ERE or Semi-ERE past Age 65

[Ego]

The thing about using social capital to support you in your old age is that you are not bearing the cost - your social network is: friends, family. By some's perspective, it is a burden that they do not want to foist on their loved ones, so they internalize the cost by accumulating money to pay professionals to bear that burden.

Last week The Atlantic had a story about exactly this.

https://archive.is/0fvUo

Lots of older adults are left with no one to rely on. In the face of such challenges, some have pieced together their own support system by relying on friends. Though this setup has limits, especially if friends need care at the same time, it can save money, prevent loneliness, and, crucially, offer a way around a common caregiving dynamic, where the person being cared for feels like a burden (a benefit that disability activists have also emphasized). It opens up a different, less hierarchical model of caregiving based on not a relationship of dependence but one of equality.

[candide]

@suo. I second that. And again, I want to try to impart that there is no way to ensure fair value will be paid back in social capital.

My grandfather was the greatest human being I ever knew. The theme the preacher came up for the eulogy of the funeral was "the perfect neighbor." See, grandfather parlayed military, national guard, and work for Boeing to retire in his 50s and then used his free time and skills to be the most helpful person for his family and neighbors. Mr. Fix-it, Mr. Watch-Your-House. He had keys to everyone's house in the neighborhood. His father died when my grandfather was 10, and from that moment he was "the man of the house" who always looked after his older sisters, took in his mother in her old age, and was the rock of the entire extended family. (Aside: he was told by his doctor in his late 70s that he had the health of 30 year old and that he might just live forever. He would be dead at 81).

My grandmother knew he had given her a great life, she and wanted to care for him to pay him back. Well, looking back, we realized dementia had probably been setting in for her. Anyway, she also tried to cure him with kooky health food and denied him pain medication for equally kooky, anti-drug reasons. One time in trying to keep the house clean, she knocked him out of the bed when he was too woozy to move... He kept expressing that there was someone scary around, but we thought it was it was hallucinations as he was really far gone. Again, retrospect, he was probably trying to express how scary grandma was to him.

I can't un-know that the last months of the life of the greatest human being I ever met was spent being tortured by one of the other most important people in my life.

Which presents a catch-22 for still planning to make social capital plan A. Those with the most time to provide care are going to be the worst at doing it... And those who are most capable of the care will have the higher opportunity cost. It is a burden. Period.

To get this right, you really need to think far, far out of our cultural box. (As per usual, I trust Jennypenny's ability to do it ... the compound sounds like it could work).

[suomalainen]

Yeah. I fully support social capital for picking up someone’s mail or cooking them dinner if they broke a hip. I’m not talking about that. I’m talking about when someone’s needs outpace their loved ones’ capabilities. See, e.g., @hristo’s experience with hristo’s father trying to care for his wife. At some point, you may be a burden and you may not want to be that. Money may be the only thing that can solve that particular problem. Up until that point, great, friends helping friends.

[J_]

Very appreciated jennypenny. I think your way as a better ( more ere) hands on to project forward at becoming impaired at old age than most of the ideas in this thread.
I have also adapted the ground-floor of my main-house, so that would I become invalid I have every thing in one level. And have started talks with others about finding solutions to help each other if..
Can you please elaborate some more on your deep adaptation ideas?

None of my parents or grandparents had dementia or were long invalidated before dying. Here in this alpine village most oldies we know, have died in their own (by more generations occupied) homes.

[jacob]

https://www.amazon.com/Gentle-Art-Swedi ... 501173243/
https://www.peacocktv.com/stream-tv/the ... -cleaning/

[Jin+Guice]

What I am hoping to do is something more like what @JP is doing. I also think it's possible to pay someone or multiple people in your social network to take care of you for much less than a full-care facility, particularly when you aren't actively dying and just need some help going to the bathroom or have trouble walking or bathing.

I'm also hoping to develop the emotional fortitude to not hang around in the case of being biologically alive but mentally and physically mostly dead. I doubt I'm there now.

Part of successful social capital building is being able to get things from your social network when you need them. It's not really a matter of being "paid back at fair value." @Candide I don't want to pick on your grandfather, who by all means seems like an exceptional person whom I envy and aspire to be like. Expert use of a social network would include knowing who needs what and who has what to give such that you could ideally get someone to take care of you to both of your benefit or at least not their resentment. I also think this is more challenging today than it used to be because we have outsourced so much to paid services.

Protecting your future self from yourself and others while you lose your mind such that you might undo said protection in a way that you also cannot anticipate is a really dilly of a pickle to solve. While friends and family members may feel you're a burden, care takers you do not know may also feel you are a burden. Do you trust a network of strangers whose only relationship to you is money to not take advantage of you if you are insane and well off? Do you trust yourself not to think they are in your state of insanity? Do you trust paid strangers to treat you better than those you have spent your life with?

There is not one answer and paying people has its advantages, but it also has its disadvantages.

[Scott 2]

@take2 - Agreed. If a legacy doesn't matter, annuitizing the estate makes great sense. Pooling risk makes a much higher tier of care affordable.


@candide - The insurers have modeled the boomers, I'm sure. Entire consulting practices specialize in analyzing scenarios like these, which then become standard products licensed by all the major insurers. If there is a mistake, it's likely impacting the full industry. This is when regulatory capture raises its ugly head. If everyone's risk pool is bad, there's simply not enough money. Promises will not be met.

@ego - Agreed. I have no idea how to correctly anticipate the boomer fall out. Someone who does can become very rich. It's part of why I want to own my personal risk as long as possible.

@jp - building your own private risk pool is a hard, but smart way to mitigate the risks. Especially if the broader solutions are overwhelmed. Hired staff will want to escape those crumbling institutions as well. Similar to what we're seeing with nurses and teachers today.


@jin+guice - The trust problem is tremendously difficult. The best I've seen, is a combination of institutional care and monitoring by loved ones. Gaps still appear, even when money is effectively unlimited. The wealthiest person I know of, effectively bought a loved one's peak earning years, to support the institutional monitoring. She is highly motivated, capable and still there are weekly problems.

[jacob]

I also think it's possible to pay someone or multiple people in your social network to take care of you for much less than a full-care facility, particularly when you aren't actively dying and just need some help going to the bathroom or have trouble walking or bathing.

Home hospice care is a thing and is available for free or almost free in better run US counties. Useful when family members can't wrestle a 250lbs person into a bathtub and similar services. (Another aspect of Swedish Deathcleaning would be to avoid ending up being someone who needs a hoist when their leg strength fails.)

Yes, the $5k/month Hilton experience can be postponed for quite a while or replaced with substantially cheaper solutions that already exist --- because the majority of people can't afford it.

That said, as others have indicated, relying on social capital for care does have a cost on others. When FIL died, I was shocked to see that MIL was surprised at some on the changes in her city (like the existence of new roads and subdivisions) over the previous five years. She'd basically been a full-time caretaker only leaving home to pick up necessities from Walgreens, Walmart, and Walbank. This ordeal cost some health as well as getting too old for some of the things she was otherwise planning to do in her retirement.

Not every family/friend in one's circle is a natural helper and drawing on them beyond the natural rate for social capital will draw it down to the point where people stop responding or even move out of range. This might even be the case for arranged situations like when a bunch of seniors get together to look out for each other. Imagine being the healthiest one, thus self-doomed to spend the last decades of your life taking care of your other roommate patients. It might sound like a good idea until you've outlived the first geriatric roommate. After that, no more roommate patients, please.

In abstract theoretical terms, end of life can be seen as a collapse of one's WOG. Things become increasingly heterotelic. An ERE person has a while to go before things get as heterotelic as the average consumer. Still, that point is also crossed. Then it becomes a question of how many inefficiencies can be punted to others. Assisted suicide came up as an option---for those who live in Oregon---above. A far easier solution would be to forego heroic interventions after a certain point and let nature take its course sooner rather than later. In both cases, I bet "moving goalpost"-arguments will soon replace hard-nosed deadlines.

The problem with humans is that we're both attached to others as well as ourselves. Like animals, we also seem to be able to get used to pretty much anything if the change is slow enough. Therein lies the trap.

[chenda]

@J_ thank you

@jennypenny - thank you, I'm praying every evening that we get mum back. I miss her so much.

The financial stress is as bad as the emotional stress, trying to work out how we can provide long term nursing care for potentially both parents. Dad wants to leave hospital asap but as soon as he leaves the care costs begin so we need to buy some time.

[take2]

Geo-arbitrage may be an option if available to you.

I’ve begun discussing LTC preferences with my parents. They are well-off enough to have multiple options; I was initially surprised when my father mentioned his plan of living in their house in Portugal and just hire nurses. Perhaps initially part time, then full time, and progressively to live in full time.

Such an option would likely be a fortune in the US but is comparatively affordable there. Lots that needs to be in place to manage this (namely a right to permanently reside there) but potentially an option if available.

[candide]

@chendra. I'm sorry I haven't put in my regrets and consolations earlier. I've walked this road myself, and memories of it hurt so much that I just freeze up... Everything I try to express sounds wrong.

My heart out to you and yours. I will pray for you all.

===

Part of successful social capital building is being able to get things from your social network when you need them. It's not really a matter of being "paid back at fair value." @Candide I don't want to pick on your grandfather, who by all means seems like an exceptional person whom I envy and aspire to be like. Expert use of a social network would include knowing who needs what and who has what to give such that you could ideally get someone to take care of you to both of your benefit or at least not their resentment. I also think this is more challenging today than it used to be because we have outsourced so much to paid services.

Point taken. I am bringing up this negative stuff in this context to see if can help people with their planning; I assure you I take no pleasure in dredging these painful memories back up.

Something else I'd like to point out is that my grandpa was a planner and had said for years that he wanted to just go to a home, even had which one picked out. So while on the one hand this lends further credence to your point about this being a culture used to outsourcing, on the other it shows how little your previous wishes matter when you are far enough gone. Grandma came up with her idea to pay grandpa back with care that only she could provide after he had Alzheimer's and cancer. (A potential lesson: People who are over 75 should probably not be a primary care-giver).

I'd be more angry at my dad and uncle for being so feckless in this situation but 1.) they're both dead now (neither reaching the age of 60) and 2) what are you supposed to do against the spouse's wishes?

End of life care is such a mess in terms of boundaries, rights, and jurisdictions. Adding a commune to that won't make any of that any clearer.

But if anyone can pull off setting up the structures, it is people here. I mean no sarcasm or malice when I point out to make sure that your planned final home is not your first experience with a commune or compound. And if this really is your plan for when you become a falling threat or lose your ability to sign your name, then you better be the kind of leader that trains and empowers other leaders. Live long enough and your charisma is not going to save you where you're going.

[Ego]

It is much easier to copy than to trailblaze. I like to see examples of things working in the real world before committing to them myself.

Adding a commune to that won't make any of that any clearer.

Despite the link to the article in the Atlantic above, I do not often see this in real life. As others have said, there is little motivation for the most capable person to stick around. Perhaps that is what is needed. A structure that motivates capable people to help those who need help. Cash is one incentive. I remember meeting the Californian in Bali who somehow motivated locals to take care of him in his old age. He was very old and very hunched, but walked every morning. I wonder how that worked out.

Live long enough and your charisma is not going to save you where you're going.

Maybe charisma is not the most useful characteristic for this? We have someone in our immediate vicinity who is more than 90, extremely frail and has constant health issues. Yet somehow he has a parade good-hearted helpers who bring him food, clothing and supplies. They also help him with expenses not covered by his Social Security. Basically everything he needs is provided. As soon as they leave, he disposes of much of the stuff they bring, making it appear that he is reliant on them alone. The next person arrives to find the cupboard is bare, so they restock it with Whole Foods and Trader Joe's foods. The givers get whatever they need from interaction. He maintains a series of overlapping people willing to help in various ways. Symbiotic manipulation?

[Frita]

@chenda Wishing you and your family moments of peace…

Just for fun, I checked out our local hospice’s website and learned I could save 10% over similar services at the hospital! I am beyond turned off. (Yes, I get that a nonprofit is simply another way to structure a business.) One must shop around for hospices just like so many other things. Good to know.

@7wb5 Eighty-five seems like a better cutoff than 80 to pull a Maude. I have been thinking of limitation benchmarks to consider (walking, cognition, self-toileting, enjoyment, relationships) using variables of frequency, intensity, and duration. Thinking about what something would be like is often different than the actual experience, so I am more in the I’ll know it when I know it. What I want more than anything is to be able to make the choice for myself without having to jump through hoops, be erroneously labeled as mentally ill, being forced to do what someone else wants, or unnecessarily die alone so as not to incriminate others.

@Jacob wrote, “A far easier solution [than assisted suicide] would be to forego heroic interventions after a certain point and let nature take its course sooner rather than later.” This would work better for some conditions (i.e., cancer) than others (i.e., ALS). It does lend itself to some clear cut if-then statements (i.e., If I am diagnosed with stage 4 pancreatic cancer, I will refuse surgery/radiation/chemo and seek palliative care.).

Also, regarding “helpers,” sometimes these people can be highly controlling and self-serving under the guise of selfless personas to meet their own needs. The last thing I want to experience as I die is codependent BS.

[jacob]

Geo-arbitrage may be an option if available to you.

Charles Hugh Smith of Survival+ fame has several posts on getting familiar with overseas care. I forget which country he targeted, but the point was to pre-establish a connection to that country decades before eventually going there.

It is crazy how so many in the US, ostensibly the richest and most powerful country in the world, are looking outside for services that are basically a given in much of the rest of the world. In that regard, one could take a [heatwave et al] risk and move very close to the border of Mexico. There's a city that caters to US medical tourists right across the border ("we speak English"). This kind of arbitrage isn't just a US thing. I know that Danes go to both Germany and Poland for 25-75% off elective procedures.

[jacob]

Also, regarding “helpers,” sometimes these people can be highly controlling and self-serving under the guise of selfless personas to meet their own needs. The last thing I want to experience as I die is codependent BS.

Yeah, one thing I like about the enneagram model is how to also incorporates healthy and unhealthy states of being. If you scroll down to the bottom of the link above, there's a description of the unhealthy levels. Ultimately, it might take some kind of saint to stay out of those though. Stress tends to drive people downwards.

[7Wannabe5]

Thinking about what something would be like is often different than the actual experience, so I am more in the I’ll know it when I know it.

Very true. I think my recent experience with Crohn's Disease has served to delineate this a bit more for me. I absolutely believe that if I was in that level of bad shape/pain again, and I was over 80, and there was little hope for timely remediation, I would take myself out, no regrets. OTOH, as my mother has exhibited on several occasions, there are health/aging events that will take you down to the level of needing nursing home level care temporarily, but then you can rise back to hobbling around your own home within a couple months. She is in better shape now, after her second hip replacement, than she was 5 years ago before her first hip replacement. OTOH, she is a bit of an outlier in terms of the fact that she still has no lines on her forehead, and has been heard to laughingly declare "Evil never dies." in reference to herself. We recently discovered that her biological father was not the young Polish working-man to whom our beautiful Rosie-the-Riveter grandmother was first married, but a man in his 40s who owned the war production factory where she was employed at age 20. He lived well into his 80s although super-portly according to his military records, and his mother lived well up into her 90s, so that might have a lot to do with it.

@jacob: Another possibility for arbitrage would be the counter-intuitive move of looking at nursing homes in lower-income areas in the U.S. Just as with fast-food restaurants, it is the affluent suburban realms that are hard to reach by bus that have the most difficulty finding workers. OTOH, locating yourself in one of the very few high Green/Yellow realms is also a good bet.

[candide]

Maybe charisma is not the most useful characteristic for this? We have someone in our immediate vicinity who is more than 90, extremely frail and has constant health issues. Yet somehow he has a parade good-hearted helpers who bring him food, clothing and supplies. They also help him with expenses not covered by his Social Security. Basically everything he needs is provided. As soon as they leave, he disposes of much of the stuff they bring, making it appear that he is reliant on them alone. The next person arrives to find the cupboard is bare, so they restock it with Whole Foods and Trader Joe's foods. The givers get whatever they need from interaction. He maintains a series of overlapping people willing to help in various ways. Symbiotic manipulation?

That is an absolute gem for anyone trying to lean on social capital in the life end-game.

I keep having a hard time disentangling what is my brain's attempt to dump horrible memories and what might be useful to people. But experience, unfortunately, I do have.

Finding ways to be easy to help is important. My grandma didn't As dementia kept trucking along, she kept getting more clutching and controlling. Now, by the point she was in assisted living, her husband and both of her children were dead (all within a year and a half), so the amount of grief we are talking is (I hope) unimaginable. But actually, she was really hard to deal with starting with the time grandpa was dying.

I feel so bad for her, and always did once the bad times started.... I only came to the realization of her torturing of my grandpa some time later in conversations with my mother about what happened at the time.

Grandma was a sweet 1950s housewife. Small staple of recopies, but well worked out. A prolific artist who was involved in the community art scene (found that out that community part from newspaper clippings when it was I who was left to go through everything). A detail I always use to try to explain about her was that no matter what step she was at working on her art, she would drop it when you came (no need announce you're coming over) and give your her attention and love. The hundreds of games spread out between of Dominoes, Scrabble, Yahtzee, and Gin with her weirdest, oldest grandchild. It only human-made place I've felt like I truly belonged... I haven't gotten it right at either of my adult homes yet. It's just so sad to have grandma be also such a key to my life, to have her be so great in her own way, only to have it all be so fucked up the last 6% of her life.

I don't know what switches can be flipped to make sure you handle dementia like my grandpa, trying what you can and then just laughing it off -- a second childhood versus being like my grandma, low capacity, but trying to find fault with anyone who by all rights should be making the decisions -- a second middle school.

Here's hoping for the former instead of the latter for all of us. But here's to hoping more can be done on healthspan instead of just keeping our husks around.

[7Wannabe5]

The givers get whatever they need from interaction. He maintains a series of overlapping people willing to help in various ways. Symbiotic manipulation?

Sounds a bit like my self-aware practice of polyamory But, I am now giving that sort of thing (reuse/recyle of discarded grouchy old men) up in pursuit of Transcendent Eco-Sexuality and/or a well-thought-out Marriage of Convenience before I turn 63.

[zbigi]

I know that Danes go to both Germany and Poland for 25-75% off elective procedures.

In Poland, there's a nursing home near the German border that has German-speaking staff and is exclusively catering to Germans. Much cheaper than the options available in Germany. Somebody has probably set up something like that in Mexico for US Americans.

[suomalainen]

in pursuit of Transcendent Eco-Sexuality

I mean, that's iDave, right there. It's staring you in the face!