Concierge Medicine: the Wave of the Future, or Back to the Past?

It always amazes us here at AgingOptions to run across people who spend countless hours (and hefty fees) to create carefully-crafted financial plans, yet overlook caring for the most important asset of all: themselves.  For that reason we were drawn to this very recent article on the website Investopedia.  Written by financial planner Robert Dalie, this article shines some helpful light on an approach to medical care that in some ways is a throwback to the past, yet is garnering increasing attention these days: Concierge Medicine.

We agree with this assessment from Dalie’s article. “In the world of investing and finance,” he writes, “most people simply focus on wealth creation and preservation. Yet, what is often overlooked and neglected is our most valuable asset. This is an asset so critical that without it, we are unable to enjoy the fruits of all of our other asset classes combined. The asset is you and your health.”  He goes on to explain that merely having health insurance by no means ensures that you’ll get the best care. “We believe that insurance is the instrument that provides us cover in the event of medical problems,” says Dalie. “The reality is that healthcare insurance is a financial hedge against unforeseen medical (financial) loss. Health insurers don’t really care about you, they care about quarterly revenue and profit margins. Insurance is for hospitals, not doctors.”

For some the answer to better, more personalized medical care may lie in the increasingly popular model known as Concierge Medicine. We found this simple definition on an industry website called Concierge Medicine Today.  “Concierge Medicine is a form of membership in which doctors provide medical care to patients generally providing 24/7 access, a cell phone number to connect directly with their physician, same-day appointments, [and] visits that last as long as it takes to address their needs and varying other amenities.” The cost for this highly personalized service is a monthly fee paid to the Concierge Doctor which, says the web site, averages between $135 and $150 per month.

The article on the Investopedia website says this model has been gaining momentum for the past two decades and is likely slated to boom with all the uncertainty in the American health care landscape. Concierge Medicine practices, says Dalie, reflect the reality of modern healthcare. Patients who can afford the fee love the fact that they have ready access to their own physician, and that their doctor is taking a far more proactive approach to better care for patients, with services such as an individualized “annual medical report” and highly personalized screening strategies.  In Dalie’s words, “Healthcare and the medical profession are on the cusp of a major redesign.”

Advocates point out that what we call Concierge Medicine today was the norm only a generation or two ago. Patients used to know their doctors personally. Doctors made house calls and typically knew everyone in the household by name. Medicine was far less encumbered by vast bureaucracies and layer upon layer of stifling regulations. In our societal quest for better care and safer procedures, we may have lost the personal touch along the way, and – for those who can afford it – Concierge Medicine (and its less costly, less personalized cousin, the Direct Primary Care practice, described here) seems like one possible way to get it back.

Certainly there are many who would argue that Concierge Medicine is only for the wealthy, but its advocates nevertheless embrace its benefits enthusiastically. “If Concierge Medicine is about super servant-hood, then it has nothing to apologize for,” writes Michael Tetreault of Concierge Medicine Today. “People deserve to have access to a physician who spends the time necessary to gather appropriate insight about patients. People deserve transparency. They deserve answers to difficult questions. People deserve accurate information, especially when it concerns their health.” Instead of following the common practice of resorting to fruitless web searches that lead to inaccurate self-diagnosis, clients who use Concierge Medicine get information that’s personalized and professionally sound. Concierge Medicine, writes Tetreault, “has redefined healthcare delivery.”

At AgingOptions we have long advocated that our senior clients adopt an approach that’s similar in some ways to Concierge Medicine by hiring a geriatric care manager, or geriatrician. These medical professionals are trained in the particular health care needs of seniors, and in the same manner as a “medical concierge” they’ll act as your personalized advocate and adviser as you navigate the health care maze. If you’ll contact us at AgingOptions, we can suggest the names of some geriatricians in your area. Having one of these experts as your health care “quarterback” is one of the most important decisions you can make.

Another closely-related decision you need to make is to get a handle on your retirement planning, something that goes far beyond maintaining your health. Planning for your medical needs is an essential component of a strong retirement plan, but it’s certainly not the only thing you need to plan for. A comprehensive retirement plan, the kind we at AgingOptions call a LifePlan, weaves five key elements of your future together: your medical protection, your legal preparation, your financial plan, your housing options, and even a communication plan for your family. When all these five fit together into a seamless whole, your future is secure. You can protect your assets in retirement, avoid becoming a burden to your loved ones, and escape the trap of unplanned institutional care.

If you’re ready to learn more, we have an invitation for you. Plan now to attend a free LifePlanning Seminar, where in just a few hours you’ll gain powerful insight into planning for the retirement you’ve always dreamed of. For dates, times and online registration, click here. You can also call us during the week and we’ll gladly sign you up for the seminar of your choice. It will be a pleasure to talk with you soon at an upcoming AgingOptions LifePlanning Seminar.

(originally reported at www.investopedia.com)

NYTimes: Most Arthroscopic Knee Surgery “Complete Waste of Money”

If you’re like most adults, knee pain is a common occurrence. Almost everyone has knee pain occasionally, and one article from a few years ago suggested that about one-quarter of adults experience knee discomfort much of the time (a figure that doubles for those with arthritis). Even though the incidence of knee replacement surgery has risen dramatically in recent years, most people will do whatever they can to put off that invasive procedure as long as they can.

Now in this recent article from the pages of the New York Times, written by popular health columnist Jane Brody, we read this discomfiting news. “Many of the procedures people undergo to counter chronic knee pain in the hopes of avoiding a knee replacement have limited or no evidence to support them,” Brody writes. “Some enrich the pockets of medical practitioners while rarely benefiting patients for more than a few months.”

That’s quite an indictment of the medical industry, but in Brody’s case it comes not only from research but also from personal experience. (In fact the article is titled “What I Wish I’d Known About My Knees.”) It seems that Brody had developed severe knee pain when in her 50s after an active life of jogging, tennis and skiing. Her orthopedic physician recommended arthroscopic surgery, a common procedure often used (as in Brody’s case) to repair a torn meniscus. While the surgery helped alleviate pain for a while, it wasn’t long before it returned even worse than before. After yet another unsuccessful procedure (this time involving injections) designed to forestall surgery, Brody finally gave up and had both knees replaced and afterward was able to resume her active life.

“Serious questions are now being raised about the benefits of the arthroscopic procedures that millions of people endure in hopes of delaying, if not avoiding, total knee replacements,” writes Brody.  In one recently published review of a dozen trials and 13 observational studies, a panel of clinicians reported that “arthroscopic surgery for degenerative knee arthritis and meniscal tears resulted in no lasting pain relief or improved function.” This review showed that fewer than 1 patient in 7 experienced “a small or very small improvement in pain and function” and, what’s worse, that those beneficial effects disappeared completely within a year.

Besides being virtually ineffective, arthroscopic surgery, like all invasive procedures, carries risks, especially the risk of post-operative infection. But those patients who avoid surgery altogether not only escape the attendant risks but seem to enjoy the best outcome. “Most patients will experience an important improvement in pain and function without arthroscopy,” the study quoted in the New York Times concludes.

In the words of one physician quoted by Jane Brody, arthroscopic surgery has its uses – for example, when used to treat younger patients with sports injuries – but is now believed to be unsuitable to treat knee pain caused by arthritis or meniscal tears. Brody writes, “The panel noted that about one-quarter of people older than 50 experience knee pain from degenerative knee disease, a percentage that rises with age. Arthroscopic procedures for this condition ‘cost more than $3 billion per year in the United States alone,’ the report stated, suggesting that it was a near-complete waste of money.”

What about steroid injections, another treatment commonly used to deal with knee pain? These can reduce inflammation, but at the same time continual use of steroids can speed up the onset of arthritis, according to a study in the Journal of the American Medical Association. JAMA said not only do steroids accelerate knee deterioration, but in a blind study compared against those receiving a placebo injection, the ones getting the steroids experienced “no significant difference in knee pain.”

Brody acknowledges what anyone with degenerative knee arthritis knows: finding the right treatment regimen can be frustrating for both doctors and patients. That’s because “there is no clear answer as to what will help which patients.” But here are some simple and generally accepted approaches that might help avoid or delay surgery, says the New York Times:

  • “If you are overweight, lose weight.” Any extra weight puts more pressure on your knees.
  • Avoid activities that aggravate knee pain if you can – things like squatting, sitting too long in one place, or climbing a ladder.
  • Take an over-the-counter pain reliever if the discomfort is bad enough, but be careful to follow proper dosage instructions and your doctor’s recommendations.
  • If the pain is really getting to you, physical therapy administered by a licensed therapist has been shown to have very positive effects. “Be sure to do the recommended exercises at home,” says Brody, “and continue to do them indefinitely lest their benefits dissipate.” You may even want to consult an occupational therapist who can teach you how to modify your activities to minimize knee discomfort.

We at AgingOptions would strongly recommend one more step: put your medical care into the hands of a geriatric physician, also called a geriatrician. These experts understand the aging body and can assist you with exercise, weight loss, and better nutrition to keep you (and your aging knees) healthier longer. Contact us here at our office and we’ll gladly recommend a geriatrician to you.

For all your retirement planning needs we invite you to put yourselves into the professional hands of the experts at AgingOptions, with a personalized retirement blueprint called a LifePlan. Financial planning alone is never enough when it comes to enjoying a secure retirement free from fear of the unexpected. Finances have to work in tandem with medical planning, legal preparation, and housing choices in order to ensure that you’re truly prepared – and your family needs to be brought into the picture to make certain they will support your wishes in the future. All these elements become part of your individualized LifePlan.

Find out more by joining us for a free LifePlanning Seminar. There are several presently scheduled and more coming up – simply click here for details and registration, or contact our office. It will be a pleasure to meet you soon!

(originally reported at www.nytimes.com)

Experts Predict Big Changes in Aging and Retirement in Coming Years

At AgingOptions, we focus a great deal of attention every day on the multi-faceted field of retirement. It’s a fascinating topic with an infinite number of variables, always changing and evolving. That’s why this article from a website called New Retirement was of particular interest to us – and we think, especially if you’re a baby boomer facing retirement, you’ll find it interesting, too.

This fascinating and challenging article is called simply, “How Aging and Retirement will Change in 2017 and Beyond.” The editors of New Retirement looked at some of the recent opinion essays written by experts in the field of aging, published on the popular aging website Next Avenue. (Next Avenue calls these experts their “List of Influencers on Aging,” and if you’re curious who these experts are you can read more by clicking here.) For the New Retirement article, the editorial staff selected seven areas where the experts in the field predict big changes are ahead. Let’s take a look at a few and see if you agree.

For starters, some experts suggest that it might be time to get rid of the generational labels that tend to divide us. As one of the Influencers put it, “Maybe we aren’t really Baby Boomers, Gen X’ers, Millenials and the Greatest Generation.” Instead, she suggests, maybe we’re all “Perennials.”  That term suggests that, regardless of age, we are “ever-blooming, relevant people” who understand how to live in the moment. As perennials we stay current with world events and we understand how to use technology appropriately. One important facet of living like a perennial is to have friends of all ages, not just people of our own generation. Intergenerational living tends to keep us feeling and acting younger and more alive, some experts on aging would suggest.

Speaking of intergenerational living, others among the Influencers are recommending that it’s a good and healthy trend to mix generations and stop segregating ourselves in the area of our housing choices. Part of this idea of living multigenerationally arises out of necessity: many older people need help from their families with activities of daily living, while some younger people, caught in the vice grip of a tight economy and rising housing prices, are moving back home. Why not make a virtue of necessity, these analysts suggest? “We all need help sometimes and if our adult children can help care for us as we age, we may be able to solve some of the problems around the tremendous expense of long term care,” says the New Retirement article.

This intergenerational mindset goes far beyond housing. When asked what one thing she would change about aging, AARP executive Susan Reinhard responded, “If I could only change one thing, I would ensure that all families are better prepared and supported to care for one another as we age. We must make family caregiving a national priority.” Asked the same question, former Disney CEO Michael Eisner answered, “If I could change anything about aging, I would create more intergenerational programs in our country. We need to find ways to utilize our aging Americans as resources, not as burdens.” Eisner noted how much seniors have to contribute to society, and how doing so benefits everyone, the seniors included. “Most seniors want to remain productive,” said Eisner, “and we should celebrate that.” We agree wholeheartedly.

Here’s one more trend cited in the New Retirement piece: our present focus on what we commonly call “Health Care” will shift to a much more well-rounded approach, emphasizing “Wellness.” We like this idea very much, especially as it pertains to seniors. Too much of our present healthcare system is about medicine – treating the body like a machine and always reacting to problems instead of solving them ahead of time. “However,” states the article, “modern doctors have begun to embrace good nutrition, stress reduction and exercise as powerful ways to foster health. Experts predict that this trend will continue.” This, we should point out, is something most geriatricians already know – one of the key reasons we urge our clients to make a geriatric physician the key member of their health team.

The bottom line when it comes to aging is about expectations. There is no reason why aging, in the words of one Influencer, has to represent a time of “disease-related decline.” Instead we have the knowledge now to “transform this precious stage of life into one of thriving….by reducing toxic stress, improving nutrition and activity and investing in social connectivity and life purpose.”  We would add one critical factor: you will need a solid plan for your retirement years, because none of this happens by accident. We help our clients develop what we refer to as a LifePlan, which is a plan that takes all the essential aspects of retirement into account. We help you protect your assets with a carefully crafted financial plan. We also make certain your estate, and your dreams, are fully protected through careful legal preparation. We help you evaluate and plan for your housing needs and your medical insurance coverage, since housing and health represent essential pillars of retirement. Finally, we help you involve your family, since aging is (as we often say) a family affair. All this becomes part of your LifePlan – your key to a secure and fruitful retirement.

It’s easy to learn more about LifePlanning, simply by attending a LifePlanning Seminar in your area. Invest just a few hours and you’ll come away with a fresh new approach to living the rest of your life with enthusiasm and purpose. These seminars are free. Click here for the Upcoming Events page where you’ll find all the information, plus online registration – or call us during the week. Then prepare to live a longer and more purposeful life than you ever thought possible! We’ll be ready to be your guide.

(originally reported at https://www.newretirement.com)

Survey Shows Most Americans “Clueless” About Retirement Finances

If you were to ask most Americans how important it is to have a solid understanding of financial issues affecting retirement, the majority would agree that it’s extremely important, even essential. Saving money and spending it wisely is one of the keys to enjoying retirement with enough money to live the way we want to live. But if that’s so, then why are so many Americans so ignorant concerning the basic elements of retirement finance?

That’s the sobering conclusion from this very recent article that appeared on the popular (and somewhat irreverent) financial website Motley Fool. The title of the piece says it all: “Most Americans Don’t Know Jack About Retirement. Do You?”

Earlier this year the financial firm Fidelity conducted their first-ever Retirement IQ Survey (here’s a link if you want to check it out) designed to gauge how well-informed the public is about saving for, investing for and spending in retirement. Fidelity says their survey uncovered “significant knowledge gaps” and that at least three-quarters of respondents seriously underestimated how much they will need to save. And as Motley Fool put it, “If you don’t understand these fundamental aspects of pre- and post-retirement finance, how can you possibly come up with a retirement plan that works?”

Before we describe a bit more about Fidelity’s survey, this seems like a good time to remind you that, as vital as a good financial plan is in retirement, it’s not enough. A truly comprehensive plan that will preserve your assets and allow you to live the way you want as you age, without burdening those you love, demands much more. Merely planning on how to save and spend your money will not get you where you want to go, any more than a stool with one leg can ever be called “stable”! Here at AgingOptions, we have the solution, called a LifePlan, which we’ll talk about in a moment.

The Fidelity Retirement IQ Survey included more than 2,000 respondents. Half were in the age group between 55 and 65 and not yet retired. The others were broadly representative of the 18-plus population. Fidelity asked respondents eight different questions, which the Motley Fool article summarized in four general categories of financial savvy. Understanding these, the article suggests, should allow you to enjoy “a financially stress-free retirement.” While that seems like an overstatement to us, here are the “critical topics” about which so many American adults seem to be in the dark:

  • The historical returns of the stock market: After the recession of 2007-2009 and the resulting investment losses suffered by many, a large number of people withdrew all their assets from stocks in favor of safer investments. Many still shy away from stocks for fear of repeating those losses. But in fact the stock market has enjoyed positive returns in 30 of the past 35 years, and the average return has hovered around 7 percent. Only one survey respondent in twelve correctly and accurately assessed the power of the stock market to build an asset base for retirement.
  • The average length of retirement: Respondents in the Fidelity study were asked how long they would need to have their retirement savings last if retirement began at 65. A large number of those surveyed said retirement would last 12-17 years. But the fact is, those turning 65 today will live an average of 22 more years and some will go on far longer. Says Motley Fool, “If you underestimate how long your retirement is likely to last, as many survey respondents did, you’re setting yourself up for financial disaster.”
  • The amount you can safely withdraw from retirement accounts: While there’s no hard and fast rule, many financial advisers suggest that a retiree in his or her 60’s can safely withdraw about 3 ½ percent annually from their 401(k) accounts and IRAs, with that percentage rising as the retiree gets older.  But many in the Fidelity survey guessed far higher, estimating that they could safely withdraw 10 percent of the money or even more starting early in retirement. Taking out more than a cautionary minimum early on, warns the Motley Fool article, could deplete your savings too rapidly and leave you without assets later.
  • The cost of healthcare: According to Fidelity, the average couple retiring last year at age 65 would need to plan on spending about $260,000 for the remainder of their lives on healthcare. But the majority, almost three-quarters, underestimated that figure by a large margin – some by a whopping $200,000! That shows a dismaying ignorance of the facts and is an ominous sign that millions are careening toward retirement with a dangerous lack of fundamental knowledge about what lies ahead.

But thanks to the professionals at AgingOptions, you don’t have to be one of those lost in a fog of retirement ignorance. With your AgingOptions LifePlan as your guide, you’ll be able to chart a course for the retirement you’ve dreamed of, confident that you’re prepared for just about everything aging can throw your way. A LifePlan from AgingOptions is like a building built with five interconnected pillars: your financial plan, your legal plan, a plan for your housing choices, a plan for your medical coverage, and even a plan to involve your family so they’ll fully support your plans and wishes. There’s nothing like an AgingOptions LifePlan.

It’s easy to find out more: plan now to invest a few hours and attend a free LifePlanning Seminar. We offer these highly popular events all throughout the region. For currently scheduled seminars, this link will give you all the details – then you can register online or contact us for assistance.

When it comes to retirement, ignorance is definitely not bliss – it’s disastrous. But with AgingOptions you can approach retirement informed and prepared. Age on!

(originally reported at www.fool.com)

Can Diet Reduce Odds of Dementia? Studies Give Optimistic Answers

We continually hear plenty of bad news about Alzheimer’s disease. It’s the illness people seem to fear the most as they grow older, presently afflicting at least 5.5 million Americans, almost all age 65 and above. The Alzheimer’s Association warns that, barring some medical breakthrough, the number of adults with Alzheimer’s will likely soar to 16 million by the year 2050. This debilitating killer, which takes the lives of more people every year than breast cancer and prostate cancer combined, is placing a terrible strain on families across the nation, not to mention the rising cost of caring for afflicted men and women. Alzheimer’s disease in just about every way represents a serious health care crisis.

So with all that as a gloomy backdrop, it’s great to be able to read and pass along some good news in the form of two very recent articles we discovered, each describing how several recent studies are demonstrating a link between the progression of dementia and the foods that we eat. It seems to be increasingly clear that by eating healthy foods today we can greatly improve the odds of maintaining and even improving our cognitive abilities tomorrow.

The first article is this one that was just published in the British website of the Telegraph. It begins with an encouraging preliminary report about a study in Europe involving a nutritional drink called “Souvenaid” that was developed specifically to help combat cognitive decline. It’s essentially “a cocktail of vitamins and nutrients which have been shown to boost brain function,” writes the Telegraph, and in this clinical trial it appears to do just that, helping manage the illness. (Souvenaid is not presently available in the US but further trials are ongoing, and we expect we’ll be hearing more about this topic in the months to come.) But to us the real news in the Telegraph piece isn’t about any “wonder drink” – it’s about the ordinary dietary choices we can make every day, at just about every meal, choices that can, researchers say, keep our minds healthier as we age. Again, some of these findings are preliminary, but signs are encouraging.

For example, one study from the University of Kansas Medical Center found that simply drinking three glasses of milk each day can help prevent damage to brain cells, potentially reducing the risk of dementia and also of Parkinson’s disease.  Clinicians found that higher milk consumption is apparently linked to increased levels of a naturally-occurring antioxidant called glutathione which appears to prevent cell damage in the brain. And while you’re drinking your milk, just like Mom always told you to do, here’s another area where she was right: eat your broccoli.  Broccoli is loaded with helpful brain-strengthening nutrients including choline, vitamin K, and folic acid.  The Telegraph reports that studies have shown “people who eat large amounts of broccoli perform better on memory tests.” Who knew?

A few more brain-saving dietary tips from the Telegraph: eat more blueberries (and other purple fruits), more fish, and more curry. Purple fruits (and also green tea) protect the body from harmful iron compounds that doctors believe are one of the root causes of damage to the body associated with diseases such as Alzheimer’s.  Most seafood has long been known to possess a wide range of health benefits generally linked to omega-3 fatty acids found in certain fish including salmon, mackerel, sardines and albacore. And finally, curry dishes that contain turmeric should be part of a mind-health diet, because turmeric contains a compound called curcumin which is believed to control the spread of plaque in the brain associated with dementia. In lab studies, the compounds in turmeric helped prevent brain plaques in younger mice and reduce plaque size in older animals – an encouraging reason to enjoy this tasty spice.

What about the second article we mentioned above? This one comes from the website Newsmax, and it brings a similar message:  “Anti-Alzheimer’s Diet Can Cut Your Risk In Half.”  “Eating the right foods can slash your risk of developing debilitating Alzheimer’s disease by half,” the article asserts, referring to scientists and researchers “who tout brain-healthy food plans as powerful weapons in your arsenal to battle dementia.” So what are these miracle foods? The great news is, eating for a healthier brain doesn’t have to be complicated, exotic or expensive, and it’s not only good for your mind but for your body as well.  For example, nutritionists in Chicago combined two proven heart-healthy diets into one plan called the MIND Diet (we’d tell you what “MIND” stands for but it’s pretty complicated sounding) that was shown in multiple studies to reduce Alzheimer’s effects by more than 50 percent. The MIND Diet combines the basics of Mediterranean eating with a diet designed to help control blood pressure. If you build a diet around green leafy vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and an occasional glass of wine, the chances of your becoming an Alzheimer’s sufferer, this research suggests, appear to be significantly reduced.

So knowing how to eat can help you stay mentally and physically healthy for years, even decades longer. In similar way, knowing how to plan for retirement can keep you on a healthy and fruitful track toward a rich and rewarding retirement, so you can protect your assets as you age, avoid becoming a burden to those you love, and escape the sad fate of being institutionalized against your wishes. With the power of an AgingOptions LifePlan, you can age on your own terms, with your finances, legal affairs, housing choices, medical protection and family communication all working together seamlessly. To find out more about this breakthrough in retirement planning, join us soon at a free AgingOptions LifePlanning Seminar. Invest just a few hours and you’ll come away with a brand new perspective on your own future!

You can click here for dates, times, locations and online registration – or call our office during the week so we can answer your questions. A healthy and joy-filled retirement is within your grasp, with an AgingOptions LifePlan.

(originally reported at www.telegraph.co.uk and www.newsmax.com)

Hoping to Age in Place? Technology Could Help Make it Possible

What’s one thing 9 out of 10 seniors say they want to do? The answer is, they want to grow older in their own homes – to age in place. Some call it “non-assisted living” and some call it “living independently,” but the simple bottom line is that people almost all say they don’t want to move into a healthcare institution until they absolutely, positively have to, and maybe not even then. We can’t count the number of times this topic comes up on our call-in radio program and in our LifePlanning Seminars. Aging in place is practically every senior’s dream.

Knowing how strongly people feel about this, we were naturally drawn to this article from USA Today which appeared a few weeks ago, talking about the role of technology in helping seniors stay at home longer. We’ve seen articles like this before, and frankly we’ve been a little bit skeptical about the role of gadgetry in the issues of aging– after all, is keeping a video camera trained on Mom really going to help her feel more secure? But as these devices have become more sophisticated and less expensive, they may be worth a look for families intent on helping a loved one live safely in their own home. It’s also interesting to note that today’s boomers are much more comfortable with digital technology (generally speaking) than their parents were, and as these boomers age we could very likely see a rapid rise in the number of them using electronics to help them live the way they want – independently and at home.

“Today, high-tech monitoring systems and other gadgets are helping seniors age in place independently,” writes USA Today, “while giving family members peace of mind in the process.  What’s more, home-based tech tools could be far less expensive than moving into an assisted living environment.” With that as a backdrop, let’s take a look at what caught the eye of USA Today. What are some of the breakthroughs helping promote aging in place?

The first technological category of interest is sensors. Any adult child who is trying to monitor the health and well-being of an aging parent living alone knows the feeling of calling on the phone several times each day to check in – and the uncertainty if Mom or Dad fails to answer or things don’t sound quite right.  USA Today says, “Rather than calling Mom six times a day to check in, activity-based sensors around the home can discreetly alert loved ones she’s up and carrying about her daily business.” Sensors can tell if a loved one is or isn’t out of bed, whether a medicine cabinet or refrigerator door has been opened or not, and even whether a loved one is drinking enough water. With one in-home system, professionals install sensors wherever the family wants them, and then (for a monthly fee) if anything is amiss, an alert is instantly sent via phone, email or text to designated caregivers. Once again, we wonder if many families are ready for this level of technology, but if a parent insists on living independently he or she may demand having those sensors installed.

Emergency pendants have been around a while (“Help, I’ve fallen and I can’t get up!”) but some of the newer models may be worth looking into to help monitor independently-minded adults. In addition to the “panic-button” feature long available, some pendants offer two-way voice communication with 24 hour monitoring. Others are designed to work outside which is helpful for seniors who spend time out in the yard. One feature we think makes a lot of sense is built-in GPS on some pendant models to guide emergency workers to the wearer’s precise location.

The final bit of tech we’ll look at in this summary of the USA Today article is the medication reminder and pill dispenser. This may not seem like such a big deal to some, but once again anyone who has cared for an aging loved one knows the difficulty of making sure Mom or Dad took their pills in the right dose at the right time. It’s potentially dangerous when a dose is forgotten, or when someone takes a double dose out of confusion or forgetfulness. Some of these high-tech reminder/dispenser systems, while not cheap, definitely take the guesswork out of prescription monitoring. Basic systems hold pills inside a special container and rotate to dispense the right medications at the right time, sending out an alarm and flashing light when dosage time comes (as many as six times each day).  Other systems are more sophisticated (and pricier): one even can be programmed to alert a loved one when a dosage is skipped.

So is all this technology a good thing or a bad thing? As with many scientific advances, we would argue that the technology itself is neutral, neither bad nor good: the key is how we use it. If a family tries to use technology as a replacement for personal, loving involvement, then we call that a negative outcome, but if these tools help an aging family member live independently and avoid becoming a burden on his or her loved ones – who are still very much involved in a loving and caring way in the senior’s daily life – then technology can be a great blessing. As we often say at AgingOptions, aging is a family affair.

All that said, we believe that no amount of technology will replace the human touch.  A living, caring person with “eyes and ears on the ground,” so to speak, will always have a different and more intuitive way of evaluating the overall health of a loved one.  To that end we would like to suggest a low-tech solution: a local care manager.  This person can be a social worker, nurse or similar professional who you can arrange to have visit Mom or Dad on a regular basis to check to make sure that all is well.  If they see anything amiss, the care manager will be the first person to intervene in a timely manner.  You can learn more about this time-tested low-tech solution by going to www.bettercaremanagement.com or to www.caremanager.org.

Perhaps you’re getting serious about planning for your own retirement, and you’re ready to take the next step. If that’s so, we recommend that you investigate the power of an AgingOptions LifePlan. Our approach to retirement planning is unique, blending all the key elements of aging into one seamless strategy: your financial plan, your legal protection, your housing choices, your medical coverage, even communication with your family. There’s no better way than with an AgingOptions LifePlan to protect your assets as you age, avoid becoming a burden to those you love, and escape the unhappy fate of being forced into institutional care against your wishes.

If this kind of well-planned independence appeals to you, come join us and learn more at an upcoming LifePlanning Seminar. You’ll find dates, times, locations and registration information here. (Or if you prefer, call us for assistance during the week.) These free seminars definitely fill up fast, so register today, and we’ll see you at a LifePlanning Seminar soon.

(originally reported at www.usatoday.com)

Warning: Even Mild Cognitive Impairment Makes Driving Dangerous

Summertime means road trips for many American families.  With the Independence Day holiday just passed, the news has been filled with stories about more and more people taking to the highways, thanks in part to gas prices (adjusted for inflation) at near record lows. With that in mind, now that “driving season” is in full swing, we’re bringing you this blog post from earlier in the year about one of the touchiest topics a family can face: when should an aging parent stop driving, especially if he or she is showing alarming early signs of cognitive decline?

As if the discussion about when an aging adult needs to stop driving weren’t difficult enough, along comes a recent Canadian research study showing the added dangers of driving with even mild cognitive impairment. Everyone knows that seniors with signs of significant memory loss should never get behind the wheel. Now it appears even those whose cognitive impairment is in its earliest stages may also pose a risk to themselves and other motorists – a risk they’re probably not even aware of.

We found this current article on a website called The Oldish (www.theoldish.com). It points to a relatively small yet significant study conducted at St. Michael’s Hospital in Toronto which compared the driving skills of 20 healthy seniors against 24 seniors with what researchers called “mild” cognitive impairment – those displaying early signs of memory loss.  The results were sobering. According to the web article, “Those with mild impairment made more than twice as many driving errors than the healthy group.” The most common mistakes included “turning left with oncoming traffic and crossing the center line or straying from the legal driving lane,” all potentially dangerous, even disastrous driving blunders.

“Driving requires quick thinking, careful attention, memory and decision making which can be impaired in the early stages of Alzheimer’s disease,” writes the author. However, and surprisingly, “there are (currently) no recognized means of assessing the safety of people driving with mild cognitive impairment.” This seems to put the onus on families to decide when it’s time for Mom or Dad to turn in their keys – a challenging conversation under the best of circumstances.

Based on our years of experience here at AgingOptions, this decision regarding older people continuing to drive seems especially hard here in America, where for a century we have had a prolonged love affair with the automobile. Getting your driver’s license is the ultimate rite of passage for most American teens. Driving is associated with freedom and independence – so being forced to stop driving is seen by most seniors as the ultimate proof of their decline, dependence and approaching end of life. No wonder many hold onto this privilege tenaciously.

In the words of the article on The Oldish website, “When seniors should stop driving or be forced to stop driving is a complex question that often polarizes older adults and their families or caregivers.” This issue is exacerbated in many communities by a shortage of viable alternatives to driving. “Reliable, affordable transportation is one of the most pressing concerns of seniors aging in place who wish to remain active members of their community without becoming socially isolated.” For that reason, if your parent or loved one needs to stop driving themselves around, you may need to help them come up with other options. “Family or friends can assist seniors in developing a list of alternative transportation options to help alleviate some of the fears and frustration surrounding stopping driving.”

Finally, this helpful article includes a link to the Dementia and Driving Resource Center on the website of the Alzheimer’s Association (for your convenience we’re also providing a link here). This site can help you determine how and when to approach a loved one whose cognitive impairment is adding to the danger when they take to the road. There’s a complete list of specific warning signs the Alzheimer’s Association website, but here’s a taste:  when driving, does your parent or loved one sometimes forget their destination or how to get there? Do they seem confused, making slow decisions, driving at inappropriate speeds, or using poor lane control? Do they become unusually angry when driving? Do they ever confuse the brake and gas pedal? Do they frequently hit curbs or make errors at intersections? Any of these, singly or in combination, should trigger a warning.

Here at AgingOptions our commitment is to help you with all the decisions you need to make as you plan for a healthy and fruitful retirement. If you need to hold a family discussion about issues such as the ones set forth in this article, we can advise you. Aging, as we always say, is a family affair, and that means part of the planning process entails making certain those closest to you understand and support your wishes in retirement. What’s more, thanks to a strategy we call LifePlanning, we can help you navigate virtually all the challenges of retirement, including your health care planning, your optimum choices for housing, your path to financial security, and your need for legal safeguards to maximize the protection of your estate. LifePlanning is the best way we know to enjoy the kind of retirement you’ve always hoped for.

It’s easy to take the next step and find out more: simply invest a few hours and attend a free, no-obligation LifePlanning Seminar in your area. You’ll come away with a brand new perspective on the power of a solid LifePlan for your future. For dates, times and online registration, click here, or contact us during the week. We’re looking forward to seeing you at a seminar soon.

(originally reported at www.theoldish.com)

If You’re Over 50, These New Exercise Rules Apply to You

Maybe you’re in your 50s or 60s (or beyond) and you’ve decided it’s time to get serious about exercise. Or maybe you’ve always been active but now that you’re getting older you’re starting to wonder if it’s time to start doing your workouts differently. No matter where you are on the spectrum between “couch potato” and “fitness fanatic,” there are two things you need to know: first, the older we get, the more important exercise becomes – and, second, the older we get, the more important it is to know how to stay fit. There are new rules of exercise that apply as we age.

That’s what we learned when we found this interesting and helpful article on the popular website Next Avenue. The article explains that as we get older our bodies respond to exercise differently than when we were younger. “A funny thing happens on the way to 50 and beyond,” writes Health and Wellness Blogger Linda Melone: “your body doesn’t respond to exercise as it did earlier in your life. Fatigue, muscle and joint aches and increased injuries seem to happen with greater frequency.” If that’s what you’ve been experiencing, rest assured that it’s a common pattern. “Unfortunately, it’s not your imagination,” says Melone. “It happens to the best of us as a natural consequence of aging.”

So if you learned some tips about exercising and working out back when you were in your 30s or 40s, you may think those same rules and principles apply today – but you’re wrong, and your body will pay the price if you don’t learn some new workout ideas.  The Next Avenue article lists several specific exercise rules that will help you stay injury-free as well as physically and mentally fit.

The reason we at AgingOptions are bringing this to your attention is because the better you are at maintaining your health, the better your odds of enjoying the kind of rewarding and independent retirement you’ve always hoped and dreamed about. Our goal is to teach our clients how to plan carefully for retirement so they can protect their assets, avoid becoming a burden to loved ones, and escape the trap of being forced into institutional care against their wishes. While staying healthy isn’t necessarily a guarantee that you’ll achieve these goals, we can say from decades of experience that allowing your health to deteriorate almost ensures that you’ll spend more money on health care, be forced to rely on others, and give up your independence prematurely. If that’s what’s at stake – and it is – then getting started on a well-planned exercise regimen and staying with it seems to us like the best investment in your future that you could possibly make.

Remember, if you’re over 50 and committed to getting more exercise, knowing the right way to do it can not only help you stay healthy but also keep you from injury. But we caution you not to start any exercise program without first getting good advice from your doctor or other health care professional – ideally a geriatrician who has a thorough understanding of the health needs of seniors. We won’t go into all the details – for that we suggest you take a look at the article – but here are the highlights of what Next Avenue recommends:

  • “Stretch after every workout, and then some.” The Next Avenue article reminds us that flexibility becomes far more important (and more elusive) as we age, so exercise experts recommend a total body stretch multiple times each week. Stretching, experts say, is not an option!
  • “Resistance training takes center stage.” You probably used to focus chiefly on cardiovascular health, and that’s still important. But as we age, we lose bone density and muscle mass, a loss which can be slowed through some forms of resistance training. Working your muscles this way has also been shown to contribute to enhanced cognitive abilities. Better start doing some carefully planned lifting.
  • “Use interval training to pump up the fat burn.” The old emphasis on slow and steady cardio workouts may need to give way to an “interval training” approach where periods of high intensity cardio exercise alternate with periods of relative rest.
  • “You may need longer than a day between workouts.” Used to be you were told to work out every other day, but now you may find you need more time than that for your muscles to recover fully. If your muscle soreness doesn’t go away quite so quickly, you may need more time between periods of exercise, says Next Avenue’s Melone.
  • “Always include a thorough warm-up.” Warming up before you exercise boosts your heart rate, increases your body temperature and improves range of motion in your joints. It may not have been quite so essential when you were younger to warm up before you work out, but now that you’re older you need to take the time to get your body used to the idea of exercise. Even a light workout on the treadmill will help.

Staying fit as we age requires a good plan, some sound advice, plenty of accurate information and the will power to stick with it. And that’s also what’s required to have a great experience in retirement. At AgingOptions, we can’t provide you with the will power to follow the plan, but we can help you with everything else you’ll need, in the form of an AgingOptions LifePlan – a unique type of comprehensive retirement plan that weaves all the vital threads of your future into one carefully crafted strategy. Your LifePlan blends your financial, legal, housing, medical and family plans together so they all support each other, no matter what the future may bring.

Why not invest a few hours and find out more about this revolutionary approach to retirement planning? Attend a free AgingOptions LifePlanning Seminar at a location near you. Simply click here for details and online registration, or call us during the week. It will be our pleasure to help you become truly fit for your retirement future. And as we say at AgingOptions, “Age on!”

(originally reported at www.nextavenue.org)

 

 

 

 

BULLETIN: Senate Health Care Proposal Means Big Medicaid Cuts

By now just about everyone has heard at least some of the details of the Senate’s version of the American Health Care Act – the law that Republicans have been crafting in order to fulfill an eight-year-old promise to their voters to repeal and replace the Affordable Care Act, better known as Obamacare. After the house passed their version of the AHCA in May, all eyes turned to the Senate to see what legislators would craft behind closed doors. The final proposed bill, released to the public on June 22nd, looks a lot like the House version, but with some proposed differences.

Now the debate will begin in earnest. But no matter what eventually happens to this legislation, the big news to us here at AgingOptions is the impact of the AHCA on Medicaid, the federal and state program which pays for all or part of the medical needs of more than 73 million Americans, most of them the low income elderly.   This is a major story to watch, because for many of our clients, radio listeners and seminar guests, Medicaid will play a significant role in their eventual long-term care. If you have a small to medium sized estate, understanding the issues surrounding Medicaid has never been more urgent.

Since the Senate released its version of the bill, there has been a blizzard of news reports and analyses trying to make sense of its provisions and changes. This article just published on the website of The Atlantic does a good job of describing the proposed new health care law from a more liberal point of view, as indicated by its title: “The Senate Puts Medicaid on the Chopping Block.”  The bottom line, says the article, is that the Senate’s version of the AHCA “restricts and slashes Medicaid funding deeply over the next decade” – and, we would add, well beyond that time if the law passes unchanged.

We should, of course, point out the obvious: we live in politically turbulent times. It’s entirely possible that the Democrats may return to power in the House in 2018 or the Senate (or even the White House) in 2020, and if they do they would likely attempt to roll back the GOP’s changes to Obamacare. But whether or not that happens, anyone regardless of political persuasion can see that we are entering a time of great instability and unpredictability in national health care policy, and if you (like millions of other retirees and those facing retirement) are counting on Medicaid to be there for you, you may need to think again. Don’t base your future security on a dangerous illusion!

There are far too many details in this proposed law for us to discuss here, but the changes to Medicaid rules in both the Senate bill and the House bill are what really caught our attention. Some of the particulars involve the GOP’s aim to roll back the expansion of Medicaid to many who formerly had been ineligible, a provision of Obamacare that a large number of Republicans have long disliked. Many of those now covered by Medicaid are part of the group often called “the working poor,” people who are employed but unable to afford health insurance in the marketplace. The Senate bill would phase out Medicaid expansion funds more slowly than the House version, which makes the Senate version sound less harsh.  But the new law, if passed, would have immediate unintended consequences. “Seven states,” says The Atlantic, “have ‘trigger laws’ that would immediately void their Medicaid expansions with any change in federal support,” which could suddenly add millions to the ranks of the uninsured.

We are also especially concerned about the proposal in the new law that changes what is now open-ended Medicaid funding into a “block grant” to the states. This change, says The Atlantic analysis, turns Medicaid into “a per-capita cap scheme, where states receive a capped amount of funding each year per enrollee.” This shift, say analysts, “would underfund Medicaid over time, leading to a growing gap between the number of patients who would be eligible under current guidelines, and the funds available to pay for their care.” The eventual outcome would be “large-scale shortfalls in every state, which would need to be closed by reducing enrollment or benefits, and cutting capacity to respond to disasters and public-health crises.” The ones who would suffer the most would be children, seniors and the disabled.

Critics of the new proposed law call it “a massive constriction of the safety net. It will have a substantial impact on both wealth and health, shifting the benefits of public policy away from the poor and the sick, and toward the healthy and the affluent.” Whether or not you agree, as we said before, it has never been more urgent that you become well informed about the need to protect your assets and cover the costs of your future health care needs with a Safe Harbor Trust or other well-planned financial and legal tool.

The best way to begin getting the answers you need right now is to attend a free AgingOptions LifePlanning Seminar. We offer these at locations throughout the area, and because of the recent spate of headlines we expect our currently-scheduled seminars to fill up rapidly. Click here for details and online registration, or call us for assistance. Don’t let the changes in the health care law catch you off guard! We’ll see you soon at an AgingOptions LifePlanning Seminar in your area.

(originally reported at www.theatlantic.com)

Too Many Seniors Leaving the Hospital are Refusing this Vital Service

One would think that a vulnerable senior adult being discharged from the hospital to recover at home from illness or surgery would welcome the offer of in-home medical help. Many do – but a surprisingly high number refuse the help they need, putting themselves at far greater danger of ending up right back in the hospital.

That’s just part of the findings in this very recent article on the website of Kaiser Health News. Kaiser author and aging expert Judith Graham reveals that as many as 28 percent of adults, most of them seniors, who are offered home health care upon discharge from the hospital refuse it, even though in most cases the cost is largely covered by Medicare, at least for a while. “Refusing home health care after a hospitalization,” Graham writes, “puts patients at risk of a difficult, incomplete or slower-than-anticipated recovery.” It also increases the likelihood that they’ll find themselves back in the hospital far sooner: a recent study shows that older adults who refuse home health care services are twice as likely to be readmitted to the hospital within 30 or 60 days.

One 84 year old man who was recovering from a mini-stroke was insistent that “he didn’t want anyone coming into his home, and he didn’t think he needed any help,” says the article. As a result the social worker cancelled the order for home health care services and sent the man home without a follow-up plan, completely disregarding the wishes of the man’s daughter who had spent weeks trying to convince her dad that the care was important and necessary. This kind of family miscommunication, writes Judith Graham, is all too common.

Why do so many seniors turn their back on services that can speed their recovery and even save their lives? There are many reasons, the Kaiser article suggests, starting with the idea that many older adults don’t understand what “home health care” services actually entail.  “Under Medicare,” writes Graham, “home health care services are available to older adults who are homebound and need intermittent skilled care from a nurse, a physical therapist or a speech therapist, among other medical providers.” These services typically last between four and six weeks after a hospitalization, with a nurse visiting several times a week. Occasionally home health care services can last even longer.

It’s important for seniors and their families to understand that “home health care” and “home care” are not the same. Home care “is delivered by aides who help people shower or get dressed or who cook, clean and serve as a companion,” the Kaiser article explains, while home health care is delivered by medical professionals. Also unlike home health care, home care is generally not covered by Medicare.

But apart from this misapprehension, families and caregivers need to understand some of the deep-seated psychological and emotional reasons for seniors to refuse home health care.  In the words of one San Francisco geriatrician, “Older adults are quite concerned about their independence, and they worry that (accepting care) might be the first step in someone trying to take that away.”  Many seniors are also intensely private and they are apprehensive about losing their privacy when a “stranger” comes into their home on a regular basis. Some may be afraid of becoming victim of fraud or abuse at the hands of a caregiver they don’t know. In some cases, a senior who is beginning to experience cognitive decline may not be able to make a rational decision, or they may be embarrassed if they’re having difficulty taking care of their own home.

But in some instances the older adult, like the 84 year old mentioned above, is just plain stubborn. They think they can get along just fine, and they really have little or no idea just how hard recovering from a hospitalization is likely to be.

Here at AgingOptions we definitely recommend the Kaiser Health News article because it spotlights a problem you might never have considered: what will you do five or ten or twenty years from now if your proud, independent parent is refusing the home health care you know they need? We do have two pieces of advice. First, if you’re a senior (or if you have a loved one who is) we strongly urge you to visit a geriatrician in your area and make him or her the most important individual on your health care team. Having a physician who specializes in issues facing older adults will be essential, not just today when things are relatively stable but tomorrow when a health emergency hits. The second recommendation is for you to contact us at AgingOptions and schedule a family conference. Our trained professional staff will guide you as you review many of these potentially troublesome issues, and you’ll find that by discussing and planning now you can avoid huge problems and conflicts later.

If you’re at the stage where you need more information about comprehensive retirement planning, why not do what thousands in the Pacific Northwest have done and attend one of our free AgingOptions LifePlanning Seminars?  Invest just a few hours in one of these information-packed sessions and you’ll come away with a fresh understanding of how all the elements of your retirement plan – legal, financial, medical, housing and family – need to mesh together in one seamless blueprint. That’s the genius of an AgingOptions LifePlan! If you’ll click on this link to our Upcoming Events page, you’ll see all the currently scheduled seminar dates, times and locations – then you can register online or contact us for assistance during the week. It will be our pleasure to meet you soon at an AgingOptions LifePlanning Seminar near you.

 (originally reported at www.khn.org)