By Susan J. Blumenthal, M.D., M.P.A. and Stephanie Heung
Reframing Retirement
With a wave of baby boomers reaching age 65, retirement is being redefined for the 21 century. In the 21 century, Americans live 30 years longer on average than they did a century ago. Average life expectancy in America is now 81 for women and 76 for men. This means that a significant proportion of the 10,000 Americans who turn 65 every day are entering the infancy of their second adulthood. Though the word "retire" means to withdraw or depart, many 65-year-olds today are healthy enough to work, travel and pursue their lifelong dreams -- with opportunities that were unimaginable a century ago. In this era, 65 is the beginning of a new, fulfilling stage of life where the concept of retirement requires disruption and redefinition.
With the number of Americans over the age of 65 expected to swell from 40 million today to over 70 million in 2030, there is an urgent need for all sectors of society to address the physical, emotional and financial challenges facing the Baby Boomer generation and beyond. Furthermore, it is crucial for individuals to harvest new opportunities for reinventing their "retirement" years.
Is Retirement the Best Option?
For some people, a lack of financial security and resources mean that they may not be able to "choose" retirement. For others, retirement at age 65 is mandatory. But for many, a traditional retirement might not be the best option. In the 21st century, there are innovative new models for working after 65. For example, some companies are retooling workers and placing them into new jobs with new responsibilities. These veteran workers are invested in the organization's mission and become a fountain of knowledge and experience for the entire organization.
Many seniors will discover other routes to remaining mission-driven. Some people are volunteering and serving as mentors. Retired professionals can also find specialized volunteer opportunities that capitalize on their particular skill set, whether it is in the health sector, education or business. Furthermore, the nation's fastest-growing group of entrepreneurs is people age 55 and above. While there may be an expectation that people will wind down as seniors, age 55 is now the era of a second wind!
The path forward will not be the same for everyone. No matter whether a person decides to retire or keep working, it is important to stay active, connected and purposeful.
Key Challenges of the Golden Years
Increasing life expectancy has made it possible for many people to chart fresh directions and enjoy novel experiences after 65. However, living longer produces a range of financial, health and relationship issues that must be addressed.
Finances are a serious concern for the modern retiree. Americans are under-saved by an estimated $14 trillion. Today, the average retiree has only $42,000 in savings, which for most people is insufficient to sustain a retirement of 10-20 years. The majority of private sector workers are not participating in a formal retirement plan. Public pensions are underfunded. Social Security provides important benefits, but resources will diminish by 2030, when Baby Boomers will be drawing on Social Security and Generation X will begin transitioning out of work. With fewer resources and a higher cost of living, many people are facing challenges in maintaining their financial stability and standard of living.
The financial crisis for retirees disproportionately affects women. Women retire with 66 percent of the retirement savings of men, live on average six years longer, and have greater medical expenses. As many as 80 percent of women are single during their later years of life. Divorced women are particularly financially vulnerable in retirement. Given the lower participation of women in the workforce in past decades, they are often dependent upon their husband's Social Security benefits if they do not have their own work history. Women lose their husband's Social Security benefits upon divorce if they were married for less than 10 years. This contributes to the significantly higher poverty rates for divorced women compared to their married counterparts. For women, the gender pay gap must be closed (women currently make 77 cents on the dollar that men earn), and this in turn would help close the Social Security gap by as much as a third. It is estimated that if women were fully engaged in the US economy, our country's GDP would rise by as much as 9 percent.
A decline in physical health may also derail a person's retirement. It is well-established that older Americans have increased prevalence of chronic illnesses such as cardiovascular disease, cancer and diabetes. In fact, 80 percent of older adults suffer from at least one chronic condition, and 50 percent have at least two.
Furthermore, retirees' quality of life can be significantly compromised by vision and hearing loss. Hearing loss affects 24-40 percent of Americans aged 65 or older, increasing to 40-66 percent of patients aged 75 or older, and over 80 percent in patients aged 85 or older. This is particularly troubling because hearing loss is strongly correlated with depression, social isolation and poor self-esteem. Meanwhile, vision loss from conditions such as macular degeneration and glaucoma affects 12 percent of Americans aged 45-74, and 15 percent of Americans aged 75 or older. Without interventions for these vision and hearing disorders, more retirees than ever will suffer from these types of debilitating age-related conditions as life expectancy increases.
Mental health is fundamental to overall health and is an important concern for retirees. Depression affects 15 percent of people older than 65. This increases to 25 percent of those with chronic illness and 50 percent of nursing home residents. Additionally, 14 percent of Americans over age 71 may suffer from dementia due to neurological diseases such as Alzheimer's and Parkinson's.
Finally, housing arrangements are also a key issue for seniors. Currently, 93 percent of Americans over 65 live independently in the community, 3 percent live in assisted living facilities, and 4 percent live in nursing homes. There is a growing emphasis on "aging in place," as defined as "the ability to live in one's own home and community safely, independently, and comfortably, regardless of age, income, or ability level."
Rx for Healthy Aging
Studies suggest that healthy lifestyles even at advanced ages can increase well-being and life expectancy. Here is a roadmap for making the most out of the years ahead:
1. Serve.
Serving one's community is one of the best ways to stay connected and maintain a sense of purpose. Some studies suggest that volunteering is correlated with better physical and cognitive functioning, fewer depressive symptoms, and a longer lifespan.
Potential volunteer activities include serving meals at a soup kitchen or helping in a hospital. Senior volunteer corps also can provide opportunities for skilled professionals with experience in business, health, journalism and other fields. Investing in a child, whether by spending time with one's own grandchild or mentoring other young people, is an extremely rewarding experience.
2. Save.
Planning ahead is critical to healthy aging and ensures future financial well-being. Saving and investing are critical investments and should begin early in one's life, but it is never too late. There are many strategies to save funds and boost resources for the years ahead. Be an informed consumer and make smart decisions to have the financial resources to live well as a senior.
3. Boost your mental health.
Mental health is fundamental to overall health. Retirement is a time for finding inner peace, forgiveness, letting go of grudges, putting your house in order, and fulfillment.
However, some people will experience depression at this time of life, so it's important to learn the signs and symptoms. These include difficulty concentrating, feelings of hopelessness, and changes in appetite or sleeping patterns. Sometimes memory disturbances in older adults can be signs of depression, called "pseudodementia." Contact a doctor if you believe you may be suffering from depression; there is effective treatment.
4. Make new friends and maintain connections with old ones.
Strong social connections with family and friends are associated with improved physical and emotional functioning. People who report rich social networks are at a lower risk for mortality and morbidity compared to those with weaker social networks. Furthermore, the presence of strong social support is associated with improved outcomes for strokes, heart attacks, osteoarthritis, dementia and depression. Some research suggests that the lack of a robust social network has adverse health consequences of a comparable magnitude as having high cholesterol or smoking.
5. Participate in physical activity.
Physical activity is one of the very best things a person can do to enhance their physical and mental health at any age. A recent study found that people over age 75 who were physically and socially active lived an average of 5.4 years longer than their less active counterparts. Along with improving one's physical well-being, exercise is associated with improved cognitive functioning and a lower risk of dementia.
Thirty minutes a day can make a significant difference. Pick an enjoyable activity - gardening, swimming, walking or dancing. Strength training is also very important to protect against falls and mobility loss.
6. Learn a new skill and keep training your brain.
Stay mentally active. Train your brain with bridge or online puzzles. Take a course, try a new sport or learn a language. Language learning may actually protect from age-related cognitive decline.
A recent study found that lifelong intellectual activities, such as playing music or reading, delayed the onset of Alzheimer's by an average of nine years for people genetically predisposed to the disease. In fact, people who were not college-educated had the most to gain by engaging in intellectual activities from middle age onwards.
Reframe what may seem initially like too much time in retirement, into meaningful opportunities to expand your horizons. Go to the movies, visit friends, follow the news and catch up on your book reading list. Take a trip and have a new adventure. Minimize the effects of stress on your body by practicing yoga or mindfulness meditation.
7. Don't smoke.
Nine percent of people over 65 currently smoke cigarettes. Not smoking is the best thing that anyone can do to promote a healthier future. Quitting smoking significantly decreases one's risk of coronary heart disease, stroke and certain cancers.
8. Eat healthy.
Maintaining a healthy weight is very important. Obesity takes a significant toll on every organ system in the body and is linked to debilitating diseases such as stroke, heart disease, diabetes, some forms of cancer, gout and arthritis. A recent study reported an association between being overweight or obese and impaired cognitive functioning, adding to the risk of mental decline over time.
Consume a well-balanced diet that includes whole grains, fruits, vegetables, vitamins and protein. Cook with friends and family, share meals together, and drink alcohol only in moderation.
9. Try new technologies.
Don't be risk-averse with new technologies. Smartphones, tablets and videoconferencing can connect seniors to new frontiers of learning, as well as family and friends around the country and world.
Seniors that develop visual or hearing impairments sometimes do not wear their eyeglasses or hearing aids because they do not want to appear "old." However, this only exacerbates social isolation and depression. New technologies can help reduce the effects of visual and hearing impairments. Additionally, many mobile devices feature voice recognition and options to increase the font size to help people with these sensory challenges.
10. Help design your community.
There is a growing movement for "aging in place," in which communities create environments where seniors can continue living in their homes. Through access to transportation, food and health services, seniors can remain in their communities and contribute to intergenerational connections. Get involved in planning these important services so that seniors have the option to continue living at home.
11. Plan ahead.
Don't wait for retirement to create a road map for the future. Conduct both a physical and a financial check-up before retirement. Start planning early, but it is never too late to invest in oneself. Small steps can yield great rewards in improving a person's physical, mental and financial health in the years ahead.
Conclusion
In the 21st century, many seniors are not retiring from something. Instead, retirement is an opportunity for reinventing, reimagining and reconnecting to one's self, family, friends and community. Robert Browning once wrote, "Grow old along with me! The best is yet to be." By investing in your physical, mental and financial health today, you can help ensure that your best years are just ahead.
Rear Admiral Susan Blumenthal, M.D., M.P.A. (ret.) is the Public Health Editor of The Huffington Post. She is a Senior Fellow in Health Policy at New America and a Clinical Professor at Tufts and Georgetown University Schools of Medicine. She is also Senior Policy and Medical Adviser at amfAR, The Foundation for AIDS Research. Dr. Blumenthal served for more than 20 years in senior Federal government health leadership positions in the Administrations of four U.S. Presidents including as Assistant Surgeon General of the United States, the first Deputy Assistant Secretary of Women's Health, and as Senior Global Health Advisor in the U.S. Department of Health and Human Services. She also served as a White House advisor on health. Prior to these positions, Dr. Blumenthal was Chief of the Behavioral Medicine and Basic Prevention Research Branch, Head of the Suicide Research Unit, and Chair of the Health and Behavior Coordinating Committee at the National Institutes of Health (NIH). She has chaired numerous national and global commissions and conferences and is the author of many scientific publications. Admiral Blumenthal has received numerous awards including honorary doctorates and has been decorated with the highest medals of the U.S. Public Health Service for her pioneering leadership and significant contributions to advancing health in the United States and worldwide. Named by the New York Times, the National Library of Medicine and the Medical Herald as one of the most influential women in medicine, Dr. Blumenthal was named the 2009 Health Leader of the Year by the Commissioned Officers Association and as a Rock Star of Science by the Geoffrey Beene Foundation. She is the recipient of the Dr. Rosalind Franklin Centennial Life in Discovery Award.
Stephanie Heung is a senior at Yale University, pursuing a degree in Molecular, Cellular and Developmental Biology. She served as a Health Policy Intern at the New America Foundation in Washington, D.C.