Complexity therefore is relative to the resources at hand, not necessarily tothe domain. Throughout life there are decisions and dilemmas. Fromchildhood to midlife the context of youth is generally a well defined path and supported with institutions and traditions. Untilrecently, midlife to retirement was pretty clear too. Work, raise children, throwa wedding or two, retire and….
But the disruptive demographics of an aging society has mademidlife to older life more complex than ever before. First, most of us are livinglonger so the question becomes what to do with the additional years – do we simply extend the activitiesof our parents over a longer period time? (a question for a future post) Evenif we choose to ‘stay the course’ and do as our parents did, that may not be anoption. The context of who and what is part of our old age has changed fornearly everyone.
In all industrialized countries, and in many developingeconomies, it is no longer feasible to count on the support of family in oldage. With far fewer children there may be no family at all or in pursuit of economic opportunity children may have moved far away. Individuals (26% of Europeans and 30% of Americans over 65 live alone) are now managing a self-directed longevity. Consider some of the ‘daily jobs of oldage’ that require comprehensive understanding, often involve significant risk, disciplined behaviors (oftendaily) and continuous coordination:
- Managing Health – Many older adults manage morethan one chronic disease requiring multiple medications. Each medication hasdifferent dosing instructions – when to take, how much to take, with whatfoods, etc. And, this is just one activity regarding health, the coordinationof clinicians to ensure quality care is a job all its own. Ensuring that yourpersonal physician is communicating fully with one or more specialists as wellas the pharmacist often requires considerable paperwork and patience. Throwinto the mix the management of medical referrals, reconciliation of personalpayments, public insurance and private payers and you have a full-time job thatwould challenge the chief of staff of any CEO.
- Financing Longevity – Many people are now entering an era ofself-directed retirement. The United States has generally moved from definedbenefits guaranteeing stability and certainty to defined contribution requiringeven more planning, tolerance for ambiguity and greatly increased uncertainty. EvenEuropeans are finding that once guaranteed pensions are now open for debate in coming years requiring greater individual planning and action,e.g., older retirement age, changes in benefits. Financing old age requires morethan just regular saving, it demands considerable forethought about what your needsmight be in the future, what those costs might be in the future, and how to choose among a dizzyingarray of possible products and services.
- Living Independently – It is easy to take for granted thethings we do every day. Cleaningand maintaining our home, food shopping and all the mundane activitiesthat, together, makes up daily life. However, as we age those simple activitiesmay become chores. Figuring out how to accomplish those daily tasks within thephysical and fiscal constraints of old age, often without the support of family, can be difficult.
- Making Long-Term Choices – As people live longer planningfor where we are going to live and how we may be cared for becomes critical.What if chronic disease, accident, and disability makes it no longer possible foryou to live independently or impossible for family members or friends to care for you?What are the options, costs and how do we address these questions before thetime of need rather than at the time of panic?
- Coordinating Care – Even if you’re not managing old-age foryourself (yet) there’s a very good chance that you may be managing someoneelse’s. Perhaps you’rebetter equipped, you have more education, are an adept user of online resourcesand may even have the income to purchase the services your loved one needs. Butthe odds are pretty high that today’s middle-aged caregiver is also managing ajob, a family, and all the otherstresses and strains of midlife with few trusted resources to turn to for helpor simply support. Moreover, even if you have the finances to fund the servicesyou want, do you have the tools to locate and coordinate the services you need?
Business innovators and government policymakers should see this as anopportunity to provide value and to develop new technology-enabledservice models as well as products that focus on managing thecomplexity of old age.
Here are a few examples of nascent innovations:
- The United Kingdom’s Department of Work & Pensions hasdone an excellent job placing many of the issues of old age on it’s directgov website providing a gateway to pensions as well as to everything from health, housing and even fun in one place;
- Wells Fargo and other financial services companies provide eldercare services that include financial management and access to otherservices for their clients and family of clients;
- CVS, Walgreens and other retail pharmacy chains throughoutthe world (e.g., UK-based Boots) are investing in the business of advice by setting aside morephysical space for private consultation as well as online medication managementservices that are ageless in appeal but critical for older adults andcaregivers; and,
- Countless technologies are available (Philips Lifeline, GE QuietCare, Vitality, just to name a few) to address individual tasks, e.g.,medication management or home monitoring.