What to Do to Retire Successfully. Martin B. Goldstein

to consult more than one cancer center and get the opinion of several oncologists, if time allows and the resultant delay is not life-threatening. Except in emergencies or life-threatening situations, whenever surgery is advised for a geriatric person a second opinion is advised. Older patients are more prone to have post-operative complications and surgery should be avoided whenever possible. In many cases, alternative therapies can be found which may yield comparable results to surgical intervention. An example would be the implementation of physical therapy in lieu of orthopedic surgery in appropriate situations.

      DEATH

      While the analysis of successful retirement focuses on the joy of living, it also has to include the ultimate prospect of the end of life and the most tolerable emotional response to that eventuality. Earlier in this book I called for embracing the thought process of a peaceful end and rest for oneself, but we must also include the response to the death of a loved one. When two lives have been entwined for a long time, such a loss can be overwhelming. Yet it is an undeniable fact that in any relationship one partner will die first and the other will be left to grieve and carry on alone. In retirement, where the two people usually spend more time together than before and get used to spending quality time together, the separation is more painful, especially if death comes suddenly.

      In my many years of treating patients with varied therapies for different psychiatric disorders, I have been called upon to administer to some in the solemn state of impending death and also to their family members. The psychotherapy of death and dying is called thanatologic therapy. In 1969 the Swiss-born psychiatrist Elisabeth Kubler-Ross introduced the concept that there are five stages that people go through during a terminal illness: denial, anger, bargaining, depression and acceptance. While I have experienced all of these emotions in dying patients, not all patients seem to go through all these phases and not necessarily in the order presented.

      In my experience, while there is some glimmer of hope for recovery, the best anti-depressive psychotherapy is to engage the patient in active exercises to marshal internal forces and attempt to combat the disease process. This draws one’s attention to the hope for improvement and away from focusing on the emotions associated with hopelessness. In giving the patient a sense of being involved actively in the healing process, concentration is not only redirected from the dangers of the moment, but in admittedly rare cases remissions have thus been catalyzed. In any event, instilling hope whenever the inevitable is still in doubt is good medicine. When the condition grows so grave that the prognosis is no longer hopeful, a different approach is indicated. I have had the best results—if such a phrase is applicable in this context—with promotion of reassurance. Presenting the positive aspects of reaching some sort of paradise, uniting with beloved departed souls, becoming closer to God (for believers) and just emphasizing the end of pain and the attainment of the peace and serenity of eternal rest in honest repetition can bring relief and solace to those approaching life’s end. Those people who believe in some form of reincarnation or soul migration can be consoled by reinforcing such beliefs at the time of impending demise. In all cases, describing some sort of positive future, even if it’s just of eternal sleep, can be of comfort in overcoming the fear of approaching death.

      GRIEVING

      One of the most common quandaries after death is what is considered to be a reasonable time period to express grief before resuming an active social life. This is certainly an individual decision to be reached separately by each widow or widower. However, it must be cautioned that in advanced age the future is short and time becomes a precious commodity. Extended grieving, no matter how close the lost relationship was, will not bring the deceased back. Loss can only be compensated for with new gain of some comparable sort, as soon as is feasible. Replacement is also a potent deterrent to the onset of clinical-level depression.

      DIVORCE

      In some ways and in some cases, divorce can be psychologically equated to a form of death. It is certainly the death of a marriage. From a financial point of view, divorce can be a retirement killer. This will be dealt with in greater detail later in this book; however, the psychological aspects of divorce can definitely be a deterrent to the ideal retirement we all crave. Divorce, prior to or after retirement, drives the average middle-class family to a position of instability wherein retirement plans are usually partially or totally disrupted. Besides the financial catastrophe, animosity is built up by the cause of the estrangement, be it neglect, infidelity, personality clash, money matters, sexual incompatibility or any of the myriad of other reasons people no longer wish to live together. A grave emotional price is paid, akin to that experienced with death. No matter how desired, as in the case of abuse, addiction or both, the sense of a loss of caring, being left alone to be responsible for all matters previously shared leaves many frightened and bewildered. Having to return to the workplace, particularly if the job is not pleasurable or gratifying, is another source of anger and resentment. Needing to go back to a single lifestyle after many years of cohabitation can also be daunting.

      In almost all cases where retirement is a desired option in later life, if the union is in jeopardy I strongly advise family counseling of some sort. Seek out your clergyman or, if you can afford it, a professionally trained mental health counselor with experience in this area. If some form of illness is involved, psychiatric consultation is highly advised to aid in the adjustment process.

      Emotions often run wild and trump practicality; therefore, the intervention of third party professional objectivity is definitely necessary when rash moves are being contemplated in older-age couples, threatening to destroy what has taken a lifetime to create. Do not overturn the planning of many years with what may turn out to be nothing more than a change-of-life fling. While such ego-boosting moves are commonplace among the very wealthy (who can easily afford such maneuvers), divorce in average-income older people can ruin retirement plans. If at all possible, make every effort to save your union. If there is a threat to your staying together, plan events that promote togetherness, like getaways to places that have special meaning in the history of your relationship (such as where you met or honeymooned).

      It may sound as if I am placing a greater value on monetary well-being than on happiness, but understand I am expressing beliefs from the perspective of many years of delving into analysis of the lives of people who wish that they had used sound judgment instead of acting on temporary romantic whims. This is not to say that some unions are just not salvageable and that one or both partners would be better off apart, seeking new arrangements. However, as I’ve conveyed, from the perspective of preserving a decent retirement, avoid separation if at all possible.

      DEPRESSION

      The aging process itself is a natural precipitator of depression. Aging is a time of loss and the loss of vitality or loved ones is a common reason people become depressed.

      I want to delineate between the unhappiness many feel in the geriatric years, a depression caused in reaction to an unpleasant situation, and endogenous depression, which is an intrapsychic disorder (that is, it comes from within, biological or genetic in nature rather than event-driven), usually requiring pharmacologic and in severe cases somatic therapy as well as psychotherapy. Some severe cases of geriatric depression can also require medication, but many, if not most, cases of depressive reaction to the disabilities associated with growing older can be treated with talk therapies.

      The loss of work itself can trigger a depressive response in individuals who have come to depend upon the work environment to be a surrogate family, especially when more time and emotional energy are exerted there than at home. In such cases, loss of work is equated to loss of family and can result in separation anxiety and depression. In the most dramatic cases, suicidal ideation can be associated with having to face a non-regimented future. An existence devoid of definitive structure can be frightening to those who have become so used to such an existence as to not be able to envision a life without it. That is