LTC Bullet:  Thriving After 55

Wednesday July 26, 2000


LTC Bullets Book Review: Henry C. Simmons and E. Craig MacBean, "Thriving After 55: Your Guide to Fully Living the Rest of Your Life," Richmond, VA: PrimeDynamics, 2000. (For more information on the book and its authors, see

Thriving After 55 is a welcome addition to the literature on "new aging." Authors Henry C. Simmons, Ph.D. and E. Craig MacBean emphasize that aging is a process for which one can plan according to one's own dreams, expectations and resources. Better to face the reality of aging sooner, they suggest, rather than "too late."

A unique section in the book outlines five major responses to old age with the pros and cons of each. For example, many people wish to live out their retirement and pass away in their own homes. While they may be thinking of the investment they have already made in making their house a home, have they thought about the need to make modifications as they become physically or mentally frail? How about the ease or difficulty of getting social and health services in the neighborhood? The authors also address the scenarios of family care, retirement communities, alternative group living, and relocation with similarly clear-eyed savvy. It is refreshing to have such clarity applied to long-term care financing in the following chapters of the book.

Regarding taxpayer-paid programs: "While there is a growing population of people who are no longer capable of functioning independently in the world and while these people have a high need for both health care and support services, neither Medicare nor Medicaid was designed to respond to those needs." (p. 148)

Regarding the artificial impoverishment of Medicaid planning: "Even ignoring whether this in an ethical thing to do, it is not a painless strategy. Impoverishment is impoverishment, and most people don't want to arrive at the end of their lives either broke or dependent." (p. 155) Simmons and MacBean debunk the "Robin Hood" myth of Medicaid planning, i.e. robbing the rich to help the poor, by noting that "the government has no money of its own" and "Robin Hood had to live in the woods," referring to the undesirability of Medicaid-funded care. (p. 157)

Thriving After 55 encourages private financing of long- term care and includes summaries of options such as home equity conversion (e.g., reverse mortgages), restructuring life insurance, and private long-term care insurance. The authors give sound advice regarding the role of adult children in planning and paying for long-term care policies. Being "financially in-between," they say, "does not rule out LTCI; rather it calls for a lot of honest conversation, good counsel, and some creativity." (p. 180)

Creativity and flexibility are the themes in the authors' final chapters on how to thrive in body, mind, heart and soul
--after 55.