When Ben Bernanke steps outside the realm of fiscal and monetary policy, it’s sensible to take notice. On April 7 of this year, the Federal Reserve chairman warned a Chamber of Commerce audience that the aging of the nation’s population poses a serious challenge to the economy. Mr. Bernanke cautioned that the U.S. “must begin now to prepare for this coming demographic transition.”
Few people know more about the potential impact of this transition than Dr. Robert Butler, head of the National Institute on Aging at the National Institutes of Health and founder of the International Longevity Center. A physician, gerontologist, psychiatrist, and public servant, Dr. Butler is widely regarded as the preeminent authority on aging and longevity. He’s also the Pulitzer Prize-willing author of six books about issues of aging. (The newest, The Longevity Prescription: The 8 Proven Keys to a Long, Healthy Life, was just published by Avery in May.)
In view of the oncoming demographic juggernaut, I asked this busy 83-year-old pioneer what investment advisors should know about the “longevity revolution,” and what they can do to anticipate older clients’ needs.
What’s the general outlook for baby boomers who are now heading into their older years?
Boomers are going to be in for a shock, because we haven’t started soon enough to address the challenges of aging.
They’re not likely to see the solution to Alzheimer’s disease in their lifetime. They’re not likely to have well-trained doctors to take care of them; they’re not likely to have enough money to live decently. They ought to get up off their you-know-whats and start struggling to get more funds for Alzheimer’s research, to push for training of more doctors to take care of them. They should be pushing the general culture to be more sensitive and not so ageist. They should fight age discrimination. Boomers are not doing any of this.
After 2025, 20% or more of the industrialized world will be 65 or older. We need to meet this challenge head on, and reexamine our views of aging right now.
What can advisors do to help?
I don’t know if it’s within the purview of advisors or not, but they could become advocates for change in these issues I mentioned. For example, only 11 of the 45 medical schools in this country even have geriatrics departments. In England, geriatric medicine is the number two specialty in medical schools.
We have a tremendous opportunity to benefit from the productivity of active, vigorous, robust older people for an extra 30 years. The boomer generation is 29% of the U.S. population. They can transform what it means to live a long life.
What’s the biggest misconception about aging?
The usual perception is that we can’t afford all those old people. We tend to view generational needs as a zero-sum game: if one person gains something, another person has to lose something. That’s very negative and ageist. We need to think about the senior or mature market as the Japanese do, as a resource to develop and exploit.
Older people should probably plan to work longer than they envisioned. The contribution they can make is very valuable. Politicians talk about Social Security and Medicare as “an intolerable burden” that has “handicapped the young.” We brought Social Security actuaries to testify in Congressional hearings in 1979. It’s very obvious and striking that if people stay in the workforce longer, they put more money into the system and take less money out.
In my view, a new body of thought is not receiving the attention it needs. Studies by the University of Chicago, the Rand Corporation, Yale, Harvard, and our own International Longevity Center show that nations where the inhabitants live longer create more GDP.
Think of the older generation’s spending on travel, college, grandchildren, life insurance, medical procedures–cataract surgery, hip replacements, and so on–assisted living and other housing arrangements…these are all related to age and all create wealth. So my argument is: we can afford old age, and we need to get off the position that we can’t.
What’s the most important issue around longevity that we need to address?
There’s a revolution in longevity–but we could lose it. What good will it do to live longer if we don’t learn to treat each other better?
First, longevity is desirable if it’s accompanied by a life of high quality. Second, most people, if they have a choice, would opt for longevity of the mind.
Not to become senile, in other words?
People used to think senility was inevitable with aging, but the 10-year Human Aging longitudinal study showed that what we called senility was actually a disease. Meta Neuman, a neuropathologist, discovered Alzheimer’s pathology in the brain.
Knowing that half of the people in nursing homes had this condition, I began working to make Alzheimer’s disease a major national priority, and later helped found the Alzheimer’s Disease Association.
Surprisingly, no one had ever dealt with Alzheimer’s up to then. It’s the most common form of dementia, but there’s no evidence that it’s more frequent than before. It’s simply that more people are surviving into old age, where they become more susceptible, and we are getting better at diagnosing it.
To attack Alzheimer’s, we need a better understanding of the role of genes and cells, of our own wiring, of behavior. I am in favor of our country sponsoring a public/private research initiative called “The Century of the Brain” to understand the brain and dementias. Let’s see how innovative we dare to be.
How will the growing cohort of people in their 60s and 70s change the country?
Dramatically! In terms of sheer numbers, one out of every four adults will be over 65. Just as when you have a very youth-oriented culture–think of China’s one child policy, which has produced a generation of “little emperors”–now, just by sheer numbers, we’ll have more of a consciousness and focus on aging.
Economically, we’ll face the reality of increased Social Security costs, but these are predictable. If people stay in the workforce longer, it will help the solvency of Social Security, or might even rescue it.
I also see cultural change. Older people have a life to look back on, while younger people are mainly looking ahead. Our cultural focus may become more retrospective, thinking about wonderful times or not-so-wonderful times. Maybe we’ll have more movies with love stories of older people. Novels and musicals might include more older people as central to the plot.
Otherwise healthy folks may have physical limitations, so I would look for more special-access provisions across our society. In fact, the whole infrastructure needs to be reengineered to cater to older people. We are made weary by speed and efficiency 24/7: the Internet, cell phones, overtime.
Regarding overtime, working hours may change. There’s a marked contrast between the “live to work” bias in the U.S. versus other countries’ focus on “work to live.” We give workers an average of 12 paid vacation days a year; in Italy, it’s 40. Time is the ultimate currency, as Daniel Kahneman has said, and boomers who are still working may well want more of it in their compensation.
I’ve been speaking of longevity as an American revolution, but the whole world is going gray, not just the United States. China will be in for a real shock: in 2030, they will have between 230 and 240 million people over 60. They are not prepared with caregiving or health care systems.
How about our health care system–will it take better care of older people?
Our health care system is a mess. Twenty cents of every dollar we spend does not go to improve health. Over the last couple of decades, the U.S. has dropped from 11th place to 42nd place in life expectancy.
So far, it’s not the age of the population that’s causing the problems; it’s new drugs and new technologies and the commercial health insurance industry. I am in favor of nonprofit insurance industry funds, which support the systems in France and Germany.
By the way, there is a perception that the European social welfare model is grounded in altruism.The fact is that these systems were developed in order to assure a secure, healthy workforce. Universal health care isn’t the enemy of capitalism. It originated to help support capitalism.
There’s a strong relationship between healthy longevity and wealth. Healthy children who become healthy adults have good jobs, save more, have a healthy old age. Imagine the economic value of an individual who can continue to be productive, to invest and give back, all his life.
We should be focusing our medical research on diseases that degrade the quality of life in older age: arthritis, sinusitis, ALS, Parkinson’s, and of course Alzheimer’s. And as organ replacement becomes more commonplace, I think people getting driver’s licenses should have to opt out of being an organ donor, instead of opting in.
What kind of legacy do today’s older people want to leave the next generation(s)?
When older people reminisce, it was once thought to be boring or senile. But when I wrote a paper in 1963 entitled “The Life Review,” it was apparent to me that reviewing one’s life, asking oneself, “How will I be remembered?,” and making sense of a life journey and a life experience, was a very significant psychological matter.
In the best of senses, older people want to leave their children good health, a reasonable environment, a reasonable economy. They join the Peace Corps; they’re involved in volunteer activities in their communities. Grandparents play a terrific role with their grandchildren, both in terms of financial support and caregiving.
One of the best legacies could be to show the disadvantages of a sedentary life–to help combat the obesity epidemic among the younger generation. I think advisors have to be direct in saying to older clients, “Your future depends on how you are now, and the childhood you experienced. You can’t change your childhood, but you can influence your grandchildren in terms of diet, exercise, and a healthy lifestyle.”
Older people should have an ethic to enrich the future. Usually they don’t think much farther than grandchildren, but they ought to go beyond that. One of my favorite quotes is by Brock Chisholm, former head of the World Health Organization: “In true maturity, one thinks beyond two generations.”
It’s a rule of thumb that people should have income from all sources that matches 70% to 80% of their pre-retirement income after they retire. Is this enough?
They are so far from that number now that it would be terrific if they could get closer to it.
How much is enough? It comes down to your reasonable expectations for the future. If they’re about the same as they were before retirement, why would only 80% be enough? If you run into health problems, you could need more.
So in some ways, retirees should have the same income as when they were working. They still want to travel, buy clothes, and so on. Who said they have fewer needs, fewer wishes?
Speaking of money, how can advisors help protect older folks from fraud and being taking advantage of?
You can build a relationship where they come to see you before they make any major financial decisions.
Even outside the area of fraud and elder abuse, advisors can keep clients well informed. For example, a lot of people decide to move to Mexico when they retire. They need to know Medicare won’t cover them outside the country.
What should older people be doing to protect their independence?
In The Longevity Prescription, I advocate eight principles for a healthy, longer life:
o Don’t smoke.
o Drink very modestly.
o Follow a diet filled with fruits and vegetables.
o Get lots of exercise, not just aerobic but also strengthening,
o Stay connected to friends and loved ones.
o Have a purpose in life, a passion.
o Try to manage your stress (see my “High Anxiety” column in 4/09 IA for ideas).
o Get enough sleep.
It’s also important to exercise your mind. Learn a new language, a new musical instrument, read great books. Advisors can also encourage their clients to develop a social network. Companionship and social connection are very important in adding to longevity.
What do advisors need to know to work well with older people who are sick or living with disabilities?
This is not such a large group as one might think. It’s often still assumed that the last third of life is a gradual decline into illness. This is no longer true. More than half of people 85 and older report no debilitating conditions. Those who are ill or do have disabilities need to know that they can still be a positive force in life, in their family, in their communities; they still have something to give.
A sense of purpose has been shown to prolong life. With advances in medicine, there’s a lot we can do; and there’s a lot that individuals can do themselves. For example, falls are a significant cause of death for people over 65. You can encourage clients to work on their balance, strengthen their quadriceps, do sit-ups. Sit in a chair with no arms and stand up 15 times, then rest and do it again. That what’s I do for exercise. I have a fitness trainer who harasses me–just kidding!–twice a week in my home. I work with weights for upper body and lower body strength, stretching and balance.
How did you develop the field of longevity research?
After my father abandoned us, my mother was not able to bring me up by herself and earn a living, so I moved in with my grandparents in southern New Jersey. I became very attached to my grandfather, who died of a heart condition when I was seven. I was devastated, and I vowed to become a doctor to cure people like him.
When I came to the National Institutes of Health 55 years ago, I began working in brain studies with my mentor, Seymour Kety, a terrific guy. He had created a method to study the brain in living subjects, rather than having to wait for an autopsy. This allowed us to study healthy older people. We discovered that much of the dementia attributed to aging was in fact caused by disease, socioeconomic status (poverty), or personality.
After a decade at NIH, I continued as a consultant for a 10-year longitudinal study on Human Aging, which showed that people who had a purpose live longer and better, and that what we called senility was not an inevitable part of aging, but was a disease. In 1975 I became the founding director of the National Institute on Aging at NIH, and in 1982 I founded our nation’s first department of geriatrics at the Mt. Sinai School of Medicine in New York.
During this time, I was also publishing as much as I could to break down some of the myths about aging and unveil more of the truths. I met Myrna Lewis, who later became my co-researcher, co-author, and my wife, when she was a social worker in Washington, D.C. Myrna, too, became quite a major influence in the field of gerontology. It broke my heart when she died five years ago.
In 1990 I established the International Longevity Center to study the impact of population aging and advancing longevity from a socioeconomic perspective, health perspective, and quality of life. We have 13 centers around the world, four in developing countries (South Africa, India, the Dominican Republic, and Argentina) and nine in developed nations (Japan, Great Britain, France, the Netherlands, the Czech Republic, Singapore, Brazil, and the United States).
I’m now moving to Columbia University to become a professor of health policy (of social-medical science) and continue running the International Longevity Center, which will be situated at Columbia. So it might be said that in the modern field of longevity research, I played an important role. But I didn’t invent the field.
Do you see any nascent trends in eldercare that will develop further over the next few years?
Caregiving has become a huge issue. We are going to see better-trained home health aides; ILC has a program with community colleges, 30 as of this year, to train home health aides. We’ve also been working with Schmieding Center in northwest Arkansas teaching caregiving to families and to home health aides, so I hope we will have better-trained family caregivers too. This needs to be happening everywhere.
Do advisors have a role in encouraging older folks to consider new options that are not nursing homes?
Yes, advisors could tell people they don’t have to be wealthy to have a secure old age. If you already live in a NORC, one of about 5,000 Natural Occurring Retirement Communities in the United States, you don’t have to go into a nursing home because you can be taken care of right there.
At Beacon Hill in Boston, they’ve set up a foundation to provide for residents’ old age, including a scholarship fund for those who lose their money. New Canaan, Connecticut, has done the same thing. There are many more choices than before: assisted living and continuing care retirement communities, some of which have educational components like those at Dartmouth, Oberlin, and Cornell.
When the baby boomer generation retires, will they be happier than their parents were?
That’s a tough one. Material things are not the only determinant of happiness, so it depends on one’s community, one’s relationships, one’s health, whether one’s spouse is still alive or not…. The most important thing is to put one foot in front of the other, keep active, and keep involved.
Any last suggestions for advisors?
Confront your own attitudes about age. Just like racism and gender bias, advisors should look at their own biases about older people. Reach out, listen, and try to understand what makes older people– this species–different from the species of younger people. And appreciate the differences, the unique gifts they have to give.
Olivia Mellan, a speaker, coach, and business consultant, is the author with Sherry Christie of The Client Connection: How Advisors Can Build Bridges That Last, available through the Investment Advisor Bookstore at www.invest-store.com/investmentadvisor. She also offers money psychology teleclasses for financial advisors and for the general public. E-mail Olivia at [email protected].