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What Retirees Want: A Holistic View of Life’s Third Age

Introduction: The following SHSMD Podcast is a production of DrPodcasting.com.

Bill Klaproth: On this special edition of the SHSMD Podcast, we talk with Ken Dychwald who offers a sobering view of an aging America and how the healthcare industry is unprepared to handle the volume of baby boomers growing into old age. So Ken has panned a five part solution to this oncoming crisis in SHSMD's, future scan 2020 to 2025 Healthcare Trends and Implications. And we're going to talk with Ken about the problems and those solutions coming up, right now. This is the SHSMD Podcast, Rapid Insights for Healthcare Strategy Professionals and Planning, Business Development, Marketing, Communications, and Public Relations. I'm your host Bill Klaproth. And in this episode, I'm very happy to talk with Ken Dychwald the Author of a Five-Part Solution to Healthy Aging in America featured in SHSMD's Future Scan 2020 to 2025 Healthcare Trends and Implications. Ken is also an Author having written 16 books with his 17th on the way, as he is the coauthor of the long awaited new book. What Retirees Want, A Holistic View of Life's Third Age. Ken is also the Founder and CEO of Age Wave a firm created to guide companies and government groups in product and service development for boomers and mature adults. Ken, so happy to talk with you. Welcome to the SHSMD Podcast.

Ken Dychwald: It's great to be with you Bill. I've been looking forward to it as well.

Host: Oh well, that's wonderful. Thank you for that. So you were featured in SHSMD's Future Scan, 2020 to 2025 publication, Healthcare Trends and Implications, and you are offering a Five-Part Solution to Healthy Aging in America. Before we get to your five part solution, I wanted to ask you, there are key challenges facing the healthcare field, you write, in caring for the health and wellness of the aged. What are those key challenges facing the healthcare field?

Ken Dychwald: Well, I'd say first of all, what the healthcare field is confronting with regard to the aging of our population is absolutely new and we're also absolutely unprepared. So let me back up and give a little context to that. First of all, during the 20th century, we had some extraordinary breakthroughs in medicine and health and public health, which among other things had the impact of causing more and more people to live longer and longer lives. So when we saw breakthroughs with regard to antibiotics, one of the effects was that somebody was going to be healthier that day. Another effect was they were likely to live longer than they would have otherwise. And so what we see now is that we have more and more and more people seeing their 60th and 80th and even 100th birthdays. So we have a longevity revolution upon us, and this has never happened before. In fact, throughout 9% of human history, the average life expectancy worldwide has been under 18.

And today in the United States and life expectancy at birth is around 77ish in the United States, but there are 33 countries in the world that even live longer than we do. So longevity is on the rise. I would also say that we have this massive baby boom after World War II, but it's a moving target. So just as back in 1946, when the boys came home from the war and 92% of all women who could have kids did, we were seeing, you know, 10,000 births a day, 4 million a year for 18 straight years. Same thing is happening right now with regard to people hitting their 65th birthday. So every day that passes another 10,000 boomers retire and other 10,000 boomers find themselves being recipients of Medicare. And we have what I call an age wave, which has never happened before. So on the one hand, we've got increasing longevity and I'm going to throw a wild card in there too. There are many people who believe that because of coming breakthroughs and exponential medicine and STEM cells and pharmacopeia's that we haven't yet seen that.

It's entirely possible that the first people to live to be 150 and beyond are alive today. So keep in mind that longevity has been rising from 47 on the first day of the 20th century to another 30 years today. And there's a chance, I wouldn't even say a good chance that it can continue rising in the years to come the future in which we'll be living combined with the massive aging of the boomers. We've got this huge swell and you referred to you use the word agent, how are we going to care for the agent? And I wouldn't even flesh that out. And I would say, how are we going to care for the aging? And it used to be, I know when I was a kid, we thought of people becoming aged at around 65. And by the way, now that, and I got interested in the field of aging when I was 24 back in 1974. So when I wrote my first kind of 10, 15 books, when I was under the age of 50, and now I just turned 70 and I can tell you that I do not see all aged. And most boomers, don't like the idea of being thought of as seniors or aged. They get, we get that we're aging. You know, we get it. You know, I saw the rolling stones last year on tour and they had clearly, you know, aged a bit but they're still fantastic.

And, you know, Jagger was being Jagger. And so what is it to be 70 today? It's not at all like what's 70 used to be. So when we think of older people, we can't think of our grandparents, although they might've been wonderful people. They grew old in the past with yesterday's medicines, yesterdays fashions, and frankly yesterdays ideas about who you could be when you were 65 or 90, we're going to grow old in the future. And so there's a whole new model of maturity and aging emerging that's more hopeful, more aspirational, more youthful, more ageless in many ways. And frankly has gotten a lot more expanse in front of it because of the increasing number of years that most of us are going to live.

Host: Yeah. So true

Ken Dychwald: Part of the challenge Bill, is that we haven't set up our medical system to deal with older people very well. It's sort of a whoops, but you know, like with capital letters, because the breakthroughs in our medical system are what are causing this age wave, but I run sonically. And unfortunately we haven't really yet reshaped our medical priorities and our intelligence and our competencies and even our funding to match our health spans to our lifespans. So we have not really created a healthy version of aging, particularly in the United States. We've got some serious catching up to do on that front.

Host: Yeah. That really makes sense. So that really illuminates the issue here. Some of the key things you said there, longevity is on the rise. The age wave is coming, this is all new and we're unprepared. So that really kind of sets the stage and I'm happy you're a rolling stones fan. So there's a lot you said there, I love that. That's all good. So these are the key challenges facing the healthcare field. So you have come up with a five-part solution to healthy aging in America. So looking forward to that, so let's take these one by one Ken, I'll read them off and then let's discuss each one of these. So number one of your five-part plan is use advances in medicine, in technology to develop innovative solutions for healthy aging.

Ken Dychwald: Yeah. I put that in the future scan piece because I think oddly many folks in the healthcare field, and when we talk about the healthcare system, we forget to include science. Many of the problems of old age of our later years are going to need to be solved in the lab. They're going to need to be solved with new technologies, with artificial intelligence, with new pharmacopeia's, with new understandings of body's metabolism, with new understandings of the brain. And unfortunately in our country, we don't go to bat for science. You know, interestingly, this COVID catastrophe that we're all living through right now has called attention to the importance of science, but with regard to heart disease and cancer and diabetes and Alzheimer's and CLPD the problems of older adults and stroke, we have smart science, but we have not really created moonshots around our science to eliminate many of the diseases of the later years. And boy, if we could do that, we'd have a healthier version of aging. We'd have far fewer people needing ongoing care.

We'd have far fewer dollars being spent on the disabilities of old days. And we have a healthier population. We haven't been doing that. We spend so little on scientific research as a nation. We should be ashamed of ourselves. And unfortunately, even for example, I've watched over the last 10 years, you know, every single political debate for the national offices, and science is almost never discussed. There's usually a throwaway comment about a battle against cancer and maybe one line about brain health, Alzheimer's, but we haven't really identified scientific breakthroughs as what the healthcare system requires as a result of the aging of our population. So I would say that we need to make that not only front and center, but an integrated part of all health discussions and considerations, which is where is the science that can save us in the first place. I'll give you a thought that I just remembered. There was a guy named Uvi Reinhart. That was a brilliant health economists professor at Princeton, who once I was sitting in the audience at a conference and he told the story of a guy going out to have a picnic, and he takes out his technic lunch and a little bottle of wine.

And he's sitting by the side of a river and he's attempting to have a lovely day. And then he looks into the river and there's somebody drowning. And he thinks, Oh my God, I better save their life. And he jumps into the river and he pulls them out. He gives them artificial respiration. He saves their life, sends them on their way. It goes back to his picnic. There's another person drowning in the river. Dives in, pulls them out, saves their life, trying to have his picnic again. Oh, there's another person drowning. Now three people drowning and the whole day is pulling people out of the river until he realized that there's somebody upstream pushing them in. And we do a lot of pulling people out of the river in our healthcare system. And we don't do nearly as much not pushing them in, in the first place. So using science and by science, I really do mean science in the lab and also tech science and the exponential worlds that are emerging, where things like artificial intelligence can substantially speed up, moving towards an exponential growth in knowledge and skills.

So with the state of technology information technology, as we know it now, as it gets more interested in biologics situations, we're going to find ourselves in the years to come being able to do things and figure things out faster and smarter and more complex ways than we ever did before. And so to me, that's got to be a part of any future vision of a healthcare system, not just a hospital in the neighborhood. It may be the lab over in the university, 8,000 miles away.

Host: Really good points. We need more funding and research for the scientific breakthroughs. And I like how you said, where is the science? So we need the science. Alright. Number two, promote research to reverse or cure Alzheimer's disease.

Ken Dychwald: Yep. Yeah, Bill, you know, this sort of builds on the first point, but so I spent, as I mentioned, 45 years now in the field of gerontology and giving talks to about 2 million people, I've gotten more emails sent to me about read this, see that, listen to that talk, meet this person. I've advised Presidents, world leaders. So I've been in this, in the trenches on this kind of theme, the aging of our population in our healthcare system, for quite a long time. And it's at least from where I sit, the biggest problem coming at us is the pandemic that's emerging with regard to brain health and Alzheimer's disease and related dementias. When we're all young, we don't worry so much about Alzheimer's and related dementias, but as more and more of us are going to be living past our 80th and 90th birthdays, this is a serious problem coming. And I would say it's the most serious problem pertaining to the aging of our population. Sometimes people will say to me, what about isolation and loneliness? Yeah. It's not a great thing, but we can fix that with more communal activities and intergenerational connections.

Okay. What about poverty and old age? Yeah, that's a terrible thing, but that can also be fixed by people working a bit longer and maybe, you know, sharing or resources, having roommates and moving to a less expensive neighborhood. And it's not perfect, but there are solutions, but you lose your mind. There's no treatment for that right now. There is no cure. There was no breakthrough today. And so we've already got 5 million people with Alzheimer's disease in America and the projections are in the next 20 years it's going to rise to 15 million. Now, keep in mind, we've got about a million people with HIV, which is a horrible disease. And we know how many people, the numbers our rising, that have been infected with Coronavirus, but we've got 5 million people with Alzheimer's right now. And it's multiplying also what scientists and researchers are telling us is that even before folks start to forget their keys or repeat themselves maybe 10 years before the beginnings of this disease started. And so there actually might be 20 million of us right now with Alzheimer's disease. And we don't yet know it.

If this continues, it will be the sinkhole of the 21st century. So for all the fact that for a hundred thousand years, we've been trying to grow long, lived people, and we're doing an okay job of it. Now we have aging all over the world. There's a billion people around the world right now, over the age of 60. If we don't solve this disease, we're in trouble and it's not just, you know, you get, you know, you get Alzheimer's and you pass away. It doesn't work like that. My mom had Alzheimer's for 12 years and just every time I'd be with her, she'd be less there. And then she couldn't remember where she was and then she'd have to wear a diaper and then she'd be falling down and breaking her hip and breaking her arm. And it's a long, slow decimation that happens with this disease. And we are not, we have not built a scientific intelligence or even a medical assault on stopping Alzheimer’s or ending it. Now I will tell you that when I was a younger guy, when I was 30, I collaborated on a book with Jonas Salk.

The gentleman who had the breakthrough with regard to polio, and one night at dinner, Dr. Salk was explaining to me how in the 1940s, when polio poliomyelitis was rampant, people were terrified of this disease and were concerned about touching strangers or drinking out of a public water fountain or, or, you know, and then the idea was, well, people have to live their lives in these weird iron lungs that looked sort of like coffins with your head sticking out of the end. And it breaths for you. And people were saying, Oh my God, in the future, we're going to need 10 times more iron lungs. And, you know, in every community and Salk had a different point of view, his point of view was no, we have to stop the disease. And I believe that's what we need to do with regard to Alzheimer's disease. It's not a matter of doing crossword puzzles or going to Amsterdam where there's an Alzheimer's friendly community, where if you wander around, somebody will know to walk your home. I'd like to see the disease put behind us ended. So, yeah, and by the way, if we could eliminate Alzheimer's disease, half of all the nursing home beds in America would be empty, and about 20 million caregivers would be relieved of that challenge. And we would save over the next 20 years, trillions of dollars. So everybody wins, if we are able to stop the disease.

Host: So you say in the coming age wave, Alzheimer's is the number one issue calling it the sinkhole of the 21st century. I know this podcast isn't specifically about Alzheimer's, but Ken are we getting any closer on research or finding at least a treatment to really slow this disease down?

Ken Dychwald: Yeah. So 20 years ago, we didn't even hear anything about Alzheimer's. People talked about, they had an uncle who was senile, or it was believed, Oh, old people. They just get silly when they got old that, you know, that's what happens to the aging brain. Well, now we know more about it. Not, we're not brilliant about the brain, but we know more, we know that there's all sorts of cognitive challenges in the lady or some of them due to polypharmacy. You know, somebody may appear to have Alzheimer's, but they don't, they just are taking too many medications and their doctors are not talking to each other, and they're getting fuzzy because of that or other people have what's called vascular dementia. So the whole idea of keeping your vascular system healthy and vital will not only prevent heart disease and stroke, but could also prevent Alzheimer's hence, you know, diet, exercise, sleep, and so on. And then there are other kinds of conditions of the later years, depression that can be dealt with maybe with more stimulating lives. Last year, the average retiree in America watched 49 hours of television a week. Now that's something I'm not personally happy about as kind of an activist in the field.

Cause I'd like to believe that we can think of a more useful and challenging assignment for all of our elders, then sitting around watching TV all day long. So that may be one of the reasons brain starts to get a little, you know, little silly. But with regard to breakthroughs to stop the disease, there's more and more discussion in the last five years about preventable activity, you know, prevention activities at certain diets, plant based diet, anti-inflammatory diet, a sufficient sleep, proper exercise, continually stimulating the mind, that we might be able to keep our brain health longer. But I still think back to the Jonas Salk reference that we're going to need to have some kind of pharmacologic breakthrough. And there's two different paths on that track. Bill one path is something like an AIDS cocktail, like back in the 1990s, where you take many medications everyday for the rest of your life, or like diabetes management, you have insulin you know, supplementation everyday, the rest of your life. That's one approach. The other way is if somebody were able to come through with some sort of a vaccine breakthrough, so you get an injection or an infusion and you, it stopped in its tracks and you have no Alzheimer's the rest of your life. I think that's what we're hoping for.

Host: Absolutely. And we are all hoping for that. And we thank you for raising awareness for this Alzheimer's issue, which is a tsunami coming in the form of this age wave that's going to be upon us. That's for sure. Well, thank you for informing us of that.

Ken Dychwald: Bill, you and I, as we're imagining the future here, the future hasn't happened yet. So we can either create a future in which we've got hundreds of millions of long lived men and women, by the way, including ourselves and our loved ones, who are productive and contributory and have purpose in their lives. We create another future in which we've got tens of millions of us who can't remember who we are and who are falling down. And we can't control our toileting and it's up to us to shape one future or the other. And I would tell you that if we don't take action, that crummier version I just described is where we're heading right now.

Host: We want that good version. We want the stones playing when they're 90. Okay. Number three. Find and recruit healthcare professionals specializing in Gerontology.

Ken Dychwald: Yeah, this is a really interesting one. And I'm even going to add another word to that, to your intro. And I know what I wrote about in that article for future scanner. What we wrote about was that it's not just finding a recruit, it's trained. Here's one of what should be one of our biggest outcries. We do not have doctors, nurses, pharmacists, physical therapists, who are sufficiently trained in dealing with the needs of geriatric population. We just don't. I mean, we've got what, 40, 50,000 pediatricians. And then we've got less than 10,000 geriatricians. And not only that, but they're the lowest paid of all practicing physicians in America. So it doesn't seem to be an appealing category and even worse. 90% of all the doctors and nurses who graduated medical and nursing school last year did not take even one elective in geriatric medicine. Whereas you go to great Britain or Japan and every doctor and nurse has got to learn the basics of dealing with older patients.

We don't do that in the United States, and shame on us and frankly, shame on ARP, and shame on the American medical association for allowing us to have, by the way, they could be incredibly wonderful people and well-intentioned, and highly motivated to help their communities. But there are many different complications that occur with the older man or woman physically, psychologically in terms of their social situation, their housing, their likelihood of falling and slipping and confusion of medications. And a lot of medications haven't even, haven't been tested on older women, which is even something we should be even more ashamed of because older women are the longest lived among us and will become the vortex of healthcare in the years to come. So what's my point there, that healthcare systems, and by the way, we have 126 medical schools in America. There's only about 16 departments of geriatrics. Shame on us. So how can we claim to be a great nation or a great medical system? How can we claim to be really concerned for the wellbeing of our communities? And we do not have people in the field with the kinds of competencies and skills to deal with this age wave.

Host: Sitting here. I didn't know of this. I can't believe that we are lacking in these fundamentals of treating older Americans. This is crazy.

Ken Dychwald: Yeah. And I have had as clients or I've given speeches to all the major insurers, United Healthcare, Blue Cross Blue Shield, Humana back in the day and, and the American Medical Association and Nursing Associations. And, you know, I can be a whistleblower and state this again and again and again, but until the media, until the healthcare system itself, until hospital administrators, until families begin to kind of throw their fist down on the table and say enough is, you know, I have an aunt who I actually, I just spoke to yesterday, she's 97. And she sort of was like a backup mom when I was growing up in New Jersey. And she's got a lot of arthritis pain. So her doctor this past year subscribed Vicodin for her, she lives alone. So of course, five days after starting to take the Vicodin, she fell down and broke her neck. So here's my aunt now she's bedridden. And it's like, what was that doctor thinking? You know, there's so much going on. I might've been a good doctor, but maybe he didn't understand that people in their nineties are very sensitive to opiates.

So how do we make sure that our docs and nurses and healthcare providers are not biased, an ageist. Robert Butler, who was the founding director of National Institute on Aging and a Pulitzer Prize winner in 1976. I think his book, why survive when the Pulitzer, Bob was my mentor. And Bobby used to say that, you know, that the medical system, you know, suffers what the, I don't know if he made this up, but he called it the Yavis syndrome. Y A V I S and I'd say, well, what is that? What do you mean? He said, they want patients who are young, attractive, verbal, intelligent, and single. That's not who they're going to be getting in the years to come. We have got to build a medical system with competencies that know how to prevent disease, help people manage their problems and often comorbidities, and also can be helpful to people throughout the entire continuum of care. We do not have that.

Host: This is shocking. And you even said in other countries, they have to have at least a baseline in caring for older people where we in the United States Don't. I think you said it right. Shame on us.

Ken Dychwald: It verges on a moral a few years ago. I decided, and I did not go ahead because the lawyer, I had dealt with chickened out, but I decided that I was going to launch a lawsuit against Medicare because it was killing old people. And people said, well, are you talking about Medicare is helping all people it's saving their lives? And I said, it definitely is doing that. It's doing so much, right. But to not insist that healthcare professionals have basic skills and competencies with older adults is dangerous and damaging and costly. And I thought just by doing a lawsuit, I'd get attention to the topic. But that topic has not sparked. It has really not kind of lifted off the ground and, you know, shame on us.

Host: Well, hopefully things like Future Scan and podcasts like this will help illuminate this key issue. Okay? Number four Ken, make lifelong disease prevention management of chronic diseases and self care national priorities.

Ken Dychwald: Yeah. This one is a sensitive one because we live in a democracy, which I personally love. And we live in a world where people are allowed to make their own decisions, which I also love. But when it comes to health for life, a lot of us don't make very good decisions. And then we get angry at our doctors or our insurers or the government. And so how do we live in a society where two thirds of our population is overweight and a third are obese. Now we know there has been so much research. There's nothing new that we need. We can say without any shadow of a doubt that carrying extra weight is if you're going to live a long life is going to raise the likelihood of you having hypertension, heart disease, diabetes, and a suppressed immune system. We just know that. We know that people who don't exercise, they're more likely to have trouble with their joints that are more likely to fall. One third of the elderly fall each year. And it can be a terribly devastating phenomenon because it sets people back. It may make their homes no longer comfortable or safe.

And you know, it can create a cascade of future health problems. Yet half the population doesn't exercise. We have so many ways in which we could be taking better care of our bodies and our minds and our own health. You know, when you're 30 or 40, you can be very cavalier about your health. And you know, so what, but you keep doing that and you're 70 or 80 and the effects of your lifelong choices. You're going to feel them and you're going to see them and you're going to be suffering with them. And so is it ever too late? Not really. I mean, I've seen many studies where 60 year olds, 70 year olds begin exercising and their body rejuvenates. I've seen many studies that people practicing mindfulness and their hypertension diminishes. I've seen many studies where people, by taking more proaction towards their own health than practicing thoughtful self care, they can become a better version of themselves and a healthier version. And again, if we were all, you know, 25, it wouldn't matter so much, but if we're going to be 70 and 90, I have not met anybody who tells me that they'd like to live a long life so that they can have disease and suffering for 25 years. What everybody really wants is to match their health span to their lifespan. So they want to live healthy until they die, you know, so they can play with their grandkids and so that they can enjoy a walk.

And so that they can have a game of tennis or they can maybe start a new company when they're 72 or play in an orchestra when they're 90, but that's going to require a teamwork, you know, an excellent science and excellent medical system. But each of us has got to be a little closer to excellent in terms of our own self care. And most people are uncomfortable saying that out loud, because we don't want to shame people, or we don't want to blame the victim. And I've written numerous books now on healthy aging. And I'm respectful of that. You know, and things happen to people, you know, what was it, Jim Fix? Wasn't he, the cardiovascular wizard who got everybody jogging and then he died of a heart attach. So things happen, you know, but nevertheless, we can raise the likelihood of being healthy and vital and clearheaded well into our eighties or nineties by practicing smarter self care. But that has got to become a priority. We've got to see that in movies. We've got to hear that in the news, we've got to have role models and thought leaders and exemplars out there so that we all believe it's possible and then do the right thing and continue doing it.

Host: Absolutely. I think you said it best.

Ken Dychwald: I will tell you one other thing. My kids, my kids are now 30 and 33 when they were teenagers, we went to Europe and we also have been to Africa and we've been to a few parts of the world. And it used to be the joke with our kids that we'd be sitting in a community square somewhere, pick a country. It doesn't even matter. Germany, Italy, England doesn't matter. And they could pick out the Americans because they'd be the ones that didn't look so good. And it dawned on them that, wow, we have people, you know, or if we're in Japan or China, most people around the world look fitter and healthier than we do. And I'd say that's on us as citizens to be more responsible for our own health.

Host: Right. Well, you talked about the 49 hours of sitting, watching TV every week.

Ken Dychwald: That's not going to make you fitter.

Host: No. And you know, coffee shops. So sugary drinks on every corner doesn't help either. So I think you said it best. We have to be excellent in our own self care and that needs to start early and be promoted as well. So that makes sense. Okay. Number five, develop a humane approach to the end of life.

Ken Dychwald: Yeah. So maybe we don't even want to talk about this cause nobody wants to talk about it, but well, maybe we should talk about it. Cause it is a part of a continuum of life. I mean, I don't want to go philosophical, although now that I'm 70 I'm, I should be more able to try that out.

Host: We want your philosophical views. We want that.

Ken Dychwald: My wife and I, and our kids we're went on a Safari a couple of years ago. It was a gift to us. And it was amazing thing. And you know, so here we are in the Maasai Mara in Kenya. And one of the things that's sort of obvious is that out there in the natural real world, you see babies, you know, you see instant giraffes, you see infant gorillas, you know, you see, you know, zebras thousands of zebras, and you see old animals and you see animals that are dying and you see dead animals. And that's kind of how it works. I mean, that's the deal and I didn't create this system, but I share every great all of it and respect for it. And the truth of it is, is that at the end of our lives, whenever that is, we die, we have done a very peculiar thing with that in our healthcare system, we are so uncomfortable with the notion of death. You know, it used to be that when we were in agricultural based communities, before the industrial revolution, the 20th century, death was around us. You know, you'd be on a farm and you'd see puppies being born and you'd see, you know, cows dying and you, you know, and grandma would die at home, and there'll be love and support, but understanding and respect and awe for the preciousness of life.

Somehow during this 20th century, we've medicalized death. And so 80% of it happens now in institutions. And strangely, we have also decided that we should fight it in crazy ways, and extend the dying process as long as we can possibly extend it. And so we've all had loved ones who were kept alive far longer than, you know, nature or God would have had them living by, you know, using tubes and wires and stream technologies to extend those last weeks or months of life. And that's fine. I'm not here to make a, you know, an ethical judgment on that, I guess, except that I think I know in both of my parents situations, my dad, when his end of his life happened, his body, he was 93 and all sorts of things just in the few days just started going wrong. Then it was pretty obvious that his body was done. And so he was in intensive care. And my poor dad who had been blind for 10 years, they were putting tubes in his face and in his butt and his penis. And he was pulling him out and there was blood all over the place.

And I knew enough about hospice care to ask his doctor, can my dad be switched to hospice? And they cleaned him and he combed his hair and they took the tubes out and the family came together and we had a beautiful, loving few days. And then my father passed and same with my mom. My mom died in my brothers arms, and she had Alzheimer's and it was humane. And we weren't trying to Jack her up to have her live an extra three months for, she didn't want to, she was done. So how do we just get a little bit less nervous and jerky about end of life? And then also realize that people have wishes. They, if you read the studies on what we're referring to as a good death, and I'm not saying death is good, I'm saying what people say is a good way to have that unfold. They'd like to be with minimum technology in them or on them. They'd like to be if possible, in a comforting situation at a comfortable, maybe a home. They'd love to be able to say their peace to their loved ones. And they don't want to suffer longer then they would have naturally.

So they don't want to be intervened with, to be made, to suffer longer. And so we got a puppy when our kids are very little and when she was 16 she was getting very sick and everything was going wrong. And one night we found her way in the back of our property and she was kind of yelping and crying. And we took her to the vet and the vet says, your dog is dying. And we said, well, what can we do? And they said, well, you could operate on her kidneys, or you could, she's blind now. And you could maybe operate on her eyes and well, what will that give her a couple of more weeks of life? And so he explained to us that we could bring her life to an end and how do we do that? And he says, well, there's a room here, a comfortable living room. You could sit with your dog. You could sit here all night, or you could sit here all week, or you can sit here 15 minutes with your dog. And if you want to hold her, talk to her, and then when you feel the time is right, you let me know and I will give her an injection. You can hold her and she'll, she'll pass comfortably. And that's what happened.

And we all loved her and we held her. And then we said, what a humane approach to dying. We thought, wait it's a dog. But then when we looked at how we deal with older humans, we don't treat them with as much humanity. And so I don't have the answers. I am not a religious scholar. I am not a physician, so I don't have the answers, but I do believe that if we're going to talk about the aging of our population, I'm not arguing for, you know, taking people's lives, who are fine, or who don't want you to do that. But to try to imagine a more humane approach, and that may be in the hospital or the institution, it may be bringing people back to their homes and letting them pass in the comfort of their own environment.

Host: Well, you're right. That nobody wants to talk about death. And a lot of times it is an uncomfortable conversation, but maybe if we had these conversations, more often, death would become easier and we would be able to achieve a more humane end of life. So you bring up a great point in that. So thank you for sharing your five-part solution to address aging in the United States. Let me ask you this, Ken. So we kind of, you've laid out the roadmap of what we need to pay attention to and what we need to do. What happens if we don't, what happens is we don't pay attention to this roadmap. What does our healthcare industry look like in 30, 40, 50 years and beyond?

Ken Dychwald: Well, I sometimes think of this as sort of like a fork in the road. You know, we spent the last hundred thousand years trying to help people live longer. And now we're doing a decent job, as I mentioned earlier, but we've got an ill and a suffering version of maturity. We have not really created a aging, healthy, long life. We haven't created health for life. If we continue to do that, what we're going to have is not a lot of people dying when they're 62 or 71, but living for decades with cognitive loss, with massive pain, with eruptions of disability, with horribleness, and that will destroy the individuals and their sense of identity that will destroy their families. And it will totally bankrupt the country. So will we have any money to invest in education or infrastructure or children or anything? No, because it will be a sinkhole. On the other hand, if your future scan, if our podcast changes the world, if we could somehow, you know, turn the rudder and Amos down the other fork side of the road, if we could create a healthier aging, then you've got the dream of history.

Then you've got 90 year olds going skiing with their 60 year old daughters and their 35 year old grandsons and their six, 12 year old great grandsons. And then you've got people who are not in so much suffering. And then you don't, we have 40 million caregivers in America who are loving, you know, and giving great attention to their elders, but often at a loss to their own families and economic and loss of job time and such. If those could be liberated, then what we've got is kind of the dream of history of six generation population with purpose contribution, and a chance for people to rise to the greater Heights in their later years. Versus like my dad said to me, when all this terribleness was going on in intensive care, he said to me, Kenny says, I spend my life on my own two feet. I'm not going out on my hands and knees, help me. And I think we want to go out on our own two feet. We want to live, stand tall. In our later years, we don't want it to be the worst part of our lives. In many ways we'd like it to be the best part of our lives. And I think it's up to our healthcare system to make that happen.

Host: Well, you called it a fork in the road. I hope we choose the right fork. And, and when it's time to go, I hope we get that humane end to life. Before we go, Ken, a quick question, we're all excited about your new book. What Retirees Want, A Holistic View of Life's Third Age. Can you just quickly tell us about the new book and I'm intrigued about what you're calling the third age. Can you tell us about that?

Ken Dychwald: Yeah, let me build on what we've been already talking about Bill. So, as I mentioned earlier, we're in the midst of this moment of increased longevity, which the world has never encountered. So when my grandparents reached 60, they kind of thought they were happy to live that long. And maybe they'd have a few years to go before their batteries wore out. And our parents had a few years in retirement and you know, that generation, so retirement is kind of a vacation, but to be 60 in this new era means he's got another 30 year life in front of you and propelled by the enormous numbers of the baby boom generation. This third stage of life, this third age is about to rise up as maybe even the cultural center of gravity, which has never happened before. However, most of us are clueless about what we ought to do after our 60th birthday. When my kids I'm giving a lot of kids reference in this call, when they were in high school, there was a lot of infrastructure and opportunities for them to consider their four year college experience. You know, there would be college counselors giving them talks. You could go visit the campuses. There were workbooks, there were comparisons. You could try out a college for a week and see if you liked it.

Maybe you want to be in the city, maybe a dorm, maybe a commute from home, but when it comes to retirement, you're just told no orientation, just have a good time. And what I've learned in my 45 years is that most people are absolutely clueless about who they could be and what's possible for them in the years to come. So Robert Morrison and I have my first book in over 10 years, it's my 17th, but I took a long time to think about this one. And we also did a decades worth of I'd like to feel at landmark research. So we've got more insights and understandings now about what is it people want in terms of their health? Where do they want to live? Who do they want to be? Do they want to go back to school or not? What is the role of family in this new third age? And not only that, but what are the opportunities for providers, whether they be health providers or housing developers or entrepreneurs or technologists, in order to meet the needs of this third age of life. And so, yeah, the book is coming out this year and we're very excited. The initial reactions have been very favorable and we're hoping it's not only a book for anybody who comes in contact with, or works with older adults, but also for anybody 40, 50, or 80, who's thinking, you know, what's possible in this next chapter.

Host: I love that. I love that thinking, love it. And I'm hoping you write the next chapter the fourth age on how we solve the coming healthcare crisis. Okay. One last question. Cause you have a quote and I've been intrigued by it. I'm so excited to ask you. You have a quote that says it's time to retire retirement. What does that mean?

Ken Dychwald: Yeah. You know, if you look up the word retirement in Webster's dictionary it says to disappear to go away to withdraw. So, you know, the idea of being retired, you know, this is going to sound like, like I'm just playing around with words, but I think there's been a lot of focus on people, we say that old people want to be youthful. I actually think that people want to be useful. And I think the idea of retirement meaning, you know, get out of the way or go off to the sidelines or go play golf everyday, the rest of your life, or watch TV 49 hours a week. I think it's, it needs to be corrected. I don't think we all ought to just disappear, withdraw, and go away. I think society needs its elders. I think that we need to remain current and useful. And I think there's going to be thousands of interesting new ways, whether it's going back to college, learning a new skill, getting a new job, falling in love again, if you've been divorced or widowed, or learning how to relate better to younger generations. But I think there's a new era coming.

Host: And I hope so. So we need to switch our thinking from being youthful, to being useful. I love that. So good. Ken, this has been illuminating and enlightening and honest and so great to talk with you. Thank you so much for spending some time with us today. We really appreciate it.

Ken Dychwald: Absolutely. My pleasure Bill. I hope your listeners enjoy what we've talked about and I hope it moves them to action.

Host: Absolutely. That's what we need. Action. We need policy in place, so let's hope that that happens and we'll do our part to keep pushing for that as well.

Ken Dychwald: Thanks Bill. All the best to you. Enjoy your family. Take care. Bye bye.

Host: That's Ken Dychwald, and make sure you check out SHSMD's Future Scan 2020 to 2025 Healthcare Trends and Implications. In that you can find Ken's five-part solution to healthy aging in America. Also, we're really excited about Ken's new book, What Retirees Want, A Holistic View of Life's Third Age. And thank you for listening to the SHSMD Podcast. We appreciate it as usual to learn more about SHSMD visit SHSMD.org, and visit our education page to learn about other upcoming programs at SHSMD.org/education. And if you found this podcast helpful, make sure you please share it on all of your social channels and please hit the subscribe or follow button to get every episode. This has been a production of Dr. Podcasting I'm Bill Klaproth. So ya.