What Has Four Legs, a Cold Nose, and Helps You Stay Healthier Longer?

Here’s something we doubt that your regular doctor will prescribe for what ails you – but it might not be such a bad idea. If you’re looking for a way to get more exercise, lower your blood pressure and improve your outlook as you age, maybe you should consider getting a dog.

This recent article on the website NextAvenue confirms what many people have long suspected: there are measurable emotional and health benefits to people 50 and older from owning a pet. The article focuses primarily on dogs, but other pets including cats, birds and fish seem to provide health benefits, too. Still, dogs bring special benefits because they tend to love their owners unconditionally and they need to be walked every day, often multiple times, which gets the dog owner off the couch and out of the house, rain or shine.

“Dogs are especially important for the 50 and over group,” says the NextAvenue article. “They keep people connected to their communities and keep them on the move, a vital part of staying healthy into the later years. And research shows that having a dog promotes walking, considered the best form of exercise for people in this age group.” One 60-year-old woman quoted in the article says she may be tired when she gets home to her two dogs in her otherwise-empty house, but “the dogs stare at her until she puts their leashes on.” She said she always feels better after having taken her dogs out for a brisk evening walk.

At the University of Missouri Veterinary College, professionals like nurse gerontologist Rebecca Johnson study the interaction between humans and animals. She’s a strong advocate for pet ownership among seniors. “It’s vitally important to stay as physically active as possible, not only from the point of view of preventing illness, but also because of the social benefits,” Johnson says. “Dog owners are less likely to have loneliness and depression than those who don’t. And when they interact with a dog on a walk, it draws them into the moment and they forget their aches and pains.”

It sounds like common sense to suggest that owning a dog or other pet is beneficial because a pet gets the owner out into the fresh air for some much-needed exercise. But owning a pet brings other surprising benefits as well. One striking example, according to NextAvenue, is the remarkable finding that those seniors who own dogs and cats can actually lower their risk of coronary heart disease, which is the most common cause of death for those over 60. This may be because, as the American Heart Association has found, pet owners tend to have lower blood pressure and lower resting heart rates. They are also measurably less affected by stress and they tend to recover from stressful situations more rapidly. One University of Maryland study even showed that patients who owned pets were more likely than non-pet-owners to survive a heart attack! Man’s best friend indeed.

The NextAvenue article also points out the emotional benefits of owning a pet – again, especially a dog. Seniors can find themselves alone for the first time in many years after their children move away and a spouse either dies or leaves following a divorce. Having a dog keeps people from facing tough times alone. Dog owners may find themselves going on “community dog walks” that combine exercise with sociability – a great antidote to loneliness. There are also many examples of a loving pet helping people through chemotherapy or post-surgical recovery. This is one reason why therapy dogs have become so popular, visiting nursing homes, rehab clinics, even housebound seniors.

We encourage you, especially if you’re a pet-lover, to read the NextAvenue article. It just may give you a host of new reasons to visit a pet shelter near you and invite a new four-legged friend (or a bird, or even a fish) into your home and your heart. Then when you’re searching for that perfect retirement community, you may need to add “Pet Friendly” to your list of must-have qualities.

If you’re starting to look ahead toward retirement, wondering how to plan for all the different aspects of this exciting yet challenging phase of life, you’re not alone. But fortunately you’ve come to the right place. Here at AgingOptions, with our radio program, our LifePlanning Seminars and our hundreds of client relationships, we have helped many thousands of people plan for a rich and rewarding retirement. When you work with us to create a personalized LifePlan, you’ll find that this comprehensive strategy effectively weaves all the critical facets of retirement together: your financial security, your legal affairs, your medical protection, your housing choices, and the all-important aspect of communication with your family. A LifePlan helps you face the future with confident anticipation.

Why not find out more? All you need to do is invest a few hours and attend one of our free LifePlanning Seminars at a location near you. For a complete list of dates, times and locations, simply click here and register online. You can also call our office during the week, if you prefer, and we can handle your registration over the phone. You’ll be very glad you attended a LifePlanning Seminar – and we look forward to meeting you soon.

(originally reported at www.nextavenue.org)

New Law Addresses Medicare Hospital Admission Controversy, but Questions & Confusion Remain

It’s an all too common scenario: a senior citizen is admitted to the hospital. The patient spends a few days getting tests and care, but when it’s time for discharge he or she is not well enough to go home, so the patient is sent to a rehabilitation facility. Imagine the shock for the patient and his or her family if they later discover that Medicare is refusing to pay the costs of rehabilitative care because the hospital had only kept the patient “for observation.” The patient was never actually admitted, even after a stay of several days.

If this sounds far-fetched, it’s not, as this extremely timely article from Kaiser Health News reveals. Seniors are sometimes kept in “observation” status for extended periods. Observation status is supposed to give doctors a reasonable length of time to determine the patient’s condition and establish a treatment protocol but some hospitals, for various reasons, seem to stretch that definition. The real problem is that Medicare treats “observation” patients differently from patients who are “admitted.” Observation is considered to be outpatient care, so Medicare charges observation patients more for the treatment they receive and – worst of all – refuses to pay for rehabilitative care for patients who were not “admitted” to a hospital.   “For years,” says the article, “seniors often found out (about this) only when they got surprise bills for the services Medicare doesn’t cover for observation patients, including some drugs and expensive nursing home care.”

So here’s a bit of good news in the Kaiser Health News article. A new federal law requires that hospitals across the country must alert Medicare patients (who make up 42 percent of hospital admissions) when they are being held for observation and why they are not being formally admitted. The notice requires notification after the patient has received observation care for 24 hours, and that notice has to be given after no more than 36 hours of care. This new mandate, says Kaiser, is “one of the conditions hospitals must meet in order to get paid for treating Medicare beneficiaries.”

Unfortunately, the article asserts, the new law doesn’t solve the biggest problem: Medicare’s policy concerning payment for rehabilitative care. Kaiser Health News quotes Stacy Sanders of the Medicare Rights Center who says, “The observation care notice is a step in the right direction, but it doesn’t fix the conundrum some people find themselves in when they need nursing home care following an observation stay.” In other words, if you or your loved one is held in observation status only, any subsequent stay in a rehab center could cost you plenty. Even with the new rule, the old policy remains in force: in order for Medicare to pay for nursing home care in a rehabilitation facility, a patient has to have had a prior hospital admission for at least three consecutive days. Observation time, says Kaiser Health News, doesn’t count.

The Kaiser article says that hospitals are trying to adjust to the new notification requirements even as Medicare keeps revising their billing codes and related policies, so the landscape keeps shifting. But here at AgingOptions we share this article as part of our commitment to keep you informed. If you or a loved one is on Medicare and facing hospitalization make sure you insist on being informed after no more than 24 hours whether you are being held in observation status or being admitted. This is also an excellent reason for you to hire a geriatric physician to be the “quarterback” of your health care team. A geriatric physician, or geriatrician, understands the physical and emotional needs of aging patients better than any standard physician and can do more than any other health care professional to help seniors maintain vibrant good health for as long as possible. If a hospital stay should be needed, your geriatrician can become your health care advocate. Contact us at AgingOptions and we will refer you to a geriatrician in your area.

We also invite you to call our office if we can answer specific questions for you about Medicare and Medicaid. We have specialists on our staff who will explain these vitally important programs to you and help you with your particular situation.

But perhaps the best single recommendation we can make for those getting serious about retirement planning is for you to invest just a few hours and attend one of our free LifePlanning Seminars. These events, held at locations throughout the area, are highly popular and information-packed. You’ll discover the power of a process we call LifePlanning, a unique approach to retirement planning that blends all the separate “puzzle pieces” of retirement into one seamless whole: your finances, legal affairs, housing options, medical coverage and family communication. A LifePlan, individualized to meet your particular situation, will help ensure that you enjoy a retirement that’s fruitful and secure.

The next step is simple. Because LifePlanning Seminars tend to fill up quickly, you can register online for the seminar of your choice by clicking here. You can also contact us for assistance during the week. Bring your retirement questions and come prepared to learn valuable answers at a LifePlanning Seminar near you.

(originally reported at www.khn.org)

Helpful Questions to Evaluate a Nursing Home or Assisted Living Facility

Moving into a nursing home or assisted living facility is often an emotionally charged experience, for the resident and for the extended family. But sometimes finding the right facility, especially in the midst of all that emotion, makes the transition even more challenging. How can a loving child or spouse know whether he or she is making the best possible choice when selecting a nursing home or assisted living facility for someone they love?

We recently found this extremely helpful and very comprehensive checklist on the website of an organization called the Pioneer Network. This 20 year old group is made up of professionals in the field of senior living and long-term care who, in the words of the organization, are committed to changing the culture of aging. Instead of focusing on institutionalized care known for regimentation and cookie-cutter sameness, the Pioneer Network is dedicated to what they call “a culture of aging that’s life-affirming, satisfying, humane and meaningful.” The key phrase the organization uses, and one with which we agree, is that they want elder care to be “person-directed, not system-directed.” Anyone who has witnessed firsthand how some nursing homes are almost like warehouses for seniors can’t help but say “Amen” to that.

Sadly, however, many facilities for seniors have never adopted the idea of person-directed care. “Person-directed care,” says the Pioneer Network, “allows the elder to make their own choices, continue familiar routines and maintain their dignity after moving into the new setting — or in other words, be at home wherever home may be.” To help seniors and their families assess what the environment of a nursing home or assisted living facility is really like, the organization has created a checklist of questions they recommend you ask when visiting a nursing home or an assisted living care community.  Under each question on the website – 18 for nursing homes, 16 for assisted living – the website includes a drop-down window that shows the answer you should receive if the facility is truly person-directed.

We don’t have the time or the space to cover all these questions but let us give you a representative sample. Then we encourage you to visit the site for yourself. You can also print out a list of the questions to bring with you as you visit and evaluate senior living facilities in your community.

One of the most important factors in making your loved one feel at home in a new community will involve assimilation – how quickly the staff and other residents will get to know the new resident and how hard the adjustment will be. For that reason several of the questions revolve around this issue. You’ll want to ask what steps the staff in the nursing home will take to get to know your family member and to welcome them into the community. You should also ask whether or not your loved one’s caregivers will be a consistent group of individuals or a different, rotating staff each day. There are questions concerning personal freedom and choices, including what time your loved one will be required to get up every morning or whether they’ll be given some latitude when it comes to food choices and alternatives. It will also be essential to know whether you as a family member will be welcomed and treated as part of the community: if there is a Family Council, for example, you may want to get involved.

Other examples: You’ll want to know whether your loved one can have a shower or bath whenever they want one, and what type of recreation facilities they’ll have available. You’ll definitely want to find out how the facility handles residents who are dealing with dementia. Other more specific questions revolve around staffing turnover and the level of staff satisfaction. If a facility has an unhappy staff with frequent turnover, your loved one may be far less likely to enjoy a happy and stable living situation. For each question the Pioneer Network questionnaire gives you the kind of responses you should be listening for. The website also tells you what you should be watching out for as the staff takes you on a tour of the facility.

The separate questionnaire for Assisted Living Facilities is similar in tone and content with some questions specific to the personal care environment. In each instance the key phrase to listen for is “person-directed care.” At the very least you should come away satisfied that the facility cares more about the individual needs and wishes of you and your loved one and less about their rigid institutional routines.

The Pioneer Network website has a wealth of information and we offer it up as a valuable resource to help dispel some of the fear involved with choosing the right retirement facility for someone you love. We recognize that 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 https://www.pioneernetwork.net)

If You Die in Debt, Will Your Heirs Have to Pay Up? Probably.

Several months ago we discovered this insightful article on the website US News. It answered a question we have heard frequently in our client meetings, on our call-in radio programs and at our seminars: “If I die with debts, will my heirs have to pay them off?” Because this question (and the worry behind it) is so common, we felt it was timely to re-address this issue.

So here’s the bottom line: If you die leaving debt behind, most of the time – if you have any assets at all – the answer is yes, your heirs will be saddled with that debt. The article explains several possible scenarios where those debts you incur in life will burden those who inherit your estate.

Debt is an especially tough problem for seniors, a group whose debt burden is definitely increasing. “With seniors’ debt burden rising, many are likely to die with debts still unpaid,” says US News. “While not all that debt will pass to their heirs,” the article goes on to say, “much of it will come out of any inheritance they expect to leave behind.”

How bad is the senior debt problem? The article states that in 1989 about 44 percent of senior households in the U.S. were carrying some debt. In 2013 that percentage had risen to just over 61 percent. But the figure that caught our attention was the amount of that debt: for households headed by adults age 60 or older, the average debt burden had skyrocketed from about $9,000 in 1989 to nearly $41,000 in 2013. One particular surprise that we’ve recently written about on our AgingOptions Blog (click here for the story) is that many seniors are loaded down with student debt incurred by their kids and grandkids, because of education loans for which the parent or grandparent co-signed. For seniors already strapped for money after the recent recession, debt can be a crushing burden now and a headache in the future when your children have to deal with it.

US News states that, if you have any assets at all, your creditors will likely get “first dibs” during the probate process. “That means,” the article reports, “that your children or other heirs effectively will pay your debts because they will be subtracted before any inheritance is transferred.” This will force your kids to pay off your debts with the cash you had hoped to pass on to them. It may even mean selling off assets such as a home to pay off your creditors after you’re gone. Depending on the state you live in, some spouses become liable for the debts incurred by their spouse (Washington is one of those states, referred to as a “community property” state). The debt you leave behind may place a severe burden on your surviving spouse. In other words, according to one financial advisor quoted in the US News article, “Debt is the last thing you want to have when you die.”

The article lists six things you need to do if someone you love dies with debt. (Again, click here to link to the US News piece and read all six.) Some of these steps are obvious, such as the immediate notification of creditors, especially credit card companies: you want to make sure no one can open a fraudulent account in your loved one’s name, and you also want to put an immediate halt to any additional fees and surcharges. A few other important things on the checklist involve filing tax returns and filing for those assets that do not go through probate, such as life insurance payouts and retirement accounts.

But the first thing on the US News “to do” list is to consult with an attorney. Here at AgingOptions, where retirement planning and elder law are our specialties, we would welcome the chance to sit down with you and go over the situation in which you find yourself following the death of your loved one. In fact, a call to our office should be one of the first ones you make, so that we can begin advising you of all the necessary steps you’ll need to take to satisfy creditors and protect your own family’s interests.

An even better idea for dealing intelligently with debt and finances is for retirees to start now to put a LifePlan in place – a comprehensive retirement plan that covers all aspects of your retirement and your estate. We can advise you on how to protect your assets and how to avoid burdening your loved ones both while you live and after you’re gone. All your legal and financial plans become part of your LifePlan, as do your housing preferences, family instructions and medical coverage needs. It truly is a “Life Plan.”

The very best way to start the LifePlanning process is by attending one of our free LifePlanning Seminars. You’ll come away with valuable knowledge that will help you face your retirement years with a new sense of confidence, knowing you’re prepared. Don’t leave your heirs with a burden of debt – or even worse, with the burden of caring for you and making decisions against your wishes. You’ll find a complete list of upcoming dates and locations right here on our website, along with simple online registration. We encourage you to register today because many of our LifePlanning Seminars are filled to capacity. And as always, if we can assist you by phone, please call our office during the week. We’ll look forward to seeing you soon.

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

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)


Assisted Living Experts Don Hansen, Chad Solvie Join Rajiv on the Air April 1, 2017

The Cascade Park Communities in Tacoma have been serving the residential needs of seniors for more than two decades, and on Saturday April 1, the man most responsible for that success, Don Hansen, joins Rajiv Nagaich the studio. Also appearing live with Rajiv will be the man replacing Mr. Hansen as he prepares to retire, experienced senior living professional Chad Solvie. This live segment of the AgingOptions radio program will allow listeners to learn more about two of the fastest growing areas of senior living, assisted living and memory care.

One of the things that sets the Cascade Park Communities apart – and a topic that has been in the headlines a lot in recent weeks as Congress debates changes to federal health care policy – is that Cascade Park accepts residents receiving Medicaid assistance. As federal policy revisions threaten to bring Medicaid cuts to low income recipients, Don and Chad will be able to present a frontline perspective on this extremely contentious and timely issue.

Assisted living is the choice of a growing number of seniors who are healthy enough to live with some independence but who still need help with some of the activities of daily living.  Most of us understand the basics of assisted living, but for those interested in deciding whether assisted living is right for them or someone they love, we suggest this article on the website Seniors Guide. There’s no single checklist that can answer every circumstance, but here are a few statements that might be helpful. How many of these apply to you or your loved one?

“When it comes to my level of independence:”

  • I am still relatively healthy.
  • I like having my own living space.
  • I like being independent.
  • I am willing to move to a smaller home, or am unable to stay in my current home.
  • I prefer to live on my own, or do not have a relative or friend with whom I can live.
  • I no longer feel safe in my home.
  • I feel isolated in my home.

“Concerning my activities for daily living:”

  • I need help getting in and out of the bathtub or taking a bath or shower.
  • I need help getting dressed.
  • I need assistance with personal grooming.
  • I get my medicines mixed up or can’t remember when to take them.
  • I can no longer cook or need help preparing meals.
  • I can no longer drive or can only drive very short distances.
  • I do not have family or friends nearby if I need help with daily tasks.

“If most or all of the above Independence and Daily Living statements apply to you,” says the article in Seniors Guide, “and you do not need regular nursing or medical care, then assisted living may be a good option for you.”

Don Hansen brings a unique background to the field of assisted living and memory care. In his extensive and varied career, he spent 20 years as a registered structural engineer and then another 20 years as a developer, bringing projects from concept to design to completion.  Don then brought his design and business skills together with his passion to provide for the needs of low income adults and developed Cascade Park Gardens in Tacoma, serving as owner and operator of this 82-bed facility for more than two decades. The Cascade Park Communities now encompass three facilities: Cascade Park Gardens for memory care, Cascade Park Vista for assisted living, and Cascade Park Active Day, one of the only programs of its type in Tacoma. Don also has many interests beyond his enthusiasm for senior care: he has traveled extensively on mission trips to Ethiopia, India, South Africa and Cambodia, and has been extremely active in his community as a Tacoma Rotarian. He has also been very involved in several professional boards and organizations.

Rajiv’s other guest is Chad Solvie, who assumed the role of Cascade Park Communities Executive Director last October.  Chad comes to Cascade Park with extensive professional experience after serving for 17 years at Poulsbo’s highly-regarded Martha and Mary senior living community, first as Administrator and then for more than 8 years as Executive Director. Chad’s long-term care experience goes back more than two and a half decades, beginning when he served seniors as a Certified Nursing Assistant in the early 1990’s.

To learn more about vibrant senior living in the heart of Tacoma, click here for the Cascade Park Communities website. And tune in to the AgingOptions Radio Show Saturday, April 1, 2017, to learn about Cascade Park and about trends in senior living and in Medicaid that will almost certainly affect you or someone close to you. If you miss the weekend program, visit the AgingOptions website here where you’ll find all our radio programs archived.  Rajiv looks forward to welcoming Don Hansen and Chad Solvie to the studio where they’ll be available to take your questions and calls.

Ten “Forgotten Expenses” That Retirement Plans Frequently Overlook

Here at AgingOptions we always remind our readers and listeners that there’s much more to retirement than finances. However – we’re the first to admit that preserving one’s assets in retirement is extremely important. So how are you doing in planning for your financial future? Do you feel you have all your bases covered?

Before you answer, we strongly suggest you take a look at this recent eye-opening article from the financial website Cheat Sheet. It starts with the question, “Are you financially prepared for retirement? You might be surprised to learn you’re not as prepared as you think you are.” The article lists ten important retirement expenses you must never ignore – expenses which people too often overlook. As the article’s author Sheiresa Ngo puts it, “Although you might know how much money you need to retire comfortably, there are some expenses you might not have thought about. Some aspects of retirement planning can be scary, so your first instinct might be to forget about it or leave things to chance. However, when it comes to life after work, letting the chips fall where they may isn’t the best strategy.” We heartily agree – so let’s consider some of these “forgotten ten.” We can’t cover them all in detail, so we suggest you read the article for the complete list. It just might cause you to adjust your plans.

The first cost you may not have planned for is the expense of helping adult children. In the words of the article, “Depending on when you call it quits, your nest might not be empty during retirement.” That’s because a significant number of 18 to 34 year old adults are living with their parents – more, in fact, than are living on their own or with a spouse or partner. As you plan your own financial future, it might be wise to add in some extra resources to cover some of the expenses this “extra mouth” can generate. A recent Pew research poll showed that about 58 percent of adults surveyed said they had provided financial help to their adult children. Is that potential cost listed among your retirement expenses?

The second extra financial bite for retirees is in the area of housing. In 1998, fewer than one quarter of adults 65 and older had a mortgage, and for those who did the average amount was $44,000. In 2012 that number had risen to 35 percent, and the debt had nearly doubled, a trend that is still continuing. Obviously housing costs will play a big part in your financial plans, and you can’t afford to forget those unexpected repairs that are a big part of home ownership.

What about the effects of inflation on your budget after you retire? We tend to presume that things will always cost about what they do today, but if you stop and think for a moment you know that’s simply not true. Seniors are especially prone to the effects of inflation because they are affected disproportionately by rising medical costs, which are going up at a rate far higher than the “official” inflation rate of two or three percent per year. And here’s a sobering thought: even at a modest three percent inflation rate, if you are 60 years old today, many prices will have doubled by time you’re in your early 80’s. Better sharpen that planning pencil.

Here are a few other “forgotten expenses” from the article. Have you taken these into account in your retirement planning? Some of these expenses are too frequently overlooked.

  • Emergency savings – how much you set aside may be up to you and your financial planner, but if you don’t have sufficient cash on hand for those unanticipated expenses you’ll regret it.
  • Taxes on Required Minimum Distribution (RMD) from retirement accounts – you’ve been setting aside funds all these years in your 401(k) or 403(b) account, and that’s great. But if those were pre-tax dollars, and if you’ve never converted to a Roth IRA, all the money you withdraw will probably be taxable. You must take that into account as you project how far your savings will take you.
  • A whole host of miscellaneous expenses that can really add up, including Personal grooming, Pet care and Memberships and subscriptions. If you’re on a budget that’s tightly planned, a sudden veterinary bill or a renewal notice from the health club can really derail your plans.
  • Health care – even if you’re covered by Medicare or Medicare Advantage, there will almost certainly be out-of-pocket costs, prescription costs and policy premiums. These need to be factored into your planning. If you’ll contact us here at AgingOptions we can put you in touch with qualified experts who will help you navigate the complicated world of medical care and make the choices that are best for you – financially as well as medically.
  • Transportation – getting around will be important in retirement, whether you drive or rely on public transportation (or alternative modes such as Über). You had better plan ahead for the cost of being mobile.

Once again, we encourage you to look at this article from Cheat Sheet and use it as food for thought when you’re planning for your retirement finances. But you must remember that finances are only one facet of planning for retirement. Here at AgingOptions we help you develop what we call a LifePlan that weaves your finances together with other key elements of retirement living – medical protection, legal preparation, housing choices and family communication. Unlike other “one-dimensional” plans, a LifePlan truly covers all the bases when it comes to planning for your future. You can find out more, without cost or obligation, simply by taking a few hours to attend a LifePlanning Seminar at a location near you. For all the details, plus simple online registration, click on this link. Or if you prefer, you can call us during the week and we will gladly assist you.

(originally reported at www.cheatsheet.com)

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)