Millions of people retire each year from the U.S. labor force, in one of life’s most health-impactful transitions. For Massachusetts General Hospital Concierge Medicine physicians, retirement, and all its complexities, is a topic patients raise frequently during their visits. In response to that, the practice hosted a virtual workshop for its patients co-facilitated by Concierge Medicine practitioners Thomas Fry, MD, and National Board-Certified Health and Wellness Coach Lisa Keer on June 4, 2024. What follows is an interview-style review of material shared during that program, including linked resources you can use to help you, or someone you love, manage this transition. As always, contact your Concierge Medicine physician, or your personal PCP, with your unique health concerns.

Retirement Today: Changing Terrain

TF: We know a surprising amount about what retirement looks like today. The University of Michigan Health and Retirement Study, a 32-year national longitudinal panel study tracking 20,000 Americans and supported by the National Institute of Aging and the Social Security Administration tells us that the path to retirement is more varied and occurs over a longer period than ever before.

If you think your retirement will look quite a bit different from your parents’ retirement, you’re correct. The ‘work full time then retire full time’ model is less prevalent. We’re seeing patients move into part-time employment or consulting. Others are taking seats on boards. Some do all of that. Others make their travel and other leisure time an opportunity for lifelong learning. And this pattern can extend for several years.

David Blanchflower’s work tells us that happiness is a U-shaped curve. The lowest level of life satisfaction occurs roughly at age 47.25 and slowly ticks up. So, you’re entering retirement theoretically happier than you might have been at mid-life. What we hear from our patients bears this out.

Retirement Transition and Health Impacts: What You’re Telling Us

TF: The easiest path to retirement? The path where retirement is voluntary, planned and wanted. The most challenging path? Well, think about the exact opposite set of circumstances.

You’re telling us that a transition to retirement is more than a simple shift in daily routine. Now, you have more time, and specifically more time to focus on your health. You tend to value good health as a support for an ideal – and longer – retirement.

What we know from our patients is that retirement, even if it’s not a full retirement, can really erode our routines. And that’s where as physicians, we see sleep disruptions, gut health challenges and even lapses in regular exercise become impactful. While you now have more time, you also have fewer demands on that time. So, you might go to sleep and wake up much later than you did when you were working because there is no train or plane to catch. Mealtimes can shift and with a more flexible schedule, you might put off exercising, arguing that you can get to it at almost any time.

You’re telling us you really care about brain health in the context of retirement. You want to find a sense of purpose in retirement. Some of you need to consider aligning your retirement path with that of a plus-one. Some of you might be passing on a family business to the next generation which creates its own set of unique challenges. Finally, the concerns of older age and the choices you have to make around things like longer-term care, tend to surface now. Individually, these are big issues to address, and taken together, managing them can feel overwhelming.

Lifestyle Management and Your Concierge Physician or PCP

TF: We’re often asked if there’s something unique or special, from a health perspective, that you should focus on when you retire. Really, it’s proactively focusing on what we already know about health-supporting behavior and that’s lifestyle management. Best practices include:

  • 7+ hours of sleep nightly
  • Stress management
  • Maintaining social connections
  • Mediterranean diet (if applicable) and monitoring of alcohol consumption
  • Fitness including 2-3 days of strength-training and 150 minutes per week of aerobic activity.

To support brain health, I like to suggest learning something new; a sport, a language or another skill are all great ideas. The McCance Center’s Brain Care Scorecard is a unique tool to help you understand how lifestyle management can support your cognitive health. Make sure you review your Brain Care Scorecard results with your physician, and share concerns you have.

Three Parts of Any Transition

LK: The transition to retirement is not the first major transition you will have made in your life. You have been here before. Transitions have three parts; the end, the messy middle (where we figure things out), and the beginning of something new. Navigating that messy middle is where having a vision for your retirement can really help your process.

At the same time, be aware that you might bring the work life you are ending into your retirement transition. Do you feel that existential sense of urgency and the need to deliver results? Relinquishing mastery of a subject or skill especially if we are continuing with our business careers but in a transitional role, might be an unexpected challenge. Likewise, your jobs have often been that source of the routine Dr. Fry noted, and those social connections that we know supports health in so many ways. How is that change impacting you?

Questions for Reflection

LK: As you consider retirement, as Dr. Fry said, the choices and sheer number of decisions you need to make can feel overwhelming. So how do you navigate that process? Setting a vision for your retirement is a great way to begin. Answering these reflection questions may help you craft your vision:

  • What is important to you?
  • Who is important to you?
  • What are you passionate about?
  • What don’t you want to do?
  • When have you felt most useful? Most valued?
  • Ten years from now, what would you regret if you don’t learn or do it now?
  • How does your health factor into your reflection?

Strategies for Retirement Planning and Avoiding Overwhelm

LK: While you have a list of must-dos as you enter any form of retirement, this is also a time to reflect, which is where setting your vision for your retirement happens. Taking action, where you experiment with options versus attempting to make a final or perfect choice can be illuminating. So, take a class, learn something new or schedule a trip to a place you have always wanted to go. If you find something you love to do, great. If you come away less enthused, that’s also a step in moving forward.

Resources

LK: Use one or more of these resources to inspire you or to help manage the next steps in your retirement plan:

Medicare Selection

In Massachusetts: SHINE (Serving the Health Insurance Needs of Everyone)
1-800-243-4636

In other states: SHIP (Senior Health Insurance Program)
Search for the SHIP in your state

These federally funded programs offer you no-charge counseling around Medicare plans and Part C and Part D choices. Highly trained counselors can provide you with an unbiased and complete look at your options.

Volunteering

VolunteerMatch.com: a national network of volunteer opportunities in your community
SocialVenturePartners.org: a national resource for philanthropy as a tool for social change
ArtandHealing.org/Project Unlonley: a resource for strategies around building community and social connection

Enjoying the Journey

The Modern Elder Academy is one of several programs for mid-life exploration. The Harvard Institute for Learning in Retirement along with the Stanford Distinguished Careers Program are two others that might help you navigate your own messy middle. Fees and terms vary.

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