Power, Perils of Age : ‘Boomers’ Face a Brave Old World

ST. PETERSBURG — Two snapshots from the Florida city once dubbed God’s Waiting Room:

A retired businessman from Baltimore, nattily dressed in a peach shirt and string tie, happily remembers courting his recent bride shortly after her cornea transplant: “I said, ‘I’ll come over and bring you something to eat,’ and she said ‘fine,’ ” recalled William Wittig, who admits only to being over 80. “I did that for three nights. I guess you could say we were attracted to each other.”

Across town, enthusiastic seniors, some older than 100, meet daily at the Sunshine Center for activities from sing-alongs to sculpture, from movies to morning exercise. “We probably call the paramedics about once a week,” said Gerald Buchert, the center’s director, but he quickly added: “We’ve never had a person die on the property.”

Today such scenes are typical of St. Petersburg. Tomorrow they could be common anywhere, as the post-World War II generation grows old.

Power in Numbers

When the so-called baby boomers start becoming senior citizens in another 25 years, they will be the healthiest, wealthiest and best educated elderly people ever. Many will enjoy active lives well into their 90s. The twilight years will attain a new glamour, and old people will command even more political power nationally than they do in Florida today.

Yet this rosy future does not lie ahead of all of today’s young people, any more than it reflects current reality for many of Florida’s retirees. For a substantial fraction of the aging postwar generation, all the advances of modern medicine will not be able to arrest physical and mental deterioration.

Some of those who once proclaimed, “Never trust anyone over 30,” will find themselves dependent on family, friends and society at large. “Providing for their support, their health care and their housing will be as great a challenge as any the nation has ever faced,” Alan Pifer and D. Lydia Bronte, directors of a major new Carnegie Corp. study on aging, predict.

Friends and volunteers will shoulder a growing share of the burden of helping the frail. Families will be less important, because the baby boomers are having fewer children and more divorces than their elders. Widows will be increasingly numerous; today’s typical married woman in her 30s will be widowed at 68 and live at least 15 more years. Pressure will mount for the old to help each other; it will become common for 70-year-olds to care for 90-year-olds.

The growing elderly population will place new strains on the political system. Workers will face a rising tax burden to pay for medical care and retirement benefits. Already, federal officials warn that the government alone will not be able to provide for the millions of elderly people who will need long-term care in nursing homes or in their own homes.

Dr. William Roper, who runs the Medicare program, has said: “If we all drift merrily along consuming our wealth, expecting there to be some mega-government program that provides long-term care services for the millions in the baby boom generation, we’re fooling ourselves.”

Largest Age Group

The concern is easy to understand. A staggering number of Americans--76 million--were born between 1946 and 1965 and are now between 20 and 40 years old. The Census Bureau projects that by the year 2030, when the youngest of these turn 65, there will be 65 million Americans age 65 or older, compared to 29 million in that age bracket today. More than one in five Americans will be elderly, compared with one in eight now.

Twenty years later, this group will cause an even greater increase in number in the oldest of the old--those most likely to be dependent. The Census Bureau predicts that 16 million Americans will be 85 or older in the year 2050; this age group numbers fewer than 3 million today.

However sobering these figures, many specialists believe that the predictions greatly underestimate the impending demographic tidal wave. Unforeseen breakthroughs in life-extending technology could make an enormous difference, says Ken Dychtwald, a Bay Area gerontologist who calls his consulting firm Age Wave. “They err so far in the conservative direction, it’s a joke around our office,” Dychtwald says.

Shifting Medical Picture

In the world of tomorrow, cancer, strokes and heart attacks will be rarer than today. For the hardy, medical breakthroughs could prolong life well past 100 years. Kidney diseases, pneumonia and Alzheimer’s disease will become the most frequent killers of the elderly. So will accidents.

Science and technology will help take the pain out of aging. Organ transplants will be routine. Voice-activated robots may wash the windows, mop and vacuum the floors.

Those who survive now-fatal illnesses may run into one of the crueler laws of nature. “As we save people from one kind of death, they have an opportunity to develop other illnesses,” said Dr. Leonard Fisher, chairman of the geriatrics department at Oak Park Hospital in Illinois. “We are buying time. We are buying more life span. We hope it is good time.”

Whether medicine can ever promise most of the elderly a vigorous, pain-free life until the final moment is a matter of considerable debate among researchers. Many medical experts believe the young adults of today will be healthier in their later years than today’s elderly people because they smoke less, exercise more and have better diets--more fish and vegetables, fewer fatty foods.

Jogging Penalty Seen

Some of their health-conscious habits may boomerang, however. Today’s joggers, says Dr. Edward Schneider, dean of the Andrus Gerontology Center at the University of Southern California, may develop into a generation “whose heart and lung capacity is enormous, who have great muscle tone--but I have the specter in front of me that these people might develop hip and knee arthritis, which may not show up until later years.”

At present, those turning 65 can expect to live an average of 16 more years, according to the Social Security Administration. But a Brown University study of elderly Massachusetts residents suggested that after the first 10 of those years, they are likely to need some help with the basic functions of life: bathing, dressing, eating, getting out of bed. Those who reach age 85 with their faculties intact can look forward to an average of seven more years of life, but only three more years of independence.

The most common crippler of the aged is osteoarthritis, a painful malady of the knees and wrists. “It’s good to attack big issues like cancer, but at the same time, we have to be concerned about chronic pain, the nagging things that make life miserable,” said Fisher.

Yet even now, healthy senior citizens are toppling conventional notions of what it means to be old.

Screaming “Eee-yah!” 90-year-old Lucille Thompson lashes out with her bare right foot and smashes 2-inch-thick boards held by her classmates in a Chicago martial-arts studio. She repeats the demonstration, using her knee.

Thompson, 110 pounds and 5 feet tall (“I gained a couple of inches because I don’t hunch over any more”) holds a black belt in Tae Kwon Do, a Korean discipline. “Killer,” her nickname, is embroidered in black on the right leg of her white uniform.

Before she joined the Tae Kwon Do class two years ago, Thompson ignored neighbors in a senior citizen center in nearby Danville, who said she would never overcome the pain in her left shoulder and the arthritic tensing of her fingers. The stretching and exercises of the martial art did the trick.

“I said this is not going to happen to me,” she said. “I wasn’t going to have old age.” Many of the baby boomers will not be so lucky in old age. Their lives will be more like that of 75-year-old Marie Pesick, whose body is wracked by rheumatoid arthritis. She spends her days in a wheelchair in the blue-and-white mobile home she shares with her daughter and their Irish setter in St. Petersburg.

“Every move I make hurts,” she says, “even to bend forward and get some water out of that straw. I can tell you two days ahead if the weather is going to change.” She holds out her wrist. “You can actually see the swelling going up.”

There is no better place to find clues to tomorrow’s aging society than St. Petersburg, where the elderly stake out independent lives in tidy and compact houses and healthy seniors volunteer to serve their frail elders at group luncheons, where retirees tool about on three-wheelers in neat mobile home parks.

What happens now in St. Petersburg “is what the entire nation will be experiencing over the next 30 or 40 years,” said William J. Simpson, who runs a counseling program here. About one resident in four here is elderly, not many more than the one in five projected for the nation as a whole by 2030.

Many of this city’s elderly have adjusted successfully to a world in which everyone is old. “I think we’re most comfortable with our own,” says Sadie Agronick, a cheerful 85-year-old widow who walks a mile and back to the Sunshine Center once or twice a week. “We have the same problems, the same things wrong with us--the same things right with us.”

Old Help Each Other

Every Wednesday, Virginia L. Schwenck helps lead the dancing and other activities at a day care center for the frail. The 76-year-old widow from Louisville has no children and has outlived her sister. Her voluntary efforts do not benefit only others.

“I feel less lonely,” she said. “The house is still empty, but I feel like there’s something else in my life.”

Wittig, the retired Baltimore businessman, pitches in every Wednesday at a day care center for those who are far more frail than he is. Mentally disabled Alzheimer’s sufferers, he says, are a particular challenge: “I’ll say, ‘eat your spinach,’ and they’ll look at me as if I haven’t said anything.”

Even in St. Petersburg, however, services for the elderly are limited. Already, a state-financed program of community care, designed to keep the frail elderly out of nursing homes by coordinating meal deliveries, household help and other services, is filled to capacity with 900 persons, and there are 1,100 names on the waiting list.

As the elderly gradually become as numerous nationwide as they are in St. Petersburg today, products and housing will be designed especially for them. Falling--a trivial concern to the young--is one of their chief hazards.

Falls Lead to Death

Every year, some 200,000 persons over 65--the majority of them women--fracture a hip in a fall, says Dr. Rein Tideiksaar, director of the falls and immobility program at New York’s Mt. Sinai Medical Center. Half of these patients die within 12 months, he says, frequently from pneumonia.

Yet a 1985 report of the congressional Office of Technology Assessment said that half of all falls are attributable to causes such as “loose rugs, poor lighting, slippery surfaces inside and outside the home, broken stairs or lack of grab-bars in bathrooms and other high-risk areas.”

To maximize safety and comfort, a “smart house” for the elderly is being designed by the National Assn. of Home Builders, the National Council on Aging and the federal Administration on Aging. Features may include bathroom grab-bars, glare-free lighting, sound amplifiers in the walls and furniture, windows that close automatically at night and power outlets at waist height instead of near the floor.

Aids for Aging Seen

Other innovations for the aging will be more dazzling, says Frank Samuel, president of the Health Industry Manufacturers Assn. He foresees use of tiny computers worn on the wrist or perhaps implanted in the chest to monitor blood pressure, body temperature, and pulse rate and transmit readings to doctors’ offices miles away.

Medication will be implanted under the skin in time-release patches to assure proper doses, Samuel adds. Already an insulin-dispensing pump, powered by a tiny motor originally designed to collect a soil sample from the surface of Mars, was implanted last month in the abdomen of a diabetic patient.

Yet such technological leaps will be easy, compared with the political and financial questions the nation will confront as its elderly population grows.

With the postwar generation now entering prime earning years, Social Security is in relatively good shape. Today’s payroll tax is more than paying for today’s retirement benefits.

The huge surpluses now being accumulated will keep the retirement trust fund in the black through 2054, the federal Social Security Administration says. One reason is that today’s younger workers are going to have to wait longer to collect benefits. The eligibility age for full benefits, now 65, will rise gradually, beginning in the year 2000, until it reaches age 67 for those born in 1960 or later.

But the projections of hefty surpluses depend on various assumptions--healthy U.S. economic growth, unspectacular extension of longevity and an increase in the birth rate--that are all subject to question. “It’s a multitrillion-dollar gamble that they’re taking,” said Peter A. Morrison, director of the Population Research Center at the Rand Corp. in Santa Monica. “If you lose the bet, you end up with budget deficits that are big enough to ruin the national economy.”

Medicare to Be Lacking

Medicare is on much shakier ground. Under optimistic assumptions, the soaring cost of hospital care is expected to deplete the Medicare trust fund by 1996. If Congress combined the retirement and Medicare accounts, the money would dry up by 2010.

Roper and many other experts predict that the federal government will quit paying separately to treat each individual’s illness. Instead, elderly people would enroll in group health plans, and the government would pay a fixed amount for each person. The care provider then would pocket profits for those members who cost little and absorb losses from those whose treatment exceeded the government’s payment.

More than 1 million of Medicare’s 30 million beneficiaries have already enrolled in such group plans, but, warns Arizona Gov. Bruce Babbit, the government must guard against “profiteering by under-treatment.” Indeed, Schneider says he worries that the group approach could lead to a system of care “rationing,” in which people over a certain age would be denied expensive medical treatments.

Many recommend that young people start saving now for their future medical expenses. Health and Human Services Secretary Otis R. Bowen suggests that the government allow tax-free savings for this purpose, patterned on individual retirement accounts.

More Than Savings Needed

To this, House Aging Committee Chairman Edward R. Roybal (D-Los Angeles), who has proposed an ambitious taxpayer-financed national health program, responded: “Pinning our long-term care hopes on private savings . . . not only writes off our current elderly generation but virtually writes off future low and middle-income generations as well.”

The payroll tax rate for Social Security and Medicare, now 7.15% each for workers and employers, is scheduled to rise to 7.65% in 1988. To keep pace with expenses, it would have to rise gradually to 11% by 2060, according to the Social Security Administration.

The generations that follow the baby boomers might find such a tax burden intolerable. “There is no doubt the baby boom, before it retires, will pay more in taxes for the elderly than any generation in history,” said Phillip Longman, research director for Americans for Generational Equity. “Whether the next generation will repeat the favor is open to question.”

Future strains among the generations will have an ethnic dimension too, especially in California, where Latinos and blacks are generally younger than whites, and have more children. White retirees may urge government spending on pensions even as Latino and black workers push for school bond issues. “Who will win and who will lose in these political trade-offs?” asked Fernando Torres-Gil, staff director of the House Aging Committee.

Extra Coverage Needed

Specialists on aging say that the baby boomers one day could help themselves greatly by buying insurance for long-term frailty, the way today’s elderly purchase policies to supplement Medicare coverage, but future availability of such insurance is uncertain. Many companies, wary of the cost of caring for the chronically ill, refrain from offering such coverage.

The baby boom generation may have to get along not only with less public support than today’s elderly, but also with less family help. That suggests that tomorrow’s elderly will have to rely more on each other.

“Group self-help doesn’t mean that you have to be a commune,” says Otto von Mering, director of the Center for Gerontological Studies at the University of Florida. “It simply means that you share certain interests and provide a certain amount of care for other people.”

In many Florida communities, elderly volunteers are already keeping down the cost of services by delivering meals, visiting the shut-ins and acting as counselors. Some retired doctors and lawyers offer free professional advice. In Miami, Washington and Kansas City, Mo., vigorous older people volunteer to help the frail home-bound in return for a promise of similar aid if they ever need it.

That approach makes plenty of sense to Charlie Rainsbury, a slender gentleman of 100 years from Upstate New York who mans a social office at St. Petersburg’s Sunshine Center. The former electrical goods wholesaler played a minor role in “Cocoon,” the 1985 movie about aliens who land in St. Petersburg and offer eternal youth to a group of retirees there.

“What is a cocoon?” he asks. “When it breaks open, it’s a butterfly. We’re all cocoons when we’re born. If we spend our time doing good for others, then we’re butterflies. Otherwise, we’re nothing.”