Although most of us nearing old old age don’t often talk about it, even to each other, it’s a time of life that necessarily brings thoughts of what could come next. As prepared as we may feel ourselves to be, both emotionally and practically — such thoughts begin to impinge more and more frequently on our consciousness because of what we see happening to our contemporaries.
“I just never thought this would happen,” exclaims a woman I know. She is two years older than I am, with a husband nearing ninety, and two sons in their fifties not living in Princeton or anywhere near it who have children of their own still to educate. Both she and her husband had been professionals throughout their working lives and seemed to me somewhat better fixed than Bill and I are. When I met her about five years ago in a reading group, they were living in a free standing, well furnished house with three bedrooms, a study and a finished basement, as well as the requisite living and dining rooms and three full bathrooms. The house had an attached two-car garage for their two cars and was beautifully landscaped by the condo association to which they belonged.
But she was already losing her vision to macular degeneration that didn’t respond to drops. Soon after we met, she became legally blind and could no longer drive. They struggled on for about a year with the husband driving wherever they needed to go. Eventually, however, they had to move to a retirement community that provides transportation to doctors, hospitals, supermarkets, shopping centers and, on notice, elsewhere in town. This was a huge downsizing — to a one bedroom apartment with den.
However, she adjusted. The other residents were educated, many of them formerly affiliated with Princeton University, and there were activities within the main building to get her out of their small apartment and keep her occupied with lectures, movies (which she could still more or less see), and a small gym with physical trainer. As for reading, first she read with a magnifying glass, and then only books she could obtain on Kindle, where you can increase the type size to 16 or 18. (It slowed down the reading, but she was determined.) Finally she needed a machine under which you slid the Kindle or iPad to magnify it still further. She could no longer see well enough to review bills or write checks. It became hard to communicate with her by email.
A year later, his emphysema took a turn for the worse and he was put on oxygen. They gave up the remaining car to a grown granddaughter. He was willing to use the oxygen at night when he slept, but not the portable one to move about the main building — which made it more and more difficult for him to reach the dining room. He had to stop to catch his breath and rest on benches strategically placed along the corridors, sometimes falling asleep while he sat there.
One Sunday afternoon, when out to lunch with one of their sons, who was visiting, the wife tripped getting out of the car. She had a heart attack and a stroke which left her mind intact but resulted in a useless left arm and leg. They took her to Philadelphia for cardiac surgery; she then went to a rehabilitation clinic where with hard work, she has managed to recover sufficient use of the left leg to walk slowly (although not too far) and to hang light bags on her left arm but not do much else with it.
She’s now back in their retirement community apartment. Because of her incapacities, she has to have home help from 9 to 3 every day. It costs $25 an hour, or about $4,500 a month over and above all their other living expenses. After an initial period when it was covered, this cost has been coming out of pocket. Three months ago, her husband’s doctor put him under hospice care. This means it was then thought he would not survive more than another six months. Hospice pays for two hours a day of home care (as well as a visit every few days by a registered nurse). However, his doctor believes he needs round-the-clock assistance, because he keeps trying to get up to reach the commode every other hour of the night and falls. His wife, obviously, can provide no physical help at all. This means another sixteen hours of home care per day at $25 an hour.
She telephoned me in despair last week. Money has been flying away at a frightening rate. She’s had to authorize their broker to liquidate funds they never thought they’d need to touch for such a circumstance — including roll-over IRA funds that are taxed after being distributed (so you have to take out more than you need to keep the amount you want after paying taxes on the whole of the withdrawal).
And the scary part is that her husband is doing well!
“What does that mean?” I asked. “He’s getting better?”
“No,” she said. “But he’s stable. His vital signs are strong. He eats. His brain seems clear when he’s awake. Three months of the six are gone, and he’s not any sicker.”
She means he’s probably not going to die in the predicted three months. The round-the-clock care may go on, and on. She is looking into the possibility of saving some money by replacing the current system of hourly home care with a live-in person; it may be slightly cheaper, but not much. (Moreover, it might not work if he keeps waking so often at night; a single live-in person would get no sleep.) Bottom line: the longer he lives, the more his home care depletes their savings, and the less is left for her own survival afterwards.
Who ever thinks the time will come when you might have to worry someone with whom you’ve lived for sixty-four years won’t die before you run out of money?