A melting pot of senses comes to mind when I think of my mother. The faint smell of hospital disinfectant clinging to her uniform. Sunlight catching the nurse badge pinned on her maroon, felt-fabric shoulder lapel. Our muffled laughter, hesitant to wake her up as she slept off her nightshift. She would recall stories about her student nursing days in Pietermaritzburg, vividly recounting tales of babies being delivered in Soweto’s Baragwanath hospital. In the height of apartheid, my mother’s nursing qualification was our golden ticket into America. She worked as a labour and delivery nurse, an antenatal class teacher, a doula and a home-visit nurse to Spanish immigrants in her community outside of Washington DC. Without hesitation, she conversed in her broken Spanish to the grateful new-mothers. My mother’s identity was her work. For her being a nurse, caring for new mothers and infants was her calling.
I don’t think she ever imagined a day when she would not work. But the process was gradual until it hit a climatic end. The gradual process started with her needing a hip replacement. While in hospital, my mom contracted a bug and her recovery took longer. She experienced a lot of pain. When she was discharged, it turned out that the surgery had not been a complete success. The length of her legs was now uneven. She had been scarred; emotionally and physically by the ordeal to even contemplate having surgery again. She needed to get back to work, and she did. She got corrective shoes. She hustled unevenly along the hospital corridors and struggled up flights of stairs with her heavy bag and scale to weigh American-born babies of mothers from central and South America. She loved her work, it gave her purpose. But her body, her physical and cognitive health were starting to hold her back.
Although my mother’s story is personal, she is not unique. Many people believe that they will continue doing the work they love. But in her early 60s, her ability to continue working was beginning to be impaired.
In today’s culture of longevity, there is a misconceived notion that we will all have the ability to continue working well into our 70s, 80s and even 90s. However, there is a discrepancy in how well people age. Our health and well-being in older age are dependent on factors such as our level of education, income, the neighbourhoods we live in and yes, our professions.
As a nurse, my mom had to transfer patients from one bed to another. When she got home after her 12-hour shift, she would complain that this was taking its toll. Her body was her vehicle of income. So although her work was physically taxing, she felt compelled to push through.
Can you imagine what it must be like for a person working on a construction site?
People who enter into labour intensive jobs are at greater risk as they age. Nursing may not necessarily be a blue collar job, but it is physically demanding and unfortunately does not pay well. Professionals in low paying/physically demanding jobs are vulnerable. Vulnerable to not having the physical capacity to continue working within their chosen profession as they get older. Vulnerable, because, having a low income means that they most likely do not have sufficient retirement savings to buffer a long retirement.
This is where the notion of an enforced retirement age becomes complex. Many countries, particularly in the Northern Hemisphere, are trying to put in place strategies which deal with a swelling ageing population. Pushing out the retirement age, from say 65 to 70 as a way to ease the dependency ratio. But this is not a one-size fits all solution. Not all older people are experiencing the same levels of health and well-being. By pushing out the age of retirement, my mom would be put at risk. Her compromised health impacted her ability to earn an income as a nurse. If the age of retirement were increased, she would have experienced a protracted period before she would have been eligible to access social security.
It is understandable that policymakers and Joe-public find this whole retirement/longevity thing confusing. Surely if we are all living longer, then we should be working longer? However, as Jim Fries and his colleagues at Stanford University point out, we are basing our understandings on the wrong metrics. Thinking of retirement in terms of modern-day perceptions of longevity is a misconception. And that is because we are basing our perceptions on life expectancy from birth. As the graph below shows, life expectancy rates from birth have increased quite significantly. However, for those who already made it to 65 years old, their life expectancy in the same period of time only increased by 4.7 years. The reality is that the longevity gains for those over 65, has been slow and may even be stagnating.
Figure 1: US expected age at death from birth and from age 65, 1950–2007.
Over the past 20 years, our life expectancies have increased but the number of years we have lived in good health has lagged behind. The graph below illustrates that although real life expectancies have increased, there has been no real improvement in the quality of life in our later years. So if you have maxed out your healthy life expectancy, it is going to be difficult for you to remain a productive member of the workforce.
Figure 2: US life expectancy compared to healthy life expectancy 1990 – 2010
How a person enters retirement has a massive influence on their well-being in retirement. Involuntary or forced retirement has shown to have the most negative effect on life satisfaction. Likewise, the adverse repercussions of having no pension or an unfavourable pension fund and of course, having to stop work due to ill-health. People who can no longer work because they are not well enough, not only have a negative association to retirement but they also assess their financial situation as less adequate than those in better health with the same income level. They say that attitude is everything. If these are the attitudes you are taking into retirement, it doesn’t bode well for your golden years.
Needless to say, my mom struggled when she entered retirement. It was tough. Tough on her, tough on me and my sisters who felt so helpless living so far away and especially trying for my brother who was her closest support. My mom now lives in Brooklyn. She has Dementia and lives in a care facility. It’s not an ideal situation, but she is closer to my brother and his family and we know that she is receiving the care that her condition requires.
Unfortunately, my mom’s entry into retirement was influenced by all three of the factors mentioned above. I’m not sure what could have been done differently. If she had a chance to do it all over again, I wonder what she would have changed? It is not something that I can ask her now. But what I do know, is that I will be forever grateful for the influence my mother had on me with regards to her passion and the commitment she showed to her work.