Wednesday, February 12, 2020

Posted by: Matthew Frere & Kelly Frere on Feb 1, 2020

Journal Issue Date: Feb. 2020

Journal Name: Vol. 56 No. 2

Let’s get the proverbial one-liners out of the way first: “At my age, flowers scare me.” (George Burns) “I’m so old they’ve canceled my blood type.” (Bob Hope) And, every senior citizen’s favorite, “Old age ain’t no place for sissies.” (Bette Davis)

Rare is the person who cruises through the transitions of aging with ease; some people are just more vocal about the trials and tribulations of the journey. We’re not going to bore you by unleashing the bombardment of articles about preparing for retirement, the statistics about how people should use their pension funds, sample commentary about the best places to choose to retire, the recommended healthy eating and activity plans to alter physical and/or mental well-being, or copies of the warning brochures found in every medical provider waiting room. 

Those of us who are “baby boomers” — born between 1946 and 1964 -— have been warned for years that because of our great numbers we will be entering our senior years locked in a battle with our fellow citizens to consume, in great quantities, every basic necessity of life. This consumption will be so burdensome on the consumer market that prices for goods and services will sky-rocket sending the following generations into a downward spiral of despair.

Surely we are being flippant and sarcastic and over-reaching.

Actually, no. Just frustrated.  

Studies abound from every direction: the very intense, statistical, hard-to-read academic analyses, to the plain language “you can understand this” articles in popular magazines, television shows and commercials. The problem is that even though we now have easily disseminated information available everywhere, people treat the topic of aging like they do the topic of death: it’s going to happen, but I (or my family) will just deal with it when it does.  

In spite of being in a state of information overload, people just do not focus on issues — even the very real costs of aging — that do not yet personally affect them.1 Rather than reading general statistics, people like to see examples of how these dire circumstances might actually apply to them. We were pleased to see a program developed by the Gerontology Institute at the University of Massachusetts Boston called the “Elder Index” ( The purpose of the program is to determine the income level that is adequate to meet the basic living needs of older adults. The online program, which is very easy to use, is divided into categories: housing, health care, transportation, food and miscellaneous expenses. And, the best part of the program is that you can plug in your city, county and state and it spits out numbers specific to your locale.2 

So, we played with the program using the largest counties in the three regions: Knox, Davidson and Shelby. For each county we sampled the same senior: a single person, living alone, who rents and is in poor health. And, our excitement dropped like a bomb. Because we know after years of assisting seniors that the figures we were given were totally unrealistic and bordering on dangerous if relied upon for a senior’s basic well-being.

According to the Elder Index program, the needs of a senior living in Knox County can be met with $2,079/month. Broken down the costs were $287/transportation, $698/housing, $257/food, $572/health care, and $265/miscellaneous expenses. Surprisingly, with a similar breakdown, Davidson County seniors’ needs can be met with $2,304/month and Shelby County seniors’ needs can be met with $2,133/month.

To fully appreciate why these figures are so undervalued you must realize what expenses are expected to be covered in each category. Health care costs for seniors typically include premiums for Part B and Part D Medicare (or, for a Medicare alternative plan), out-of-pocket drugs, insurance supplements, bandages, adult diapers, therapy, hearing aids, dental work, skin/wound care, foot care, assistance devices (wheelchairs, canes, walkers, bedside potties, Hoyer lifts, non-emergency ambulance assistance), heating pads, water mattresses, joint braces, oxygen tanks, and many other items not covered by insurance. 

Housing? That one is easy. Whether you own or rent, simply look at your own necessary monthly expenses and realize that seniors also have upkeep, utilities, HOA fees, appliances that go bad, pest infestation, yard care and storm damage. But even if they live in a modest-sized house, costs like utilities can increase because seniors often need warmer temperatures and that’s expensive. Many, fortunately, subscribe to monthly “I’ve fallen and I can’t get up” monitoring devices, but those, too, carry a subscription fee. Even one visit a week for help with laundry and house cleaning adds up. (Is that a luxury? Pay attention the next time you move a load of wet towels from a washer to a dryer and imagine a frail woman with arthritic hands trying to do the same.)

Transportation. Food. Miscellaneous. All you have to do is closely observe the needs of the senior members of your family and you’ll soon realize that a monthly income in the neighborhood of $2,100 just doesn’t cut it. 

The Elder Index does not include expenses related to recreation or entertainment, nor does it even mention pets and pet care. Obviously, these items are not considered by The Elder Index to be necessities. We disagree. The presence of pets brings comfort and calmness, stems the feelings of isolation and depression, and can even be an alert system, but they add the cost of food, vet care and occasional boarding. Dues to the local Y are an expense, but it provides a safe, social environment in which a senior can work on balance, strength, blood flow, lowering blood pressure, and have a laughing good time with friends.  

So, what is the benefit of a program like The Elder Index? It justifies the effort and contributions made by community organizers and services such as Mobile Meals, the Salvation Army Food Pantry, the Interfaith Health Clinic, senior day care centers, free denture and hearing aid programs, low-cost drug programs, free or discounted phone and utility programs, health care facilities that have programs that donate used assistance devices, pet food pantries, and church, school and fraternal organizations that have established programs specifically to combat the shortfall of retirement income and government provided financial assistance.

Thirty years ago the older of our senior clients were typically in their 80s. Now, clients over the 100-year-old threshold are not an unusual sight. But that longevity means a retirement term of 30 to 40 years. Let’s keep finding ways to bring them not just the “necessities” but also quality of life.

MATT and KELLY FRERE are husband/wife partners in the Elder Law firm Guyton & Frere in Lenoir City. They are members of the Council of Advanced Practitioners of NAELA. Matt was Tennessee’s first certified Elder Law attorney.

1. In the practice of Elder Law we like to promote our services as “long-term care planning” but, in reality, much of our practice is “crisis mode” assistance. Mama has fallen, is coming home but needs assistance, what do we do now and how do we pay for it?
2. Elder Index. (2019). The Elder Index [Public Dataset]. Boston, MA: Gerontology Institute, University of Massachusetts Boston.




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