New Website Helps Seniors Plan for Late-in-Life Challenges

We just discovered this very recent article on the website of Kaiser Health News, one that really captured our notice. The article is called “A Playbook for Managing Problems in the Last Chapter of Your Life,” and it calls attention to two themes we emphasize repeatedly in our seminars and on the radio – the need for better planning as we age, and the need to involve our families and other loved ones in our care. We encourage you to read this piece and see if you agree.

The article spotlights the work of Dr. Lee Ann Lindquist, chief of geriatrics at Northwestern University. Virtually every day, she noticed, she would receive panicked phone calls from family members about seniors in distress as a result of unplanned hospitalizations, injuries due to falls, and the effects of dementia. Loved ones were at a loss, not knowing what to do or where to turn. Dr. Lindquist, says Kaiser Health News, “wondered if people could become better prepared for such emergencies, and so she designed a research project to find out.”

As the doctor stated in the article, “Many people plan for retirement. They complete a will, assign powers of attorney, pick out a funeral home, and they think they’re done.” But she goes on to say that there are critical things that fail to get addressed, including “how older adults will continue living at home if health-related concerns compromise their independence.” In order to help seniors plan for late-in-life challenges, primarily those that typically occur from about age 75 onward, Dr. Lindquist and her associates developed a unique website, called Plan Your Lifespan (www.planyourlifespan.org). As the Kaiser article explains, this website isn’t “end of life” planning – instead, “it’s planning for the period before the end, when health problems become more common.”

Dr. Lindquist and her team, funded by a $2 million federal grant, gathered focus groups of seniors with an average age of 74. The research team asked the seniors what events or crises would make it difficult or impossible for them to remain in their own homes. The subjects listed five: hospitalization, falls, dementia, illness or death of a spouse, and inability to handle home upkeep.  Yet even though there was broad consensus on the impact of these five events, researchers noted that most of the study participants had never planned or discussed what they would do if these types of events should occur. When asked why they had never planned for the things they seemed to fear most, the seniors gave a common list of reasons: “I don’t know what to do, I’m uncomfortable asking for help, I’m not at immediate risk of something bad happening, my children will take care of whatever I need, and I’m worried I won’t have enough money.” In other words, these typical seniors were living in denial.

Armed with this information, the research team developed and fine-tuned the website. They narrowed the focus down to the “Big Three” events – hospitalizations, falls and the onset of dementia. What impressed us here at AgingOptions was that the developers made sure the website helped seniors communicate thoroughly with their family members and also plan for the financial impact on their lives should they one day face one of these health crises. In the words of one 74 year old who worked on the project, the website “forces people to sit down and think about their future in a very helpful and non-threatening way.”

The process is both simple and specific. Seniors visiting the website are presented with explanatory information and brief instructional videos, then asked a series of personal questions. For example, the website might ask which rehabilitation facility the senior would want to go to for post-hospitalization therapy and recovery? Who will care for his or her pets, check the mail and pay the bills?  If memory becomes an issue, would the person be willing to wear a medical alert bracelet? Would he or she be willing to undergo a formal driving evaluation?  Would they be willing to have someone coming into their home on a regular basis to provide some degree of assistance with activities of daily living or with home maintenance?

The website is not intended to be overly detailed. “The goal,” says the Kaiser article, “is to jump-start conversations about these issues” in much the same way that seniors are encouraged to talk about their end of life preferences. The point, says Dr. Lindquist the study leader, is to give seniors facing a health crisis a voice, instead of having their confused and frightened loved ones making decisions in a vacuum. “That doesn’t have to happen,” Dr. Lindquist says, “if only people would consider the reality of growing older and plan ahead.”

If that sounds exactly like a statement we might make here at AgingOptions, it should. Planning ahead for all facets of retirement is our number one focus, and while you can never consider every possible eventuality, there are certain events and transformations that most seniors can not only anticipate but also plan for. That’s why we developed a unique form of comprehensive retirement planning called LifePlanning. Your LifePlan serves as the strategic document that binds all the key aspects of your future together: your financial security, your legal protection, your housing choices, your health care coverage, and communication with your loved ones. All these threads are woven together into one strong cord. A LifePlan is the type of plan that will allow you to face the rest of your life with confidence and joy.

It’s easy to learn more about LifePlanning. Simply plan to attend a free LifePlanning Seminar coming soon to a location near you. We assure you that you’ll come away armed with extremely valuable information, not to mention the answers to many of your most perplexing retirement questions! We invite you to click here for information and online registration. Or, if you prefer, feel free to call us at AgingOptions during the week so we can assist you.

(originally reported at www.khn.org)

 

Eating Disorders among Seniors Often Go Undetected or Misdiagnosed

Your mom is getting older and she’s really starting to lose weight. At first you think it’s merely the side effects of aging, but then you begin to wonder – could something else be going on?

The answer could surprise you: Mom may be suffering from an eating disorder. In spite of the fact that we generally associate disorders such as anorexia, bulimia and binge eating with much younger people, experts say a growing number of seniors are being diagnosed with some of these conditions.  One study that was done a few years ago found that about one woman in eight over the age of 50 had some symptoms of eating disorders, with most trying to lose weight even when it was unhealthy to do so.

If you have a senior loved one in your life, we encourage you to read this recent article on the US News website. The article asks – and answers – the question, “Can Older People Have Eating Disorders?”  The subtitle definitely caught our eye: it reads, “Clinicians rarely detect the conditions in elderly patients, but they exist – and can be treated.” This article represents one more solid argument why every senior should have a geriatrician on his or her medical team – because it reflects the fact that “regular” doctors often miss the medical conditions that are unique to older adults. As you know if you are a regular reader of our blog or listener to our radio program, we at AgingOptions will gladly refer you to a geriatric physician in your area, to protect your health or the health of someone you love.

What is an eating disorder? According to the National Eating Disorders Association, these conditions are “psychiatric illnesses marked by extreme feelings and behaviors around weight and food.” Eating disorders can have life-threatening physical and mental consequences, especially for already-frail seniors. The US News article states, “While the conditions most commonly emerge in adolescence and early adulthood, middle-aged and older adults aren’t immune, particularly if they didn’t resolve body image issues earlier in life.” Sometimes the stresses associated with aging can trigger eating disorders.

What are some of these stresses? Doctors know that eating disorders can be exacerbated by body changes during adolescence or by the stress of constant relocation and job-related tensions in early and middle adulthood. As we reach retirement age, these emotional stress points can reoccur, set off by changes such as leaving our jobs, losing our friends to illness and death, and for many the pressures of serving as a caretaker to an aging spouse or family member. Author and eating disorder expert Margo Maine explains, “By the time women are … going through the psychological stressors of that time period … there’s a renewed desire to have something to control.” Maine adds, “The body is the way that we do that.” In other words, when a person’s life feels like it’s out of control, he or she will find something to control, even if that desire leads to dangerous disorders that can cause irreparable harm.

The challenge, says the article, is that it can be extremely hard for most clinicians to diagnose eating disorders in older adults. That’s partly because eating problems among seniors can be caused by many age-related conditions that are more common: dementia, or decline in tasting ability, or lack of access to healthy food choices. “What’s more,” US News reports, “few clinicians who work with older adults have the training or awareness to consider eating disorders a potential cause for general symptoms like weakness, dizziness or dehydration.” One doctor quoted for the article said physicians who evaluate health problems in older people have a tendency to look for anything but an eating disorder.

But it’s critical, geriatricians say, to recognize and properly diagnose eating disorders in seniors. Conditions like anorexia and bulimia require special treatment. However, to an untrained eye, the visible problems – a weak immune system, poor wound recovery, anxiety, cognitive impairment, weight loss, weakened muscles and bones, and an increased risk of falls – tend to be blamed on other, more common conditions of aging. US News suggests these three tips from experts on eating disorders among seniors.

First – don’t jump to conclusions. The older adult in your life may be losing weight or having trouble eating for any of several reasons. But don’t rule out an eating disorder, either. Instead, get an informed opinion from a geriatrician who knows what to look for.

Second – be careful when you approach your loved one about an eating problem. You don’t want them getting defensive or angry if you can help it. One suggestion is to begin by eating some meals with the senior in your family to see if they have difficult preparing or eating food. Be alert to comments about “getting fat” from a senior loved one who already appears thin.

Third – you can teach an older adult new strategies to help him or her enjoy eating once again. But if there seems to be an underlying issue with food, don’t assume it will resolve by itself. Your loved one may need to see a mental health professional. The US News article links to some helpful resources.

If you need helpful resources to plan for your retirement, look no further than AgingOptions and one of our LifePlanning Seminars. At these highly popular events you’ll learn about a comprehensive approach to retirement planning that blends every key element of retirement living: your financial plans, your legal protection, your housing choices, your medical coverage, and communication strategies with your family. A LifePlan will be your blueprint as you build the retirement you’ve always hoped for.

There’s a free LifePlanning Seminar coming soon to a location near you. Simply click here for dates, times and online registration. We’ll look forward to meeting you at an upcoming AgingOptions LifePlanning Seminar.

(originally reported at http://health.usnews.com)

 

Lewy Body Dementia: Less Common than Alzheimer’s, Still Devastating

Almost everyone who reads the AgingOptions blog or listens to our radio program knows something about Alzheimer’s disease, and many of us have had personal experience with a loved one suffering from it. Experts estimate that nearly five and a half million Americans have Alzheimer’s disease and that number is expected to rise dramatically in the years ahead.

But there’s another, less common form of dementia that in many ways mimics Alzheimer’s disease and is often mistaken for it. It’s called Lewy body dementia. This lesser-known cousin of Alzheimer’s affects an estimated 1.4 million Americans, and it often goes misdiagnosed because of its odd array of symptoms. But because Lewy body dementia responds differently from Alzheimer’s disease to commonly prescribed medications, getting a correct diagnosis is important.   That’s why we found this recent article on the website of the Mayo Clinic extremely insightful, and we hope you’ll take the time to read it – especially if someone close to you is wrestling with severe cognitive decline.

Lewy body dementia, like Alzheimer’s disease, is a brain disease that gets progressively worse over time. Experts say it’s caused by an abnormal protein, called synuclein, that becomes deposited in nerve cells and affects nerve processes. These deposits are called “Lewy bodies,” named after the physician who first identified them. In the Mayo Clinic article, author Dr. Neill Graff-Radford explains that “Lewy bodies are found in the deep structures of the brain that control movement, as well as in the middle and outer structures involved in emotion, behavior, judgment and awareness.”  The disease progresses over several years but the effects can vary greatly from patient to patient.

What are some of these symptoms? Because many people suffering with Lewy body dementia also have significant Alzheimer’s disease, the Mayo Clinic article points out that the symptoms seem to mimic Alzheimer’s – things like memory loss and difficulty with names and places. Those with Lewy body dementia may also experience tremors such as the ones occurring with Parkinson’s disease, sometimes before the dementia becomes obvious and sometimes after. But one of the major distinctions of Lewy body dementia among some sufferers is the early onset of hallucinations, often within the first year after diagnosis.

In researching this article, we discovered this very recent profile of a woman in Lincoln, Nebraska, who had been diagnosed with Lewy body dementia just nine months ago. The article describes in vivid detail how this 63 year old woman has been emotionally paralyzed and left virtually housebound by a worsening series of vivid hallucinations.  As her doctor described it, her illness not only brings on severe, threatening hallucinations but is also accompanied by “vast fluctuations in cognition” and mental symptoms that come and go. “With Lewy body dementia, a patient may not recognize you one day, and the next have total recall of extended family members,” the article reported.

Another common symptom of Lewy body dementia is significant difficulty sleeping.  As the Mayo Clinic describes it, “People who have Lewy body dementia also may experience a sleep condition known as REM sleep behavior disorder, in which people act out their dreams while they sleep.” This is obviously disconcerting to spouses and family members. The Mayo Clinic article adds that Lewy body dementia sufferers “may have instability in their blood pressure and heart rate, and the body may have difficulty controlling body temperature and sweating.”

Is there any good news in all this? There are clinical trials currently underway (the woman featured in the Lincoln, Nebraska article is a participant) testing to see whether new drugs might reduce symptoms or slow the advance of Lewy body dementia, with a particular focus on reducing hallucinations and improving sleep. But at present there is no known cure and no approved therapies in the U.S. or Europe.  Still, because Lewy body dementia presents such an array of symptoms, correct diagnosis is imperative: for example, says the Mayo Clinic’s Dr. Graff-Radford, “In people who have Lewy body dementia, medications to improve motor function may make symptoms such as hallucinations worse, and medications used to combat dementia may increase Parkinsonism.” It’s not a cure if it makes the disease worse.

Whether you or a loved one are facing dementia or simply trying to plan for your health care needs as you age, we hope you’ll call us here at AgingOptions and allow us to refer you to a geriatric physician – a geriatrician – in your area. This is the health care professional you need to see, a doctor who understands the particular physical and emotional needs of aging patients. As for the rest of your retirement planning, we can help you there as well by showing you how all the facets of your retirement plan fit together like pieces of a puzzle. Along with your medical needs – helping you preserve your health – you need to take your housing desires into account, to make certain you’re living in the environment that’s right for you. In retirement, your finances will play a pivotal role, as will your legal affairs. Finally, unless your family is aware and supportive of your retirement plans, you could be heading for major family conflict in the future. An AgingOptions LifePlan is the one plan we know of that blends all these elements together: financial, legal, medical, housing and family.

If you’re ready to learn more, why not take a few hours and attend one of our free LifePlanning Seminars? There’s no obligation whatsoever – just bring your questions and prepare to have your eyes opened about a new approach to retirement security. For dates, locations and registration, click on this link – or call us during the week and we’ll gladly assist you. We hope to see you very soon at an AgingOptions LifePlanning Seminar.

(originally reported at http://newsnetwork.mayoclinic.org and http://journalstar.com)

Frequent Brisk Walks May Help with Effects of Early Alzheimer’s Disease

If someone you love has been diagnosed with early-stage Alzheimer’s disease, one of the best things he or she can do may be to get outside for a frequent brisk walk. This is according to this recent article in the New York Times, which we found encouraging. Hopefully it will encourage you as well.

The article reports on a study out of the University of Kansas that apparently was among the first-ever studies of the potential of physical exercise as a treatment for dementia. Other studies (and there have been several) have focused on the power of exercise to prevent or delay the onset of dementia among otherwise healthy seniors, but this study was different: it concentrated on people already diagnosed with Alzheimer’s disease. The total study group included 70 men and women. Because Alzheimer’s disease affects physical coordination, the researchers looked for people in early stages of the disease who were still living at home and were able to walk unaided.

Alzheimer’s disease is estimated to affect over 5 million Americans and more than 35 million worldwide. There is no reliable cure, although past studies have demonstrated that physically active older people seem less likely to develop mild cognitive impairment, an Alzheimer’s precursor, than their more sedentary counterparts.  However, in the words of the Times article, “Little has been known about whether (exercise) might change the trajectory of the disease in people who already have the condition.”  That’s what made the University of Kansas study so interesting. After carefully assessing the mental and physical capacity of their subjects, researchers divided them into two groups. One group began a supervised walking program, gradually increasing speed and distance until they were walking briskly for at least two and a half hours each week. The other group began a program of light exercise focusing on stretching and toning, taking the same amount of time and offering the same level of social interaction as the walkers but without any aerobic benefit.

So what happened at the end of the six-month evaluation period? Initial findings were inconclusive. There were cognitive improvements in some of the patients, but the degree of improvement was uneven. In the assessment of the New York Times, “The study’s results, while encouraging, showed that improvements were modest and not universal, raising questions about just how and why exercise helps some people with dementia and not others.”  Still, however, there were unexpected bright spots. “Some of the walkers were thinking and remembering much better (after the test period), according to their cognitive tests. These volunteers also generally showed slight increases in the size of their brain’s hippocampus, an area of the brain affected early in the course of Alzheimer’s disease, whereas the other participants did not.”

The question was why some walkers improved while others didn’t – and when the researchers studied their data more closely, they found a possible clue. It turned out that there was a correlation between cognitive improvement and aerobic improvement. “The walkers who had increased their aerobic fitness had also improved their ability to remember and think and bulked up the volume of their brains,” says the Times. Oddly, though, not all the walkers showed better aerobic health. Researchers suspect this inconsistency suggests that Alzheimer’s disease affects how the body responds to exercise.   “It seems likely that the right exercise programs could be disease modifying,” said the study leader. “We just don’t know yet what the ideal exercise programs are.”

What’s the bottom line from this first-of-its-kind study? It appeared to demonstrate that improvement in endurance among Alzheimer’s sufferers generally improved cognitive abilities as well. As people’s aerobic fitness improved, their disease progression appeared to slow. We’ll be watching future articles and will report if new research should disclose which exercises seem to show the greatest aerobic improvement for people with Alzheimer’s disease. Meanwhile the advice we often hear about staving off the onset of dementia remains valid: stay active, stay healthy, and stay engaged both mentally and socially. What a blessing it will be to millions of Alzheimer’s sufferers and their families when science finally unlocks a cure for this devastating and frightening condition!

Some of the things we fear as we look ahead to our senior years are things over which we have little control: the onset of ill health, for example, or economic recession, or the bad choices made by those we love. But there’s a great deal about our retirement future that we can control, provided we take the planning process seriously. Here at AgingOptions, retirement planning is at the core of our professional practice, and over the years we have guided thousands of clients, radio listeners and seminar attendees to make choices that help them toward a safe and secure retirement. We call the process LifePlanning, because it blends all the elements of “retirement life” together: finances, legal affairs, medical coverage, housing choices, even communication with your family. In a LifePlan, nothing is left to chance. Why not take just a few hours and find out more about this planning breakthrough? Attend one of our highly popular LifePlanning Seminars, held at locations throughout the area. There’s no cost and absolutely no obligation.

Take the next step and click here for information and online registration. Or if you prefer, call us for assistance during the week. Let an AgingOptions LifePlan help guide you into achieving your retirement goals and dreams.

(originally reported at www.nytimes.com)

Kaiser Report: Geriatricians Best at Helping Manage Multiple Ailments

As you know if you’ve listened to our radio programs or attended our seminars, here at AgingOptions we are passionate advocates for the vital role of geriatricians in senior health. Our observation over the years is that no medical expert is better qualified than a geriatric physician to care for the needs of aging men and women.

So when we find an article as convincing as this recent piece on the website Kaiser Health News, we feel the need to share it with our readers and radio listeners. It’s called “Geriatricians Can Help Aging Patients Navigate Multiple Ailments,” and we think it does a very persuasive job of arguing the benefits of geriatric physicians for seniors. If you’re a senior yourself or a loved one caring for an aging parent, spouse or friend, we strongly recommend this article.

As we age, our health problems frequently grow more complex. Many seniors are dealing with multiple health challenges and taking several prescriptions, all at the same time. But the Kaiser article suggests that traditional physicians seem either unaware of how to deal with these overlapping issues or unable to do so. Not so with geriatricians. “[We are] experts in complexity,” says one geriatric physician. But the challenge is that few patients and health care providers have an adequate grasp of the difference these geriatric specialists can make. “No one better understands how multiple medical problems interact in older people and affect their quality of life than these specialists on aging,” writes Kaiser Health News. “But their role in the health care system remains poorly understood and their expertise underused.”

Kaiser explains that “geriatricians are typically interns or family physicians who have spent an extra year becoming trained in the unique health care needs of older adults.” Some geriatricians serve as primary care doctors to senior patients while others serve in a consulting capacity helping other doctors understand the issues their older clients are facing. Ironically, though, even as the senior population grows dramatically, the number of geriatricians is declining. In 2016 there were fewer than 7,300 geriatricians in the U.S., which is a drop from the total number just two years earlier. This makes geriatricians “among the rarest of medical specialties,” Kaiser reports.

What makes geriatricians uniquely qualified is their “expert understanding how older adults’ bodies, minds and lives differ from middle-age adults,” the Kaiser article explains. One expert, Dr. Kathryn Eubank, medical director for seniors at the San Francisco Veterans Affairs Medical Center, said geriatricians “take a much broader history that looks at what our patients can and can’t do, how they’re getting along in their environment, how they see their future, their support systems, and their integration in the community.” Geriatricians focus on issues (often called “geriatric syndromes”) that other primary care doctors often neglect, including everything from falls to incontinence to frailty, fatigue, and cognitive impairment.

“If you’re losing weight, you’re falling, you can’t climb a flight of stairs, you’re tired all the time, you’re unhappy and you’re on 10 or more medications, go see a geriatrician,” said Dr. John Morley, professor of geriatrics at Saint Louis University, quoted in the Kaiser article. “Much of what we do is get rid of treatments prescribed by other physicians that aren’t working.” The Kaiser article reports on one seriously ill patient, 88 years old, who was on a total of 26 medications! A geriatrician evaluated him and took him off all but one, dramatically improving his strength and quality of life.

If you’re ready to talk to a geriatrician, we have a few suggestions for you. The Kaiser Health News article contains a link (which we’ve included here) to the website of the American Geriatrics Society where you can search for a geriatric specialist in your area. You can also ask your own doctor if he or she has special training in geriatric medicine, but you may have to probe a bit for the answer. “Many doctors claim competency in caring for older adults,” says the Kaiser article. “Be concerned if they fail to go over your medications carefully, if they don’t ask about geriatric syndromes or if they don’t inquire about the goals you have for your care.” Above all, don’t hesitate to ask pointed questions. But the best option, we suggest, is to call our AgingOptions office and let us refer you to a geriatrician near you. You’ll be glad you did.

If you’re getting serious about retirement planning, you’ll also be very glad you attended one of our AgingOptions LifePlanning Seminars. There you’ll discover a uniquely powerful approach to retirement planning that integrates all the elements of your retirement into one seamless plan: your finances, your housing choices, your legal protection, your health care requirements, and communication with your family. You can explore this breakthrough in retirement planning without cost or obligation. To find out seminar dates, times and locations, and to register online for the seminar of your choice, simply click on this link, or call our office during the week. We’ll look forward to meeting you as together we explore the power of LifePlanning – your number one tool to ensure a secure and fruitful retirement.

(originally reported at www.khn.org)

 

New AMA Study Appears to Link Sleep Apnea with Alzheimer’s Disease

A common sleep disorder which experts say may affect up to half of all seniors has been linked to memory decline and dementia, according to a study just released by the American Medical Association. This newly discovered apparent linkage between sleep apnea and dementia is extremely important for seniors and their loved ones because it reinforces the idea that apnea, which for most people is treatable, should never be ignored.

We found this article on the Alzheimer’s Association website describing this new finding. Hopefully it will motivate you or someone you love to seek medical attention for any persistent sleep disorders.

The AMA study was conducted by researchers from the University of California at San Francisco and published in the Journal of the American Medical Association. They studied nearly 300 senior women (average age 82) for a five year period. All these women were apparently healthy and none had memory problems when the study period began. When they were monitored using special home equipment, about one-third were shown to have some degree of sleep apnea, a condition that occurs when soft tissue at the back of the throat relaxes too much during sleep, blocking the airway. People with sleep apnea can “wake up” hundreds of time during the night, although they don’t recall doing so, and can often experience grogginess and fuzzy thinking all during the day because of undetected sleep loss. Sleep apnea has been linked to heart disease, high blood pressure, diabetes and other memory problems. But, according to the Alzheimer’s Association article, “This is the first study to document sleep apnea using medical monitoring and to study its effects on the brain and cognition over time.”

So what happened to the women in the UC San Francisco study? “By the end of the study,” says the article, “more than a third of the women had developed serious memory problems.” The study also showed a strong linkage between apnea and dementia, with more than 44 percent of the women with sleep problems developing dementia or mild cognitive impairment. This was significantly higher than the 31 percent of those without sleep disorders who developed dementia or impaired cognition. Even after controlling for age, weight and other factors, “the association between breathing problems during sleep and dementia persisted.”

As the study authors put it, “Given the high prevalence of both sleep-disordered breathing and cognitive impairment among older adults, the possibility of an association between the two conditions, even a modest one, has the potential for a large public health impact.” Hopefully this study will trigger more research, including studies involving men (who are more prone to sleep apnea than women) and women of color, since all the women in the AMA study were white.

The most common treatment for sleep apnea involves wearing a CPAP machine over the mouth and nose. CPAP stands for “continuous positive airway pressure,” and while CPAP machines can be cumbersome, they do seem to work for most people. Other treatments that can be explored include surgery, special devices that change the position of the jaw and tongue while sleeping, and lifestyle changes, especially weight loss. But whichever treatment is right for you, we strongly suggest you start your medical evaluation with a geriatric physician, or geriatrician, who will have a thorough professional understanding of the full range of your health needs as a senior. We invite you to call us during the week at AgingOptions and allow us to refer you to a geriatrician in your area. Then he or she can evaluate your situation and give you the kind of treatment protocol that’s right for you. But no matter what else you do, if you suspect that breathing problems during sleep might be contributing to concentration challenges during the day, you should definitely seek professional advice.

But what about seeking professional advice for your retirement planning? If you’re like many people approaching retirement, you’re probably confused and a little bewildered by all the conflicting advice and information coming your way. Wouldn’t it be great to find a source of objective advice and guidance you can trust? Here at AgingOptions, we want to be that source. We’re not trying to sell you a product or baffle you with biased advice! Instead our goal is to help our clients develop a comprehensive retirement blueprint, called a LifePlan, than combines all the vital elements a true retirement plan needs to have: your financial strategy, your legal protection, your housing options, your medical coverage, and communication with your family. With a LifePlan in place, you can face the future with confidence and security.

We invite you to explore the power of a LifePlan in a simple, no-obligation way: attend one of our free LifePlanning Seminars. These are held in locations throughout the Puget Sound area. For dates, times and locations, and online registration, click on this link, or call us during the week and we’ll gladly assist you. It will be our pleasure to meet you soon at a LifePlanning Seminar near you.

(originally reported at https://www.alzinfo.org)

Caring for Elders While Holding a Job: the Prescription for Stress

Some months ago we read a report on the blog of the AARP that revealed a problem too often overlooked, but one that will sound familiar to a significant number of Americans. The problem is the growing number of people, estimated at nearly 24 million workers, who are holding down paying jobs while at the same time serving as family caregivers. That’s a sure prescription for stress, fatigue and uncertainty, not only for employees but also for employers. “For employers big and small,” says AARP, “the need to support workers who also provide unpaid care for a family member is a growing reality.”

You can read the AARP article by clicking here. Even though the article first appeared in mid-2016, the information – and the predicament of working caregivers that it describes – are all too relevant today.

These days, says AARP, serving as a caregiver to an adult relative (especially an aging parent) is growing more and more complex than it may have been in the past. Caregivers today often have to navigate a fiendishly complicated health care delivery system while performing more intense and complex care in the home, all while coping with the demands of work. Research suggests that employed caregivers feel a growing sense of stress and performance anxiety at work, with more and more pressure and less and less job security. Research also reveals that parents who are caring for young children at home often enjoy far more workplace flexibility than workers who are caring for older family members. Some caregivers even suggest they have experienced workplace discrimination, which according to an AARP research report from 2012, is not prohibited by most federal and state employment laws.

According to a study entitled Caregiving in the United States 2015, cited by AARP, about 60 percent of family caregivers are also employed outside the home, and most of these “working caregivers” (nearly two-thirds) are caring for a relative 65 years old or older. As if this weren’t enough of a recipe for stress, the caregivers are also aging: half of these employed caregivers are themselves 50 years old or older, which means they are already experiencing the challenges of being an older worker in today’s high-stress, increasingly insecure workplace.

There are two chief take-aways from these articles. The first, in the words of the AARP blog: “As the U.S. population rapidly ages, the need to support workers with family caregiving responsibilities will grow.” In other words, AARP favors more generous family leave and paid sick day policies, along with greater work flexibility for caregivers. The organization advocates legislation to give caregivers increased measures of employment security and, when necessary, paid time off. Above all, we need a “culture of understanding about eldercare needs” especially as they affect those in the workplace.

The second point is more concerning: as the population ages, “we’re facing a caregiving cliff,” said Dr. Susan Reinhard, AARP Public Policy expert. “By mid-century, there will only be three caregivers available for each person requiring care.” As today’s baby boomers age, there may not be enough people able to care for them. “That means,” says AARP’s Reinhard, “we need to provide support for existing caregivers who are underserved” by current services. In other words, we had better be planning now for the caregiving needs of the not-too-distant future.

Planning for the future is the centerpiece of our activities here at AgingOptions, and that includes planning for your future care needs. This will most probably involve your family members, because aging is a family affair. Have you sat down and talked with your adult children about your expectations and wishes for the future? Have you and your family members had an honest conversation about the fears and concerns each of you is experiencing as you contemplate your aging years? Far too many families leave these issues unaddressed and unresolved until it’s too late. Here at AgingOptions, we frequently conduct family conferences in which all these issues are laid out on the table for open, constructive discussion. We would be glad to do that for you. Through planning and preparation, you can successfully avoid becoming a burden to your loved ones as you age, and also avoid being forced into unplanned institutional care.

The key is to have your own personalized AgingOptions LifePlan – our name for a fully-developed, individualized retirement plan that takes all your needs into account: financial plans, legal protection, medical coverage, housing options and family communication. If you’re ready to start creating your own LifePlan, we can help. The best way to start is to attend one of our free LifePlanning Seminars – popular, information-packed sessions held in various locations throughout the area. These seminars fill up fast, however, so we encourage you not to wait. Instead you can click here for dates, and free online registration. It will be a pleasure working with you as together we plan your ideal future.

(originally reported at http://blog.aarp.org)

Some UK Seniors Wait a Year for Home Care – Could That Happen Here?

In case you hadn’t noticed, there’s a new administration in Washington, D.C., and the Republican Party is now in firm control not only of the Oval Office but also of both branches of Congress. Because some of the policies now being advocated by the new political leadership – particularly concerning Medicaid – are of special interest to seniors, we want to share two articles that fill us with a sense of foreboding. Here at AgingOptions, we fear that proposed changes to Medicaid could pose a serious risk to vulnerable retirees, and we want you to be informed.

The first “red flag” that caught our attention appeared in this article that was recently published in Great Britain, in the Daily Mail. This article revealed the shocking news that vulnerable seniors in the United Kingdom, already deemed to be eligible for home care, were being forced to wait for up to one year before receiving the help they urgently needed. One survey cited in the Daily Mail article “revealed many vulnerable people routinely face delays of more than six months before they get the help they need with tasks such as washing, dressing, cleaning and cooking.” For some the wait stretched for twice that long.

Along with this disturbing delay in providing treatment, separate figures from Great Britain also revealed a parallel problem: an unconscionable delay in releasing patients from hospitals to nursing homes. “Almost three quarters of hospitals in England have had patients wait for more than 100 days to be discharged (to a nursing home), even though they are medically fit to leave,” the article reports.

The Daily Mail suggests that a big part of the crisis stems from government budget cuts. Social care spending in the UK has fallen 6 percent, having been cut by more than $20 billion (16.4 billion pounds) in the past year alone. These reductions have forced Britain’s National Health Service to make drastic service cuts including keeping patients hospitalized far longer than necessary to avoid the higher cost of government-subsidized nursing home care. In some cases there aren’t enough nursing home beds to meet the need, and not enough home health care workers for those awaiting care in their own homes. One expert quoted by the Daily Mail asserted that “Only genuinely new additional government funding will give any chance of protecting… our elderly and disabled (to) ensure they can enjoy dignified, healthy and independent lives.”

 

So what does this have to do with Medicaid and the policies of the new administration? For that answer we discovered this very timely and revealing article on the website of the authoritative Kaiser Health News.  It’s called “Everything You Need to Know about Block Grants – the Heart of GOP’s Medicaid Plans.”  According to this analysis, which first appeared in late January of this year, the administration of incoming President Donald Trump has expressed agreement with what Kaiser calls “an old GOP strategy for managing Medicaid: turning control of the program to states and capping what the federal government spends on it each year.” This strategy is called “block granting.”

Today, following a significant expansion in 2010, the Medicaid program covers almost 75 million adults and children. “Because it is an entitlement,” says Kaiser Health News, “everyone who qualifies is guaranteed coverage, and the states and the federal government combine funds to cover the costs.” (Kaiser explains that poorer states receive a larger federal subsidy while wealthier states receive proportionately less.) Under block grants, supported by most conservatives, states would receive a lump sum from the federal government and then manage the program as they saw fit. On the surface, that may sound good. However, advocates for Medicaid recipients warn of unintended consequences. Block grants, these advocates argue, “would mean less funding for the program —eventually translating into greater challenges in getting care for low-income people.” Under a scenario like that, the situation now being experienced in Great Britain could certainly happen here.

The stakes in this debate are extraordinarily high. In 2015 Medicaid expenditures, according to Kaiser Health News, accounted for 17 percent of the nation’s health care expenditures. The 75 million people covered under Medicaid make up nearly one-quarter of the U.S. population. By far the majority of Medicaid expenditures go to benefit lower income elderly and disabled Americans, which makes it hard to see how program cuts could avoid harming those most vulnerable.

Rajiv Nagaich of AgingOptions has this sobering assessment. “This story from England gives a glimpse of what could hit us if the Trump administration passes the block grant bill,” he says. Today the amount of federal subsidy, based on a match from each state, is essentially unlimited. “If the block grant model is adopted, there will be long waits for care,” Nagaich warns – “and without money, the wait could easily be one the client may not be able to outlive.  It is even more important NOW for people to get this issue addressed and not rely on the government when instead they can do something about it themselves.”

This is clearly a critical issue, one most of our clients and radio listeners – essentially anyone with a combined estate worth $500,000 or less – will have to face. As an excellent next step, and to learn more about your options in retirement, we strongly suggest you attend one of our free LifePlanning Seminars, held in locations throughout the area. Here you’ll learn how every piece of the retirement puzzle – finances, medical care, housing, family communications and legal protection – fit together into a seamless LifePlan. You’ll also learn how to protect yourself and your assets, regardless of how the political winds may blow. For information and online registration, click on this link, or contact us during the week.

We urge you to become informed about some of these critical retirement-related issues facing us today. It has never been more important!

(originally reported at http://www.khn.org and http://www.dailymail.co.uk

Medicaid Coverage of Nursing Home Care: Who Qualifies, Who Doesn’t

On our radio program and in our seminars, one of categories of questions we receive most frequently involves Medicaid.  This social health care program for individuals and families with limited means has been around since 1965, and it’s true that many changes have been enacted through the years. Yet the level of misunderstanding and misinformation about Medicaid continues to surprise us.

For a good, straightforward primer on Medicaid, we suggest this recently updated article on the website Caring.com. It explains some of the basics of the Medicaid program including what it covers and who qualifies. But be advised that this article is not specific to Washington State, and since Medicaid is a state-administered program, each state has its own set of rules. (We found plenty of detailed information about Washington’s regulations here on the website of the Washington State Department of Social and Health Services.)

Before we dive into this topic, let us remind you from the outset that here at AgingOptions our professional staff members have many, many years of experience in dealing with the twists and turns of Medicaid. Once you’ve read the Caring.com article we’re certain you’ll still have questions, because this is a complex subject. We urge you to contact us, or to attend one of our LifePlanning Seminars so we can answer more of your Medicaid questions in person. You’ll find seminar information at the end of this article.

First, let’s consider the bare bones of Medicaid – what it is and what it does. It’s a federal program, administered by each state, which pays long-term nursing home costs for people with low income and almost no assets. In order to qualify for Medicaid, a person has to be unable to care for himself or herself at home, and he or she has to meet the state’s stringent income and asset requirements. These requirements differ significantly depending on whether the person seeking Medicaid coverage is single or married. Under Medicaid, a person can move into any level of nursing home that will accept them – but as you’ll discover when you start searching, the availability of Medicaid beds is sometimes strictly limited, and you may find far fewer options open to you or your loved one that you had expected.

Some people get confused because they have heard that Medicare also covers nursing home care. This is a misunderstanding based on a partial truth. Medicare does cover some forms of rehabilitative care in a skilled nursing center – for example, if you need to be in a nursing home for a short stay while recovering from surgery. But this coverage is strictly limited, with plenty of restrictions: it typically kicks in only after hospitalization and generally can last no longer than 100 days. By contrast, with Medicaid (unlike Medicare) the patient is not required to have come from a hospital stay in order to qualify, and he or she is not required to be housed in a skilled nursing center. With Medicaid, once a person qualifies and assuming their circumstances remain unchanged, there’s no limit to how long his or her coverage will continue. Medicaid pays the full costs of room and board plus any therapies that are part of resident care, along with other personal services. There are no co-payments to make. For many people who lack other options, the Medicaid program is the only program that allows them to live securely, in relative safety with some degree of dignity, albeit with new frills.

What often disqualifies a person from Medicaid coverage is the simple fact that they have too much money. The rules can get complex, so we encourage you to contact us to review your specific circumstances, but the basic requirement for a single person is that you have no more than $2,000 in total assets to your name in order to qualify for Medicaid coverage. For married people the rules are different: the spouse of the person needing care can have a home, a car, clothing and personal effects and a higher amount of savings on hand.  A decade ago when one of our own family members needed to go on Medicaid, her husband was permitted $40,000 in savings and he retained his own Social Security and pension income, but his wife’s Social Security check went straight to the nursing home to help pay for her care. As we said, each situation can be unique and the rules can change from year to year.

If the asset requirements are so stringent, some people still ask, why can’t I simply give my money and other possessions away before claiming Medicaid coverage? The answer is what’s called the Five-Year Lookback. Medicaid will examine your finances once you apply, and if they discover that you have transferred assets any time within five years of your application, coverage will be denied or delayed.  The short answer is, you need to prepare ahead of time.

So, will Medicaid be the right solution for you? The answer is, “perhaps” – but with Medicaid, as with all aspects of retirement, it is absolutely essential that you plan ahead. Waiting until you need the coverage before getting your financial affairs in order is a serious and costly mistake. This is yet another area of retirement where you need expert advice – the kind you can count on from the professional staff at AgingOptions.  Your best bet is to plan now to attend one of our free LifePlanning Seminars where we go over all aspects of retirement planning: medical needs, including long-term care coverage; financial plans to protect your assets; housing options, to make sure you are never a burden to those you love; the legal protection your estate requires; and how best to communicate your wishes to your family. To register online for the seminar of your choice, click here, or contact us during the week.

Don’t let fear or confusion about Medicaid – or any other aspect of retirement – make you fearful or discouraged. Contact AgingOptions today. You’ll be very glad you did.

(originally reported at www.caring.com)

It’s Official: Doctors Admit that Drugs Can’t Fix Most People’s Back Pain

Do you suffer from lower back pain? If you do, you’re definitely not alone. Medical studies have shown that nearly seven out of eight adults suffer periodically with this painful condition, and for about 23 percent of adults lower back pain is considered “chronic” which means it lasts 12 weeks or more. Lower back pain is one of the top reasons people see their doctor and one of the main causes for people missing work.

Because we’re no strangers to lower back pain ourselves, we were intrigued by this recent article on the news website Vox that presented a stark fact: not only are physicians still in the dark about what causes nonspecific lower back pain, but they’re finally admitting that the drug treatments and painkillers they’ve been prescribing all these years don’t work. The article is called “Doctors finally admit drugs can’t fix most cases of back pain,” and it refers to a recently released set of recommendations from the American College of Physicians.  “America’s doctors have finally admitted it,” says Vox. “Their pharmaceutical tools to treat one of their patients’ most common ailments don’t work.” In fact, the article suggests, “drugs should often be the last line of treatment” for nonspecific lower back pain.

Before we dive further into this article, let us be clear up front that our purpose here at AgingOptions is not to impart medical information particular to your situation. For that you definitely need the advice of a qualified physician who knows you and your physiology well. We highly recommend you seek out and hire a geriatrician to be your medical “quarterback,” someone who understands the medical realities of senior adults. Contact us here at AgingOptions and let us refer you to a qualified geriatric physician in your area. It could be one of the most important calls you ever make. Instead, this article talks about the kind of common back pain that periodically nails just about everybody.

According to Vox, nonspecific lower back pain is the type that has no discernible cause such as tumors, pinched nerves, osteoporosis and fractures – just a few of the detectable triggers for back pain. Most lower back pain sufferers can’t point to a specific cause – they just know they hurt. Doctors have theorized about several possible contributing links to lower back pain, including obesity and smoking, but the actual cause is both complicated and elusive. Doctors are now increasingly realizing that a big part of the underlying cause is seldom just physical – it’s often psychological and emotional, aggravated by depression, anxiety and stress.

Here’s a tidbit of information we found particularly revealing. Sometimes a sufferer with lower back pain is sent to get an MRI, and the scan seems to reveal a physiological problem, but it may not be that simple.  “In patients who have nearly identical results from an imaging test like an MRI, those who are depressed or unsatisfied with their jobs tend to have worse back pain than people who aren’t.” For this reason, says the Vox article, doctors don’t generally recommend an MRI for cases of lower back pain because they can lead to misdiagnosis and overtreatment, often with drugs that can be addictive (such as opioids).

So what does work? Anyone who has suffered with lower back can tell you that relief is hard to come by. But the American College of Physicians does have some recommendations, starting with heat therapy as what they call “a first line of defense.” After that, you might want to try massage therapy, acupuncture or chiropractic manipulation, but as Vox puts it “the evidence isn’t as strong for these alternatives.”  The best outcomes appear to result from a combination of exercise and stress-reduction. If you feel you need a painkiller, ibuprofen seems to work best, but you’ll want to check with your physician since too much ibuprofen can create health problems in some people. Also, for most people, lower back pain tends to resolve over time, so it may be best, if you can, to go about your normal routine and have patience. Typically the discomfort tends to subside – gradually

Here at AgingOptions our goal is to help seniors enjoy a happy, healthy, fulfilling retirement. Getting the right health care, staying active, controlling your weight and avoiding injury are obvious steps you can take to keep you on the right track medically. But planning for your retirement means far more than meeting your medical needs with good health and the right insurance. Your financial plan has to be well crafted to make sure your assets are protected in your retirement. You’ll need to make certain you’re fully protected with the right legal preparation. You’ll want to plan ahead to ensure you choose the right housing options to match your needs and preferences. You’ll want to know that your family is completely on board with your wishes, too. Is there a retirement plan that weaves these elements together?

Happily the answer is yes – with an AgingOptions LifePlan. You owe it to yourself to find out more about this breakthrough in comprehensive retirement planning, and you can do that with no obligation. Simply take a few hours and attend a free LifePlanning Seminar at a location near you. Click here to select and register for the seminar of your choice,  or contact us and we’ll be glad to assist you.

(originally reported at www.vox.com)