Dec 04 2012

America is No Place to Get Old In

“America is no place to get old in.” Gloria uttered these words over five years ago. And this would evolve into one of the main reasons we decided to retire overseas, specifically, Costa Rica. There were other reasons to be sure, but “America’s no place to get old in” got us started and is related to our other reasons, among which were:

  1. Rising cost of healthcare
  2. Fear of terrorism
  3. Lack of civility in our culture
  4. Cost of living, in general
  5. We wanted to live a different, more adventurous, life

Have you ever heard that you spend 80% of your healthcare dollars in your last two years of life? Certainly, in America, with run-away healthcare costs, spending 80% of your lifetime healthcare dollars would be easy. But if you have money, you can afford good healthcare just about anywhere. And you better have a lot of money, because you might end up in a board-and-care or retirement home, and they’re not cheap either. Someone’s got to pay the $5,000 per month. Will it be you?? Will it be your kids? Will it be the government? Or do you have some long-term care insurance to ease the burden? (P.S. The monthly premiums aren’t cheap & they won’t cover you indefinitely.)

But Gloria’s statement wasn’t just a monetary consideration. It spoke more to how you’re treated, how you’re viewed by society, as an aging senior citizen in America, in a culture of youth that doesn’t seem very civil to seniors. Matter of fact, to a large degree, you’re discounted, disposable.

Gloria’s mother lived until she was 92, the last 15 years of which she lived in a retirement community of her own choosing. As she aged and declined in health, she had her daughters nearby and a son in Florida to watch out for her interests. There were many occasions when one of them had to intercede in their mother’s care, to fight for her interests and desires. Many of her care-givers were low-level healthcare workers (CNAs-Certified Nursing Assistants) who wanted to be somewhere else. Gloria, who never had children, started thinking, “Who will look out for MY interests when I’m old and frail?” The fear of being vulnerable in a setting where you’re seen as an inconvenience was frightening to her. And certainly, even if you have children, there is no guarantee that they will take care of you when you’re old.

“America IS no place to get old in.” 100 years ago, this wasn’t the case. The extended family, not just the nuclear family, was involved in daily life. And like the U.S. of years ago, in Costa Rica and much of the world, family is still number one, and respect and care for the elderly is just part of society’s norms. It doesn’t even have to be your aged relative. As a group, people here are kinder, gentler, and more respectful to the elderly.

And of course, the costs associated with aging in other countries is less too. Whether it’s hospital stays, medicine, home care, or hospice, it’s going to cost less. And because it’s less, you can hire caring, wonderful people to assist in your home far longer than you could in the U.S. That means that the elderly aren’t sent away and forgotten. They are part of the fabric of daily family life. So not only are you treated a lot better, but it’s going to cost you a lot less too.

Almost all countries in the world treat their elderly better than the U.S. Why is that? Our society in the U.S. is built on producing, working hard, and moving fast. And when you are elderly, you are no longer producing, nor do you move as fast, or do anything as fast, as you used to. As the baby boomer generation reaches retirement age, they are increasingly viewed as a drain on the system – in regards to Medicare and Social Security especially – and that is leading to a growing spirit of resentment in the U.S. towards the elderly. People are living longer now, so they have more retirement years ahead of them, many of them good years. But gone are the days of working hard until retirement, getting a pension along with your Social Security, and retiring at 65 for a life of leisure.

What have we done wrong? Was it the desire to acquire all that stuff and “raise the standard of living?” It’s so very alluring to have a lot of material possessions. Advertising does a great job of making you feel “lesser than” or like you’re “missing out” if you don’t keep up with your neighbors, the Joneses. In doing so, we forgot our families. There was a time when we cared for our parents and grandparents. It was honorable to take care of them. It was just part of life. After all, didn’t they take care of us when we were young? Guiding us through life? Isn’t it their turn, and our turn to take care of them?

Costa Rica, on the other hand, is a great place to get old in. And for all the right reasons — civility, caring, respect, and relatively inexpensive health care. Yet, many people who move to Costa Rica end up leaving within 5 years. Over 33% exit and some estimates say 50%. Now we know there are reasons, like family, grandkids specifically, that kindle the desire to return. And we know too that some who are uninsurable in the States, come here to take advantage of less expensive private doctors and hospitals, waiting patiently to reach 65 or 66 when Medicare kicks in so they can go back.

But we think one of the main reasons is that they don’t trust the healthcare system in Costa Rica. They come here with high hopes but many get disillusioned. In the World Health Organization’s ranking of the world’s health systems, Costa Rica come in at #36, one better than the U.S. ranking at #37. And people here do live a long time, as long as in the developed world. Costa Rica brings healthcare to the people through its 1,000 local EBAIS clinics. So, why is there a lack of trust in the healthcare system here? Because it’s different than what we’re used to? Because you have to wait in lines? Maybe that’s part of it. We think the language barrier is a big concern. It’s harder to communicate your symptoms and concerns when you don’t speak the language.

So, for all of these reasons, we still think it’s valid to say, “America is no place to get old in.” We’ve seen how the elderly are treated in the U.S., and we’ve seen it here. It’s no contest. Costa Rica and most other countries win, hands down.

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