Have you visited an assisted living facility for the elderly lately? If you have, I'll bet it was clean and professional, but also unspeakably sad. The residents are well cared for, but they look lonely and bored and forgotten. Maybe we should figure out how to fix that situation before it's our turn.

If you consider the huge demographic wave of retirees coming down the road, and the fact that many haven't saved enough for retirement, and the fact that science keeps finding ways to keep our withered bodies alive longer, we have a big problem brewing. Where will all of those old people live?

Some oldsters will live with family, of course, and some will be independent until the end. But that still leaves tens of millions of old people in need of assisted living. What will that look like?

Let's begin by imagining an elder care facility designed to stimulate the residents and provide a great quality of life. Current facilities appear to be designed for efficiency, more like hospitals than hotels. What we have now are clean and bright facilities that are needlessly depressing. Let's start by getting some better colors in there, and adding some real design. Every room should have a second floor view of something beautiful and interesting, a gas fireplace, porcelain tile floors, interesting lighting, beamed ceiling, and a little extra space. Think of a lake cabin or a Spanish bungalow. Good design costs more, of course, but I'll talk about economics later.

Now imagine that each room has a huge flat screen TV on the wall, and speakers in the ceilings. The residents would also have the option of wireless headphones with built-in microphones for Skype calling, or for listening to loud shows, or music, or books on tape. I imagine the remote control for all of this in the form of an arm band, so it never gets misplaced during the day.

The TV and speaker systems for the one-room apartments would have interfaces designed especially for old people. The upcoming wave of elderly people will be comfortable enough with technology that we will have more options than before. The onscreen menus would be large and simple, and also operate on voice command. The lights, phone, and temperature would also be controllable from the menu on the TV. Let's also assume the oldsters can use the armband controller to speak directly with the staff in case they need something.

The genius part of my idea involves locating the elder care facility next to an animal rescue facility. It's the perfect symbiotic relationship. Both the old people and the animals want company. They can have each other all day long. There will be some extra hygiene issues, but humans live with dogs and cats now without much trouble. We might want to create common areas for human and pet interaction, to keep the fleas out of the main living areas.

I would also combine the elder care facility in the same building with a childcare area. Kids are germ carriers, and you wouldn't want much direct contact between the snot nosed kids and the seniors. But I think you could let the healthier seniors work part time in the childcare facility to give them something active to do. And for the rest of the seniors, it's just a happier environment when you can see kids coming and going, and playing behind glass windows. Call it the ambiance of life. And in some cases, the kids might be the grandkids of residents.

I'd also want each senior to have his or her own garden space, arranged in rows, at wheelchair height, in a common greenhouse. This gives the seniors something to cultivate and have fun with. There's something about gardening that appeals to most old people.

Now imagine a kid-sized soccer field in the courtyard of the assisted living facility. During the school day, the kids from childcare would use it to run wild. After school, older kids from the area would schedule the field for team sports. The elderly residents would have front row wheelchair access to watch the action.

Now imagine that the seniors can use their big screen TVs to Skype with family and friends from anywhere in their apartment. And let's assume the interface is designed with only a few visible options, such as "Call Timmy" or "Answer Call."  If your grandma is in the facility, just fire up your iPad and visit her without leaving your couch. If you're having a birthday party for a grandkid, set up the call on the iPad and just leave its camera pointing in the direction of the action. Grandma will feel like she's in the room.

I can also imagine wheelchairs of the future being motorized and guided by a sort of in-house GPS system. If grandma wants to visit the animal petting area, or take a ride through the adjacent park to get some sun, she just tells the chair where she wants to go and it takes off on a slow ride.

Let's also imagine that all recreational drugs become legal for people over the age of 75. While drugs are clearly bad for kids, can we say the same thing about senior citizens? Recreational drugs might actually keep seniors healthier by increasing their happiness, energy, appetites, and general interest in life. And it's not as if seniors in assisted living will be operating heavy equipment or making important decisions. I don't see a downside.

Now that we've done a great job designing the assisted living facilities to be stimulating and life-affirming, how do we pay for all of that extra stuff without government assistance?

For starters, the facility can have a few extra sources of income. The childcare wing would be an income source, as would the sports field that could be rented out. I could also imagine beautiful garden areas around the grounds that are suitable for weddings and events. That's another revenue source. The facility could cater the reception as well. All of this activity helps to make the residents feel connected to the circle of life.

Now imagine that these senior facilities are owned and operated by a company that also sells long term care insurance. People would start paying for their assisted living while still relatively young. With insurance, most people will pay and never reap the benefits. I think people would pay a premium to know they have a guaranteed spot in a high end assisted living place if the time comes. Compare that sort of investment to the stock market, which is iffy at best. I think an argument can be made that investing in your own future assisted living is the smartest retirement investment you can make.

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May 9, 2012
I have a different plan. I have instructed my children that when I reach that point they are to buy a sailboat, stock it full of provisions and beer, throw a big going away party, and shove me off into the Gulf of Mexico on my last great adventure. WAY cheaper! Besides, as far as I can tell those places should be called "assisted dying" homes. I prefer to live to the end, even if the end comes a little quicker.
+1 Rank Up Rank Down
May 8, 2012
Let's see... voice operated videophone, user with dementia...
"Call daughter."
"Hi dad. Nice to hear from you again."
"Who are you?"
"I'm your daughter."
"Oh, were we married?"
"No dad, that was June."
"Who are you?"
"Bye Dad"
"Call Daughter"
"Call Daughter"
"Daughter not available"
"Call Daughter"
"Daughter not available"
"Call 911"
"911 dispatch, what is your emergency"
"Who are you?"
"Sir, are you in distress?"
"What? I'm wearing pants"
"Call Daughter."
"Hi Dad."
"I think I just pooped my pants."
"Push the Nurse button, Dad."
"They're trying to kill me."
"No one is trying to kill you, Dad."
"They are! They're poisoning me!"
"Call for a Nurse, Dad."
"May I have your credit card number."
May 8, 2012
I enjoyed Deborah Orr's recent article in the Guardian:

Essentially she posits that we only value profit generation rather than caring. This appears to be true to a certain extent - it is obviously not the only correct perspective.

I would certainly say that to make the idea work in today's world there are a couple of fundamental issues that need to be addressed:
a) motivating (profit wise) the insurance company to spend even one more penny than necessary on the care provided
b) a means to encourage the care provision to actually want the residents to live longer - clearly they will make greater profits by encouraging residents to be so miserable they just cork it.

I am a little terrified of retirement - it's why I keep in good health so I can look after myself, hopefully until I drop dead of an instant heart attack. My wife has done care work, to keep herself through university, and the provision varies from barely acceptable to downright scary. The owners of the care homes appear to do well enough though, it's fair to say.
May 7, 2012
ive actually pondered their fate quite a bit.

to me its deeply profound that dozens of seniors living together, who eat together, watch tv together, etc feel so lonely.

its not a question of dying old and alone due to misanthropy, its about not becoming crusty and unsuitable as a conversation partner to the lady down the hall who lived thru the depression just like you. they have ppl who love them-children/spouses, they just have their own lives outside the facility.

yet the elderly refuse to make friends with their peers in meaningful ways. imo, its a lack of respect for their fellow man. only their offspring (or other visitors) are 'worthy'.

really fills me with revulsion. elder care facilities could be massive parties, like a dorm or spring break. i dont mind dying old and alone, but i hope its not because i cant make friends when opportunity exists.
May 7, 2012
Albert Brooks had what I thought was a nifty idea in his book "2030." Convert an old ocean liner into a retirement home. The cabins would be small and the food communal, but you would be constantly changing your scenery! I might go for it once all my books have been converted to digital format.

May 7, 2012
Overall, most of this sounds pretty ingenious, within reach of modern technology, and not too unrealistic, financially. I like it. Of course, by the time I'm older, I'll just need a few computers to be happy. It's all that I really need right now...
May 7, 2012
The maximum discomfort that old people experience comes from the fact that they lose control over their bowels.
If medical science or any other technology can solve this one problem, it will increase their quality of life much more than all the TVs, gardens and "ambience of life" combined.
May 7, 2012
Unfortunately Scott I can only assume you have never had to look after an elderly person whose brain doesn't work properly any more. I do, every day, my 90 year old mother in law. None of your ideas would work for her, eg she can't read or watch TV and is incapable of dealing with children or pets. Many old people in homes are worse than her. The only option is to pay people to mind them, if my wife didn't care full time for her mother, we'd have to put her in a home. If her brain still worked, she might be able to live independently from us or a home. As many have pointed out, it is going to be a huge problem for society as more and more peoples' bodies outlive their minds. I think it will need increased taxation to pay for the staffing costs, which are much the biggest issue, some elderly folk need constant human supervision and assistance, ie 24/7.
May 6, 2012
Don't spend the best years of your life making others wealthy.
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May 6, 2012

There is enough sadness in the world already. I wouldn't aggravate anybody's injuries if I can't nurse them.

If we can't make things happen, lets focus on what we can.

Have a good Sunday.

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May 6, 2012
Sounds like a typical "senior residence" with some added gimmicks. I've seen prospectuses of two of them here in germany. Including everything (and shopping, cinema and stuff), you need about 2500-4000 euros per month. Only, in those two you'd be in the city centre (Munich and Dresden) and watch tourists instead of kiddies.

I guess, a good state pension may cover about a third, the rest has to come from income from investments. So, you'd need about a million in order to afford it.
May 6, 2012
I'm 65 and I have 91 yr old mother living in independent living in a retirement community and a 82 yr old mother-in-law living in another assisted living community. I've read many of the responses here and have occasionally discussed experiences with friends of similar ages and parental situations. And let me tell you, from what I've discovered, most people are in compete denial about what will happen to them as they age. It will cost far more than you realize, you will live longer than you realize, you will not commit suicide, or engage in death rituals. It will be long and traumatic and boring and senseless. Government will not have a solution nor will private enterprise for at the least the next 50 years. The loving community described by one of the above is mostly a pipedream for the rest of us. The comments by the person who shields his/her kids from seniors is the norm (you're going to 'love' being a senior, just wait!). Scott's ideas won't ever be implemented, and the reality is, it's a coming nightmare. I don't see any hope. Especially from reading the responses. Sorry. It's going to be bad.. And all our pretending and pontificating and ignoring aren't going to change a single thing. I wish you all the best, but hope? It just ain't there.
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May 5, 2012

This is a continuation of my previous entry.

Depending on what you perceive, you may say, "It can never be an ideal world." or "It has never been better than this." Or perhaps both. The fact remains that 'you care'; never mind how.

Couples, specially if they are parents, generally feel nice about the kids in the neighborhood; but that comes nowhere close to what they feel for their own kids. Some children are nice to the oldsters in their neighborhood; but that comes nowhere close to what they feel for their parents.

There are seven billion ways of 'how' to love oldsters; but there is only one reason 'why' - because they belong to us. I can't imagine any other.

It seems to me that you have put all this into context, and offered something material that can be accepted as a 'strategic fit'.

May 5, 2012
This is my experience of 'retirement homes' for the elderly:

Simply put, it is a place you go to die, in order to minimise costs the 'residents' are fed dinner in the late afternoon, to keep them tractable they are given drugs.

Yes, this is due to simple economics, it seems that a facility which provides the level of 'care' we would demand for ourselves is not financially viable. Especially if it's being funded by a (very) stretched government pension fund.

The flip side is that the average household does not have the ability to care for the elderly with 'special needs'.
E.g. a dementia patient needs more or less constant supervision, someone with delicate health needs a minimum level of medical supervision (etc).

Now, as nice as Scotts idea is, I have to ask where the money is coming from to pay for this?

A realistic solution as I see it would be to immediately impose minimum standards of care (and there are some REAL horror stories out there) where the directors of the facility were personally liable for the state of the residents.

The second part of the solution would be to organise a volunteer group of people to visit rest homes and entertain the residents (and here's the big part) IN PERSON!
Imho, TV doesn't provide enough stimulation, they need human interaction and with a variety of people.
If you want to make the elderly happier in these places, then give them something to look forward to and be happy about. A volunteer organisation wouldn't put any additional costs onto the rest home and the volunteers could report suspicious situations (such as being barred from visiting a rest home) to the proper authorities.
+9 Rank Up Rank Down
May 5, 2012

I am scared of commenting on such subjects; there is such a vast cultural gap between what I live in and your post-industrial world. My comment will sound odd and out of step.

Let me first 'share' what I live in rather than comment hurriedly on what you have said.

In the community and town that I live in, taking care of parents and oldsters in the family is an ancient tradition. It's just something that everyone does. My grandparents did, my parents did, I have done and the next generation will do.

There are community halls in every place where oldsters sit every day, read newspapers, books, write articles and discuss social issues. Their opinions are considered necessary by the local governing council before a decision is taken that can affect everyone.

There are large joint families in the community. Each one has at leasat 10-15 people in the house - several women, children, old and young people of all ages. Children are not displaced when they become adults. They build homes nearby or annexes to the same house when more space is required.

Individuality, identity and freedom are not compromised by living in a family. Each one has a life.

The societies here have not advanced to the stage where 'commerce' is needed to inspire altruistic thought, or to put it the other way round, commerce in altruistic ideas is not considered ethical.

Different people, different perspectives.

Sorry, I had to say this before I can comment on the kindness hidden in your post. I'll do from my office tomorrow. My boss is going on a leave for a week.


+18 Rank Up Rank Down
May 5, 2012
Dealing with old people is hard. My own 84 year-old Dad has COPD and is basically bed-bound, and if it weren't for my step-mom, he would have to be in a home, (as we euphemistically call it here). But his real problem is the weariness he has with life. He can't think of anything he wants to eat, anyplace that is worth going to, (if he has to pack along his oxygen), and the TV gives him headaches when he can see it at all. He raised his kids, so he's done with that. He NEVER liked animals,unless they could be turned into Sunday dinner. He is, quite frankly, high-maintenance with no possibility for return on investment. But, because of exceptional heredity, he could live in this state for another 10 to 15 years. We three kids are over there all we can manage, but he has heard all the stories, he has given all the advice and related all the family history he knows, and about the only way we can cheer him up is to bring news of someone he has outlived. This, Scott, is going to be the poison pill in your plan. People who have outlived not only their money, but their niceness. And, again frankly, no matter what they do to Social Security or private retirement plans, these kind of people are going to become a larger percentage of the population. Hell, I'm 56 this summer, and I feel it creeping on me already.
+4 Rank Up Rank Down
May 4, 2012
This idea horrifies me, but only because I'm an admitted geriatriphobe. I do not want my children anywhere near old people. But now that I think about it, it may be that old people are so horrible because of the poor treatment they receive, and not because they're inherently horrible.

Somewhere close to 85-95% (wild guess) of the old people I know (and I'm talking the 75 crowd, not the 60-75) are such horrible people that the best thing they could do for society is die as quickly and quietly as possible. But I admit that it could be because they're shut away and people like me really want nothing to do with them.

Medical science is doing us a disservice by prolonging life without improving quality of life. Maybe Scott's idea could change this.

I know that barring cardiac arrest or trauma I'll probably be that old someday, but I intend to opt for cybernetic conversion. Failing that, cryonics. Failing that, suicide.
+12 Rank Up Rank Down
May 4, 2012
Scott, did you notice you have an inherent conflict of interest in the business model? A long-term care insurance provider is incentivized to take steps to ensure their profit by finding ways for their residents to die quickly. Like an annuity, the longer the policyholder lives, the less money the organization makes so the hope is for a quick demise of the annuitant.

Also, from an economic standpoint, anyone can design the perfect long term care facility filled with fun, activities, and stimulation. Problem is the cost of running such a facility that few care providers have found a solution to and many retirees don't think far enough ahead to ensure their retirements are well-funded.
May 4, 2012
I can see the headline "Scott Adams supports putting Seniors on drugs" or some such 8-}. Also - it may be naive to think that even pot can be given to seniors indiscriminately without creating more health issues (i.e., it may be good for some, bad for others).

Also - Why should it be run by a long-term-care insurance company? Why not a funeral home? They have the same conflict of interest :-).

Reading the first part, I thought you had some idea to keep Seniors feeling productive and active (or at least, keeping their minds and bodies active). Adding bright colors and the latest technology to a lonely cell won't improve it at all. The day care and animal ideas aren't new.

I like the self-guided chairs - there's probably a business opportunity there. But otherwise Scott, though I'm usually a fan, I think you had an off day (don't sweat it, we all do).

May 4, 2012
On a somewhat related topic, assuming you are less than 60 years old now, how would you react if you learned that you were definitely going to die when you hit, say, age 79? Would it fill you with dread and a sense of loss; or would it be liberating - knowing that you only had to work out your finances to make it that far, and that you weren't going to linger on forever in a slow death?

And what are the social ramifications if a significant percentage of people would take that deal?
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