Old folks at home...

Like every other aging person I know - and, as you can imagine, at my age, I know plenty of aging persons - I would like to be able to keep all my marbles and my mobility, stay in my home up until what I hope is not a bitter end, and die in my sleep (or, second best, drop dead while eating ice cream).

Realistically, I know that this full scenario is unlikely. 

There may come a time when I need to move into a place where there's some level of assistance. As did my mother.

The year before she died, my mother sold the family home and moved into a congregant living facility. She had decided that too much of her energy was going into maintaining - or finding people to maintain - a 4 BR house with a big yard. None of her kids lived nearby. Finding someone to rake, to shovel, was getting to be too much. My mother was fully compos mentis, and still leading a full and vigorous life -  volunteering, traveling, taking classes. Still, at 81, rattling around her house was getting to be a bit much.

So she moved on out. 

Her new digs were pretty near ideal.

She had her own apartment - we called it her first "single gal" flat. It was a good sized one bedroom, with a small but full kitchen, a nice combo LR/DR, and a bathroom with a walk-in shower. (One of our worries was that, despite our suggesting it, she hadn't put one in her home. She did concede to grab bars but that was it.) Her apartment had a balcony overlooking a pond. (Okay, the pond was across a busy street, but still...) One of the best parts of her new home: right across the street from the church she'd been a member of since she'd married my father and moved to Worcester 55 years earlier. All she had to do to get to daily Mass was walk out the door and cross the street.

My mother's facility provided breakfast and lunch, changed her bed and laundered her sheets and towels, did light housekeeping, and offered plenty of social activities. Plus she had friends who lived there. There was also a section you could move into if you needed a higher level of care.  

Ideal!

Sadly, less than a year after we moved her in - raving about how great the storage was - my mother died. (We, sadly, emptied out her apartment, lamenting that she hadn't been able to enjoy it for that long and raging about how great the storage was.)

That was 21 years ago. Now, 21 years older and (perhaps) at least a bit wiser, well, objects in mirror closer than they appear. 

Not that I have to move tomorrow, but I do occasionally put 'what next' on my fret list, fast forwarding to the point where I may need to act on it. (Objects in mirror closer than they appear.)

So I was more than a little interested to read about how the Netherlands takes care of their old folks when they can no longer stay home.

Unlike in the US, where, as with so many social needs, you're on your own, baby, the country has been planning for their "demographic tidal wave." In 2040, they estimate that 25% of their population will be older than 65. (In the US, the forecast is that, by that point, 20% of our population will be that old.)

Here in the Netherlands, a social welfare state roughly twice the size of Massachusetts, leaders have been planning for this graying of society for a half century. Drawing on public funds, a sense of shared responsibility, and compulsory insurance premiums paid throughout their working lives, those born in the post-World War II baby boom take for granted that they’ll have the home and nursing care they need as they age.

“It’s pretty much undebated,” said Bram Wouterse, assistant professor in health economics at Erasmus University in Rotterdam. “People know that when you get old, the government will provide good care.” (Source: Boston Globe)

Here, people stay up night worrying about whether their money will run out before they do. Whether they'll end up warehoused in a grim nursing home, doped up and with bedsores. If you have good fortune (and/or a reasonably big fortune), you'll be okay. But for everyone else, it's worrisome.

But in the Netherlands:

The Dutch use the word solidariteit, or solidarity, to describe their commitment to older residents. The Netherlands was the first country in Europe to introduce a mandatory long-term care system in 1968. It has updated and refined its plan several times since, holding to its vision of universal care even as it relies more on managed competition between nonprofit providers and insurers to control costs. The most recent overhaul, in 2015, aims to help residents age in place.

They do so with a system that's "varied, experimental, and humane." And by paying for it from the get-go. In the Netherlands, more than 4 percent of GDP is devoted to long term care, which far exceed the percentage spent in the US (which is roughly 1.5%, the lowest amount among industrialized, comparable countries). To support this, Dutch workers are levied payroll deductions that can near 10% of income.

The system pays off. Old Dutch folks are happier, healthier, less stressed, and live longer than Americans. And: 

In a separate 2021 survey on loneliness, which casts a discomforting shadow over tens of millions of older folks worldwide, the database firm Statista found that only 15 percent of Dutch adults acknowledged feeling lonely, less than half the share of Americans (31 percent).

The Netherlands knows they'll be facing some hurdles. More old folks, fewer healthcare workers. So they're already enlisting locals to look in and hang with the aged in their communities, and they're exploring innovative technology that will help people age gracefully and in place. (There's plenty of exploration in the US in the aging tech arena as well.)

“We have a very strong belief in societal responsibility,” said Marco Varkevisser, an Erasmus University professor. “We call this solidarity. It’s there, we nurture it, and we like it.”

Somewhere along the line, I read that homogeneous societies are more likely to provide more support across the boards for their citizens. In more diverse countries, like ours, it's easier to us and them. 

Still, wouldn't it be nice if we could nurture a bit more of that Dutch solidarity. 

This once and future old folk sure hopes it happens.