The idea of “consumption smoothing” tries to balance how our income changes over time with our spending needs. In theory, it may be ideal to go into debt when you are really young, save heavily when you are middle-aged, and spend it down when you are old ():
The book Die With Zero () reminds us that when we are young, we tend to have little time and lots of health. When we are old, we tend to have lots of time and much less health. So we should spend most of our money during our younger “best years” instead of when we are old. Here is a graphic from the book:
I enthusiastically support the idea of creating a specific bucket list of items designed for each stage of your life. However, I don’t like the title “Die with Zero” because it suggests that your time at the end is not valuable. A young, healthy person might think – why bother saving too much when you’re too old to enjoy it? Well, I would say that you start to appreciate the bottom layers of when you see them missing in someone’s life. ()
We help take care of an older relative, and she has recently gotten to the stage where she can no longer safely live independently. According to the , here are the basic activities of daily living (ADLs):
- Bathing and showering: the ability to bathe self and maintain dental, hair, and nail hygiene.
- Continence: having complete control of bowels and bladder.
- Dressing: the ability to select appropriate clothes and outerwear, and to dress self independently
- Mobility: being able to walk or transfer from one place to another, specifically in and out of a bed or chair.
- Feeding (excluding meal preparation): the ability to get food from plate to mouth, and to chew and swallow.
- Toileting: the ability to get on and off the toilet and clean self without assistance.
You may be 100% there mentally and only be struggling with one of these things, but that’s enough that you can’t live independently. The next level of “instrumental” activities of daily living includes things like cleaning, laundry, paying the bills, managing medication, cooking, shopping, communicating via telephone/computer, or transportation.
According to AARP, nearly 80% of adults age 65 and older want to remain in their current residence as long as possible. Seniors vastly prefer “aging in place” to facility care, and why wouldn’t they? The standard of care in an average nursing home is simply not that great. Medicaid pays for 6 in 10 nursing home residents. There isn’t enough staff. You live on their schedule, ignored most of the time. They are only required to give two baths a week. There are often no hard minimum ratios, so it might be or worse. According to , the three most common complaints are slow responses to calls, lack of social interaction with other residents and family members, and poor food quality.
However, if you have the financial means, you can hire your own personal home health aide. This 1:1 ratio gives you your freedom back. You get to live in your own house. You wake up and live on your own schedule. You get to choose the food that you eat. You bath every day. You have someone to drive you wherever you want. You can still do your own shopping. You can have lunch with your friends. You can go to social events (memories! experiences!). This can get expensive at $15 to $30 an hour (often less overnight), but I’ve discovered that 1-on-1 help is the “luxury good” that the wealthy buy at this stage of their lives.
One of the findings of behavioral psychology is that (maybe $80k a year in 2021?), you don’t get that much happier. At a certain point, you have your needs met and you feel safe and relatively comfortable. Above that, it’s mostly a nicer house, fancier car, better restaurants, etc. Earning more doesn’t give you a more loving family and group of friends. When you get older, I’ve now seen how extra money can get you back to that level of comfort if you have health issues. Isn’t the freedom to spend our time how we wish the true goal?
Upgrading from the “economy” to “business class” lifestyle in your 40s is nice, but so is upgrading from a nursing home to 1-on-1 personal attention in your 70s and 80s. If you make enough money for both, then you’re set. If you have to choose, it’s something to think about. Maximize pleasure when you are young, or minimize suffering when you are old?
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