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A recent study said that more than 70,000 Americans are over 100 years old and that one-third of them were still driving. What those folks represent is the statistical "long tail" of the bell curve that represents how long the average male and female will live beyond 65.

Former President Bill Clinton, in a speech at the MPSF Speaker Series in Oakland this month, identified one of our country's greatest financial challenges when he cited the high proportionate cost of health care spent on just the last few months of life. At the rate we're sliding down life's mortal coil, we baby boomers will soon be costing our children a bundle. Anyone curious as to why this is the case can read Atul Gawande's best-selling book, "Being Mortal," to find the answer.

Gawande, a Boston surgeon, offers a compelling argument for a more quality-of-life emphasis on the last years of life. Instead, modern medicine has turned the process of aging and dying into "medical experiences, matters to be managed by health care professionals." The book tells a number of stories illustrating the extent to which seniors, as very ill patients, and their family members are ill-equipped to make informed decisions about end-of-life treatment. Doctors have yet to be trained to have an arrow in their quiver that can make them effective at telling patients what the latter are reluctant to want to hear.

In an hourlong documentary on PBS, Gawande leads us through a series of real-life instances of patients coming to terms with their deaths. It is difficult to watch, but it conveys a powerful message of how important these decisions can be. In the end, many people are better served by making decisions that enhance their quality of life rather than their length of life. In too many instances, the medical community is geared toward fixing problems and curing people -- even if for just a few days or weeks.

Ending life in a nursing home is within the reach of every American either through one's own resources or through state welfare programs, so this expectation has become the norm. Only recently have we developed alternative concepts such as independent living and assisted living. An advantage of these alternatives is that they relieve the senior citizen and family members from having to make the decision to move from one status to another. What may seem like too many requirements regarding capabilities and behavior qualifying one to remain in their chosen location can be a godsend to family members. Otherwise, they would be on their own to quantify what changes in condition would call for a more restricted life for a family member. Everyone wants to enjoy their independence indefinitely, and giving it up can excruciating.

The problem for retirees has to do with money they may have budgeted for retirement based on an average life expectancy. Unfortunately, the averages don't apply to single individuals. The bell curve for some resembles the landing of a ski jump with a long, flat run-out. While the median age of death for males and females age 65 is 84 and 87.5 respectively, there is an 8.2 percent chance that a male will live to age 100 and a 4.4 percent chance that a female will live that long as well. The probability that at least one of two spouses will live to 100 is 12.2 percent.

So, there's more than a 10 percent chance that a typical baby boomer will have more than 35 years to contemplate end-of-life expectations and make them known to physicians and family members. "Being Mortal," offers a blueprint for these difficult, substantive discussions.

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