Close Close

Life Health > Long-Term Care Planning

LTC planning in world history: You are here...

Your article was successfully shared with the contacts you provided.

Some weeks, trying to help consumers plan for long-term care (LTC) costs may feel like trying to hold back a hurricane with a napkin. Interest rates are still low. Stock prices are erratic.

See also: Gross asks world’s central bankers: ‘How’s it workin’ for ya?’

Government officials snub private insurance products. The think tanks that seem as if they might be your friends lobby for throwing your LTCI baby out with the bath water.

Some of the LTCI issuers themselves seem… tired.

Meanwhile, maybe you’re still out there with the LTCI policies you can still sell, the annuities, the life insurance-based hybrids, the short-term care insurance (STCI) policies, the reverse mortgage loan applications, the PACE program fact sheets, and whatever other planning instruments you can find, and you may wonder why you’re still beating your head against the wall.

One response might be to shrug and close your eyes.

Another response might be to read “Aging in World History,” a new book by David Troyansky that talks about how societies around the globe have handled aging and the issues related to aging, such as long-term care, since recorded history began.

Reading the book may help you put your current situation in perspective and help you see that you’re part of a battle to help people have a decent quality of life in old age that’s been going on for thousands of years. You might not be the one to win the battle. You might have a hard time even staying in the battle. But at least you’ve played some part in it.

For a look at some of the LTC and LTC finance highlights from the first chapters in the book, which deal with aging in antiquity, the Middle Ages and the Renaissance, read on.


1. Egypt

In ancient Egypt, Troyansky writes, Ani, a scribe born more than 3,200 years ago, talked about the importance of intergenerational obligations.

“Nourish your mother as she nourished you,” the scribe wrote. “Sustain her in the same way as she bore you.”

Troyansky found a reference to an ancient Egyptian woman who disinherited her children from her second marriage because they had neglected her in her old age. 

See also: The Business Faces


2. China

In China, followers of Confucius, a philosopher born more than 2,600 years ago, took the idea of the importance of venerating elders a step further.

Like Ani of Egypt, Confucius talked about the importance of children re-paying parents for the love and care the parents have provided the children.

“In serving his parents,” Confucius taught, “a filial son reveres them in daily life. He makes them happy while he nourishes them; he takes anxious care of them in sickness; he shows great sorrow over their death; and he sacrifices to them with solemnity.”

For Confucius and other Chinese philosophers, caring properly for the aged had an impact outside the family. 

“Chinese thought presented filial piety as the fundamental value the basis of all social, cultural, and even political connections, including one’s relationship to state authority,” Troyansky writes.

Imagine how well LTC planners would be treated in the United States if the country truly viewed “nourishing the old” as the basis of each citizen’s relationship with the federal government.  

See also: 33 of the best retirement quotes 


3. Greece

Hippocrates, a Greek physician born more than 2,400 years ago, helped establish the field of gerontology.

He came up with the idea that aging was the result of the body becoming cold and dry. He gave patients recommendations for changes in diet and behavior that might slow the aging process, Troyansky writes.

Hippocrates was, in effect, the great-grandfather of the wellness tips you may put in your own marketing newsletters and Web articles today.

See also: Saltzman: HSAs: From Panacea to Broken China

Image: Hippocrates (Wikimedia Commons/Young Persons’ Cyclopedia of Persons and Places, 1881)


4. The Roman Empire

The Romans had no systematic traditions or institutions for providing for the elderly, but they started to collect the kind of data that modern scholars can use to generate statistics on aging.

In the first century, about 6 percent to 8 percent of the people in the Roman Empire were over 60, and about 2 percent were over 70, according to Troyansky.

Pliny, a Roman historian, wrote about Domitius Tullus, an aristocrat who was unable to handle the activities of daily living, such as turning over in bed, and received extensive home care from slaves.

Cicero, a Roman politician and philosopher, made what looks like one of the first statements about the importance of retirement and long-term care planning. He declared that, “Old age will only be respected if it fights for itself, maintains its rights, avoids dependence on anyone, and asserts control over its own to the last breath,” according to a modern translation cited by Troyansky.

See also: 5 financial lessons from Game of Thrones

Image: Aesculapius, the Roman god of healing (Wikimedia Commons/Baumeister/Denkmäler des klassischen Altertums, 1888) 

Corpse in a Paris mortuary

5. Medieval and Renaissance Europe

Troyansky notes that, in the Middle Ages, epidemics killed many of the young people and left communities with a relatively old population.

In 1427, in one region in Italy, about 10 percent of the peasants and 11 percent of the working class people were over the age of 65, Troyansky reports.

Troyansky found an account of a retirement home for old knights that was founded in 1351, and another of a medieval hospital in Lyon that mainly served the elderly.  

Some people planned for long-term care needs by making donations to religious communities in exchange for care.

Others combined long-term care planning with estate planning. They tried to use provisions in wills to ensure that their heirs would provide for them in old age.

Some adult caregivers used wills to structure long-term care arrangements for their own elderly or incapacitated parents. Troyansky describes one in which a man required his heirs to provide food and clothes for his father, “as long as he lives in a proper way.”

See also: 

PPACA: A history

5 Ways to Handle a Falling Sky


Are you following us on Facebook?


Image: A body in a medieval mortuary in Paris. (British Library/Guillot/Paris Suffers, 1887)


© 2023 ALM Global, LLC, All Rights Reserved. Request academic re-use from All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.