The baby boom generation is comprised of those Americans born 1946-1964, and according to the US Census Bureau (Bureau of Census), their numbers are estimated to be 73 million strong. This number represents nearly 20 percent of the American public. As they enter their 60, 70, and 80th decades, their influence will help to guide how billions of federal funds will be spent on critical public services like health care, housing, and social safety net programs like social security. The guiding forces behind baby boomer life in the 2020s are high expectations during a much longer retirement, more investment choices but less investment safety, and rising interest rates. There is more of a reliance on personal savings instead of pensions (which are often underfunded), while the gap of aging success between the rich and the poor remains.

As a demographic group, baby boomers wield the most financial power of any living generation.

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As such, they continue to have a powerful impact on the direction of the US economy. Aside from federal spending, baby boomers are a significant focus of the marketing campaigns and business plans of many corporations. As a generation, they are also shifting focus from lifespan to healthspan. The all too cliché phrase 60 is the new 40 is rooted in how many baby boomers feel, more active and vibrant than ever before, and with a bank account to command attention and buy the freedom of choice. An extension of this wellness trend is a retiring populous that is busy traveling, running marathons, building homes, starting new businesses and new chapters of life. Mindfulness and wellness are hallmarks of this generation, and it is leading them to a higher quality of retirement life.

Despite this aggregate of optimistic financial data, there is evidence suggesting the current poverty rate of 9 percent in the elderly American population will remain steady in the coming decade. Approximately 7 million older people will be living without sufficient income to meet housing, utilities, food, and medical needs. Many more baby boomers may fall into the poverty category in the 2020s because of insufficient retirement planning. Addressing this inequality will be challenging as successful aging is in large part due to financial stability as the rich are living longer while the poor are dying younger. Measuring retirement security then is based on overall healthspan (the number of years you can live independently) and wealth span (the amount of money over time you have available for your non-working years). The success of baby boomers’ retirement is generally defined decades earlier by a person or their spouse’s education level, work history, economic affluence and accumulation throughout their working years with a bit of luck tossed in.

The time in which baby boomers have had to accrue wealth has been primarily an economic boom cycle with a couple of economic corrections and downturns, most notably the Great Recession of 2008. Depending on how a baby boomer may have been financially positioned during these times can be the difference between substantial personal savings and struggling to meet retirement income needs. The equivalent purchasing power of one dollar in 1980 is $3.12 in 2020. A steadily increasing interest rate and an overall lessening of the dollars purchasing power can make fixed income living a precarious situation. Additionally, the cost of living adjustment (COLA) through social security benefits is not favorably weighted to living expenses of the aging US population. The deregulation and rules of financial vehicles that offer low to no tax rates like IRAs, Roth IRAs, annuities, life insurance policies, and more are continuously amended, mostly in the economic favor of the government or corporations offering the financial options. Even private and government pensions are not safe from payout reductions. The Social Security Administration (SSA) is admitting that without legislative reform to its program, social security benefits will only meet 75 percent of scheduled benefits by the year 2035.

The socioeconomic impact of the baby boomers will be an active force throughout the 2020s. As a generation, they are morphing the word “retirement” into the notion of a transitional life phase as they seek to repurpose their lives rather than sit on the proverbial front porch swing. Creative and inventive life shifts are inevitable as baby boomers spend down their wealth and money-making institutions, private or government, are poised to earn or tax those dollars.

We help baby boomers create comprehensive estate plans that focus on their current health and financial needs and the needs of those they wish to leave an inheritance to.

If you have questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Cincinnati, Ohio office by calling us at (513) 771-2444.

There is an entire senior industry built around preventative measures and responses to protect older people from falling, and with good reason. According to the National Council on Aging Falls Prevention Facts, “falls remain the leading cause of fatal and nonfatal injuries for older Americans.” Aside from grievous and sometimes fatal injuries, falls are costing money, lots of money. In 2015 Medicare and Medicaid paid 75 percent of the 50 billion dollars in total cost due to fall injuries. With an ever-aging US population, the financial toll is projected to reach 67.7 billion dollars in 2020.

The Centers for Medicare and Medicaid Services (CMS) made a declaration that falls should never happen in a hospital environment and created penalties that became effective in 2008. The penalty still allows for patient care billing through CMS but will no longer bump payments up to a higher level to cover the treatment of fall-related issues. The advent of the Affordable Care Act (ACA or “Obamacare”) saw Congress introduce more stringent penalties by reducing federal payments by one percent for those hospitals with the highest rates of falls as well as other hospital-acquired conditions. The financial aspect is of significant concern as the American Hospital Association (AHA) finds that nearly one-third of US hospitals report negative operating margins.

These government assessed fall penalties could damage a hospital’s reputation and reduce its profitability. As a result, many hospital policies are now overzealous with regards to fall prevention, creating an epidemic of patient immobility. While this epidemic may serve the financial interests of hospitals, it does not serve the needs of older hospitalized patients. There are nominal reasons that hospitals are promoting increased “bed rest.”  These reasons include a shortage of staff, insufficient walking equipment, and no current means to record ambulation in a patient’s electronic medical record. Some nurses and hospital aides, to evade being reprimanded if a patient under their supervision falls, find reasons to avoid getting a patient out of bed and walking. Patients themselves are being instructed not to get up on their own and are subject to bed alarms that will alert hospital staff if they do.

Elderly patients are bedbound and discouraged from walking. This practice degrades the patient’s mental well being and their ability to become well to protect hospital profitability. Many older patients are weak and frail upon hospital admission, and after a few days in bed, find their muscles can deteriorate significantly enough to bring severe long-term consequences. Dr. Kenneth Covinsky, a researcher and geriatrician at the University of California-San Francisco, states, “Older patients face staggering rates of disability after hospitalizations.” His research cites that one-third of patients age 70 or more leave the hospital more disabled than when they were admitted.

Ultimately the policies put in place to reduce the number of falls in a hospital setting have created a climate of “fear of falling.” Hospital staff feels that a patient falling on their watch will lead to blaming, reprimands, even termination when the fault of the fall might be the patient themselves. This staff self-protection mechanism creates a cycle where the patient languishes in bed, growing weaker by the day. When they do get up, the patient is more likely to fall and become more seriously injured due to a decrease in muscle coordination and an increase in strength deterioration.

Barriers to the mobilization of elderly hospital patients do them a great disservice and may lead to increased length of hospital stay as well as disability after hospitalization. The limiting of patient mobility may have begun as a response to financial penalties but has very serious, though perhaps unintended, patient health consequences. Inpatient walking activity is a good predictor of readmission in elderly Americans. Research shows that just 275 steps a day while in the hospital yields lower rates of readmission after 30 days. Programs such as the Hospital Elder Life Program (HELP) are trying to reduce the barriers to patient mobility and reverse the epidemic of elder patient immobility. Across America, there are efforts to get patients moving again in special hospital wings called Acute Care for Elders. In these specialized settings, elderly patients can be provided the proper staff and equipment to walk and enhance their rehabilitation and wellness safely. For the best elderly patient outcomes, the trend of patient immobility must become less prevalent in hospitals despite the risk of falls.

If you have any questions or need guidance in your planning or planning for a loved one, please do not hesitate to contact our Cincinnati office by calling us at (513) 771-2444.