coming up next book tv presents "after words," an hourlong program where we invite guest hosts to interview authors. best-selling author susan jacoby tackles the mass of old age and her new book never say die. "the washington post" blog her claims american culture attempt to dilute the aging population into believing that 90 is the new 50. she discusses growing older in america with aarp's state news editor sylvia smith. >> host: susan jacoby, welcome. you're the author of a new book "never say die" with the subtitle the myth of marketing of the new old age. what is the myth of the new old age? >> guest: this is a new old age is that we are all -- baiji we've i really mean people who are not old now.

the age in the boomers, people in their 50s and early 60s now and in their forties. but our old age is going to be lived in a way that's totally different from the way in which old age has been lived in the past, that we are going to all be skydiving centenarians, i like to think of it that way. [laughter] that we are simply going to get older, but not actually old. >> host: and so why do you think the culture is invested in sugar coating old age? >> guest: well, it's really interesting. when i was growing up like all of the oldest boomers in the 1950's, i would say that attitudes toward old age were - in a particular way. old age was just something that started the minute amana retired and she returned home to bother his wife. her only role was to be the

grand mother to her grandchildren, and that was whole idea, not just of old age, but of anybody who was retired in their 60s. now i think we have had a great corrective to that, which the aarp has had a role in in the sense that we now understand that people over 65 can do a lot of things and that their only role isn't just lying around the house watching tv and looking after the grand kids. but there is a new ageism which is this as long as you don't suffer any of the typical problems of old age, and old age has been very much redefined in terms of the younger old age, which sociologists and doctors call people in their sixties and seventies who are basically pretty healthy even if they have

had all kinds of diseases like cancer and heart disease, and old old age in the late 80's and 90's of whom so many more boomers are going to live to that era, the typical problems of people and old old age are downplayed as if 90, well i decided to write this book when i went to a panel with the world science festival few years ago titled "90 is the new 50," in my thought is anybody really believe that? and the answer was there are a lot of people in their forties, fifties and sixties who do believe that. so we -- it is a kind of more subtle form of ageism that it's great to be old as long as you don't have any of the typical problems of people who are really old. >> host: use the phrase old old. what you mean by that? >> guest: old old is a phrase used by doctors and sociologists, and it's used basically for people in their late 80s and 90s as opposed to those in the 60's and 70's, and

it's quite right to make that distinction because people in their 90's, in terms of health and abilities -- i'm not talking about exceptions, i'm talking about the majority of people -- to talk about them as though they were the same as people in their 60s is as upsurged to talk about people in their 60s as if they were in their 30s. now there are people in their 60s who might like to think that they are in their 40's, they are diluted. [laughter] >> host: uzi that the to overwhelming problems of old old age or health that worsens over time which is inevitable and the tendency for most people to get poor, and use it just there's some collective action that we should take in response to that. what are those key points? >> guest: health there's not much we can do about, and there are lucky people whose health doesn't constantly worsen over time, but i think those of us who have parents who've survived in their 90s, and grandparents as i have, know that the typical person has to deal with many

more health problems over time. and this, by the way, the problems of the oldest old have to be looked at as not entirely, but there are huge women's issue because right now the vast majority of people over 85 or when the vehicle women and devotee gets poorer over time except people like let's say warren buffett. i'm sure he is going to be well fixed at 92. but women in particular get poorer because there's lots of things that happen to total income with the death of a husband. now this is true of women today, most of whom didn't work outside their home who were in their 90s, but it's also going to be true to some degree of boomer women because women have more interrupted work patterns than men do, which reduces the total amount of either penchant or social security income over a lifetime. so people get poorer as they get older and moreover, this is also

connected with worse health because people need many more services as they get older that cost money. most of which none of our social service programs, which the republicans are now so eager to cut and certain democrats as well, before already. so that people's needs in terms of the assistance they need if they would like to go on living independently become greater at a time when their income becomes less. >> host: in fact you mentioned in the book you had a friend who when you told her you are writing a book about aging in old age she said your writing a book about women. for the exact reason that you say, statistically women who live longer and have a more problematic -- >> guest: right, and people in this age group among the women in their nineties, social security makes up about 90% of their income. there's not a lot of money left around by them, and i would like to say something also that i often forget in interviews.

i think that one of the problems here in thinking about this rationally is that we do live in a society in which the idea that people ought to be able to save enough, to finance a 30 year retirement, that there is something wrong with you if you can't do that. and this is ridiculous. when the social security act was signed into law into 1995 -- 1935 the life expectancy was 62 and people were not old enough -- able to save enough then. that is why social security was enacted, but no one foresaw the time when right now all of the baby boomers who are turning 65, and 20 years they are going to be 85, and the year will be 8.5 million of them. saving enough money to finance it in your retirement and 30 year retirement if you have an average income, if you're not rich, are two different things. it is not a matter of moral turpitude. if the average family in this country cannot save enough to

finance a 30 year retirement. furthermore, there is a real question of do we want a society in which let's say 45 or a 50-year-old parent says to their kid in college well i can't help you, i'm putting aside money for long-term care. is that a healthy society? i don't think so. >> host: well, some of the consequences perhaps of growing up, as i did and as you did, in an age of medical miracles -- i was just a little girl when the polio vaccine came along. there's always been antibiotics. we have to take tips, fake knees, organ transplants. that's the medical norm. people who have taken advantage or have not been disadvantaged because they have had access to this kind of care, would assume i think that that is a good thing. but you paint a sort of overall picture in your book that these things do have consequences because they prolong life beyond

what our social network, our social safety net work was able to provide or was created to provide. >> guest: well, that's true, but i think they have -- the of the other consequences, too. i mean antibiotics, yes they do. people who would have died of pneumonia at 65 or if they got a bad case of pneumonia don't any more because there are antibiotics, talking now about in the older age group. but i think there's something else about medical miracles that really creates a problem and thinking realistically about old age is that things like -- my source rediker memory is standing in line for the salt vaccine, too. i am just old enough to remember life in the summer before the vaccine in the early 50's when your parents would never let you go out to go swimming because they were so terrified of polio. the was eradicated overnight. i think because we've grown up

amidst these medical miracles, we don't realize that some of the things that tell people in old age inevitably, alzheimer's disease, for example, or forms of cancer that hit in old age, that if they don't hit at old age your immune system becomes to weaken the to overcome them. but these things are far more complicated. they will require, if they are ever to be ameliorated, they require research at the basic biomedical level, which is now going on, and they are very connected. the more alzheimer's research is being done, they had assumed when they started it that a disease that is common and nearly half of all people over 85 have it, something else nobody likes to hear. don't shoot the messenger. [laughter] but these things are not as easy to find an answer to, not that anything like polio seemed easy before they found the vaccine,

either, but they are far more complex. most of the scientists i talked to, far from the 90's, the new 50 crowd feel that the solution to these things or even let say something that would delay alzheimer's, which would be a wonderful thing, they are much more likely to be there for our children or even our grandchildren, for people who are now in their 50s and early 60's to count on this, to give them a new old age is really not being realistic. and i like to quote my dear friend, dr. robert butler, who lives sure you know who died at 82 last year of leukemia. and he basically invented the field of a gerontology and was the first director of the national institute on aging, and he was the only voice of rationality on that 90 is the new 50 panel. and i asked him a few months before he died -- i interviewed him for the book -- and i said you know, what do you think about prospects, you know, for, say, a cure for alzheimer's?

he said honestly i'm a scientist, and nobody believes in science more than a scientist, and i'd like nothing better than to wake up tomorrow morning and see newspaper that there is a cure for alzheimer's. he said realistically at the reason we need to invest more in basic research now is that it's still a long way away. and furthermore, you can always hope for something like that, but you can't base a strategy for dealing with old age on the assumption that this is going to happen for you and magically wis get away, and i think that's my view. we can always hope for a medical miracle, but help isn't a plan of action. hope is just hope. >> host: well, i thought that your chapter on alzheimer's was the most passionate in the book, or maybe i was bringing my own experiences to that. but talk to us a little bit about how you developed that chapter and the personal experiences that you had that may be shaped that chapter.

>> guest: well, alzheimer's is not in my family. my mother and my grandmother lived -- my grandmother lived to be 99 with a row when the body and a sound mind, and i never personally had experience with alzheimer's until my partner, who was 15 years older than i got it, and mercifully he died three years of cancer before the last remnants of his mind went. one thing this experience of helping to care for some with alzheimer's changed my thinking about one thing. first of all, it changed my magical thinking about it, and i realized although i know better, i've written about science, i know that intelligent and educated people get alzheimer's, too, but i had sort of magic fought mainly out of it and fought well, if you're really -- if you're smart and engaged with life and you work hard and you

do intellectual work coming to get exercise and eat your vegetables you're not going to get alzheimer's. well, this of course is nonsense, as the national institute of health found out in a major review of this in august, and all these people who believe that exercise and greens are going to protect them from alzheimer's, those are good things in themselves, the exercise, the dreams and intellectual work, they are not a magic pill that's not going to meet you get alzheimer's. but one of the things about it that's so tragic, and when you think the risk doubles and every five year period for 65, and that half of people who are over 85 have dementia of which alzheimer's is the leading cause -- my partner i can remember when he was sort of in the middle stages of it, when he could still do some things but not others, i can remember him turning to me on the crosstown bus and saying i feel that

somewhere inside me is the person i really am, the person i was before, but he said i can't find him, i can't talk to him. if there is ever a definition of what happens quote in the dying breed of a person with alzheimer's that is eight, and you understand what this means and you also understand how tragic all of this false hope is and why i have to say that one of the things that particularly in regions me are these ads for these so-called memory polls. i won't mention the brand names, but you know what they are, helping dad be more like himself, which by the we were also found to be basically have no effect at all in the national institutes of health review. one daughter turns to the other and said it helps that be more like himself, it doesn't show his dad taking the pill, walking

out of the house, getting lost and not being found for seven hours, and i will just close with one more personal thing. my partner took them, but i know when he was still able to think things through he had no faith in them. i can remember him taking the memory pill one day and singing in yiddish [inaudible] which means basically nothing will help. this is the punch line of the old jewish jokes he used to tell when the days when he could tell jokes. and i think that this clause idea that there are all sorts of ways right now that we can armor ourselves against this, this is not good for people. it's great to hope you will never get it, but to and because you're looking right things are going to turn out right for you. >> host: do you think the boomers are particularly susceptible to that kind of wishful thinking or delusionary thinking, and if so, which comes first? the products that you mentioned that are advertised and the

leaking pipes, the viagra, all those sorts of things -- >> guest: now viagra works. [laughter] i have a different opinion of memory pills. that actually works. >> host: the different products aimed at the baby boomers to make us think that if we take them or use them coming you know, i won't change as i become 80 or 85. >> guest: well, i think there's a lot of -- i mean, there's a lot of our history, our social history that makes us have a lot of faith in the idea of self transformation that you're the master of your feet, the captain of your soul. and i don't for one minute want to denigrate the value of good health habits. these habits, things like exercise and so on have been shown to make you healthy year when you're healthy. they may make you healthy year in old age the and he may have been otherwise. they probably will. they are good things in

themselves because they make your life better. they are not an antiaging pill. they are something that is good for their own sake, but they are not any more than transcendental meditation was or babaramdas. we can remember all of the self-help movement of the 70's. some of them were good, some of them weren't, but they don't or mur you against something which is inevitable, which is getting older and the realities of disease and economic problems that now a company getting older. there are some things that are not within our control. we can make the best of what life hands us and part of that is the genetic hand that we are dealt, but i like to see that, you know, we are all capable of aging successfully until we aren't. >> host: what you mean by that committee to successfully? >> guest: aging successfully, what i mean by it is making the best of your health at any given

point. but what i think society means buying it is not seeming old at all. now, my mother is now 90. if you had asked me, she would have been a prime example of successful aging four years ago. she did 25 hours of volunteer work at the critical care unit of her local hospital, a huge job. if you asked me anybody about her you would know she was on the top of her game. but like my grandmother, she has a fully functioning brain in a body that has led her down and is now mostly confined to her room in an assisted living facilities. so, she was capable of aging successfully until some diseases she had had, because as you get older your immune system's ability to fight off things that when you're 60 and 70 you can live with a lot more easily goes, and so what we mean by aging successfully is doing everything you can at that

moment, but they're comes a point unless there is this fairy tale we all have i'm going to drop it at the age of 95 in the middle of making love or a pair of lighting or skydiving. >> host: with no pain living up to it. >> guest: no pain, noticeable become nothing leading up to it. and in fact, but you don't get to choose the manner of your own death in that way. my mother, who is very frank and has had a living will and a health care proxy for years, her children don't need to wonder what she wants done. my mother says frankly that she doesn't -- the life she is living now, she does not consider life. she would have liked to have dropped dead of a heart attack while she was doing her volunteer work but that's not what happened for her. >> host: what does she think of your book? >> guest: she likes my book, and by the way, it's very interesting. i've had a huge number of e-mails in response to various articles i wrote in various places. the older people are, the better

they like my book. i have had a lot of responses from computer savvy people in their 80s, you know, singing you've said what i'd like to say but i don't dare to say. and i find these things interesting. you asked about successful aging. what they mean by the don't dare to say them is one of the ways in which you get viewed as a hit the older person by younger people is this one, you never complain about your health because nobody who is in good health wants to hear, and i don't think anybody who's in good health really understands what it is to get up every morning and fight to deal with, you know, various pains and things like that that you don't feel the way 30-years-old or a 50 year old does when you're 85, even the relatively healthy 80 five-year-old person, so you don't talk about bad health. you don't talk about losses. if you are grieving for a

partner, a longtime partner who died, yes, you are allowed a month or two of tears, but i saw this ridiculous piece in "the new york times" a few days ago, and op-ed piece about some social scientist has done a study, you know, that basically most people are supposed to get with it after about six months. and yes, they may still grieve for their partner, but tears or thinking about a partner all the time or constant feeling of sadness may be a sign of depression or something more. and that is another thing. so you have to project a positive attitude. frankly, i don't understand anybody who six months after the death of a partner of 30 years feels okay and doesn't think about them all of the time. but i think that is one of the positive thinking business is something our society imposes upon everybody, but with no group is more coerced by that than the old because if you --

if you express sorrow or dissatisfaction when you're 85, with something that the 45-year-old would just be considered a normal guy. at 85 its well he's just a cranky old geezer, she's just a mean old crone. what people express when you're older is put down to old age other than legitimate response to a loss, which anybody would have if they had it at any age except old people have more of them. >> host: i suspect that old people are reluctant to express those genuine emotions because of another point you make in the book which is loneliness factor, that when people get old, may be their partner has died so they don't have the primary person to laugh or maybe there's not a child in the picture, and their social circle has shrunk, so i would think what you're saying is that the society coerces

people not to be that kronor that grumpy old man because it pushes people even further away. some talk a bit that, the loneliness factor. >> guest: that's true, and that particularly affects the oldest old. i mean, one of the reasons it's been advanced, and it may be true is women do better as widows than man has widowers is women have more women friends and this is true. women relate to other women who more closely throughout their lives, at least now. that may not be true in the generation from now, but still, than the man to do. but when a woman lives to be really old into her 90s, then, because she is the oldest of the old survivors, she begins to lose her female friends, too. my grandmother, who did live to be 99, i talked to quite a lot about this. and one of the things she said to me was -- and she was a person who always made younger friends throughout her life, too much. if anybody had as good of old

age you couldn't tell you can't, she did. but she said one of the hardest things about being in her 90s is she out of every one who didn't see her as this old woman but who remembered her as who she was, a young and vibrant girl and woman that those people were all gone. and of course you could have friends of all ages and good friends, there is a special thing to the friends of your own generation. and for the people who live the longest, they have to cope not just with one loss of the primary person in their life, but a succession of losses as the people who aren't as hearty as they are dhaka off before them. >> host: my father, who's 86, and with lives right in the area where he grew up, and his high school class still has a reunion once a year and it's such a highlight of his year to go to this and see people that he probably doesn't see from year to year. but i think that element of

having children together, it reminds them of themselves at that age. >> guest: maybe not necessarily children but just somebody you knew when you were young adults, all of the people, you know like my grandmother and my grandfather used to do things with and so on, she outlived them all. and even a loving child cannot make up for the absence of your contemporaries. >> host: you mentioned aarp a few times in your book, and say that the organization hasn't really helped the american society have a full picture of the realities of the old old. what should the organization to? it is the big senior organization. >> guest: yes. i do believe that, and i should say i'm not just criticizing aarp. i wrote for aarp publications for years. so who live in criticizing is myself. but my thinking about age has changed since i was writing for

the bulletin and the magazine. i think that one of the things that aarp needs to do is it needs to first of all stop concentrating on -- which i think it does in its publications -- on the 50 and 60 and early 70's something in start presenting a full picture of older people as well. if you look at any of the aarp features on people we love, almost all of them will be in their 50s and 60s. now i know, that's where the business is, that's where the boomers are, and there will be one person in their 80s, and this was always the case in the aarp publications, because articles about people who are really sick and how they cope with it, i think they ought to be doing more of that. but they are also dillinger articles. it's hard to do them well. the story i told on myself in this book is this was many years ago and none of the editors now or the editors then, but i was

asked to do a story about people who after a serious illness had made big changes in their health habits and had greatly improved their lives, and the first person i thought was a high school classmate who had a form of cancer in her 50s that she was supposed to die from and she didn't and when it became clear that she wasn't going to die, she responded by giving up smoking and losing 50 pounds and they ran a picture of her. she was 56 then. i swear she was so gorgeous she looked not release the six anybody would have recognized her as a high school cheerleader she was. i didn't interview anybody over 64 for the article because i couldn't find these triumphs and stories and people who were in their late seventies and eighties. now they exist, but i think that simply by featuring a number of people in these publications so constantly and not older people, they are suggesting that people like in their eighties can

expect the same results and the five aging in the same way that people in their 50s can. and by the way, i think that it's fine, people over 50 -- i've been a member of aarp since i was over 50, but people in their 50s comparing them to people in their eighties is also ridiculous, but i think mostly the aarp publications present in their personal with samples the sunny side of old age always come and i don't think that -- given that the aarp represents all seniors and has a huge battle on its hands and is going to for the next ten years, to maintain medicare and social security in ways that old people need, that the aarp needs to start featuring more of the worst problems as well as the best case outcomes. >> host: is there any aspect of popular culture that does in

your mind present the accurate view of gritty old age? do we have any tv shows? do we have any -- disco in popular culture? >> host: in popular culture. >> guest: will of course, you know how few television shows there are that feature older characters, but the fact that we keep coming back to betty white shows you how few of them there or because when anybody asks you about that, the only person you can think of is betty white. you know, the most wanted talk-show guest and so on. and i did -- and by the become this wasn't about people who were old, really they were the young old, even the series "golden girls," i thought it was completely unrealistic about life for women in their 50s and 60s. >> host: they had a lot of dates. [laughter] >> guest: all fees' "golden girls" seemed concerned about was getting another man. i don't think it was in any way realistic about the problems the real women in their 50s and 60s

faced. so no, i don't think that there is anything in the popular culture because popular culture doesn't -- what it likes to look at is the rear old person like betty white who doesn't seem old. for getting, you know i couldn't move my hips and dance like betty white when i was 30. betty white is one of those unusual people. but i don't think there is anything in popular culture that accurately reflects the lives of old people because it's a downer. and even not in popular culture, the hbo production "alzheimer's project," which was the real first tv series to really examine alzheimer's and produced by maria shriver, of course, whose father recently died of a it. there was a lot wrong with that series, and one of the things wrong with it was it presented only nice long-term care facilities, or it was horrifying

enough, it didn't accurately show the people in the last stages of alzheimer's were like, but there was always a caretaker, a home, a woman, there was nothing in that about the people who have no caretakers in the late stages of alzheimer's, people who are not in a nice nursing home whose life savings have run out and are in nursing homes on medicaid, and i've done articles on how nursing homes when i was younger and they are not nice places. and so it did not -- in a way it should the worst case scenario you lose your own mind. but there was always a caretaker, there was always a woman. there was a woman who had given up her job in minneapolis to care for her mother. who's going to care for that woman of the years that she's lost caretaking? that is a very, very serious issue, which is -- >> host: you mean because of her earning power? >> guest: yes. let's just say a woman is willing to quit her job in her 50s to take care of her mother.

well, that woman is when to need to be taken care of and one way or another when she's older, and the fact that she quit her job, we don't have anything really that provides for long-term care in homes even people in the middle alzheimer's you can do a lot. when my partner was in the middle stages of alzheimer's -- and i emphasize he did not reach the -- cancer mercifully took him before that -- but there were a lot of people involved in his care, and he had something i thought was stupid and devoted children and people who subbed for each other. he had a big network, and for when there couldn't be somebody there, because he did reach a point where he really could not be left unsupervised, even though he could still do things like enjoy the old movies and things like that, but he couldn't be trusted not to turn the stove on and burn the house down -- he had taken when he retired he took a lot of medical

benefits that provided for some home care. we needed that. most people can't afford that, and we are now talking about cutting down, when in truth to provide home benefits for families who are willing and able and eager to help care for a person costs so much less than to the people's life savings runout and put them in a nursing home. >> host: you make a number of criticisms of the medicare program, particularly that assistance for the home caregiver is and covered. why don't you talk more about that. >> guest: and this is a hard thing to talk about because nobody is talking about expanding services now. all people are talking about in medicare is ways to cut them, and in fact i think that there are a number of things we are going to have to do to reduce and if life care which only prolongs death. i will talk about that in a bit. but it is a great criticism of medicare that you cannot -- let's say you have a husband at

home in the middle stages of alzheimer's, but you cannot care for him 24 hours a day. you have the job yourself, and in come you very much need. medicare will not pay for people to come in for eight hours a day, the eight hours you need to work, which would be so much cheaper in the long run, but we are a country that doesn't do long run thinking, than having people lose their assets and having to put somebody into a nursing home when there is someone who is willing and eager to provide care at home if only they have some help in. >> host: the statistics i've seen is that nursing homes cost maybe three times as much as -- >> guest: that's right. >> host: -- assisted home care. >> guest: there are people who need the nursing homes, make no mistake about it, but there are people who could stay at home longer. there are healthy old people who could live independently longer if they could have nursing homes. if they could have some kind of

home care, not necessarily medicare, which our society doesn't pay for unless you are -- have completely exhausted all of your assets to read this is going to be an urgent issue has more of the boomers live to be over 85. and of course, now there certainly isn't quite to be any discussion of it right now because all we are talking about is about how to cut the cost of medicare. well, now i will talk about that. i can tell you -- i can tell you one thing that would cut the cost of and of life care, and it's not death panels. it is the thing that out of political cowardice has been retreated from which is paying for voluntary consultations between older people when they are healthy. it doesn't have to be when they are sick, in fact it's much better if it isn't. talking with their doctors about what are their feelings about and if life care? duty -- would they like for instance do they want -- there are two things do everything which is as long as the heart is

beating, whether you are in a coma or not, and that is what we spend a huge proportion of the medicare budget on in the last month of life upon. i think that if people were encouraged to discuss this with their doctors, and by the way, doctors who are just as scared of death and dying just as anybody else need this discussion just as much as the patient, would encourage them to go home, talk to the people they love, investigate the legal issues. only one-third of americans have living wills. even fewer have what you also need, which is someone legally appointed to make decisions for you if you can't take care of yourself. if only half of the 70% of americans who don't have any and of life care instructions would make those decisions for themselves, it is intolerable how much since we spend so much in the last month of care, and this is and death panels, its people being encouraged to think about what the 90% of americans say they would like to die at

home only 20% do. now, i will definitely use my mother as an example. she made out her living will and appointed my brother and me as her legal representatives 30 years ago and we are no doubt about what she wants. and in fact, she has rejected all kinds of care already. we don't have to make decisions for her now because she is of sound mind. if she ever is not, then we will do exactly what she said, we would be afraid not to. but the point is she is taken care of. my mother is not going to cost one-third of the medicare budget in the last year of her life. she understands and accepts the difference between care that can only prolong her dawning and care that could return her to a good quality-of-life. and there isn't much of that for her any more. and she made these decisions when she was healthy. and i'm not saying everybody is as strong minded as my mother, but a lot of people are if they are encouraged to do it.

that is a way, without having death panels or even talking about assisted suicide, we can encourage people who want to make plans for their own end of life care to do it instead of avoiding the subject and eating it. >> host: so if somebody wants to have a living will, tell us what that means, what steps somebody has to go through and what questions they have to ask themselves and answered. >> guest: first of all the living will, not every state by the we've recognizes living wills, first of all, you have to find out what your state lotteries about this. and this is something -- aarp is full of information. if you can't use the internet, you can call the diprete office of aarp, and they will tell you exactly what your state law is about this, and even those people who can't use the internet, which i think more boomers will be able to use the internet, the even if you can't, you can call up aarp, you can call up your local citizen's council and they will tell you what the state of lobbyists. as a myth if you are not rich,

if there are financial issues involved with your regular well, you need to have a lawyer for that. i understand there are people who want to do the do-it-yourself willes, but there are all kind of senior centers that offer aid with that at a fairly moderate rate. but a living will sort of states your wishes, you know, seeing a living will states, for example, in a new york state that if there is no chance of my returning to recovering to life, being able to speak again, i do not want to be hooked up to ventilators, i do not want to be force fed by tubes, it spells it out quite explicitly. and any lawyer will drop one of those and stage that, but a living will is and all you need. you must discuss this with whoever and appoint a legal representative to act for you if you cannot act for yourself,

because many people by the time these issues arise can't act for themselves. your children, your spouse or your friend if you are not married, this is going to be a bigger issue for boomers because many boomers were divorced. boomers have smaller families, the assumption that there is going to be someone, and by the way, the person you a point may not necessarily be your charnel. it will be if you don't appoint anyone come and it may be a child who doesn't agree with your ideas about that at all. people need to appoint legally a representative, you actually do need a lawyer and a notary to do it, but it does not cost a great deal in most places. if you call aarp doherty senior organization they will tell you how to find legal help with this for not very much money. but you have to have the will it spells out what you don't want done to you if you can't recover. and somebody to sign the papers for you if you cannot assign them for yourself. and the people who criticize

this and talk about these as death penalties -- panels, as far as i'm concerned, the are idiots. leon kass, who is not an idiot, he's a famous ethicist and was the chairman of president bush's counseling bioethics, president bush the younger -- he's opposed to living wills because he writes that no one can possibly imagine what they would do in all future contingencies, and there is no substitute for a loving partner. well, good for him. he's got a loving partner, a wife, but there are a lot of people, particularly women, who won't have a loving partner, even if the had a loving partner for most of their lives. and why lit is certainly true that you cannot know what he would do in every circumstance, i can't know, you know, whether if my knee gets worse if i'm willing to go to ray knee replaced or hobble around on a

knee i tore up on a lettuce leaf a few years ago. i don't know the answer to that. but i do know that if my brain -- am i hi your brain functions are done that i do not want to be force fed to keep my body alive. i do not want to be hooked up to an artificial ventilator if i'm 85-years-old and cannot be on my own. i can't answer what i would do in every situation doesn't mean that i can't know what i would do in the most common situations and i think whatever anyone says about this, i do think the all objections to this are a particular kind of highly conservative religion. i was raised catholic. i'm an atheist i was raised catholic, and i know the catholic church has no objection to say you don't want to be on a ventilator if you can't get better. that is not -- that is not considered suicide. it's considered you don't have an obligation to have everything to keep your body alive as long

as possible. but there's a particular kind of i would say very antiindividualistic religion which says everything is in god's hand. we don't have the right to make any decisions for ourselves, and i think that is where the opposition on the far right is coming to a whole idea of living wills because mainstream religions do not object to these things at all. many mainstream religions to object to assisted suicide but that is a different thing. assisted suicide is a very different thing from saying i don't want extreme things done just to keep my heart artificially pumping when i am never going to be me again. >> host: you do say that suicide or assisted suicide can be a rational choice and you go on to make the point that in medicine at least, as practiced in this country tends to view anybody that reaches that decision that that's the option that they want to take has either lost their marbles or is

depressed and can be cured by the hills. >> guest: welcome the fact that -- the fact that so was i. is rare under any circumstances is borne out by states like oregon could have had assisted suicide laws for ten years. very few people lose them. the number of people who have used them are people who were terminal within six months and who numbered in the hundreds. many who went through the process of applying for this didn't do it. most people are not going to commit suicide under any circumstances. but i believe that for people who are in the unbearable pain, it is a rational choice, and i don't agree at all that everybody who wants to commit suicide is irrational or depressed, and i think this is -- this is your patronizing. i don't deny for a minute that there are some people who are depressed, and rick symbol, i will give you an example of people who were depressed. there were people who, people in

their 60's and 70's or even when they receive a diagnosis of something like same multiple sclerosis or parkinson's, which you are eventually going to die of, but unlike say alzheimer's or some variant forms of cancer, they are manageable and treatable and you can have a meaningful life for a long time, they are not a death sentence, but there are people who will treat that kind of diagnosis as if it were an immediate death sentence. those are people whose thinking is distorted, and many of them might need not only to be on antidepressants, but to have therapy and to have their disease explained to them that person that they don't. a lot of people who treat something that's not a death sentence as a death sentence are depressed and irrational and they're thinking about what is always a blow, likes to be told that they have ennis or parkinson's, nobody. but since we can cite huge numbers of examples of people who have lived meaningful lives long coming years, decades after these diagnosis, you can live

with it on like some of the worst diseases of old old age. but to say that everybody, even people who are not terminal, everybody that has said life had a good life and i've had enough is depressed. one example i used in my book is this 100 two-year-old man in st. louis, very well known in st. louis. i'm sure the shrinks would have just loved to have gotten their hands on him. he was a leader in the jewish community. he built half of st. louis. in the 1940's when st. louis was still very much a southern town and its racial attitudes, she insisted that unions on his construction projects admit african-americans. he was a huge civic figure, philanthropist and builder in st. louis. and he was just fine until he was about 99 when he fell and broke his hip. anyway, again, a great extent with someone who can age successfully until you can't, then he had to have a companion which for a man like this he did. there was nothing wrong with his

mind. two weeks before he committed suicide, he had given a long from memory speech at his synagogue about his life, about what a great life he had. he out lived two wives and some of his children, has grandchildren. what he did one morning -- and he hated living with a companion. well, i sure there are a lot of people who commit suicide are all crazy, thank god the health professions didn't get their hands on him. he, one morning sold the keys to his companion's car. he had been a champion swimmer in high school and college. he drove it from his lifelong home and he had all the money in the world, he would have died at home, but he didn't want to have his every move monitored by another person, obviously. he drove his car to the missouri river, got up on the bridge and drove off and committed suicide. now i am not advocating that people do this. i am saying i don't think this man was crazy. in the letters he left for his grandchildren said please don't grieve for me or think i was out

of my mind. he said i don't want to live until i have no control over my own death. i can't do any of the things really that have given my life meaning, and i'm not -- i think this is a case of a man who said enough, i've had a great life. it's downhill from here, and again, i don't advocate this, but i don't think he was crazy. and i'm glad some psychiatrist with anti-depressant and xanax didn't get him in his hands before he took his own. >> well, i don't want to get away from this before i ask you the two or three or four public policy decisions or retrofits need to be done in order to start addressing the issues you raise in your book. >> guest: you mean everything that is being talked against in washington right now. one, we need social security is

not in desperate straits now. but we need not to reduce social security benefits. cresco not increase the retirement age. >> guest: know, i actually think we can increase the retirement age. i.t. we can increase it a few years, but it has to be with an understanding that it's not an absolute requirement. i hate the idea of retirement until the public five years me i'm not retiring, which could happen, but until that happens, and as long as i have my mind, i intend to be working. but there are people who have spent a whole lifetime of physical labor and i don't just mean working in coal mines, i also mean i consider physically on the body having stood behind the retail counter on my feet for 40 years is far more physically taxing than having been a writer. there are people who need to retire before age 70. firefighters, and but not just that, there are a lot of low-income jobs that are

relentless physical work, and i think that to say, for instance, that every -- everyone that has made their living say as a health care aide in the hospital can't retire until they are 70 is wrong. so i think that there have to be a lot of exceptions. raise the retirement age, yes, but also build a lot of physical exceptions, juneau, into that wall. the hardest thing in the world to do. we do have to raise the retirement age for a lot of people the retirement age could be raised to 70. for a lot of people, it can't. there is no one-size-fits-all. i don't think we need to cut social security benefits at all. i think that we must not, because they are not that generous now. three-quarters of people over 75 live on $34,000 a year or less including social security. does that sound like rich and greedy geezers do you? but we first of all, we need to tax -- we need to raise the social security withholding tax

and apply it to everyone. >> host: even the rich people? >> guest: but even people right now i think the ceiling is $109,000, and there aren't many people who make more than $109,000, but everybody should pay social security withholdings on every bit that they make. whether they make -- whether they make $109,000 or $1 million. that said, you can do that, there will still probably have to be an increasing the taxes as well. cutting the return of age and taxing all income will do part of it, but there will have to be probably a higher tax. i don't think that higher taxes, and i am not in that fortunate millionaire category, higher taxes on understand our a dirty word. and what we have right now is politicians who are encouraging a public than on reality about

this. the polls show the majority of people were totally opposed to cutting either medicare or social security benefits. they are also totally opposed to paying more taxes for it. that cannot be. right now we have no politicians and either party who have the courage to tell people we cannot cut social security benefits. old people need that. i think also, yes, you could also have a means test in the people who make a billion dollars a year who are 80-years-old don't need social security. but that is such a small percentage of it. that inevitably referring social security is going to mean raising the retirement age in a sensible way, taxing everybody on all of their income for social security and probably raising it. if we don't do that, if we don't do that, we are going to undo the most stellar achievements of the american 20th century, which is the reduction of old age poverty. medicare is harder. the medicare system -- and

again, i'm talking policy in the sky because nobody is talking -- is talking right. every morning on morning show i hear them talk constantly about the need to cut entitlements. medicare, medicaid. medicare really does need a fix, but it's the kind of fix the has to come the way that it's come. the equivalent of old age medical care does not cost european countries the proportion of their gross national product that it does us. why? first of all, there are real tight government ceilings on certain procedures, and if you have government cost controls, for instance, for the bush prescription drug plan, which passed the prescription drug plan, a great thing, but without passing cost controls in which the government demands certain concessions from big pharma which can still make money charging a lot less for those drugs. if the government is going to be your biggest customer, it has the right to demand a ceiling on

drugs, which cost, the same drugs which cost so much less than every other country in the developed world. there is no solution to providing universal health care for the old without more government cost controls. but i believe also there really is no solution to the problems of medicare for the old. the financial ones, without a solution to the rising cost of health care and health insurance for the young. i write in my book when i started working at the "washington post" in 1965, social security seemed a lot bigger on 105-dollar a week salary even than a bit later. [laughter] but i didn't resent it, that was for my grandparents. however, if i had good health insurance for the "washington post," and health care did not cost that much then. now, for the last 20 years i have been spending 15% of my

after-tax income for bad private health insurance plan. the next generation below the boomers, of whom there are fewer than us, is not going to so easily accept those taxes for medicare and social security if the cost of their own bad health insurance keeps rising. i don't believe the one problem can be solved without the other. and by the way, i am not very impressed by the stands of old people over 65 on the last health reform -- health care bill, which whatever you think of that bill was the first attempt to address this issue. the majority of people over 65 were opposed to universal health care for anybody but themselves. sorry, bad thing. the aarp knows that. a lot of people resigned because the aarp supported that health care bill. there is no solution. the young are not going to support the old of the old don't recognize the financial stress

of the young as well. >> host: one reviewer called your book or called you a reality in structure and says it's not a cheerful book. [laughter] are people buying it? >> guest: i don't know actually. i am in book tour land in which you hardly know. but i will tell you people either love or hate this book. the people who hated this they say it's too pessimistic. i call it realistic. the older people are the better they like it, the floods of e-mail site how long by author website from people in their seventies and eighties have been, you know, this is what i want people wanted to save it didn't feel i could. people either love this book and consider it singing something that they've wanted to say or they considered it an absolute diatribe. >> host: use of your friends and fellow writers encouraged you to end the book on happy note. >> guest: i tried. [laughter] >> host: did you think it comes of happy? >> guest: no, i tried to --

well, they wanted me to end the note on what good advice to i have for people to solve these problems. >> host: solve the problems of old age. >> guest: and of course one of the things i say in this book is that old age itself is not ultimately definable. the practical pieces of advice i have, they would work for everyone -- first of all, i think people need to stop thinking about retirement unless their whole purpose in life is living in a sunny climate, which i admit after this winter seems more attractive. but the best place to be older is in city with public transportation systems. there aren't a lot of them but there are some. >> host: valentines in new york in here. >> guest: one of the things that is so bad about a lot of this country is the minute he can no longer drive, you can no longer have a life. people can be an excellent mental shape, wanting to go to the theater, wanting to go out, wanting to go shopping, wanting to do all these things and are

perfectly capable of doing, but not for let's say reasons of vision or something like that, unable to drive safely. well, and new york i see it every day, i see people pushing their walkers on to the left of the buses and going all kinds of places. i see people with a little more money getting taxes than you do not need a car to live in only a few cities in this country. so, we have a country without public transportation. it is actually a many trend, people moving back to the cities when they reach retirement age. i do think that whether it is paid or unpaid work, people who have their mind need to keep engaged and working in the community as long as they can, not because it is going to guarantee that they will never get alzheimer's or die and they can defy old age forever, but because it makes for a meaningful life now. but apart from that, i don't know, in other words, those are

things control. you don't live the life of a vegetable when you're not one. you live in active and engaged life come to make the best of your physical situation. new york is an assisted living community. i don't understand why more places like lansing, michigan, where my mother lives, don't deliver food at home for people, and they don't. there are cities that have a culture of delivery and people