Estate Planning for Boomers: Risking Old Age in America

Long-Term Care: The U.S. vs. Canada

Harry is joined by Jim Lomastro to discuss the state of long-term care and nursing homes, particularly focusing on the differences between the systems in Massachusetts and Canada. Jim shares his extensive experience working with the Accreditation of Rehabilitation Facilities and his observations about the superior quality and regulatory rigor of Canadian facilities. Key issues discussed include systemic deficiencies in U.S. nursing homes, the impact of governance structures, and potential lessons from the Canadian model for U.S. policymakers. The episode also explores recent legislative changes in Massachusetts and provides recommendations for seniors and their families.
 
Topics
01:47 Comparing Long-Term Care in the US and Canada
03:04 Experiences and Observations in Canadian Facilities
03:26 Challenges in US Nursing Homes
05:46 Differences in Regulatory Approaches
09:05 New Legislation in Massachusetts
12:45 Financial Struggles and Facility Conditions
14:30 Public vs. Private Facilities
16:49 Nonprofits and For-Profit Entities in Healthcare
18:10 Impact of Budget Cuts on Medicare and Medicaid
19:27 Comparing Healthcare Systems: US vs Canada
22:17 Recommendations for Policymakers
25:17 Advice for Baby Boomers
26:46 The Future of Elder Care
29:44 Conclusion and Final Thoughts

Bridge Meadows Executive Director Dr. Derenda Schubert

Harry speaks with Dr. Derenda Schubert, executive director of Bridge Meadows, a unique senior housing concept based in Portland, Oregon. Bridge Meadows communities are designed to support both elders and families impacted by foster care, creating an intentional intergenerational living environment. Derenda explains the layout and features of these communities, the financing and subsidies involved, and the benefits of creating such integrated spaces for fostering connection, purpose, and stability. They explore the adoption process, discuss support systems for aging residents, and highlight the broader implications for housing policy. Derenda also mentions similar communities across the country and emphasizes the importance of addressing the housing crisis through innovative intergenerational solutions.
 
Topics
00:00 Introduction to Bridge Meadows
00:35 Purpose and Design of Bridge Meadows
01:33 Locations and Living Arrangements
04:06 Community Facilities and Activities
05:15 Funding and Affordability
07:52 Youth Programs and Foster Care
14:12 Elder Support and Community Care
17:01 Intergenerational Living Models
21:20 Policy Recommendations and Final Thoughts

The Future of Social Security with Nancy Altman

The guest is Nancy Altman, president of Social Security Works, discussing the current challenges facing Social Security amid governmental upheaval and projected fund depletion. Altman highlights the efforts to privatize and outsource the administration of Social Security, which could create inefficiencies and put beneficiaries at risk. She explains the importance of human decision-makers in the administration, especially during vulnerable times for beneficiaries. The conversation also touches on the potential depletion of the Social Security Trust Fund by the 2030s, the impact of income inequality on funding, and the possible solutions proposed by Democrats to expand benefits and ensure the program's sustainability. Altman urges listeners to contact their congressional representatives to demand oversight and prevent further erosion of Social Security services.
 
Topics
01:23 Current State of Social Security
02:03 Impact of Government Actions on Social Security
03:08 Challenges Faced by Social Security Administration
04:37 The Role of AI and Outsourcing
05:53 The Bigger Picture: Government Efficiency and Privatization
11:47 Future Projections and Trust Fund Depletion
25:59 Social Security Works: Mission and Activities
29:08 Final Thoughts and Recommendations

Former Health Secretary Mary Lou Sudders

Harry engages in a detailed discussion with Marylou Sudders, former Secretary of Health and Human Services for Massachusetts, about long-term care and healthy aging. They explore the demographic trends in Massachusetts, with an older-than-average population, and initiatives to make the state more age-friendly. Sutters highlights legislative and policy efforts, including housing adaptation, health and transportation services, and the creation of age-friendly communities. They discuss the impact of the COVID-19 pandemic on long-term care facilities, lessons learned, and measures to prepare for future health crises. Sudders emphasizes the importance of advanced planning and thinking of aging as an asset rather than a liability.
 
Topics
00:49 The Aging Population in Massachusetts
03:30 Creating Age-Friendly Communities
05:17 Housing Solutions for Older Adults
14:22 The Impact of COVID-19 on Long-Term Care
21:04 Lessons Learned and Future Recommendations
30:32 Personal Planning for Aging
34:09 Conclusion and Final Thoughts

The Future of Aging with Paul Irving

In this episode, Harry Margolis talks with Paul Irving, the former president of the Milken Institute and current special advisor and founding chair of its Center for the Future of Aging. They discuss Paul's book 'The Upside of Aging' and explore how extended life expectancy impacts society. Paul emphasizes the gift of additional years and the ongoing need to address ageism and the underutilization of older adults in work and volunteering. They explore research on the positive effects of having a purpose and social connections on longevity and health. Furthermore, Paul shares insights on global aging trends from his experiences in countries like Japan, China, and Singapore and advocates for policy changes to support aging populations. The conversation culminates with Paul’s recommendation for a national aging czar and the importance of intergenerational integration within communities.
 
Topics
 
00:52 The Upside of Aging
02:29 Progress and Challenges in Aging
04:44 The Impact of Attitude and Purpose
08:26 Volunteering and Health Benefits
10:18 Rethinking Retirement and Aging
23:29 Global Perspectives on Aging
28:01 Policy Recommendations and Final Thoughts

Exploring Renewment with Helen Dennis

Harry welcomes Helen Dennis, who discusses the innovative concept of 'renewment.' This blend of retirement and renewal supports career women transitioning out of their work lives. The conversation covers various challenges and opportunities of retirement, such as identity, financial security, and caregiving. Helen Dennis, a nationally recognized leader on issues of aging and retirement and co-founder of Renewment, shares the origin and evolution of the Renewment movement, its impact on women, and its unique approach to creating enduring communities. The discussion also touches on gender differences in approaching retirement, financial concerns, and the current inadequacies in policy support for aging populations, particularly around healthcare. Listeners will gain insight into how Renewment helps career women navigate the complexities of their later years with purpose and fulfillment.
More on Helen at https://www.renewment.org/home/
 You can visit Harry’s blog on these topics at https://okboomer.substack.com/ And if you have questions, comments, or suggestions for other topics or speakers, please email him at harry@margolis.com
Topics
00:00 Introduction to Renewment
00:55 Origins of Renewment
01:55 Renewment in Practice
03:05 Challenges and Opportunities in Retirement
05:47 Gender Differences in Retirement
08:34 Financial Security in Retirement
12:06 Evolving Expectations of Retirement
23:47 Policy Recommendations for Aging Population
27:13 Final Thoughts and Recommendations
 

Aging with Dignity: Lizbeth Heyer of 2Life Communities

Lizbeth Heyer, president of 2Life Communities, joins Harry to discuss how the nonprofit organization provides affordable senior housing combined with coordinated services in the Greater Boston area. She highlights their mission to support older adults who cannot afford high-end senior living, emphasizing the importance of dignity, connection, and wellness. Lizbeth and Harry explore 2Life's innovative solutions, including their middle-market Opus community and engagement in policy advocacy to align housing and healthcare resources. The episode also addresses the importance of planning for aging and the benefits of community living over isolation.
 
Visit https://2lifecommunities.org/
 
 You can visit Harry’s blog on these topics at https://okboomer.substack.com/ And if you have questions, comments, or suggestions for other topics or speakers, please email him at harry@margolis.com
 
Topics
 
00:00 Introduction to 2 Life Communities
00:38 Understanding the Mission and Services
01:22 Addressing Elder Economic Insecurity
03:26 Advocacy and Policy Changes
09:12 Challenges in Home Care
11:10 Innovative Solutions for Affordable Senior Living
21:59 The Opus Middle Market Community
24:49 Future Plans and Expansion
29:32 Recommendations for Policymakers and Seniors
35:53 Conclusion and Final Thoughts

Medicaid Reimbursement and Nursing Home Costs with Edward Miller

Edward Miller provides insights from his study on Medicaid reimbursement rates for nursing homes. The discussion covers the economics of nursing homes, including how Medicaid reimburses only 82 cents per dollar of nursing home costs on average, the impact of these reimbursement rates on for-profit vs. non-profit nursing homes, and the variability of reimbursement across different states. He also explores the complexities of cost reporting, the importance of reimbursement in policy discussions, and the implications for future long-term care planning.Topics00:58 Debate on Nursing Home Profitability01:18 Medicaid Reimbursement Rates03:17 Data Collection Challenges08:19 Study Findings and Analysis15:31 State-Level Variations25:45 Policy Implications and Recommendations27:28 Planning for Long-Term Care35:12 Conclusion and Future Discussions
Risking Old Age in America

Understanding Aging Inequality with Deborah Carr

In this episode of 'Risking Old Age in America,' host Harry Margolis speaks with Deborah Carr, a sociology professor and director of the Center for Innovation in Social Sciences at Boston University. They discuss her book, 'Golden Years, Social Inequality and Later Life,' emphasizing how small disadvantages in finances, education, and health accumulate over time, leading to greater disparities as people age. The conversation covers topics like life expectancy gaps, racial inequalities, gender differences in aging, housing insecurity, and the impact of socioeconomic factors on the quality of life for older adults. They also explore the demographic trend of increasing numbers of people aged 85 and above and the societal challenges this poses, urging the need for robust social policies and individual planning to ensure a dignified old age for everyone.Get Deborah’s book, 'Golden Years, Social Inequality and Later Life,': https://a.co/d/8sQM0VlTopics00:47 Understanding Cumulative Disadvantage02:33 Life Expectancy and Health Disparities06:31 Racial Inequalities in Aging11:34 Gender Disparities in Old Age16:51 The Growing Elderly Population19:14 Addressing Inequality in Elder Care24:06 Policy Recommendations and Final Thoughts
Risking Old Age in America

Navigating Demographic Shifts with Bintu Zahara Sakor

In this episode of Risking Old Age in America, host Harry Margolis explores the implications of an aging population and the youth bulge phenomenon in Africa with Bintu Zahara Sakor, a doctoral candidate specializing in African demography. They discuss the potential security risks and opportunities associated with Africa's large youth population, the impact of structural issues like governance, and the contrasting traditions of elderly care between Africa and Western nations. They also touch on migration as a potential solution to demographic shifts and the importance of international collaboration and empathetic policymaking.Topics00:00 Introduction to the Aging Crisis00:31 Meet Bintu Sahara Sikor01:04 Understanding Africa's Youth Bulge02:28 High Fertility Rates and Their Implications03:40 Economic and Security Challenges07:26 The Role of Governance and Structural Issues12:43 Migration as a Potential Solution20:58 Lessons from Africa on Aging26:11 Policy Recommendations for Global Leaders28:57 Final Thoughts and Conclusion
Risking Old Age in America