Caring for Aging Parents Creates a Crisis for Working Daughters

Anyone who has cared for an aging, infirm parent knows how incredibly difficult it can be. Caregiving takes a huge toll, physically, financially and emotionally. We’ve talked with hundreds of AgingOptions clients and radio listeners and have heard many tearful stories about the overwhelming challenge of being a caregiver. That’s why we wanted to share this powerful article from The Atlantic magazine, published last year but still extremely timely, which paints a troubling picture of the long-term crisis being faced by today’s working women who are also caregivers for aging parents.

The article is titled, “The Crisis Facing America’s Working Daughters.”  It says quite bluntly that “the troubles of women with aging parents are unseen and widely ignored.” It also says that society’s willful ignorance of this growing problem will have long-term social and financial consequences for all of us.

The Atlantic article starts by pointing out that there seem to be limitless resources available today to help working mothers, but almost none to aid the 44 million unpaid eldercare providers in the United States, most of them women. Because the need to care for aging parents typically hits a woman in her 40’s – her peak earning years – she may find herself forced by the demands of her new role to take a less demanding job, cut back her hours or quit altogether. The article quotes a MetLife study which calculates that women lose an average of over $324,000 in compensation due to the demands of unpaid caregiving – earnings which will in most cases never be recovered.

This financial challenge is compounded when you figure that the caregiver who has to reduce her earnings in her 40’s may find it difficult if not impossible to reenter the workforce five or ten years later when Mom or Dad has passed away.  “These same women are expected to live well into their mid-80s,” says The Atlantic, “and outlive (by about two years) the average man. How will they afford their own care later in life if they can’t save for it at midlife while they are caring for someone else?”

As significant as the financial challenge can be, it’s the emotional impact that can hit daughters the hardest when they become caregivers. “People tend to think that caregiving is mainly about chores like food shopping,” one expert says in the article. But in fact it’s “the intimate nature of some of the tasks and the general role reversal between parent and child” that truly come as something of a shock.  One healthcare policy analyst quoted by The Atlantic emphasizes the great challenge of caring for an aging parent. “When you are caring for a child, it doesn’t threaten your identity,” she says, “because that’s what parents do. But when you are a daughter, you are cared for. You turn to your parents for refuge. When they seek refuge from you it shakes your identity.” Eldercare, say the experts, requires a degree of emotional involvement that can feel relentless and draining, far more than caring for a child.

While the article in The Atlantic doesn’t offer any specific solutions, it does sound a clarion call: as we talk about the competing demands of work and family, we need to consider the urgent needs of working daughters. “The focus must not just be on the need for maternity leave or even parental leave, but family leave—and other accommodations such as flex time, mentoring, and reentry-assistance programs—that will enable workers to care for their aging parents without their lives falling apart,” the magazine concludes.

Here at AgingOptions we want to offer our services, whatever your circumstances. If you or someone you care about is burdened with the care of a senior loved one, we encourage you to contact us. With our many years of professional experience and our carefully selected resource network, we can assist you as you evaluate your caregiving situation and help you discover options you may not realize existed. Sometimes as you explore an unfamiliar path it helps to have a professional guide walking alongside you.

In fact, that approach – serving as your professional guide – is the same one we use for the entire process of retirement planning. We call this strategy LifePlanning.  Your own individual LifePlan becomes your blueprint, guiding you as you create the retirement lifestyle you’ve always hoped for. Best of all, the process of creating your LifePlan doesn’t have to be overly complicated. You can find out more about this exciting breakthrough in retirement planning by attending one of our popular LifePlanning Seminars. These events are absolutely free – but the information you’ll gain is priceless. You’ll discover how all the facets of your retirement plan – financial, legal, housing, medical and family – fit together into one seamless LifePlan. To find out dates and times, and to register online for an AgingOptions LifePlanning Seminar, simply click here, or call us during working hours. We’ll look forward to meeting you soon!

(originally reported at www.theatlantic.com)

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Is “Medicare for All” the Health Care Solution for the U.S.?

In the midst of the debate over health care – a national argument that never seems to subside – one school of thought popular with mostly liberal politicians such as Vermont Senator Bernie Sanders is a policy which is being called “Medicare for All.” America, argues Senator Sanders and other proponents, is ready for “single-payer” health care, and the Medicare program historically available only to those 65 and older (with rare exceptions) is a turn-key solution.

In a New York Times op-ed column recently, Senator Sanders laid out his argument in favor Medicare for All. He made two key assertions – that “the majority of the American people” wants universal coverage, and that Medicare for All would function very much like the single-payer government-run medical systems in Canada and Great Britain. As a follow up to the column by Senator Sanders, the New York Times published this article just a few days ago in which the newspaper sought to find out how true these statements actually are.

Regardless of how you feel personally concerning the political and economic virtues and drawbacks of a single-payer health care system, it’s helpful to know which way the debate is going and who is saying what. This seems to us to be especially true for those already on Medicare, since we think any major expansion of the program could affect which doctors accept the program and which ones don’t. Additionally, any move to lower the eligibility age for Medicare (or eliminate the age requirement altogether) could have a significant impact on the retirement plans of couples for whom one spouse is Medicare-eligible and the other is not. As the law now stands, it’s fairly common for the older wage-earning husband or wife to delay retirement until their younger spouse reaches 65, but that could conceivably change.

Is Medicare for all, as Senator Sanders asserts, highly popular with American voters? Here’s what the New York Times article had to say. “Mr. Sanders claimed that ‘the majority of the American people’ want Medicare for all, citing an April poll…in which 60 percent of Americans agreed that Medicare should be expanded to cover everyone.” However, says the article, that polling result doesn’t appear typical.  “This appears to be the high end of support,” writes the Times. Other national surveys show support for the concept in the low to mid 50 percent range. Interestingly, asking respondents about “single-payer health care” generally polls more poorly that the idea of “Medicare for all.”  Several national polls asking if Americans favor single-payer health care, with no mention of Medicare, show approval rates in the 30-40 percent range.

So with that in mind, how does the proposal of Senator Sanders compare with other systems already in place in nations like Canada and Great Britain?  The fact is that the sheer number of different variables in the various national plans makes an “apples to apples” comparison difficult. For example, in Canada, provinces administer their own health care programs so some benefits vary by location (especially in health categories such as dental and vision care). In Britain the National Health Service (NHS) owns the hospitals and contracts with the doctors, a model that Senator Sanders does not envision for the U.S. But there are some comparisons that can be made, including one to which we can all relate: how long does a patient have to wait for emergency medical attention?

According to the New York Times, “One of the most common critiques of the British system revolves around long waiting times. In 2011, patients in N.H.S. emergency rooms in England waited a little over two hours on average from attendance to departure.” These waiting times in the U.K. are actually going up, now about 20 minutes longer this year. However, contrary to common perception, the median emergency wait time in American hospitals was actually comparable to Great Britain in 2011 (the most recent year for which data is available).  According to stats from the CDC, the average emergency room patient in the U.S. waited 30 minutes to see a doctor and about 90 minutes for treatment.

But there’s one statistic from Senator Sanders’ op-ed that’s tough to refute, and that’s the cost of health care in the U.S. compared with other industrialized nations. As the New York Times summarizes, “The Organization for Economic Cooperation and Development estimates that the United States spent $9,890 per person on health care in 2015. That’s about twice as much as the four countries with universal health care systems that Mr. Sanders listed: Canada ($4,640), France ($4,600), Germany ($5,550) and Britain ($4,190).” We also spend far more on drugs than any of our international peers, partly because our government, under an odd stipulation in federal law, is legally barred from negotiating Medicare drug prices (although, the Times points out, Medicaid and the Veterans Health Administration can and do obtain discounts). Common sense would suggest that this restriction on Medicare is overdue for change.

Here at AgingOptions we share this information with you because we feel you need to be well-informed about anything that affects the Medicare system, which insures over 55 million Americans. As you age, it’s virtually inevitable that Medicare will be central to your health care. We also want to remind you of the critical importance of planning for all aspects of your retirement, instead of moving into this potentially complex phase of life without forethought. Your medical plan is essential to a successful retirement, but it must work in concert with the housing choices you make. This has a direct bearing on your financial and legal planning, and on communication with your family, since no one wants to become a burden to those closest to them. Here’s the good news: an AgingOptions LifePlan blends all these facets of retirement into one seamless strategy, helping you enjoy the retirement you’ve always dreamed of.

Why not accept our invitation and learn more about LifePlanning? Come join us for a free, no-obligation LifePlanning Seminar with Rajiv Nagaich, where in just a few hours we’ll answer many of your questions and help you determine what the next steps ought to be. There are LifePlanning Seminars taking place throughout the area, so simply click here for details and online registration, or call us during the week for assistance. It will be our pleasure to meet you soon at a LifePlanning Seminar near you.

(originally reported at www.nytimes.com)

 

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Assisted Living May Be Ideal for Many Seniors, but Families Have Got to do Their Homework

If you subscribe to the authoritative magazine Consumer Reports, you were probably intrigued just as we were by the October 2017 issue. The cover showed the hand of a frail senior being tenderly held by a much younger hand, beneath the headline, “Who Will Care for You?” The subtitle said, “Understanding the facts about elder care and assisted living will help you and your family be prepared and protected.” On the inside we found a 13-page special report in which Consumer Reports investigators took a deep dive into the plusses and minuses of this multi-billion dollar senior care industry.

As a result, this comprehensive and at times controversial report has already been picked up by other news outlets and has spawned several articles including this one on the aging website NextAvenue. Editor Emily Gurnon of NextAvenue zeroed in on the Consumer Reports article and wrote her own, focusing on some of the complaints that have begun to surface about assisted living facilities. “With the boomer generation aging into their 50s, 60s and 70s and many of their parents now in their 70s, 80s and 90s, there is an increasing need for long-term care,” Gurnon writes. “Most older Americans would stay in their homes if they could, but health problems and lack of assistance often make that impossible.”  For many seniors who need some help but not the intensive medical care of a nursing home, the growing number of assisted living facilities offers a strong option. “But,” says Gurnon,“according to a story in the October issue of Consumer Reports, consumer complaints about assisted living facilities are on the rise.”

Gurnon cites the Consumer Reports investigation which showed that many of these long-term care communities are plagued by staffing shortages and resulting inconsistent care. What’s more, while assisted living facilities are often (but not always) regulated and inspected by state officials, they are usually not under any federal government regulation. The words from Consumer Reports are stark: Oversight of assisted living facilities is “uneven at best,” the report says. “A good one can be an excellent choice for someone who can no longer live on his or her own. A bad one could put your loved one at risk.”

So what is a family member to do in attempting to evaluate a care facility for mom or dad?  One of the best places we suggest you begin is by contacting a Care Management service who can provide you with vitally helpful information about your choices and next steps. If you’ll contact us at AgingOptions we can recommend a Care Management professional who will guide you through the maze of important decisions that you are facing. But if you’re just starting the investigatory process, here are four questions Consumer Reports suggests you ask in order to help separate the viable assisted living options from the places to avoid.

The first question is, What kind of help will my loved one need?  This may seem obvious but it’s essential that you start with a complete and objective medical evaluation of your loved one before selecting a care facility. “Assisted living communities vary greatly in the amenities, services and levels of care they provide,” writes NextAvenue’s Gurnon. “In general, they will help residents — whose average move-in age is 84 — with activities of daily living, such as bathing, dressing and taking medications. But some may not have a licensed nurse on staff, according to Consumer Reports, which means your parent may be sent to the emergency room for an evaluation after a fall, for instance. And some will not take residents who use a wheelchair or have multiple chronic conditions.”

Second, make sure you ask, How good is the care at the facility you’re considering?  Make sure it’s licensed and that recent inspections have shown no red flags. (Here’s a helpful link where you can find licensing and inspection information for facilities in Washington state.)  Gurnon writes that “The most frequent complaints…included understaffing and delays in response to residents’ calls for assistance.” She adds that “Most of the staff at assisted living centers are low-paid, often making just minimum wage, and may be only minimally trained.” If you can’t get the info you need from the staff, “try talking to current residents or their relatives about the facility. Find out: Do staff respond promptly to issues? Does medication arrive on time?” You should also pay a surprise visit during mealtimes and on weekends see how the place operates during off-peak hours.

The third question Consumer Reports says you need to ask is, How much does it really cost?  Assisted living is expensive, averaging more than $3,600 per month in 2016. Almost all that cost will be out-of-pocket unless your loved one qualifies for Medicaid. Make sure you find out what services are included in the basic rent and which ones cost extra.

Finally, Consumer Reports urges you to ask, Can my loved one be forced to move? The threat of eviction was a major cause of complaints, writes NextAvenue, either because of unpaid bills or because of worsening health. Make sure you read the terms under which your mom or dad can be forced to move, and find out how much notice the facility is required to give you. “And be wary of verbal promises from a marketing director that your parent will always have a place there,” Gurnon writes. “The marketing and sales people are trying to fill apartments.”  They may not always give you a straight answer.

The bottom line is, before you select a home, do your homework. As we said, the best way to start is by contact AgingOptions so we can refer you to a Care Manager, the person best equipped to guide your evaluation process with solid, objective information. We know from personal experience and hundreds of testimonials that there’s no better solution to solving the emotional and financial puzzle of choosing a care facility for someone you love.

If you need similar help “untying the knots” surrounding retirement planning, we can help there, too. At AgingOptions we offer a unique and comprehensive approach to retirement planning that we call LifePlanning. Wouldn’t it be wonderful to enjoy retirement secure in the knowledge that your assets will be protected as long as you live, you’ll never become a burden to those you love, and you won’t be forced against your will into institutional care? A LifePlan makes this retirement dream come true. Come to one of our AgingOptions LifePlanning Seminars and discover for yourself how your financial, legal, medical, housing and family plans can all work together interdependently.  You’ve never seen a retirement planning strategy like it!

For a complete list of seminar dates, times and locations, click here – then register online or give us a call. Let us guide you into the retirement you’ve always hoped for!

(reported at www.nextavenue.org)

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Government Warning: Federal Officials, Nursing Homes Not Doing Enough to Prevent Elder Abuse

Everyone agrees that abuse of any kind perpetrated on vulnerable elderly residents in care facilities is abhorrent.  Yet a recent warning issued by the Office of the Inspector General in the Federal Department of Health and Human Services (HHS) charges that the process of preventing and reporting elder abuse is woefully inadequate at just about every level, from local nursing homes to state agencies to the officials in charge of Medicare and Medicaid administration.

The warning comes in a 14-page memorandum (you can access it here) sent just a few weeks ago from the HHS Inspector General to the leadership at the Centers for Medicare and Medicaid Services (CMS). Even in the light of the stilted bureaucratic language of such documents, the report is striking. “The purpose of this memorandum,” says the IG, “is to alert you to the preliminary results of our ongoing review of potential abuse or neglect of Medicare beneficiaries in skilled nursing facilities.” The bottom line, says the report:  “The Centers for Medicare & Medicaid Services has inadequate procedures to ensure that incidents of potential abuse or neglect at skilled nursing facilities are identified and reported.”

According to an analysis about this disturbing finding from the watchdog group Center for Medicare Advocacy, the audit by HHS was part of an ongoing effort to better understand – and more effectively combat – elder abuse. Here’s how the Center for Medicare Advocacy describes these findings, which came after an OIG investigation of emergency room records for Medicare beneficiaries, a review of State Survey Agency reports, and interviews with officials from the Centers for Medicare and Medicaid Services. “The preliminary results are striking,” says the summary report. “Of the beneficiaries whose injuries may have been caused by abuse or neglect, a significant percentage (26 percent) may not have been reported to law enforcement by the hospitals, despite states’ mandatory reporting laws.” Nursing homes are also failing to comply with tougher rules about reporting elder abuse mandated by the Affordable Care Act.

In short, from top to bottom, says HHS, not enough is being done to protect seniors from physical and sexual abuse in the very places where they’re supposed to be safe: skilled nursing facilities.

According to the warning sent from HHS to the Centers for Medicare and Medicaid Services, the laws governing suspected abuse couldn’t be clearer. Skilled Nursing Facilities “must ensure that all alleged violations, such as mistreatment, neglect, or abuse (including injuries of unknown source)…are reported immediately to the administrator of the facility and to other officials, including the [State] Survey Agency,” says the HHS document. These allegations then must be investigated with results reported within five days. If the alleged violation is verified, says HHS, “appropriate corrective action must be taken.”

But it is clear from the findings in the HHS document that these policies are often being ignored or circumvented. HHS identified 134 suspicious incidents of probable elder abuse covering 33 states in the U.S. during 2015 and 2016. According to the Office of the Inspector General, “Many of the incidents of potential abuse or neglect that we identified may not have been reported to law enforcement.” The IG found that while 96 of the 134 incidents had been reported as required by law, “we found no evidence in the hospital records that the remaining 38 incidents (28 percent) were reported to local law enforcement despite State mandatory reporting laws requiring the hospitals’ medical staff to do so.”

The conclusion was stark. HHS found that procedures put in place by Medicare and Medicaid officials to prevent elder abuse are inadequate.  Health and Human Services officials reported “significant concerns that incidents of potential abuse or neglect at Skilled Nursing Facilities have gone unreported.” The only way to combat elder abuse, the HHS report inferred, is for all agencies to meet their responsibilities, including residents, families, nursing home staff, state agencies and the federal officials in charge. The report suggests that some of the links in the chain of reporting and prevention appear to be broken.

We echo the words of the Center for Medicare Advocacy, a long-time advocate for the rights of nursing home residents. They “urge [the Center for Medicare and Medicaid Services] to take strong enforcement action.” They add that “Medicare beneficiaries in nursing facilities deserve to live with dignity and in safety. Elder abuse devastates the lives of its victims and must be reported appropriately.”

So what can you as a family member of a nursing home resident do?  We suggest two things. First, says AgingOption’s Rajiv Nagaich, don’t be naïve. “Looking to the government for a good fix to the problem of elder abuse is foolish,” says Rajiv. “Government officials have already acknowledged that their systems are broken! We strongly advise our clients and radio listeners to use their own resources to ensure future security safety and happiness.  Get a care manager in place and let him or her guide you. Seniors and their families need to take this problem seriously and plan with care!”

Our second piece of advice is, don’t be uninformed: elder abuse, while statistically rare, is still too frequent, and can tragically go unreported. Be on the alert for any signs that something is amiss with your loved one. Be observant and ask questions. You might also want to review this list of abuse prevention tips from a website called Elder Protection Center. As a caring loved one, family member or friend, you may be the first line of defense against abuse – and if you see something, for heaven’s sake say something, to nursing home staff, administrators, and (if necessary) law enforcement.

Elder abuse in nursing homes is not only a medical and family issue, it can also be a housing issue, since failing to plan ahead may force a senior into a substandard institutional facility. The best way to ensure that you’re able to live the life you want as you age, on your terms, is by starting right now to prepare an AgingOptions LifePlan – a retirement plan that blends housing, family, financial, legal and medical aspects of retirement together into one seamless blueprint. Why not take the time to learn more, without cost or obligation?  Come to a free AgingOptions LifePlanning Seminar where you’ll get your questions answered concerning this revolutionary approach to retirement planning. For all the details plus convenient online registration, click here, or call us during the week and we’ll be glad to assist you.

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A Family Caregiver Contract Can Prevent Conflict, but Getting it Right May Require Professional Guidance

If you’re searching for the best person to provide in-home care for an aging loved one, you may have a family member in mind – a sibling, adult grandchild, or other relative who you can trust to provide the kind of care your loved one deserves. Maybe you’re the one tapped to be the caregiver. No matter what the situation, as we have unfortunately seen countless times in our AgingOptions practice, these arrangements often start out well but too soon degenerate into misunderstanding and family fights. The caregiver may come to feel unappreciated while the rest of the family thinks the caregiver is getting preferential treatment. These kinds of disagreements left to fester can literally tear families apart.

Because we understand so well the issues involved in this type of family care situation, we found our attention drawn to this insightful article from the Kiplinger website.  The advice from this recent article: if you are in a situation where you or some other family member has primary caregiving responsibilities for a housebound loved one, you should consider drawing up a family caregiver contract. These contracts, says Kiplinger, can range from informal agreements to complex legal documents. But as you’ll see, while we support the concept, we were surprised that the Kiplinger article doesn’t do a stronger job of recommending when you should consult an attorney. We’ll discuss that more in a moment.

As the Kiplinger article explains, “Family caregiver contracts, also called personal care agreements, range from informal…to complex professional contracts drawn up by lawyers.” These documents, says Kiplinger, are typically created “when one relative is handling most of the care for an elderly parent. A contract enables family members to spell out payment, a work schedule and expected duties.”  The idea is that, by clarifying expectations, a family caregiver contract can avoid misunderstanding and, at least in theory, get family members all on the same page when it comes to a loved one’s care.

There’s another important facet of caregiving that needs to be spelled out in these contracts, writes Kiplinger: compensation. Signing a family caregiver contract allows families to “formalize the compensation for a relative who is making financial sacrifices to provide care.” It’s common for family members serving as caregivers to cut back on their works hours or even stop working altogether in order to be available for their duties. On top of this loss in income, primary caregivers typically incur out-of-pocket expenses that are too often unaccounted for, expenses of which other family members may be completely unaware. (A 2016 study by AARP estimated the average annual out-of-pocket costs for a family caregiver at $7,000.) On the positive side, the family member providing primary care may be living in the relative’s home rent free, something that a family caregiver contract can take into account.

So let’s say you decide to follow Kiplinger’s advice and sit down to draw up a family caregiver contract. This is often where things can become difficult.  “Sometimes,” says Kiplinger, “drawing up a contract stirs up emotions tied to sibling rivalries and past disputes. Non-caregiving family members may resent paying a relative whom they see as living rent-free in a parent’s house.” Another major problem is procrastination: “families often don’t draw up contracts until a crisis arises,” warns Kiplinger, which means you’ll be trying to negotiate caregiver arrangements under extreme emotional pressure – a recipe for major family problems and potentially disastrous divisions.

Here’s where we have a problem with Kiplinger’s advice. The article suggests you call a family meeting to discuss the contract. “Set an agenda, and keep it narrowly focused,” the article says, and make it clear from the outset that this is “a business meeting and not a therapy session.” Kiplinger goes into detail about some of the items that belong in the contract: starting date, work schedule and payment details, for example. This is all well and good as far as it goes, but in our experience it’s the rare family that can sit down for this type of emotionally charged and finance-driven conversation without having an attorney present. At AgingOptions we conduct this type of family meeting frequently, and we guarantee that our professional legal staff will come up with questions and issues you had never dreamed of. An objective third party can also serve as referee when and if things get testy. Having a professional meeting with your family helps ensure a positive, productive outcome.

No matter what issues your family is facing, a family conference hosted by AgingOptions is an excellent way to minimize future problems and maximize cooperation.  Contact us here at AgingOptions and let us explain how this type of conference works. And when it comes to retirement planning in general, AgingOptions is your number one resource for creating a plan that’s truly comprehensive. Besides dealing with family issues – something too often overlooked in retirement planning – we also take housing choices, legal issues, financial protection and medical coverage into account, making certain that all these facets of retirement work together seamlessly.  There’s no other retirement plan we know of that accomplishes what an AgingOptions LifePlan can do for you.

There’s a quick and easy way to find out more: take just a few hours and attend a free AgingOptions LifePlanning Seminar. In fact, why not bring your family members with you so you can all get the same excellent information? These highly popular events are offered at locations throughout the region, so click here for dates, times and locations, then register online or by phone during the week.

Conflicts, confusion and family quarrels don’t have to be part of your retirement future. Chart a course to the retirement you’ve always hoped for with the help of an AgingOptions LifePlan.

(originally reported at www.kiplinger.com)

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Studies Appear to Link Disrupted Sleep and Alzheimer’s Disease

Could it be that losing sleep might add to your risk of developing dementia? Or are patterns of sleep interruption not actually a cause, but an early indicator of future cognitive impairment? Either way, two recently reduced studies are adding to the growing body of evidence that healthy sleep and a healthy brain are somehow linked.

This article, for example, appeared just a few weeks ago on the NBC News website. It’s called “Poor Sleep Raises Alzheimer’s Risk,” although the title sounds a bit more definitive than the article itself.  The article, written by health reporter Maggie Fox, begins, “There’s more evidence that losing sleep can raise the risk of Alzheimer’s disease. It’s the latest in a series of studies that show even a little sleep loss can add up to a greater risk of Alzheimer’s, the leading cause of dementia.”

The NBC News piece quotes a study just published in the professional journal Neurology. In the study, conducted by researchers at the Boston University School of Medicine, analysts looked at the health outcomes for 321 people over the age of 60 who had volunteered for a sleep study during the 1990’s. During the 12 years after the study, 10 percent of the group developed dementia, most of whom were diagnosed with Alzheimer’s disease. The researchers found what appeared to be a correlation, fairly small but still significant, between lack of REM sleep and the development of cognitive impairment. (REM sleep refers to the “dreaming phase” of sleep characterized by rapid eye movement – “REM.”) The less REM sleep observed in the study group, the greater the likelihood of developing dementia.

The big question is why this correlation exists. “Our findings point to REM sleep as a predictor of dementia,” said the study leader. “The next step will be to determine why lower REM sleep predicts a greater risk of dementia.” In other words, does poor sleep cause dementia or simply predict it?

It’s certain that people with dementia develop interrupted sleep, which often plays havoc with their families and other caregivers. It’s not uncommon for those suffering with dementia to be awake in the middle of the night, sometimes up and about doing things that are inappropriate, such as trying to cook a meal or pack a suitcase.  According to the Alzheimer’s Association website (www.alz.org), “Many people with Alzheimer’s experience changes in their sleep patterns.”  Sleep disruptions are fairly common even among older adults without dementia, “but these disturbances occur more frequently and tend to be more severe in Alzheimer’s. There is evidence that sleep changes are more common in later stages of the disease, but some studies have also found them in early stages.”

Another Maggie Fox article from the NBC News website (you can click here to read it) shed some light as to why sleep disruption and dementia might be linked. This article also referenced a scientific study, this one released a few months ago in the journal Brain, that demonstrated how a single night of interrupted sleep results in an increase in the brain proteins believed to cause Alzheimer’s disease. These researchers hypothesize that a good night of deep sleep helps the body clear away these brain proteins while interrupted sleep may allow too much of them to build up. One of these compounds, amyloid, is “the protein that clogs the brain of Alzheimer’s patients,” writes NBC’s Fox.

Doctors theorize that amyloid is produced during times of normal waking brain activity. When we enter deep REM sleep our brains stop producing this clogging compound and the “normal clearance mechanisms” can work as designed. But too much amyloid built up the brain increases the risk of clumps called plaques, which appear to be linked to various forms of dementia.

So what’s the take-away from articles like these? Until researchers come up with some clearer answers, and more effective treatments, dementia is still going to present us with more questions and speculation. Meanwhile, there are several healthy habits all of us – especially seniors – should adopt, habits that will not only help us feel better but may also prevent, or slow, the onset of dementia. No doubt you’ve heard this list before:

  • Get plenty of exercise, not only aerobic but also strength-bearing exercise.
  • Stay socially active – don’t allow yourself or a loved one to slip into isolation.
  • Quit smoking, and only use alcohol in moderation.
  • Get your blood pressure under control and keep it there.
  • Make sure your diet is healthy – some studies have shown that the Mediterranean Diet with less red meat and more healthy oils, vegetables, grains and seafood is better for the brain.
  • Get plenty of sleep, as the articles above suggests.

Is there any one type of medical professional who can help you accomplish all this? The answer is yes. Here’s another recommendation to add to that list: make sure you have a geriatrician in charge of your health care. As you age, your physical, mental and emotional needs change, so you need to make certain that a properly trained geriatric physician is the quarterback of your health team.  Please contact us here at AgingOptions so we can refer you to a geriatrician whose practice is near you.

What about planning for all other aspects of retirement? Do you have a plan in place that can help you protect your assets so matter what life throws your way? Are you able to say with assurance that you’ll be able to avoid becoming a burden to your loved ones? Do you know that you’ll manage to escape ending up being institutionalized against your will? The only plan that can help you face retirement with true confidence is an AgingOptions LifePlan. A LifePlan combines financial, medical, legal, housing and family plans all in one carefully crafted retirement blueprint. Why not take a few hours and find out more? Accept our invitation to attend a free LifePlanning Seminar near you. For details and convenient online registration, click here, or call us for assistance over the phone. We’ll look forward to meeting you at an AgingOptions LifePlanning Seminar soon.

(originally reported at www.nbcnews.com)

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Who Bears Most of the Costs Associated with Dementia? Families Do.

A great number of articles have been written in recent months about the increasing prevalence of Alzheimer’s disease in the U.S. Today there are more than 5 million Americans, nearly all seniors, suffering with the disease, a group whose care this year will cost the nation almost $260 billion.  These costs, according to experts, could exceed $1 trillion by 2050 as the number of people diagnosed with the disease is projected to triple.

You’ve probably heard numbers like these before. But one fact which startled us, and which should get your attention if you’re caring with a loved one diagnosed with dementia, is that by far the largest share of these staggering costs are borne by families. This is according to a new study published in the Journal of the American Geriatrics Society that looked at the lifetime cost of caring for someone with Alzheimer’s disease or other forms of severe cognitive impairment.  We found some of the basic information about this sobering reality in this article from the website Insurance News.

According to the article, public health experts from Brown University wanted to find out just how costly caring for someone with dementia can be over the course of his or her lifetime. They came up with a mathematical model derived by studying Medicare records and other national studies, a model which allowed them to simulate the progression of dementia in a patient who had just been diagnosed.

The model the team came up with was a real eye-opener. In the U.S. an average individual with dementia will receive almost $322,000 worth of medical care over a five year period.  This compares with an average of less than $140,000 in care over the same five-year period for the person without dementia. And here’s the shocker: of that $322,000, about 86 percent is borne by families, in the form of informal care expenses, co-pays and other out of pocket care costs. That represents a staggering average cost of more than $55,000 per year for five years for the family of the loved one with dementia, either in direct cash outlay or in the value of care services the family is providing.

This figure comes close to the statistics compiled by the Alzheimer’s Association (www.alz.org). According to the group, there were almost 16 million family and friends in 2016 providing care to those with Alzheimer’s disease and other forms of dementia. When the value of these unpaid caregiving services was calculated it came to about $46,000 for each dementia sufferer. That’s in addition to the medical costs associated with dementia, currently approaching $260 billion: Medicare and Medicaid cover two-thirds of that amount, but about $56 billion comes in the form of out of pocket costs paid for by families.

Of course the greatest burden to those caring for loved ones with dementia is emotional, but the financial cost makes the sadness even more acute. The pain of watching a beloved parent or friend slip into the twilight of Alzheimer’s disease is terrible enough, but it’s compounded by the growing realization that caregiving brings with it a potentially catastrophic financial weight. Here at AgingOptions we talk every week with people who find themselves in this devastating situation, and our advice for you is not to try to go it alone. There are excellent resources online, such as the Caregiver Center on the Alzheimer’s Association website (click here for the link.) But one of the best things you can do is to get some professional advice, and that’s where we can assist. For example, a family conference, guided by one of our experienced professional staff, will help ensure that everyone in the family is on the same page when it comes to caring for mom or dad. Another excellent idea is for you and your entire family to attend a free AgingOptions LifePlanning Seminar.

LifePlanning is our descriptive term for a type of comprehensive retirement planning offered only by AgingOptions. Traditional retirement planning, which focuses almost entirely on finances, is literally a recipe for disaster – like trying to make a stool that can stand securely on just one leg. Our conviction, built on decades of experience, is that all the aspects of your retirement planning have to work together: finances, housing choices, medical coverage, legal protection and family communication. That way all five facets of your retirement plan reinforce each other.

We invite you to bring your questions about all aspects of retirement and plan now to attend a free LifePlanning Seminar at a location convenient for you. In just a few hours you’ll discover an approach to comprehensive retirement planning that will guide you into the future you’ve always dreamed of. For dates, times and online registration, click on this link, or call us for assistance during the week.

No one wants to become a burden to their loved ones as they age, but dementia can unravel the most carefully-laid plans, robbing families of their assets and often forcing loved ones into institutional care. No matter what your situation, get the facts now so you can prepare for whatever the future may hold. We’ll see you soon at an AgingOptions LifePlanning Seminar.

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Nearing Retirement? Six Financial Moves You Still Need to Make

This week we ran across this article on the Yahoo Finance website, written by Jeff Rose of Credit.com. We have to admit, we were a bit suspicious of the title: “Ignoring These 6 Financial Moves Could Ruin Your Retirement.”  In our experience, articles like this tend to be far too simplistic, focusing on financial planning at the expense of everything else – an approach that we’ve found to be a recipe for disaster. So we were somewhat pleasantly surprised when we read the six recommendations and found them more useful than we had expected. Still, while the Yahoo Finance piece does offer some helpful advice, we think it leaves out some very important components of retirement planning, and that there’s a lot missing from this list.

“You finally have enough money to retire,” writes Jeff Rose. “The excitement is palpable, and you can hardly believe you’ve reached this milestone.” However, he adds, before your retirement dreams can come true “you still have some work to do if you want to actually stay retired.” In other words, if you don’t complete a handful of important tasks now, “you could wind up heading back to work part-time or cutting back on spending just to get by.”

So what are these six financial moves? Let’s take a look and see what Jeff Rose got right and what (in our view) he may have overlooked.

The first must-do task is to “have the money talk with your adult kids.”  Rose cites a Pew study from 2015 that says more than 60 percent of U.S. parents helped their adult kids financially during the past 12 months. In the words of the Yahoo Finance article, “Helping adult kids may not have been a big deal when you were working, but it can make a huge difference to your bottom line once you’re on a fixed income. This is why you need to have the ‘money talk’ right away.” Your adult children need to know that you can’t keep supporting them financially once you’re retired or your own security could be jeopardized. “If you set expectations early, your adult kids will have time to learn how to fend for themselves and break the cycle of living paycheck to paycheck.” It’s hard to argue with that suggestion, although in our experience it’s certainly not a good idea to wait so long to have the family conference Rose is talking about.

Second on the list is to “dial down your investment risk.” Rose writes, “It’s crucial to reconsider your desired level of risk as you start getting close (to retirement).” What too often happens is that people set up their 401(k) portfolio while they’re still employed and then never bother to adjust it again. Shifting your portfolio away from riskier stocks toward a blend of stock and bond funds could be good advice, but in any event don’t overlook the importance of a “portfolio tune-up.”

The third recommendation is also one we subscribe to: “meet with a financial planner.”  Again, though, while meeting with a planner is a good idea, waiting too long to get solid financial advice is a bad one. “There is no one-size-fits-all retirement income portfolio or investment approach retirees should take,” says Jeff Rose, but “a financial planner can find the right mix for your financial goals.” The sooner you sit down with a planner you can trust, the sooner you can get yourself onto the right financial course – but remember our strong advice to select a fee-based financial planner and not one who has a product to sell. Contact AgingOptions and we can recommend a trusted, experienced financial planner who meets these criteria.

Number four on the list sounds a lot like number three. Jeff Rose advises you to “create a long-term financial plan” – because “with a solid plan in place, you won’t have to stress over market fluctuations that would normally leave you stressing out.” Of course this makes sense, but we always remind our clients, radio listeners and seminar guests that a financial plan absolutely must be made in concert with the rest of your planning process! That’s why a LifePlan is the only approach to retirement planning we endorse. We’ll tell you more about LifePlanning in a minute.

The fifth item is to think long and hard about your long-term care options.” “No one ever thinks they’re going to need long-term care or have to move to some kind of facility,” Rose writes, “but more and more individuals are finding out that’s not the case.” For that reason, “even if you don’t think it’s ever going to happen, you still have to prepare.” The article only mentions two types of preparation – buying long term care insurance and what he calls “setting up steps with your children.” We think this simplistic approach is woefully inadequate. It takes careful preparation and solid professional advice to make certain you can avoid becoming a burden to your loved ones as you age – which is all the more reason why a LifePlan is absolutely essential.

Finally, Jeff Rose’s article from Yahoo Finance advises that you “decide how to handle Social Security.” Considering that this article is written for the benefit of those about to retire, we can’t really understand why Rose tacks this advice onto the end as an afterthought. In our experience, the time to talk about and plan for your Social Security strategy is years before you stand on the doorstep of retirement. Most people know that waiting to draw benefits until age 70 not only maximizes those benefits for the recipient but also in many cases for a surviving spouse – so if this is your strategy, then you must plan well ahead to make it happen. The important thing is to weigh your options carefully, and if possible do so years before you have to make a Social Security decision.

As is so often the case, we find the advice from this article to be basically sound but definitely insufficient. The only way for you to plan adequately for the type of retirement you’ve always hoped for is to adopt the type of planning strategy that takes all the critical facets of retirement into account: finances (of course) but also your legal strategy, your housing plan, your medical protection and your communication with your family. The sooner you learn about LifePlanning from AgingOptions, and the sooner you adopt the LifePlanning precepts, the sooner you can begin experiencing the kind of retirement security that only a LifePlan provides.

Ready to find out more? It’s simple to do: come to a free LifePlanning Seminar. Click here for upcoming dates, times and locations, then register online or call our office for assistance. An inadequate retirement plan is almost worse than no plan at all, because it can lull you into a false sense of security. For true peace of mind, you need a LifePlan from AgingOptions!

(originally reported at https://finance.yahoo.com)

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As Doctor’s Visits Get Shorter, You Need to Ask the Right Questions

Does it seem to you that your doctor has less and less time to spend with you?

We hear it over and over, from doctors and from their patients: because of changes in our health care system, doctors believe they have to see more and more patients in less and less time. This means, when you go to see your doctor, it feels like he or she may have precious few minutes to spend with you.  For most patients, the days when your doctor would have a leisurely office conversation with you are long gone.

One study we read suggested that about half of all doctor’s visits last 16 minutes or less. The fact is that this statistic doesn’t appear to have changed dramatically in the past decade or more, but still the perception lingers that your physician is busily trying to convey more information to you in less time than ever before. So how can you plan ahead to make the most of your doctor’s visit? What are some of the most important questions you need to ask during the brief time you’ll spend in his or her office?

We found this helpful article early last year on the website Grandparents.com, and we’re sharing it here once again because we think it provides some very worthwhile answers to the question of how to make the most of precious time with your medical provider. The article is titled, “10 Questions You Should Ask Your Doctor.” The idea is simple: since you seem to have less and less face time with your doctor, you need to make the most of it in order to get the best health care your physician can provide. These helpful questions are excellent whether you’re an aging patient or a loved one responsible for a senior’s medical care. If you want the entire list we suggest you consider printing a copy of the article and sharing it with your physician.

The article starts with some questions you should ask your doctor if this is your first visit, or if you haven’t seen him or her for over a year. It suggests you begin with the basics, for example, by asking, “What is your schedule?”  Don’t assume he or she is there every weekday during “normal” hours – especially if your doctor is part of a clinic where evening or weekend hours are not uncommon. If you haven’t seen your doctor in a while, his or her hours may have changed since your last visit. Get this information clarified right at the outset.

A second related question you should ask upfront is, “What’s the best way for me to communicate with you about test results, lab work or general questions?”  Some doctors use the telephone, while others rely on email. Some only call with bad news, while others inform patients about everything. You deserve to know exactly what to expect. The article quotes a Cleveland Clinic physician who reminds patients, “You should leave the doctor’s office understanding the [communication] plan. It sounds very obvious, but a lot of patients don’t know how and when results will be communicated.” Asking the easier questions like this one up front will save a lot of harder questions later.

Here’s an unusual question we found interesting: a patient can ask the doctor, “What can I tell you about myself that will help you remember me?” As the article points out, your doctor sees hundreds of patients every month, and the more he or she remembers you, the better your individual care will be. At least, the article suggests, this question will get your doctor thinking!

Some other questions from the Grandparents.com article may seem obvious, but for some reason many patients hesitate to ask them. Here are a few examples.

  • You need to be upfront when you ask, “What’s my diagnosis?” And when you ask, make sure you understand the answer before you leave the office – insist on clarity!
  • It’s perfectly fine to ask, “How long until it gets better?” Again, try to get a clear, easy to understand response, and pin the doctor down about the specifics.
  • If extra drugs or tests are ordered, don’t be afraid to ask, “Can you explain why you’re ordering a test or prescription?” Your doctor should be able to provide a clear explanation, and you should expect an answer you can understand.
  • Finally, don’t leave without asking, “When do you want to see me next?” Make sure you clearly understand the next step in your care plan. Otherwise the long wait before your next appointment can be a stressful, uncertain time of delay.

The article concludes with a question that’s one of our favorites. When you’re feeling scared, uneasy or confused during a medical appointment, look your doctor in the eye and ask, “Can I stop you for a minute?” As the article puts it, “Save this question for when you don’t understand what the physician is saying to you or when you are feeling scared. This lets the doctor know that you need a minute to collect your thoughts.”  You deserve as much information during your appointment as possible, so don’t be afraid to insist on clarification.

Here at AgingOptions, the best recommendation we can make for seniors to ensure optimum health care is to make a geriatrician part of your health care team. A geriatrician is a doctor who specializes in senior health care. When you consult with a geriatrician, you’re talking with a professional who already has a deep understanding of your health care needs. If you’ll contact our office, we can recommend a geriatrician in your area.

What about understanding your retirement needs? Working with clients to develop a personalized retirement plan is our professional specialty. We call it a LifePlan, and it would be our privilege to help you create a comprehensive, personalized roadmap to guide you into a retirement that is secure and fruitful. Your LifePlan weaves your medical care together with financial, housing, legal and family considerations to create a powerful retirement strategy – and the best way to start learning more is by attending one of our free LifePlanning Seminars, held frequently throughout the region. To register for a LifePlanning Seminar near you, simply click here.

And make sure to bring your questions! We’ll do our best to provide you with helpful answers. See you soon at a LifePlanning Seminar near you.

(originally reported at www.grandparents.com)

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From AARP: Protect Yourself and Loved Ones from These Two Scams!

Here at AgingOptions we typically find blog stories to share with you from various reliable online news sources – but this story is taken from a flyer that just landed in our mailbox. As part of their ongoing effort to protect seniors from unscrupulous thieves who are always trying to steal their identities and their cash, AARP has just mailed out a flyer called “The Watchdog,” with the subtitle “Beating Con Artists at Their Own Game.” A few of these articles grabbed our attention, and we felt compelled to share them with you – both to help you protect yourself and to arm you so you can safeguard older loved ones who are depending on you.

(If you want more information about AARP’s fraud prevention programs, click on this link to take you directly to a nine-page guide called “AARP Watchdog Alert.” You can read it online or print a copy for yourself or a loved one.)

The first article in the AARP flyer, one that really got our blood boiling, is a warning to veterans, called “America’s Vets Have a New Enemy: Scammers!” According to a recent AARP study, one in three victims of investment fraud in the U.S. is a military veteran. “The bad guys deliberately call former military,” warns AARP, “pretending to be old friends, offering ‘sure thing’ investments, finding ways to steal their money.” According to AARP the situation is getting worse, with a 65 percent increase in fraud complaints from veterans just in the past five years. Fraud targeting American vets has gotten so bad that AARP is launching a new program called “Operation Protect Veterans,” enlisting anyone and everyone to be on the lookout for suspicious solicitations that seem to target those who have served our country. Here’s a link to a state by state AARP website describing this nationwide effort.

The Watchdog article mentions at least four different types of common scams aimed at veterans – but there are certainly more varieties out there since thieves are notoriously creative. Do any of these sound familiar to you?

  • The “Update Your Military File” Scam: A caller claiming to be from the VA contacts the veteran pretending to be seeking information to update a personnel file. In reality this is nothing more than thinly-disguised identity theft.
  • The “Cash for Benefits” Scam: Scam artists offer a cash-starved veteran an immediate payment in exchange for their future disability benefits, but the supposed payouts are worth only a fraction of the value of the benefits the vet would otherwise receive.
  • Charity Scams: Callers claim to represent charities serving disabled veterans or other vets in need, but in most cases these “charities” are either fraudulent or disreputable. (Suggestion: always check out charities on a website such as Charity Navigator before you make a donation.)
  • VA Loan Modification Scams: Callers contact military families offering to refinance their VA loans, for an upfront fee. Once the fee is paid, the scam artists vanish.

There’s a second scam you need to be on guard against, this one triggered by the recent decision by Medicare officials – finally – to stop using Social Security numbers on Medicare identification cards. This change is the result of a 2015 law, but it is taking until April 2018 for the change to start kicking in. In the meantime, says AARP, “Medicare beneficiaries are getting calls claiming to be from Medicare asking for payment to receive a new Medicare card, or asking them to verify their Medicare number.” AARP warns that these calls are completely illegitimate. “Medicare will never call to verify your number because they already have it,” says the organization. “Also there’s no cost to get your new card.” What do you or a loved one do if you get a call like this? “Hang up immediately.”

No senior wants to be a burden to those they love, and many seniors tend to be proud and stubborn, so your loved one may not tell you they’ve been approached or even victimized by scammers. Our advice is to be on the alert. Watch the mail (or, if you have access, the email) for suspicious correspondence, and talk to the manager of the bank where your loved one does business. You can also call us at AgingOptions and let us provide some sound advice on avoiding scams. And we also strongly recommend that you and your loved one attend one of our free LifePlanning Seminars. At these popular events you’ll discover an approach to retirement planning that is truly comprehensive, weaving together all the vital aspects of life as you age: finances, legal affairs, medical insurance, housing options and family communication.

We offer these seminars at locations throughout the region, but they do fill up rapidly, so please accept our invitation and register now for the seminar of your choice. Click here for details and online registration, or call us and we’ll gladly assist you.

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