Tuesday, October 29, 2013

HEALTH - Voyager Space Program and Lessons For Long-Term Care

"What the Voyager space program can teach you about preparing for long-term care" PBS Newshour 10/28/2013

At first glance, comparing a 36-year-old, one-ton spacecraft hurtling through interstellar space at about 37,075 miles per hour to the realities of planning for our long-term care needs seems ... odd.  But the more we thought about it, it made sense.

We brought together the wisdom of NASA scientists and health experts to highlight 10 9 lessons the Voyager spacecraft can teach us about planning for long-term care.

1. Be prepared to adapt to changing situations

NASA didn't know what Voyager was going to find

As Voyager 1 left the "comfort of the heliosphere" (our solar system) and entered much-denser interstellar space, it was like leaving a warm pool and jumping into a vat of cold pudding.  Voyager is the farthest man-made object from Earth, and the first to reach interstellar space -- completely unexplored territory, said Ed Stone, chief scientist of the Voyager mission.  When the agency planned for Voyager's mission, NASA tried to keep the ‘unknown’ in mind, realizing they couldn’t anticipate everything that might happen.

Plan for the unexpected as you get older

Even if your home isn't ideal for growing older, some simple adjustments can help you stay there longer than you originally expected.  These could include things like installing motion sensor lighting in dark corners and tub bars in the bathroom to prevent falls.  Check to see if your community is one of more than 400 in the U.S. that has established villages offering seniors support to live independently in their own homes and communities.  The map (see full article) above lists locations and information on established "villages" that offer seniors support to live independently in their own homes and communities.  Many governments are realizing they are unprepared to help their populations age gracefully and are therefore developing new transportation options and civic services for seniors.  Others are cutting these services back.  Check with your local government to see what's happening in your community and make your voice heard about what's needed.

Just as importantly, plan ahead for a time when it may no longer be possible for you to live at home.  Alternative housing arrangements for older Americans, including assisted living and nursing homes, are often expensive and are usually not covered by Medicare.  Don't get left out in the cold pudding.

2. Build in redundancy as a back-up plan

Voyager has backups of its backups' backups

The engineers who designed Voyager didn't want the space probe to be sidelined by a simple computer failure or a small mechanical problem, so they built in multiple layers of redundancy.  The probe carries three dual-redundant computers on board, and seven fault protection routines.  Voyager can go into "safe mode" in a matter of minutes, which is crucial to saving data and power while waiting for almost a day to receive messages from Earth.  NASA has used Voyager's redundant systems as the primary systems fail, to extend the tiny probe's mission into deep space.

Social Security Might Not Be Enough

Like the Voyager engineers, make sure your plans have fallback options in case your intended future doesn't materialize.  Consider a long-term care insurance policy in case investments and Social Security are not enough to cover your medical needs after you retire.  Understand the availability and kinds of care options your state and local government provides, and make plans should you need additional support.

3. Be flexible and consider new goals as time goes on

Voyager completed its original mission, but continues making discoveries

Originally, the Voyager 1 mission was to study Jupiter and Saturn.  After that was completed, the spacecraft was still functional so it went on to explore further reaches of the solar system, aiming for Neptune and finally interstellar space.  The Voyager mission continues to make scientific breakthroughs that are rewriting astronomy books.

Successful aging is defined by continued activity and engagement

Many seniors find that part-time jobs, volunteer activities or social clubs can help sustain psychological, financial and health-related benefits that are sometimes easily lost after retirement.  As Paul H. Irving, president of the think tank the Milken Institute, put it, "Successful aging is defined by physical activity, work, learning, and social contribution, as opposed to withdrawal and disengagement.  For individuals, this brings better health, improved financial opportunities, a sense of purpose and personal happiness.  For our society, successful aging brings innovations and economic growth, intergenerational collaboration, and the mitigation of public burdens associated with chronic disease, inadequate retirement resources and the like."

For more, see our indepth interactive New Adventures for Older Workers.

4. Build a support network

Voyager's team continues to support the probe after 41 years

There are still 12 engineers and 20 scientists dedicated to working with Voyager, many of whom have been on the project since it began in 1972.

Build your own health-care tools

We are living longer than ever, meaning that as we age, we're faced with increased daily and health needs.  Yet most agree that the U.S. government lacks a comprehensive system of care and support that enables aging with dignity, independence and choice.  How are Americans responding to that reality?  Nearly a third said they "would rather not think about getting older at all," according to a recent poll.

"Sadly, there really aren’t that many tools out there for American families," said Bruce Chernof, president and CEO of the SCAN Foundation, which focuses on senior issues.  "That’s why we think this discussion is so important."

Talk to your family, friends and neighbors about your needs and what might help you live independently longer.  Consider your social network before deciding to move to a new locale for retirement and, if you decide to change locations, do so with a plan of how to build supportive and fulfilling relationships in your new community.

5. Keep checking in with home

Voyager regularly sends transmissions back to Earth

The information NASA receives from Voyager tells them, among other things, that the spacecraft is still alive and working.  Ed Stone, chief scientist on Voyager, said the team regularly checks in with the spacecraft, listening to hours of data and readings and tracking its journey through our galaxy.  It takes more than 24 hours for the scientists to send a message to Voyager and receive a reply.

Check in regularly with family and friends

Routinely checking in with family or friends as you get older, especially if you live alone, can reassure your loved ones you're OK.  Missing a check-in at an appointed time can alert them that something may be wrong.

6. Budget wisely

Voyager has squeezed years of science out of its budget

The total cost of the Voyager’s planetary expedition was $865 million.  That’s about 8 cents per U.S. resident per year from the program’s beginning in 1972 until 17 years later when Voyager 2 reached Neptune in 1989.  That sum may sound like a lot, but in return, both Voyager spacecraft have sent more than 5 trillion bits of scientific data.  Enough to fill more than 7,000 music CDs, and the data is still coming.  NASA estimates that Voyager will continue delivering data until 2025.

Make sure you're financially prepared for what lies ahead

70 percent of Americans over the age 65 can expect to use some form of long-term care during their lives, yet many wrongly believe their medical insurance or Medicare will pay for all or much of their long-term care needs.  In general, health insurance covers only very limited and specific types of long-term care, and disability policies don't cover any.  Furthermore, you will not be able to access Medicaid benefits until you spend down most of your assets.  The average nursing home today costs about $81,000 per year and part-time help at home or in the community typically costs about $21,000 per year.  For some people, purchasing long-term care insurance is the best option even though price tags can be high.  Others will need to rely on other resources or savings.

7. Keep good records

Voyager's mission is all about data collection

Both Voyagers are equipped with Golden Records, phonograph records that contain sounds and images representing the diversity of life and culture on Earth, and intended for intelligent extraterrestrial life form or future humans who may find them.  Voyager 1 was also built with a tape recorder on board to play back data for scientists on Earth, and it was built to last.  Imagine playing a two-hour VHS tape once a day for 33 years without fail -- it's that good.  The scientific instruments on board can hit their target with accuracy of one-tenth of a degree, whether for navigation or taking a photo.  The television cameras aboard are good enough to read a newspaper headline half a mile away.  To get good images in the darkness of space, it needs to be this accurate.

Your records could be your lifeline

Gather a list of important contacts including professionals, family members, friends, and loved ones who can provide support in a time of need.  Keep this information in an accessible place, such as near the refrigerator or telephone.  Also keep your medical records up-to-date.

8. Get help when you need it

Voyager got an extra boost along the way

To speed up the trip from one planet to the next, the Voyagers piggybacked on Jupiter's gravity to slingshot towards Saturn, increasing Voyager 1’s speed by 35,700 mph.  The gravity-assist from Saturn hurled Voyager 1 out of the solar system, and gave Voyager 2 the power to reach Uranus.  And Uranus’ gravitational pull hurled it toward Neptune, and Neptune gave it the extra push it needed to reach the edge of the heliosphere.

Anticipate needing some assistance

More than 12 million Americans need long-term care to assist them with daily activities.  The government estimates that someone who is 65 today will need some type of long-term care services for three years (and if you're a woman, you can expect to need care longer than men -- 3.7 years compared to 2.2 years for men, on average).  Reach out to your neighbors, form a community support group, and most importantly, talk to your family early about the type of support you prefer when the time comes for more assistance.

9. Plan to live longer than you expect and have an end-of-life plan

Voyager's systems slowly shut down as it ages

No one thought Voyager would still be working and sending data this long.  But as Voyager's plutonium reactor runs out of power, the vessel will lose contact with scientists.  While Voyager will likely be able to sustain its functions for another decade, the plan is to turn off instruments one by one, trying to make the most of the ones still functioning.  These decisions will be based on energy-efficiency, keeping Voyager as productive as possible.

Make a plan – just in case

Make an aging and end-of-life plan with your family that includes where and how you will live as you grow older.  Choose someone you trust to be a surrogate decision-maker who will honor your health care wishes if there comes a point where you cannot make decisions for yourself.  Don’t wait until an emergency or major event to start the conversation -- that may be too late.

Some things to consider:  What kind of care do you want, and what do you not want?  Do you want a "do not resuscitate" order? If you must face a terminal illness, at what point do you want to stop life-support or treatment?  If you’re starting these discussions early, what health concerns should your family or providers plan for so you can continue to live at home?  But most importantly, get out and enjoy life.  You never know what you may discover.

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