation it is actually a many trend, people moving back to the cities when they reach retirement age. i do think that whether it is
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paid or unpaid work people who have their minds need to keep engaged in working in the community as long as they can. not because it is going to guarantee that they will never get alzheimer's or die and they can defy old age for ever, but c


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