This Monstrously Scary Expense Will Hit 70% of Seniors: Are You Ready to Face It?

Halloween is awesome. The candy, the costumes, the opportunity to use genial mockery to take the sting out of things that actually do scare the pants off us. But before the real Grim Reaper shows up to turn you into a ghost, the odds are pretty high that you're going to pass through a major health crisis or two, or develop a chronic condition, and in the aftermath, you're likely to need long-term care. And haunted houses have nothing on the scare factor of opening the bills for that expense -- especially if you haven't prepared for it.

You can prepare though, so for this episode of Motley Fool Answers, hosts Alison Southwick and Robert Brokamp have brought in a special guest to help them guide their listeners through what they need to know about it: Dr. Jean Accius, vice president of independent living and long-term services and supports at AARP.

First, however, in the "What's Up, Alison?" segment, they take us on an illuminating review of some highlights from Sears' (SHLDQ) impressive and even noble life as an American retail icon. And it's worth the tour, because the company's decline into Chapter 11 bankruptcy has been so long and dismal, many of us have forgotten just how powerful it once was. Investors of all stripes will want to pay attention to this history lesson.

A full transcript follows the video.

This video was recorded on Oct. 23, 2018.

Alison Southwick: This is Motley Fool Answers! I'm Alison Southwick and I'm joined, as always, by Robert Brokamp, personal finance expert here at The Motley Fool.

Robert Brokamp: Hey, Alison!

Southwick: Hey, Bro! We have a special guest here, today. It's Jean Accius and he's from AARP. He's going to help us better understand the looming concerns of long-term care that are facing all of us. [Sighs] All that and more on this week's episode of Motley Fool Answers.

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Brokamp: So, what's up, Alison?

Southwick: Well, Bro, to paraphrase King Solomon in the Book of Ecclesiastes, there is "nothing new under the sun," and a fantastic example of this is Sears in light of the recent news that it filed for Chapter 11 bankruptcy. And you've probably seen about a million articles about the death of Sears, thanks to Amazon (AMZN -1.14%).

But today I'm going to share with you a few ways that Sears was the Amazon before Amazon, and I'm going to crib a large amount of this from Dylan Thompson's article [yes, Rick, from The Atlantic], titled, The History of Sears Predicts Nearly Everything Amazon is Doing, and also another one on Investopedia called Who Killed Sears? The answer is all of us. So, let's get to it!

Like Amazon, Sears began as a convenient way to shop from home and have stuff delivered to your door. As Dylan Thompson writes, "Mail was an internet before the internet," and because of it people were able to shop at home through catalogs and have things delivered to them thanks to the rise of mail, and trains, and all these wonderful things that helped us communicate.

So in 1845, Tiffany's Blue Book was the first mail order catalog in the United States and in 1872 Montgomery Ward had their first mail order catalog. So when it was founded in 1892 [Sears, that is], some 40 years after Tiffany's Blue Book, it was not the first mail order company, but it went on to become the biggest. In fact, in just the first 13 years of Sears' existence between 1892 and 1905, Sears' revenue grew by a factor of 50 from about $750,000 to about $38 million. First 13 years.

Like Amazon, Sears started off selling one thing... watches [not books]... and then went on to sell everything. Sears eventually had an unrivaled range of products. Only two years in, by 1894, the Sears catalog had grown to 322 pages, featuring sewing machines, bicycles, sporting goods, automobiles; all sold for a minuscule profit. Sounds familiar?

Brokamp: Yes.

Southwick: If Amazon thinks they can sell everything, Sears really went on to sell everything including kit houses, mortgages from Coldwell Banker, insurance through Allstate and, of course, anything you'd want to put in that house. Oh, and just charge it on your Discover card, because yes, Sears owned that, too.

Brokamp: And let's reemphasize. You could buy a house through Sears. From like the first house...

Southwick: And a car. Yeah!

Brokamp: ... like the pieces of the house would be shipped on a train and then you would hire contractors to put it up, although in the early 1900s you just got your friends and family to do it.

Southwick: Yes, your adorable little Craftsman house, which in the D.C. area now goes for like $3 million.

Brokamp: Right, and back then they were selling them for like $2,000.

Southwick: The Sears catalog eventually hit over 1,000 pages and was known as the Consumer Bible. Also according to Investopedia, it was often used as toilet paper. Like Amazon, Sears put small-town retailers out of business. Before Sears, most farmers relied on the local country store for buying everything, often at steep prices, a very small selection, and at a high rate of credit. And here comes Sears with a massive catalog of goods at an upfront, cheap price and it's delivered to your home. Good-bye, general store!

Here's a fun bonus. As The Washington Post writes, "Because Sears was a mail order company, it was also able to help African-Americans living under Jim Crow laws purchase things without having to face racism at the general store."

So in the South [and probably all over], African-Americans going into stores would have to deal with price gouging, getting really bad terms on credit, or just straight-up awfulness. Like if there was ever a white customer in the store, they would ignore the black customer until all the white customers were served. The catalog gave them anonymity. The catalog didn't care if you couldn't spell things correctly. The catalog didn't send you poorer-quality goods because of the color of your skin. Suddenly I feel a lot better about catalogs.

Like Amazon, Sears eventually moved into bricks and mortar. In the 1920s, Sears decided to start selling out of storefronts. The first ones were opened up in existing mail order warehouses. At the start of 1925, there were no Sears stores in the United States, but by 1929 there were 300. At one point of growth, they were opening a new Sears department store every three days. So what caused the move to bricks and mortar? Do you want to guess?

Brokamp: I don't know.

Southwick: The car. It made it easier for people to travel longer distances and they didn't need to rely on a catalog. The stores they opened in the 1920s outsold the catalog by 1931. Revenues totaled $180 million in 1931, by the way, which is roughly $2.8 billion [today].

Of course, Amazon went on to buy Whole Foods with its 400 grocery stores and has roughly a dozen physical bookstores and just announced a partnership with Kohl's (KSS 4.53%) to allow returns at their locations.

Like Amazon, Sears was the juggernaut in retail of its time. Sears went public in 1906 with a stock placement of $40 million, which is about $1.1 billion today. That same year it opened a 40-acre logistics center in Chicago. According to the Sears corporate website, Henry Ford, himself, made a pilgrimage to the "seventh wonder" of the business world to learn about the company's storied efficiency. It had an elaborate series of belts and chutes to deliver packages through the assembly line and messages in between departments were delivered via pneumatic tubes.

Fast forward to the late 1970s and 1980s. Sears' annual revenue would reach about 1% of the US gross domestic product. By comparison, Amazon's $99 billion revenue last year, excluding [Amazon] Web Services, would equal about 0.8% of the U.S. GDP.

In closing, you can read a ton of articles about the downfall of Sears, because over the years they did a number of things wrong that maybe weren't obvious at the time. If you're interested, there are a ton of articles out there Monday-morning quarterbacking that game. Go read them. You can get all the play-by-plays.

But my lesson, here, isn't about poorly managed companies that fail. It's that all companies fail eventually.

Brokamp: That sounds like it came straight from the awfulizer!

Southwick: I know! I knew you'd appreciate that. I was reading a column this week that Kara Swisher wrote. Kara Swisher is a co-founder of Recode. She's a powerhouse tech journalist. And she wrote this column about all the aggressive, horrible bosses that she had stood up to over time [not necessarily sexually aggressive, but just like real jerks], and in it she accounts how one boss was being particularly jerky and self-absorbed]. Do you remember The McLaughlin Group? Like that guy?

Brokamp: Yes.

Southwick: She worked for him. He sounds like a real treat. In it she recounts the story where, again, he was being particularly awful and she writes, "Listen, Dr. McLaughlin, I was in Greece this summer at a temple, and there was something written on it that said, 'Babylon was,' which means every major power falls. So I took that to mean that some day I'm going to be really powerful and you're going to be in a wheelchair in an old folks home being fed apricots or something."

Brokamp: Goodness gracious!

Southwick: And apparently he laughed it off and was like, "Uh-huh." Of course, what Kara Swisher meant when she said "Babylon was" was more in terms of toxic workplaces [run] by toxic leaders. But it also holds true for businesses who, or whatever is on top, will one day topple and be replaced. Where our grandparents shopped isn't where we shop and Lord knows where our grandchildren will shop. I guess Mars. Whatever that company is, I want to buy some shares. So in closing, Sears is dead. Long live Amazon! See, I can awfulize, too!

[...]

Brokamp: What do you think of October? Visions of ghosts, goblins, and people dressed up as characters from Game of Thrones may be dancing in your head, but October is actually officially "Long-Term Care Planning Month," and covering the cost of long-term care can be a scary prospect.

But it can be less frightening with proper planning, and here to provide some advice on just how to do that is Dr. Jean Accius, vice president of independent living and long-term services and supports at AARP. Welcome, Jean!

Southwick: Hello, Jean!

Jean Accius: Well, first of all, thank you so much for having me! I'm excited to be part of this conversation, today!

Brokamp: Well, thanks for joining!

Southwick: Yeah! We're excited to have you making the trek out here!

Brokamp: If you don't mind, let's start with you talking a little bit about your life story and how you ended up on this path and having this role at AARP.

Accius: Sure. I was raised by my grandmother for the first three years of my life, so this affinity toward older adults is something that's been ingrained in who I am since my very existence.

My first job, in fact, while my friends were getting jobs working at retail stores, malls, and things of that nature; I got a job working at a retirement community. I started off as a busboy, made my way up to a server, and then eventually became the dining room manager for a retirement community in South Florida. And I said, "You know what? I enjoy working with older adults, I enjoy the environment, I enjoy hearing their stories, and also learning and benefiting from their knowledge base and their wisdom."

So I said, "I'm going to go off to college and major in hospitality." That turned into not just majoring in hospitality but also getting a master's in gerontology and then working in policy. I got an opportunity to do a lot of work on long-term care issues, both in the private sector and then working for the state of Florida for the Department of Elder Affairs doing a lot of policy work for them. That ended up opening the pathway to doing work here in D.C. and then at the federal level.

So a lot of my work has been looking at how you pay for long-term care, how we can create options for people as they age, how we can think about the systems that are in place to support people who are providing care. There's over 40 million family caregivers in this country and they need a lot of help and support.

So I'm excited to be part of this conversation; in part because this is something that we typically don't think about nor do we want to talk about, and unfortunately we have to face it when there's a period of crisis. And to the extent to which we can plan and to the extent to which we can have these conversations, the better off we will be; not just the family member but also the person who needs care.

Brokamp: Part of what's scary about it is that people see the stats on long-term care and the expenses and think "there's no way I can do anything about it, so I'm not going to do anything." Just so we can scare everyone, let's do some of those stats.

Southwick: Woo-oo-oo-ooh! Scary stats!

Brokamp: Here we go! Woo-oo-oo-ooh! So most [of the stats come] from AARP, but other places as well. The stats are, generally speaking, that about 70% of people 65 and older will need some type of long-term care. Average cost is $138,000 of any kind of care. A stay in a nursing home across the country is an average of $100,000 a year. Living in assisted living is about $45,000 a year. Adult day care of some kind is $70,000 a day, so that's almost $20,000 a year. That's an awful lot of money and when people see that they think, "There's no way I can plan for that." That's not necessarily true, right?

Accius: That is exactly correct. I think part of the issue is the fact that it is overwhelming. When you hear those numbers, depending on where you live, you can be paying significantly out of pocket.

Brokamp: For example, a nursing home in Alaska is almost $300,000.

Southwick: Wait, what?

Brokamp: Yes!

Accius: Absolutely.

Brokamp: The highest state in the country.

Accius: Absolutely. When you hear those numbers, you don't know even where to start, in part because of the fact that we don't necessarily have a long-term care system that is actually person and family centered. And what I mean by that is the fact that the person and the family are in the center of these conversations. The cost for 30 hours of having someone come into your home is roughly about $30,000 to $34,000 give or take. And that exceeds the vast majority of what older adults can actually afford on an annual basis.

In fact, we did a study culled across the States where we wanted to put out all these numbers: the amount that it costs for nursing home care, the amount that it costs for assisted living, or the amount that it costs for home care; and one of the key findings is the fact that it's unaffordable across the country. So you do need to have a plan, and the question becomes what that plan exactly looks like.

There are four factors that typically impact long-term care cost. One is exactly where you live. Where you live matters significantly. The other is what type of care you need; whether that's nursing home care, assisted living, or home care. Whether it's moving into an age-restricted active adult community or a continuing-care retirement community. Whether it's assisted living or whether it's adult day care to provide you with some support during the day. The third aspect of this is how much care you actually need and then, of course, for how long. So all of those four factors impact some of the cost that you're hearing in terms of some of these staggering numbers.

But there are things that people can do. We know that of the vast majority of people -- and you can think about yourself -- as you age, where would you like to receive care? And oftentimes it's in your home and in your community. So one of the things we're encouraging people to do is that when you go home, or if you're home right now, assess whether or not where you live can accommodate your needs as you age.

And what I mean by that is [whether there are] universal design principles. And universal design features are things like whether there is a bedroom and a full bathroom on the first floor. Why is that important? In part because of the fact that as you age your ability to go up and down steps might become a challenge.

Or how safe is the actual home that you live in? Are there grab bars? Are there zero entry steps? Can you get into your home without having to take the steps in there? Are there handrails? What are some of the modifications that you can do in your bathroom? What are the things you can do to live independently for as long as possible with a sense of dignity?

And the earlier you can start that process, the better off you'll be just in terms of assessing, and then coming up with some sort of a plan. We think about what our current needs are today. But can [the homes and communities] where we live, eat, play, work accommodate our needs as we age? That's the question.

And one of the things that is extremely important for us to think about is to imagine what you want for yourself. The earlier you can start planning the more likely you are going to be able to have more choices. More options. It helps to reduce the sense of stress and the sense of being overwhelmed by some of these stats, because you have a plan in place.

And it also, to the extent that it's possible, helps you help your family, because one of the things that we're trying to do is foster these conversations so that way your family knows exactly what you want and more importantly, you're in the driver's seat in terms of executing what you actually want. That's one thing. Assess what the home environment is like.

The other thing I would encourage you to do is [assess] your community. Do you have the right community features in terms of whether there's a grocery store nearby? Are there doctors' offices nearby? Can you get to and from? Think about it. Your neighborhood is your gateway to all things in terms of social engagement. So what are the transportation options that are available? What are the alternatives if you can no longer drive? Are you able to get to and from?

I'll give you a good example of what I mean by this. When I worked for the federal government, I had an opportunity to actually do a site visit to Richmond, and I got an opportunity to talk to someone who was part of a program who transitioned out of a nursing home back into the community. Check this out. He was roughly in his early 40s. A former police officer. A tragic situation. Gun shots. Paraplegic. Was in a nursing home for quite some time.

He was able to transition out of a nursing home and was back living with his brother and his brother's wife in a beautiful home in Richmond with a beautiful lake. There were some home modifications that were done to accommodate the gentleman's needs. And [we asked him to walk us through his day].

What he said was every day there was a personal care attendant that comes in and is with him during the day, at least around 01:00 or 02:00 in the afternoon. Neither his brother nor his brother's wife come home until about 05:00 or 06:00. So from 01:00 to about 05:00 or 01:00 to 06:00 he's pretty much isolated in this home.

And he said, "Look, I may not have the physical abilities, but I still want to work. I'm mentally sharp. There's a lot I can do, but I'm having a hard time getting to and from." So we asked, "How engaged or integrated are you in the community?" He said, "Well, we live in a cul-de-sac and the public transit only comes to the entry of the neighborhood. They're not going to come to the front of the entrance." That was an issue that we had to try to resolve. Here you have someone who wants to be socially engaged and who wants to contribute and provide value, but because of the infrastructure and some of the barriers in the community, he was not able to do so.

I think it's also important to think about, as you age, what the options are in your community to support you in your aging process. What are the abilities in terms of transportation? In terms of social engagement? In terms of the different types of opportunities? We have a tool called AARP Livability Index. You can go in, you put in your zip code, and it will tell you exactly how livable your community is. That's for all ages and people with disabilities.

The other aspect of that is to understand exactly what the different types of programs that are available to support you as you age. Again, we hear the stats. It's $100,000 per nursing home care; $34,000 to get someone to come in and provide you 30 hours of care, and that can be overwhelming and, frankly, stressful.

But there's a lot of programs and opportunities at the local level that may offer services on a sliding scale. Whether that's home-delivered meals. Whether that's transportation options. Whether that's caregiver support. I would encourage you to look through your local Area Agency on Aging and find out exactly what services and supports are available for you in your community. Or if you are a daughter or a son, or a friend caring for someone who's long-distance, what are the different types of services that are available in that person's community? That's something else you can think about in terms of planning for your long-term care needs.

Brokamp: When people think of being older and healthcare needs, they think of things like Medicare, but how much can people expect from Medicare and maybe Medicaid in terms of helping with a lot of these costs?

Accius: That is a very good question. One of the biggest myths and misunderstandings is the fact that Medicare will pay for long-term care, or your private insurance will pay for long-term care. In fact, neither Medicare nor your private insurance pay for long-term care. They just don't. That's just one of the areas they don't cover -- those different types of benefits.

And when we talk about long-term care, we're referring to things like assisting you with your bathing and your dressing, your eating, your medication management. Or helping with managing finances or taking care of transportation. Some home modifications. These are personal and social support activities that you need assistance with. And Medicare doesn't cover those.

Medicaid, on the other hand, does; but in order to qualify for Medicaid you have to have limited resources. It varies by state in terms of the eligibility requirements, so it will be very important to assess what the eligibility requirements are in your particular state; but on average, you can only have about $2,000 worth of countable assets. That excludes the home, but depending on your state, it depends on the equity in your home, so there's limitations there.

I want to go back to something else that I mentioned is this whole issue about choice and why it's important for us to plan ahead and plan as much as we can with respect to long-term care, because it increases your options and it increases your choices when you actually have a plan in place.

What do I mean by that? Well, in the context of Medicaid, if you do become eligible, meaning the fact that you've met their requirements for eligibility, nursing home care is a required service, meaning that every state has to offer you nursing home care. So if you're eligible, automatically you would be eligible for nursing home care. Home and community may service this -- that means getting service in your home -- but it's an optional benefit, so they are not required to offer that and with the states that do offer it there are limitations in terms of the caps, the allotments. So in some cases there might be long waiting lists to actually get these services.

Brokamp: You talked about being in the driver's seat with this. Once you get to the point where you need Medicaid, you're no longer in the driver's seat.

Accius: Again, it really depends on where you live. It depends on where you live in the sense that some states provide you with the option to get home community-based services, so you can actually get those services in your home, but you have to go through the process of being eligible. Some states provide what we refer to as "consumer-directed care," so it allows you to be in the driver's seat.

But what I mean by increasing options is the fact that once you've gotten onto Medicaid, because there's so many different factors that come into play, you could potentially be in the driver's seat, but it depends on whether or not the services are available; not just in your state, but also in your geographic area.

Brokamp: Got you. So some ways that people have tried to plan for this is by buying long-term care insurance policies. I think these first came out in the 1970s and for a while were generally popular except that when people bought the policies, they were often told your premium won't go up.

But that ended up not really being the case and that the vast majority of people ended up having to pay more. The promised benefits didn't keep up with the cost of long-term care, and it's gone from something like 125 insurance companies offering it down to about 15 because it's such a tricky business. What's your take on whether long-term care insurance is a good way to manage these potential costs?

Accius: Currently there's about 7.5 million people that actually have a private long-term care insurance policy. When you think about the overall cost for long-term care, we know that the vast majority of people are getting their care from their families. Family caregivers contribute roughly about $470 billion of unpaid care every year. Private long-term care insurance is an option for those who can potentially afford it. It is a niche product in a sense that, as I mentioned before, 7.5 million people have these options.

What we're seeing in terms of the private long-term care insurance industry is that it's going through a transformation for many of the things that you just mentioned, Robert. That there was an assumption that there might be more in terms of lapse rates, and that the interest rates would actually be viable so that the [insurance companies] could actually make us some money, if you will, in order to be able to pay out claims. And what we've known over the last couple of years is that given the Great Recession, and the drastic rates in terms of declining interest rates, that when people buy a long-term care insurance policy they hold onto it.

So there were some assumptions that were made with that product that didn't bear out, as you indicated before.

Brokamp: There's one stat from an AARP report that I'd never seen -- that for every 1% drop in interest rates, the cost of providing the policy to the insurer goes up 10-15% because when the insurer takes that money in, they invest it.

Accius: That's exactly right.

Brokamp: They're investing the float, but they have to play it safe, and when interest rates are so low they're just not making much money and that's been a big problem for the insurance industry.

Accius: The other thing is there are some challenges both on the supply and demand side. As you indicated, for insurers that's been a challenge. But also, if you think about it from a consumer standpoint, you're asking me to purchase a product that I may or may not necessarily need 30 or 40 years down the line. And the other aspect of that is there's different variations and complexity. And then tag on top of that the increases in premiums.

So I think the industry itself has done a deep look to try to get a sense as to exactly how they can be more responsive to the needs of consumers, and how they can reduce some of the complexity in terms of some of the products while meeting an actual need. And what we're seeing is that while stand-alone policies have gone down, you are seeing an increase in hybrid products. You're seeing an increase in what consumers are looking for, both in terms to address more of long-term predictions in terms of what the need might be, and then also what benefits might actually happen.

Brokamp: By hybrid product, you mean life insurance with a long-term care rider...

Accius: Right.

Brokamp: If for some reason you need it as an acceleration of the death benefit. That's one variation.

Accius: That's one variation, exactly. We just released a report on the state of private long-term care insurance. I would encourage people who are thinking about that as a product to try to get it when you're younger and also when you're healthy, in part because of the underwriting requirements.

The way that private long-term care insurance works is that the younger you purchase the product, the cheaper the premium will be. That's something to also consider. And also think about some of the trade-offs. The private long-term care insurance market is looking at different variations of how to actually provide the product so it's more affordable for some consumers, but I think it's critically important for consumers to understand exactly what that affordability looks like and what does that actually mean should they ever need it.

Is there inflation protection and why is that important? In part because you might not need the product for 30 years, and if there is not inflation protection then the benefit itself erodes over time. What are the issues in terms of lapse rate? And what could you potentially do with getting some of those benefits back?

I think there's questions that consumers should think about as they explore private long-term care insurance which, again, is a viable option for those who can actually afford it. We know that the industry, itself, paid roughly $9 billion in claims over the last two years and we know that more and more people are claiming benefits and they are generally satisfied with the product.

Brokamp: Part of the solution is deciding where to live and the right community for you. One concept you've written about is "the village" movement, not to be confused with The Villages down in Florida, but "the village" concept. Can you talk a little bit about that?

Accius: Absolutely. The villages concept started off in Beacon Hill in Boston. It's really grass roots. It's neighbors helping neighbors. I love to tell this story. We had an opportunity to hear from some of the founders.

They wanted to age in their community, and they were told, "Well, you can't."

They said, "Why can't we?"

So they formed a village. It's really neighbors helping neighbors organize as a non-profit. It's designed to help them age with options. There's roughly several hundred in the United States, and it does a couple of things. One is that it allows you to engage with others and it allows you to age in your home and community for as long as possible. These are non-profits for the most part. They're volunteer-driven. They reflect the needs and preferences of the communities in which they are in. Some of them are staffed with executive directors. The one in Beacon Hill has a full-time executive director and some staff.

They do a range of things. They help with some of the managing of home modifications. Or providing you with a list of providers that you can contact for help in your home. They do a lot of social engagement activities. In the case of Beacon Hill, one of the things they did is work very closely with the healthcare system. One of their members was getting discharged from the hospital. Their family lives in another state.

The hospital discharge planner called the executive director and said, "Ms. Jones is about to get discharged from the hospital and she's going to need some help." And by the time Ms. Jones actually got home from the hospital, the executive director and some of the volunteers had already stacked her fridge up with food and then they would constantly check up on her. So it is really grass roots. It's really that sense of community.

Brokamp: There's one not too far from here -- Mount Vernon home -- and if I understand it correctly, it's a bunch of people [saying], "We're all in this together, so let's help each other out."

Accius: That's exactly right.

Brokamp: Someone can't drive. I can drive, so I'm going to help you with the shopping. Or I'm going to help you get to church. It just connects all the people together.

Accius: That's exactly right. It is a sense of community and it is really looking out for one another. Again, the desire to age with options and to age in your home and community is so strong and something that we've been tracking for about 20 years. It has consistently stayed extremely high. People are looking for options, alternatives that are not as expensive as moving into assisted living or as expensive as getting nursing home care or moving into a retirement care community. And the village movement is playing that meaningful role.

Brokamp: One thing I read about you in an interview with Black Enterprise magazine is you said, "Aging, in my opinion, is a social justice issue. People, especially people of color, are easily marginalized, devalued, and discriminated, just because of their age." To me that nails it on the head, but you don't really hear aging talked about as a social justice issue, so I'd love to get more of your thoughts on that.

Accius: Absolutely. This is a subject I'm extremely passionate about. In fact, this is something AARP, through our work around Disrupt Aging under our CEO, Jo Ann Jenkins, is leading a charge on. It's the idea that how people are aging is drastically different from how they've aged in the past. The notion is the fact that we put labels on people, particularly as they age, and those labels constrain. I think it's extremely important to think about what the value statements are that we're making when society makes these types of statements.

I look at my family and they couldn't wait to get us out of the house. They are actively engaged in their community. They're going on trips with their friends. They're living their best life as best as they can actually do it. However, you don't see those types of images often, and so the question becomes, "What are the stereotypes we see in terms of older adults? And why is it that for all the isms that we have set as a society, that that is not acceptable?"

However, when it comes to ageism, there's a little bit more leniency, and as an organization we're trying to disrupt aging. We want to help people age and live their best life the way that they want to live their best life, realizing that how they want to age is drastically different from what society might think it is.

Sometimes these comments, or these statements, or these jokes are said in jest, but I think there's the potential of some truth behind some of those jokes. We have a great opportunity to think about how we design, innovate, and create both solutions so people can age with options, age with dignity, and with a great sense of purpose. Older adults are not a liability. They want to be great contributors. They want to provide value. There's a great sense of wisdom and excitement, and to the extent that we can work collectively to embrace what it means to be your age.

Many years ago we had a major conference in Miami. It was one of our AARP conferences and our CEO challenged everyone to walk around saying how old you are. It was so powerful to see people walking around saying, "I am 77 years old and I am proud of it."

Just think about that. Your life history has shaped who you are as a person. So rather than shy away from it, embrace it. What we're trying to do is stimulate these conversations, not just in the public sector but also in the private sector. What types of products are we creating? And we're excited to see companies saying, "We're going to stop using the term 'anti-aging.'" That's a good thing, in part because it embraces the full you and everything that has happened that's gotten you to that point.

So that is what disrupt aging is about, and particularly in that clip what I was referring to is the fact that oftentimes it's so easy for society to marginalize people just because of their age. We have some wonderful clips on our AARP website around disrupt aging. We did this with millennials and we said to the millennials, "When you think of an older person, what comes to mind?" And you can see these millennials do different gestures, whether it's the flip-up phones or walking extremely slowly.

And then we paired the millennials with some older adults and we had the millennials teach the older adults something, and then we had the older adults teach the millennials something. And it's an amazing clip to watch because one of the older adults tried to teach one of the millennials how to do a yoga stance and he just struggled. He just struggled. Or a millennial tried to teach one of the older adults how to do one of these hip dances. He showed her once and then she was able to pick it up and did it better than he could.

Then we said, "How old do you think is old? How old is old?" Their response was drastically different once they actually had an opportunity to engage with the person. That is what disrupt aging's about. That is what we're trying to do. That it is a social justice issue. It's the fact that you don't see the individual. You see the person's age. But if you were to actually talk to the individual, connect with the individual [that sense of connection], your perception of what it means to get older will be drastically different. We want to challenge that.

Brokamp: That's great. Let's conclude with a few actionable things that people can do if someone is listening to this and they are concerned about their own long-term care planning. What are one or two things that they should do immediately?

Accius: First of all, visit us at our AARP website. We have a caregiver resource website that has a range of information, tools, tips, and check lists that will give you options in terms of exploring what the cost of care is in your community. We have a long-term care calculator where you can look at your state and you can compare how much the cost of long-term care is by the different types of options that are available. You can have that as a plan.

The other thing is a range of resources for you to think about in terms of your finances, whether it's your 401(k), your retirements, your savings all in one place. Then we have a list of resources in terms of who you need to contact to get a sense as to what options are available in your local community. And hopefully by having that check list, that plan; you're better off in terms of having those options and those choices.

The other thing we would encourage is to have these conversations with your family. Family caregivers are unrecognized and need to be recognized for the hard work that they do each and every day. The vast majority of them are working and we at AARP say, "Either you are a family caregiver, you were a caregiver, or you're likely to become a caregiver," in part because the family caregivers are the ones that are providing the bulk of the long-term care in this country.

So we want to encourage them to think about their needs as a family caregiver and what types of resources and support can be provided to help support you as you care for somewhere else. And part of that is having that conversation. What are your preferences as you get older? What are your preferences in terms of where you would like to receive services should you need them? And then having that conversation so your family can honor those preferences and be in a position in the event there is a crisis they know exactly what to do.

Brokamp: That's great! Jean, thank you for coming in!

Accius: Thank you so much! I really appreciate this! It's really our honor to be part of these conversations and we look forward to working very closely with all of you and thinking about how we can help people, broadly speaking, age with options.

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Southwick: That's the show. It's edited terminally by Rick Engdahl. Too dark?

Brokamp: Too dark!

Southwick: Keep on sending us your home buying, selling, and moving advice so I can read it all on the upcoming show. Our email is [email protected]. For Robert Brokamp, I'm Alison Southwick. Stay Foolish, everybody!