Question

Explain why are women in old age more likely than men to live in poverty during the retirement years?

Describe end-of-life issues that can arise and how they can be managed

Answer 1

During their working years, women tend to earn less than men, and when they retire, they're more likely to live in poverty.

These are women who raised children and cared for sick and elderly family members, often taking what savings and income they do have and spending it on things besides their own retirement security.

The National Institute on Retirement Security, a nonprofit research center, reports that women are 80 percent more likely than men to be impoverished at age 65 and older. Women age 75 to 79 are three times more likely.

While experts cite a pay gap as a major cause for retirement insecurity, other factors play a role, from single parenthood and divorce to the fact that women typically live longer than men.

For Marsha Hall, 60, the process of trying to save for retirement has been nearly impossible.

"I've had jobs that included a 401(k) and I was able to put some money aside, every month," she says. "But then I would get laid off and have to cash out the 401(k) to have money to live on."

Born and raised in Detroit, Hall is divorced and doesn't have any children. She works part time as a file clerk. She and her siblings pitch in to care for their 75-year old mother. Hall says she tries not to think about what her situation will be like at that age.

"My bills are current, I have food," she says, "but I'm still living paycheck to paycheck, if it wasn't for Section 8 (a housing subsidy), I don't know where I'd be living."

Joan Entmacher, vice president for family economic security at the National Women's Law Center, says "the solution to the retirement (funding) crisis starts with the earnings and wage gap."

That gap narrowed between the 1970s and 1990s, but stopped shrinking in 2001. Women earn about 76 cents to 79 cents on the dollar, compared with men.

End-of-life care presents many challenges (e.g., the management of pain and suffering) for clinicians, as well as for patients and their families. Moreover, the care of the dying patient must be considered within the context of the psychological, physical, and social experiences of a person's life. Foremost among those who require end-of-life care are the elderly, who are prone to loneliness, who frequently underreport pain, and who have a greater sensitivity to drugs and to drug-drug interactions. Unfortunately, clinicians who are responsible for the treatment of patients at the end of life commonly lack adequate training to help guide end-of-life decisions and to deliver bad news to patients and families.They must also face their own discomfort with discussions about death and deal with poor compensation for the time spent discussing end-of-life care with patients and families. Given the unique process of each person's death, algorithmic strategies are often inadequate to guide patients, their families, and the clinicians who care for them through this complex and emotionally challenging process.