• Banned from a restaurant for getting nursing home care: Frank Bilisoly, 90, and his wife, Indiana, 85, loved dining in the white-tablecloth River Terrace restaurant of the upscale Harbor’s Edge retirement community, where they live in Norfolk, Va. When Bilisoly’s health required him to switch to skilled nursing care at Harbor’s Edge, their restaurant meals together stopped. Why? Because the nursing home was worried about a state law governing where nursing home residents eat. Click to read more.
• Are you still driving? Many seniors worry about how long they can safely drive. New research tells us that rather than put away the car keys for good, people often start and stop driving several times in old age. More than 70 percent of older drivers get behind the wheel daily. Read more here.
• Is care a handout or a right? Do you have a right to publicly funded long-term care, no matter how high your net worth? Many people believe they do, but in an opinion piece a researcher of long-term care argues that nursing homes deserve the fees that would-be heirs often want. Click to read his full thoughts.

Health

• Dire consequences for dialysis patients. A shift last year by the federal government in how it pays for drugs to treat dialysis patients may have had an unintended and potentially dire consequence, according to new research: a significant jump in blood transfusions for patients who now may not be getting enough of the medications. Read more here.
• Not enough pills to go around. Drug shortages have quadrupled since 2005, and now some 250 medications are in short supply – including those used to treat cancer, provide anesthesia during surgery or feed people intravenously when they cannot eat. Click to read more.
• New front in fight against Alzheimer’s. The Obama administration is moving forward with an ambitious, fast-moving agenda to improve the treatment of Alzheimer’s disease and unlock a method to prevent it by 2025. The final draft of the plan also sets up a wide-ranging effort to improve the care that Alzheimer’s patients receive and support families. Read more here. The rollout of the national plan was accompanied by the launch of a new website, www.alzheimers.gov, which provides legal, financial and medical resources, along with strategies for dealing with daily challenges and other tools.
• Comparing the candidates. At first glance, the GOP presidential candidates seem virtually identical in their health policy platforms. They are unanimously opposed to last year’s health law, favor reducing federal investment in Medicare and expanding state flexibility in managing Medicaid. But there are important distinctions in policy and tone, which Kaiser Health News summarizes here.
• Changing cancer treatment options. Cancer treatment is changing: Increasingly, pills are the drug of choice rather than intravenous chemotherapy that drips into a patient’s vein. Because health plans have been slow to adjust to the change, states are increasingly requiring better coverage of oral cancer drugs. Read more here.
• Fish can fight cancer. Not only is fish great for your brain, it could also lower your risk of rectal and colon cancers, doctors say. Click to read more.
• Good news for coffee fans. Regular coffee drinkers are likely to live longer, according to a study that followed 400,000 AARP members for more than a decade. Read more here.
• Shingles vaccine holds promise for seniors. Large clinical trials show that a vaccine can reduces the risk of developing shingles by roughly half. Shingles infects more than 1 million people every year, and older patients are especially likely to face complications. Read about the promising vaccine here.

Finance

• Conservative group would cut benefits for wealthy. Multimillionaire seniors are getting too much in government subsidies for their Medicare coverage, according to a report from the conservative Heritage Foundation. Click to read more.
• Share your frugal insights. Do you clip coupons, hold on to ancient attire, and re-use old objects long past when others would consider them “junk”? Then you may be interested in the winners of AARP’s Savings Challenge. Click here for their frugal insights.
• Tough times for unemployed seniors. The number of long-term unemployed workers aged 55 and older has more than doubled since the recession began in late 2007. Getting back to work is increasingly difficult, according to a new government report being. For unemployed seniors, the chances of reentering the workforce are grim. Read more here.
• New look at retirement options. One of the biggest flaws in most people’s retirement plan is that few amateur investors have the skill to pick fund allocations while young that will guarantee monthly income for life when they retire. But before long, many people’s 401(k) plans could start looking a lot more like old-fasioned pensions. Click here to read more.
• Estate tax could climb. The Obama Administration recently released its 2013 budget proposal, which calls for a decrease in the estate tax exemption level and an increase in the top rate that beneficiaries must pay. Read more here.

Legal

• Bad billings. Medicare paid $5.6 billion to 2,600 pharmacies with questionable billings, including a Kansas drugstore that submitted more than 1,000 prescriptions each for two patients in just one year, government investigators have found. Click to read more.
• What happens if your beneficiary dies? It’s a bit of ancient history, but Jim Morrison’s will highlights a misunderstanding in estate planning that is still common today: What happens to the balance of a bequest when the beneficiary dies?  Click for an answer.

• Who do you love and where do you live? Shacking up is not just for kids anymore, MSNBC reports. The number of people over age 50 who are living together in romantic relationships but are not married has more than doubled over the past 10 years. Read more here.
• How do you compare? Senior housing and long-term care communities can be expensive. So how do most residents of these communities pay their expenses — and what are the costs they take on? Click for answers from a new survey of residents.
• Grandkids step in. More 20- and 30-somethings are caring for their grandparents than ever before. Click to read more.

Health

• Can you afford to be healthy? A new calculation says the average American couple should save $240,000 to cover health care costs while in retirement. Click to read more.
• Osteoporosis drugs could hurt your bones. Women who take anti-osteoporosis drugs may want to think twice about their bone-building pills. A new review finds that long-term use can actually weaken bones in some women, causing serious and devestating health problems. Click to read more.
• A sense of purpose and meaning in life may slow the advance of Alzheimer’s. Read more here.
• Do bigger muscles make a smarter brain? Research from the Laboratory of Neuroscience at the National Institute on Aging found that exercise training leads to better performance on tests of cognition. Click to read more.
• Poor care for older patients. Doctors are failing to ask basic questions and bring up simple interventions that could make a big difference in the health of Americans age 65 and older, accordign to a new poll. Click to see what your primary care physician should be doing — but may not be.
• Battling mumbo jumbo. Tired of hard-to-understand jargon on your Medicare summary notices? Thanks to a 92-year-old Ohio woman, those statements are about to get easier to read. Read more here.
• Eat fish for a healthy brain. People who eat more omega-3 fatty acids have less of the protein that researchers think may cauce Alzheimers. Most got the healthy fats from foods, not pills. Read more here.
• Cutting Medicaid to pay for wars. House Republicans unveiled their plan for the U.S. budget this week. It would cut Medicaid and other social programs to protect funding for the Pentagon. Click for more information.

Finance

• Social Security shortfalls. Social Security “faces a real, but manageable, shortfall, and stabilizing the system’s finances should be a high priority,” according to a new brief from Boston College’s Center for Retirement Research. The report found that Social Security’s deficit is significantlyhigher than a year ago, in part because of the slow economic recovery and and an increase in disability payouts. Read the full details here.
• More seniors choose to retire. Older Americans are leaving the workforce in large numbers, according to the lastest U.S. jobs reports. And it looks like many are choosing to retire, rather than to hunt for work in a tough labor market. Click to read more.
• Politicians ignore what real people want. Leaders in Washington, D.C., are making too many decisions about Social Security and Medicare behind closed doors, and are spending too little time listening to ordinary citizens, according to people polled in a recent survey commissioned by AARP. Read more here.
• Read this before you retire. What financial considerations do you need to keep in mind as you transition from full-time work to permanent retirement?  Click for an overview.

Legal

• Daughter has to pay dad’s nursing home bills. Diana Gaetano promised to use her dad’s money to pay his nursing home bills. When he died with $80,509.55 still owed to Springs Nursing & Rehabilitation Center, the home went after Gaetano — seeking payment out of her own account if his estate could not cover the bills. Now a New York appeals court has ruled that Gaetano can be held personally liable for her father’s unpaid bills, since she continued to use his assets to make mortgage, tax and other payments on a house he would clearly never live in again while failing to pay the home. Read more here.
• Sons sued over mom’s bills. A Connecticut nursing home can proceed with its lawsuit against two sons who accepted money from their mother while she failed to pay her bills. Her Medicaid application was denied because of those financial transfers. A trial court ruled that while they sons were not personally liable for their mothers’ debt, the son who promised to be responsible for her finances could be found liable for a breach of contract. Read more here.
• Don’t get kicked out of your care facility if you run out of cash. Seymour and Mildred Altman paid $393,970 to move in to their continuing care retrement community, with the understanding that if they ran into financial problems they could take advantage of a hardship discount. But when they tried to use that discount, Lifespace Communities balked, saying they needed a third party to guarantee their monthly costs. Now a federal district court has ruled that the continuing care retirement community cannot require third-party guarantee of existing residents of its independent living units. Read more here.
• Are your kids on the hook? A Pennsylvania appeals court has found a son liable for his mother’s $93,000 nursing home bill under that state’s law. She entered the nursing home temporarily after a car crash, then left the country without paying her full bill. Pennsylvania’s filial responsibility law requires adult children to provide support for their indigent parents. Read more here. Florida’s just one of 30 states with filial responsibility laws. Here’s the full list.

This is an often overlooked planning opportunity for many retirees who may be in too much of a hurry to start their own benefits. The planning opportunity discussed here is for married couples and not single claimants. This does not mean that there is no planning opportunity for single claimants around social security benefits — indeed there is — but it is limited to timing the benefits.

Under the current Social Security rules, married individuals are entitled to a retired worker benefit based on their own earnings and/or to a spousal benefit equal to one half of their spouse’s benefit claimed at the Full Retirement Age1. If a married individual claims before the Full Retirement Age, the Social Security Administration assumes that the individual is claiming both types of benefits, compares the worker and spousal benefits, and awards the highest. Upon reaching the Full Retirement Age, individuals can choose which benefit to receive. As a result, married individuals can claim a spousal benefit at 66 and switch to their own retired worker benefit at a later date. This approach allows a worker to begin claiming one type of benefit while still building up delayed retirement credits, which will result in a higher worker benefit later.

In the past, providing these benefit options for spouses was not particularly valuable, since those who postponed benefits beyond the Full Retirement Age were giving up expected lifetime benefits. With the recent advent of an actuarially fair delayed retirement credit, lifetime benefits are roughly the same whether claimed at the Full Retirement Age or at age 70. As a result, the availability of benefit options has real value for couples today, thereby inevitably increasing the cost of the Social Security program.

What the rules allow one to do is to claim spousal benefits instead of one’s own benefits until a later age and then claiming a higher benefit later. Let us look at an example of how this might work: Husband- age 66, Wife-age 62. Both are considering retirement, and the husband would like to retire now and start his Social Security benefits immediately, which would be $1,934 per month. The wife could also start her benefits at age 62, at $986 per month. Husband is full retirement age, which means that the wife does not have to take her $986 per month now. She can, instead, go to Social Security and ask that she be awarded spousal benefits based on her husband’s work record, which will be 50% of his total benefits, or $967 per month. However, since his wife is taking her benefits earlier than at her full retirement age, the benefits will be adjusted downward by one half of one percent each month she takes early retirement. So, here the total reduction will be 24%, making the total payout $734.92. But this lower amount will allow the wife’s own benefits to continue to increase. The wife’s own $986 per month in benefits was the reduced amount, which would increase to a full sum of $1,297.38. And if the wife can afford to wait until age 70, she can claim $1,712,54 per month, for each year she delays taking her own benefits beyond her full retirement age the benefits increase by 8% (assuming she is born 1943 or later – or 2/3rd of 1% per month.3)

There are many reasons to delay retirement, particularly for women. Women generally live longer than men and have lower benefits than men for the most part. At the death of a spouse, the surviving spouse has the ability to take the higher of the two benefits, his/her own or the deceased spouse’s benefits. It only makes sense to take the latter. Finally, with all of the above in mind, it does make sense to consider delaying the benefits, especially if the family can delay the larger of the two benefits (in our example above it would mean delaying the husband’s benefits). Financially, sometimes this simply is not feasible. Hence, the need to look at all the alternatives available and to make a decision that will serve not only the immediate needs, but future needs as well.

My counsel is guided by some retirees who come to me in their later years wishing they had never started the early retirement because they lived longer than they had expected and now their incomes significantly handicapped their ability to live a comfortable life. As with most things, there is no one right answer or wrong answer, it is an answer that has consequences. Any answer is the right answer so long as you understand the consequences of the decision and can live with it.

You can find some good information at http://www.ssa.gov/retire2/yourspouse.htm.

May is Older Americans Month. Since 1963, communities across the U.S. have taken time out in May to celebrate the contributions that elders make. This year’s theme is “Never Too Old to Play,” and is part of a broad national effort to keep older Americans active and engaged. Read more here.

And click here to read facts about older Americans.

Housing

• What aging parents fear most. When parents become too frail to care for themselves, many adult children have to decide between moving their elders into a home not equipped to handle them or submitting mom and dad to nursing care. Increasingly, though, adult kids are instead settling their parents in their back yards — not in tents, but in well-equipped cottages known as “granny pods.” Read more on this trend.
• You want to age in place and now Medicare wants to help you stay put. The Department of Health and Human Services (HHS) has announced several Affordable Care Act initiatives aimed at keeping more chronically ill patients at home for care. The new efforts, which are scheduled to roll out over three years, kick off June 1. Click for details.
• Concerned about nursing homes? You may have good reason. At least 34 people died in a single New Orleans nursing home when Hurricane Katrina hit and the facility’s owners had no disaster plan in place. Seven years later, at least 95 percent of nursing homes inspected by the U.S. government still had serious gaps in how they said they’d handle tornadoes, hurricanes, floods or other catastrophes. And there’s no timetable in place for making things better. Click to read more.
• Institutional care — CAUTION!!! More worrying news for nursing home residents: As your checks contribute to record profits for nursing home owners, most of these care facilities are cutting back on what you get for your buck, by reducing staff or cutting workers’ wages and benefits. Read more here.

Health

• PSA tests could do more damage than good. Men older than 75 should not get routine PSA prostate cancer tests, according to medical recommendations, but older men are largely ignoring this advice. This is a problem, because as they age men are increasingly likely to receive false positive PSA tests. By the time they are 75, they are more likely to be hurt by the test or the treatment it spurs than they are to be harmed by prostate cancer. Unnecessary tests increase the risk of pain, incontinence and impotence.  Read more in the New York Times.
• MEDICARE ALERT. If Congress does not act, Medicare will run out of money within about 12 years, according to an updated look at the U.S. healthcare program for the elderly. Experts who reviewed the report say even that estimate is overly optimistic. Click to read more. The question is, what can you do about it? I think there is a lot you can do to protect yourself. Listen to Aging Options Radio or attend a seminar to find out more. Click here to register for a seminar and to access AgingOptions.
• A donut may not prove as sweet as you’d expect. Medicare’s infamous “Donut hole” — the gap in medication coverage that requires patients to pay 100 percent of costs above a certain benefit level — leads people to skip taking necessary pills, according to a new report out of Harvard Medical School. Read more here.
• Medicare advances: Does your doc know? Medicare’s sickest patients can now receive transcatheter aortic valve replacement if they have heart valve damage. The treatment is a new technology that is less invasive than previous options. Read more from the Centers for Medicare & Medicaid Services.
• Alzheimer’s news. New research adds to scientific efforts to reveal beta-amyloid protein plaques, the brain-clogging fragments that have been associated with Alzheimer’s disease. Read more about this promising research.

Finance

• Retirement issues – are you counting on Social Security to allow you to retire? American workers are either more confident in the future of Social Security than they were five years ago, or less confident in their personal retirement funds. In 2007, just 27 percent said they expected Social Security to be a major source of income in retirement. A recent poll found that now 33 percent do. Read more here.
• At what age do you retire? As the age at which people can receive full Social Security benefits has climbed, so has the age at which Americans expect to retire, according to a new Gallup poll. Today, the average working American expects to retire at 67. In the mid-1990s, the average expected age of retirement was 60. Click for more from Gallup.
  

Legal

• About time and good riddance. More than 100 people have been arrested across seven cities in a massive Medicare Fraud Strike Force operation that resulted in charges related to $452 million in false billing. Read more from the Department of Health and Human Services.
• Not a Safe Harbor Trust, even though the client was led to believe it was. A Massachusetts woman who transferred $17,400 to a trust to benefit her children will have to wait before she can received Medicaid benefits — even though a court approved her estate plan. Read more about this case. If you’re using Medicaid to pay for nursing care, watch out for the income and asset rules that govern this need-based program.

 Map Links

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Housing

• Planning to hire a home health care agency to help you remain independent? Seniors just got more help from Medicare, thanks to its Home Health Compare. Click here to read more about the new tool, and click here to start using it now.
• Countless seniors have found peace of mind by signing up for programs like Medic Alert, which makes it easy to call for help if you have an accident while home alone. But more sophisticated monitors aimed at keeping older patients at home, rather than in the hospital, may not be as effective, according to a new study. The study found that “telemedicine” systems that automatically check blood pressure, weight and other health-related measurements don’t keep patients out of the hospital and in their homes. Read more here.

Health

• How good is your state at providing long-term services and support for older adults, people with physical disabilities and family caregivers? The answer may affect your health, quality of life and how long you are able to remain independent. AARP has established a state-by-state scorecard and rankings at www.longtermscorecard.org.
• Take advantage of new Medicare perks – like prescription drug savings and free wellness exams – while you still can. They may go away if the Supreme Court decides to strike down all or some of  the Affordable Care Act, also known as “Obamacare,” experts tell the Chicago Tribune.
• Don’t let your chronic health condition dash your vacation dreams. Here are tips on how to take your chronic condition on a trip.

Finance

• Will the government pay for your long-term care? Probably not, but it depends on your financial circumstances. Here’s what you need to know.
• Older people are more vulnerable to phone, mail and digital cons. Here are tips for seniors fighting fraud, from the New York Times.
• What’s the best age to start receiving Social Security benefits? And how are survivor benefits calculated for your spouse? The answers to these questions depend on your personal situation, but these guiding principles from ElderLawAnswers can help determine what’s best for you.

Legal

• Elma Gsellman thought that moving her personal property into a irrevokable discretionary trust would protect her personal property and allow her to get Medicaid funding for her nursing care. But after she died, Ohio’s Medicaid program went after her estate, saying  that she could have used the trust to pay for care instead of Medicaid. This month the Court of Appeals of Ohio agreed, ruling that discretionary trusts can be used in determining Medicaid eligibility.
• The federal government has launched benefits.gov to help people find out what federal benefits they qualify for, including disability assistance, living assistance and Social Security – plus programs for people at other stages in life. Click here to see if you’re missing out on benefits you’re legally entitled to.