The following is a conversation between Jim Firman, President and CEO of National Council on Aging (NCOA) and Denver Frederick, Host of The Business of Giving on AM 970 The Answer WNYM in New York City.
Denver: One of the most underreported stories is the aging of the population, not just here, but across the world. It is rarely discussed and is an issue that not only individuals are failing to prepare for, but so are their governments. An organization that has been focused on it in the US since 1950 is the National Council on Aging or NCOA, and it’s a pleasure to have with us their President and CEO, Jim Firman.
Good evening, Jim, and welcome to The Business of Giving!
Jim Firman
Jim: Thank you. I’m delighted to be here.
NCOA has been working for the last 75 years in communities all across America to help older people be healthier, more secure, and to live independently.
Denver: So, for listeners not familiar with NCOA, share with us some of the history and mission of the organization.
Jim: NCOA has been working for the last 75 years in communities all across America to help older people be healthier, more secure, and to live independently. We’re a respected national leader and a trusted partner for helping people to navigate the hazards and vicissitudes of growing older. We partner with thousands of community-based organizations, government, and businesses to provide innovative community program and online services, and policy changes that can lead to a better world.
Denver: Thank goodness, because I found it startling to realize that two-thirds of the people who have ever lived to be 65 years of age are alive now. That’s incredible.
Jim: Yes. There is an unprecedented gift of longevity. We’re living much longer than our grandparents did, many more of us, not only in the US but all across the world. But with this extra gift of time come some very serious challenges as well.
Denver: Now, on average, how much longer will someone who’s 65 years of age now live to?
Jim: Roughly 20 years.
Denver: Wow. Jim, in what way does NCOA differ from AARP?
Jim: We differ in several ways. AARP focuses on everyone over the age of 50. We focus more only on people over the age of 60 who are struggling today, who are at significant risk of struggling, and unfortunately, there are a lot of those people.
AARP offers many different programs and services for the 50-plus market and sells health insurance and financial services. We are a 501(c)(3) charity focusing on developing evidence-based solutions that really make a difference in people’s lives, and bringing them to scale nationwide.
Many people think they have enough money to retire, and they won’t.
Denver: What are some of the common misconceptions that people have about retirement?
Jim: Many people think they have enough money to retire, and they won’t. In fact, it’s startling. As we’ve looked at the analyses of the population over the age of 60 in the United States, basically, 20% are underwater right now. They have almost no assets, or they’re in debt. And surprisingly… they’re the younger group; people who are retiring now are less well-off than people 10- or 15 years ago.
The second group is almost certainly going to run out of money before they pass away because they’ve got maybe $25, 000 or $30,000 in assets, and out-of-pocket healthcare costs and other things make it difficult. So we look at it and say 2 out of 5 are pretty likely to run out of money before they pass away. And then there’s another big group that will probably be okay unless they have a catastrophic health event or need nursing home or long-term services and support.
Denver: So there’s a lot of fragility in that system that you just described. Are people taking full advantage of all the benefits that might be available to them?
Jim: Not even close. There’s at least $50 billion in benefits that people are eligible for and not receiving. This is something that we’ve been doing a lot of work on, and we have a solution. But government, federal legislators or state legislators think they solve a problem when they pass a law, providing a new benefit to help pay for food or healthcare or home energy assistance or weatherization, but there are major barriers in connecting people to what they’re entitled to.
Denver: How do you help them do that?
Jim: We have a program called BenefitsCheckUp.org, which has helped millions and millions of people connect to more than $30 billion in benefits, and we’ll continue to grow that program as the need grows as well.
Denver: Is it a free program?
Jim: It’s free, confidential, 24/7 for anywhere in the country, and we hope and encourage your listeners to take advantage of it.
Denver: Let’s talk about Medicare. Boy, there’s so many choices that you can make with all that supplemental insurance and things of that sort. How can we go about navigating that system?
Jim: Regardless of whether you’re wealthy or on a fixed income, pretty much everybody has access to Medicare, but what you do with that choice is where the rub is. Many people are not able to make informed choices, so they just guess about a plan, and they typically will pick a plan that’s not the best plan for them.
And so, what we’ve tried to do is make it easier for people to go to a trusted source, to places that are not getting paid different compensation or to steer you to different things. That service was called MyMedicareMatters.org. It helps you to navigate and decide what kind of insurance is best for you and to find the plan that works best. The thing that people need to know is you may have made the right choice when you’re 65, but chances are when you’re 68 or 72, that that plan may very well not be the best plan for you anymore.
Denver: That’s a great point because I think we just go on automatic pilot and renew it every year without even thinking about it, and we do need to think about it, I gather?
Jim: People are afraid to make mistakes so they don’t do anything, but inertia is quite often a mistake in itself.
Denver: So I was speaking to someone the other day who just was promoted to becoming a manager. And she said to me that when you become a manager, her company just thinks she knows how to manage automatically without any kind of training. In listening to that, I found it to be a little bit analogous about what it’s like to grow older, that people just assume that we know how to grow older and can handle it. But that isn’t really the case, is it?
Jim: No, that’s really an insightful point. If you think about it, there are a couple of major transitions in life. The first transition is from youth to adulthood. Well, what do we do? We have elementary school, high school, college, Girl Scouts, Boy Scouts, YMCA, religious organizations – all sorts of institutions prepare people for that first transition in life to become a responsible adult. What do we have to help people prepare for this next transition from full-time work into what we now call retirement? The answer is nothing. No institutions, no curriculum, no real ideal of how to age well.
So, somehow, we have 80 million people who are, just in this country, struggling with this issue – what does it mean to age well? – and then there aren’t the resources and tools and even the science to do it well. So that’s a tremendous white space. I recently spoke to the presidents of many colleges and universities telling them that I thought there’s a tremendous opportunity to create long life education, education for the age of 60 to 100.
Denver: And you do have a program that helps address that, don’t you?
Jim: Yes. We have a program that we’re very proud of called the Aging Mastery Program, which is a fun and engaging education and behavior change program. It’s a classroom experience, and it covers 10 topics, and it’s taught by facilitators with guest speakers and videos. It’s currently being offered in 600 locations across the country.
When people graduate from this program, they’ve set goals for positive actions because it’s much about behavior change and learning. They’re exercising more, eating better, have better handle on their finances, plan for the future with advance care plans, more engaged in communities, and better and healthier relationships. These are all aspects of growing older, which we need to learn how to do this.
The results are very encouraging. The studies since 2013 have showed significant increases in social connectedness, physical activity, healthy eating, use of advance care planning, greater participation, and many other healthy behaviors, as well as an understanding – and I think this was really one of the keys of the program – is that we’ve been given a gift of time, and like any gift, you should be grateful for it, and you should spend it wisely.
There are undoubtedly challenges and aches and pains that come with growing older. There are undoubtedly things we can’t do as well as when we were younger. But we are here, and we have a gift, and we either will appreciate it and spend it wisely, or we’ll do what unfortunately most people do – spend about nine hours a day sleeping or trying to sleep; and eight hours a day in leisure, mostly watching television or on computer screens; and probably on average, less than an hour a day doing things that are good for themselves, or good for others. We hope to change that paradigm through the Aging Mastery Program.
Denver: Good for you. One of the ironies about turning 65 and beyond is that you actually have more choices to make then than you did earlier in your life. Would that be the case?
Jim: You have many more choices. I mean, you think about it, most people, they’ll decide maybe if they’re going to go to school, adopt a trade? Are they going to get married? Not get married? Buy a house? Don’t buy a house? And maybe a few career choices.
When you retire, you have this almost blank slate. You have all of this unstructured time – most people do – and what you do with it and how you spend that time is really up to you. Really, the question of meaning and purpose comes in in a significant way. Most people who are younger don’t think about meaning and purpose, and they don’t need to. They’ve got a mortgage to pay; they got kids to raise; they got parents to take care of; they got a job to go to–
Denver: Yes. On the treadmill.
Jim: –all of those things. A lot of those things, by the time you turn 65, those aren’t there anymore.
And so, in this society, it’s not obvious what you should be doing; it’s not automatic what you should be doing, and you almost have to be very intentional about discovering your purpose and acting to achieve it.
The worst aspect of ageism is lack of expectation.
Denver: You just said a moment ago, you’re not particularly fond of that word “retirement,” but instead prefer “graduation.” Explain.
Jim: There’s been a lot of talk about ageism in this country, and it’s a real phenomenon. Older people are dismissed. They’re not valued. It’s harder for them to get jobs. But I don’t think older people are the victims of ageism; I think we are the cause of ageism. And by that, there’s a guy named Wes Moore who’s now the President of the Robin Hood Foundation, who wrote a wonderful book on racism, describing his experiences and others in Baltimore, and he said the worst aspect of racism is lack of expectation.
The worst aspect of ageism is lack of expectation. I’ve been through dozens of audiences and thousands of people, and I’ve stood up and said, “What do we expect of people over the age of 65?” And I get no response. The reality is we have this phase of life for which there are no expectations. There’s no sense of any responsibility other than “I’m supposed to do whatever I want to do,” and that’s a terribly destructive idea, especially if you’ve got 20- or 25 years of life left as opposed to when my grandfather retired at 65– 50 years ago – he was forced to retire, by the way – but he would have about six or seven years of good health left.
So my belief is that we need to retire the word “retirement,” which is all about moving away from, and think in terms of “graduation.” You’ve been in training all of your life for this moment where you’re no longer perhaps going to work full time – how are we going to use all your skill and talent and connections to continue to make the world better in whatever way is meaningful for you?
So people should be thinking about graduating much in the same way that college students are. You’ve been prepared. You have all this experience. Now is your opportunity to do what you really do well and enjoy. And that could include taking up a new hobby, painting, learning, teaching, et cetera, but it should also include continuing to make a difference in some way to make the world better – whether it’s one person, your neighborhood, your community, or the country.
Denver: I think the average retirement age, if I can use that term, is now about 63 years of age. Do you think we need to rethink the concept of work?
Jim: Yes. I tell my…I have several millennial children, and I say, “Take your time to figure out what your career is going to be or what you really want to work at because you should probably think about working to 75 or 80.”
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We have this very weird construct in this country and around the world that the purpose of the first phase of life is learning. The second phase is work. And the third phase is the pursuit of leisure. It’s really a terrible idea. The real question should be: What’s the right mix of learning, work, and leisure at any given point in time?
So I think it would be really helpful if we had more time off, more leisure in our middle years, but also realize that we should continue to work, perhaps not full time, part time; perhaps not in the same job; if you didn’t like it, definitely not in the same job. But we should be thinking about ways to phase down working instead of stopping work.
Denver: That makes all the sense in the world because we have a construct that is outdated, and everything else around us has changed, particularly the lifespan, yet we still have the same construct that we did in the first half of the 20th century.
Jim: Well, even 65 from — Bismarck in about 1855, it’s a very old construct that still drives a lot of policy.
Denver: I saw somewhere that the lifespan of an Israeli man was like 13 years longer than it is of an American guy. That’s really simply astounding. What are some of the factors that contribute to this incredible differential?
Jim: That’s a fascinating topic; in fact, I went over to Israel just to learn more about that difference. And as we peel back the onion, there were four factors that contribute to most of it.
First of all is universal military service, which means that most people, at least between the ages of 18 and 20, are in good physical condition, and many of those people continue those habits well throughout their lives.
Denver: That’s a great point.
Jim: The second is universal health care, so people don’t have undiagnosed, untreated conditions which become exacerbated. The third is that people in Israel literally eat the Mediterranean diet – fresh foods, vegetables, not a lot of red meat, and not a lot of processed foods as well – so they’re healthier. And then the fourth is…I’m 68, so when I went around and met with other people…the topic naturally comes around to grandchildren. And I said, “How often do you see your grandchildren?” And the answer is either every weekend or three or four times a month because the furthest you can live away in Israel is 200 miles, and people live 30-, 40 miles from their grandchildren at most, so there’s a much greater sense of social connectedness.
So when you put those together – staying physically fit, eating better, good access to health care, and strong social connection – those really are key parts of the formula for living well.
Denver: Let’s turn our attention to public policy. What are some of the changes that your organization is advocating for that would really improve the condition of people as they age?
Jim: There are many policy changes that we think are important. The first is to Medicare. Medicare has holes in it. Medicare doesn’t pay for hearing aids and vision. It doesn’t pay anywhere near enough for preventive services, and it doesn’t pay for long-term services and support. So, Medicare, the basic program needs to be improved and strengthened.
We also have to recognize under Medicare that much of what people need to do to stay healthy has nothing to do with the doctor and the hospital. It has to do with behavior change. The things we just talked about – eating well, exercising, managing stress, taking your medication – so that we have to shift the system from paying unlimited amounts of money to keep people alive for another three days, and much more of a focus on helping people stay healthy in what now is called the social and behavioral determinants of health.
We also need to fix Social Security. Social Security has not been touched since 1982 with Tip O’Neill and Ronald Reagan. It’s a simple math problem, but we haven’t had the political will to do it.
And then I think we really have to figure out how to encourage people to work longer – whether it’s paid work or community service, whether it’s helping children or helping older adults who need help – but we need to shift the paradigm and find ways to encourage people to be more active, contributing members of society for as long as possible. And that’s why even things like putting hearing aids in Medicare matter because you can’t be an active contributing member of society if you can’t hear, and 30%, 40% of all the people are walking around with untreated hearing loss.
Denver: Those are all great points because I think we all know, even from our own families, that you have to have purpose and a reason to get up in the morning, and you take that away, and sometimes you don’t know whether it’s Tuesday or Thursday. That structure really provides, I think, a vitality.
You had an objective at the start of this past decade to improve the lives of 10 million seniors by 2020. Now, you not only met that goal, you got there early. Congratulations!
Jim: Thank you.
Denver: So what is your target for 2030?
Jim: We set a goal – and we publicly announced it – to make meaningful, measurable improvements in the lives of 40 million older people by 2030.
Denver: Four times.
Jim: Four times. Well, because we’re social entrepreneurs, we’re a mission-driven group, and we love great challenges as well as the great satisfaction that comes from really making people’s lives better.
Denver: And you have a nice corporate partner in this, don’t you?
Jim: Yes. We work with a variety of companies nationwide – Anthem, Walmart, and others. And that’s part of what we realize is in order to have a 4X increase in performance, we can’t do it alone.
Denver: No, you have to plug into established lines of communication. It’s the only way you can get it done.
Jim: And partnerships, both business…We’ve always had a robust network of community partners, but we all have to work together in order to make a difference in the world.
Denver: To make that meaningful difference in 40 million lives, how do you go about measuring that?
Jim: We’re very serious about measurement because without measurement, it’s just all stories and it doesn’t matter. We’ve set specific targets. In terms of economic improvement, we need to help a person improve their economic status by at least $1,200 a year, and our average is closer to $3,500 a year, which, if you’re on a fixed income, is a big difference.
Denver: Adds up.
Jim: In the area of health, we participate in evidence-based programs that have been proven to improve health outcomes. And the third area right now is actions, services, or policies that enable people who would otherwise be in a nursing home to live in the community.
Denver: Do you ever take a look at qualitative data?
Jim: Yes. We certainly listen to that a lot because we think at the end of the day, what people think about their situation, how they evaluate their own well-being is equally, if not more important than some of the more “objective” measures.
Denver: Generally speaking, Jim, have you noticed a difference between how men and women approach retirement in this phase of their lives?
Jim: Yes. I think there are different challenges for them. I think women are more likely to be economically insecure, and if they’re not married, or if they’re a widow, then that makes it worse. So they’ve got the financial challenges in particular. I think for men whose lives are centered around work, the loss of identity is a significant issue as well. But everybody faces the health challenges that come with these things.
So, we at NCOA, in the 40 million that we’ve committed to helping, we have extra high targets for women, minorities, people living in rural communities, and LGBTQ population because we know that they have additional challenges.
Denver: Yes. Added burdens.
Speak a little bit about your philosophy of leadership, maybe some of the influences in your life that helped you, shaped you as a leader, and maybe a lesson or two or two that you’ve learned along the way that have served you well in this role.
Jim: I’ve had the privilege of seeing in action older people, people in their 70s, 80s and 90s, who have continued to do good. My mentor was a fellow named Arthur Flemming who was a wonderful public servant. He was Secretary of HEW under Eisenhower, the president of three universities, the head of the Civil Rights Commission and the Council of Churches, and many other organizations.
Denver: He did it all.
Jim: He did it all. He was a quiet, behind-the-scenes guy, but he really did wonderful work. He was a mentor of mine. Esther Peterson, the consumer advocate was a mentor of mine. If you don’t mind, I’m going to tell you a story about some mentors, and I don’t know if you can use it, but I’m going to tell you the story.
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I’m 68 now. When I was about 40 years old, I was the CEO of a group called the United Seniors Health Cooperative in Washington D.C., and I had a board of directors comprised of all their people, some of whom were very accomplished people. Once a month, we’d have a breakfast meeting, business meeting of the board. And one day after the meal was done, we still had some time, so I looked at all these people in their 70s and 80s and early 90s, and I said, “Okay. I’m going to ask you: what is your secret to vital aging or aging well?” And I looked around the table, and three of them had bacon and eggs, and two of them had eggs benedict, so it wasn’t necessarily what they were eating.
Denver: It wasn’t diet.
Jim: But I got this two-minute seminar on aging well. The first person was a gentleman named Wally Campbell, who was the founder of Care International. He said, “The key to aging well is to have a purpose larger than yourself.” The next person was Esther Peterson, the consumer advocate under Kennedy, Johnson and Carter, and she said, “Each night before I go to bed, I ask myself ‘What did I do today to help another human being?’” The next person was a gentleman named Roger Egeberg, who was a General MacArthur’s aide-de-camp and then was the Secretary of Health under Nixon, and he said, “Every day I stop to notice something small and wonderful, like a flower or a child laughing.”
And then Dorothy Height, the founder of the National Association of Negro Women was there and she said, “Have a dream, and live it every day.” Then the next gentleman was John Pickering from the law firm Wilmer, Cutler & Pickering, the head of the ABA Commission on Law and Aging, and he was in a cast and he said, “The key to vital aging is: Don’t fall down.”
And the final person was Arthur Flemming, who was at that point 88- or 89-years-old, very frail with a cane; every time I would be on a podium, I’d worry that he wasn’t going to be able to get up there, but then when he got up there – he was a former preacher – the light would come down, and he would have to…and he said, “It’s really simple – it’s to keep going.”
And those lessons really inspired me. The sense that we should have a purpose larger than ourselves. We should have a dream. We should make sure we’re helping people each day. We’re noticing something wonderful. We’re doing what we can to prevent injury, and don’t stop. Keep going.
…we all should be dreaming, and we should all recognize that we want to contribute to a better world…It’s all part of why we’re here, I believe, is to keep making a difference in the world; and that’s what gives life richness and meaning.
Denver: Quite all right. Thirty years ago, and you remember it like it was yesterday.
Jim: I do remember it like it was yesterday. And then I’ll mention one more quote I read more recently, it was an autobiography by Shimon Peres, one of the founders of the State of Israel. And he said that: aging is really a state of mind, and that you’re young when your dreams are greater than your past accomplishments, and you’re old when your past accomplishments are greater than your dreams. And he said he thought the key to aging well is to remember that “we are as great as the cause we serve and as young as our dreams.”
And I just love that quote because we all should be dreaming, and we should all recognize that we want to contribute to a better world, and that could be being part of a cause. It could be taking care of your spouse with dementia. It could be reading to a little child. It’s all part of why we’re here, I believe, is to keep making a difference in the world; and that’s what gives life richness and meaning.
Denver: Well, that’s a perfect segue to my final question, which is: You have announced that you will be retiring, or should I say “graduating” here, sometime during the course of 2020. Tell us which one of those lessons you’re really going to take with you and what you have in mind as to what your third phase is going to be.
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Jim: The insight I’ve had is that this next phase of life can be the best and most rewarding time of our lives; that rather than thinking that we’re on the decline and the good parts are over, that we have a tremendous opportunity to make life wonderful, rich and meaningful. That doesn’t mean we’re not going to have illnesses. That doesn’t mean we’re immortal. All those things are going to happen. But most fundamentally, we’ve been given a gift, and we should really make the most of this. And for me, that continues to serve the great cause of helping millions of people to age better and…. living the dream. And for me, that will be creating new and exciting ways to help billions of people to age better in the future.
Denver: Well, fantastic! Well, Jim Firman, the President and CEO of the National Council on Aging, I want to thank you so much for being here this evening. Tell us about that website of yours, what listeners are going to find there and how they can become part of this organization.
Jim: Well, you should come to www.ncoa.org and that’ll get you started on the variety of services and programs and ways we can help you and your community.
Denver: Thanks, Jim. It was a real pleasure to have you on the show.
Jim: It was delightful to be here. Thank you.
Denver: I’ll be back with more of The Business of Giving right after this.
The Business of Giving can be heard every Sunday evening between 6:00 p.m. and 7:00 p.m. Eastern on AM 970 The Answer in New York and on iHeartRadio. You can follow us @bizofgive on Twitter, @bizofgive on Instagram and at www.facebook.com/businessofgiving.