A holistic care management and elder care company that helps families plan for, pay for, and coordinate the long-term care of elderly loved ones. Our blog is the best way to keep up-to-date on current issues, new ideas and important considerations as you navigate your way through the elder planning process.
The doctor-patient relationship is sacrosanct – we all realize that. Our physicians generally know more about us, inside and out, than any other human being. When the relationship is healthy, it is characterized by a sound sense of trust and a high degree of mutuality and openness. A patient in a strong relationship with his or her physician feels listened to, valued and cared for.
Breaking Up is Hard to Do
But what if all those good vibes from your doctor are missing? When is it time to say good-bye and to fire your doctor? Because we at AgingOptions encounter this question frequently, and because we (as you might suspect) have strong feelings about the matter, we were immediately drawn to this brand-new article from the aging-related website NextAvenue. The title says it all: “9 Signs You Should Fire Your Doctor.” Not all physicians are right for all patients, writes author Hilary Thompson, and because that’s true you should be on the lookout for these telltale signs that it’s time to search for a new MD.
Before we take a look at these nine warning signs, we feel the urge to share some perspective. It does seem to us that older patients tend to trust their doctors more implicitly than younger patients do, and that seniors tend, as a rule, to be more compliant and less skeptical. It is helpful to remember that you as a patient are a consumer, purchasing medical care from the doctor of your choice. If you feel you’re being ignored or patronized, you owe it to yourself and your family to find someone else to serve as your primary care physician. For older adults our strong recommendation at AgingOptions is to select a geriatrician to serve in that capacity: thanks to their training, these geriatric physicians have a much more complete understanding of the needs of seniors than most doctors do, and they will generally take the time to listen and respond with care and empathy. Please do yourself a favor and contact our office so we can refer you to a geriatrician who practices in your area.
Watch for These Red Flags
Now, what are the “red flags” that NextAvenue says should send you to the exit door of your current medical clinic? Here they are:
You don’t feel heard. “Your doctor should listen – really listen – to all of your concerns,” says author Hilary Thompson. “If you want to discuss your heart disease risks and your family’s cancer history and all your doctor wants to talk about is your hearing, there is a major disconnect that may not be bridgeable.” Active listening is the key.
You have a serious personality conflict. It’s important that you have a doctor you at least get along with. “Would you want someone you can’t stand operating on you or making major medical decisions for you, despite the fact this person may be talented? For some, this is a deal-breaker,” Thompson says.
Your doctor is “too stretched to serve you.” Your health is your single most valuable asset, and if you can’t seem to get the appointment you need, try somewhere else.
Your doctor’s approach is not providing the healing you need. If things simply aren’t working, a second opinion – and maybe a change of physician – could be warranted.
Your doctor doesn’t educate you. We all know the internet is a great source of information – but much of it is either biased or bogus. “Hopefully your doctor is a reliable source for all the information you need,” Thompson writes, “so you don’t feel compelled to seek more information elsewhere. You should be educated completely about your medications, conditions and treatment options.”
You feel you can’t be honest with your doctor. Trust between doctor and patient is essential, says the NextAvenue If for some reason you find you can’t be open and honest with your physician, it might be a sign that you should seek medical help elsewhere.
Your doctor is too aggressive. “Be careful how quickly your doctor moves to extreme treatment options,” Thompson cautions. “For instance, if you go to see a doctor about your back pain and he or she immediately wants to schedule surgery, that should be a huge red flag.” The doctor should take an appropriate amount of time – but not too much – to observe, assess and evaluate. If he or she is rushing your treatment in a way that seems inappropriate, you may want to head for the door.
Your doctor won’t talk with other specialists about your case. This seems like basic common sense, since care coordination is so important. “If your doctor won’t communicate with your other doctors about your care, it might be time to find a new one, especially if this physician is your [Primary Care Physician],” says Thompson.
You feel bullied. “A doctor who doesn’t answer all your questions, doesn’t return phone calls, speaks condescendingly or keeps you in the dark is not well-suited to you,” says A doctor who pressures you into procedures or medications with which you feel uneasy, without providing a thorough explanation, is very likely wrong for you. If this is happening, it’s time for you as the patient or loved one to take charge.
Time to Take Control
In researching this article, we were amazed at this statement from a group called the Patient Advocate Foundation. “Statistics show that over one-third of adults in the United States will never seek a second opinion,” the group states, “and almost one-tenth of newly diagnosed patients rarely or never understand their diagnosis.” This is madness – yet it speaks to the “magical aura” that seems to envelope the medical community. Whether you’re the patient or you’re caring for a loved one, the NextAvenue article is well worth reading, because we have a hunch that many of you are seeing the wrong doctor and are reluctant to do anything about it. For the sake of your health, the time to remedy that situation is now.
In the same way, the time to take action in planning for your retirement is also at hand – and in this area we have great news. There’s a simple, cost-free way for you to get started on your retirement planning journey, and that’s to accept Rajiv Nagaich’s personal invitation to join him at one of our upcoming informational presentations that we call LifePlanning Seminars. There you’ll join a sizeable group of men and women just like you as you learn from Rajiv how essential it is to have a plan for your golden years that is truly comprehensive. Your financial plan has to mesh with your housing choices. Your medical coverage must take into account your family’s abilities to provide care. Your legal framework has to provide the protection you need. An AgingOptions LifePlan is the only retirement planning tool we know about that accomplishes all this and so much more.
Who Do You Trust?
Ready to take a simple next step? This link will take you to our Live Events page where you’ll find a listing of all the seminars presently scheduled. Select the one that works for you and sign up online to reserve your spot – it’s as simple as that. If you need assistance, feel free to call us this coming week. Just as your physical health depends largely on having the right doctor, your retirement health depends on the type of plan you have and the professionals you trust to guide you. It will be our pleasure at AgingOptions to serve you. Age on!
What stresses you out? If you’re like nearly two-thirds of Americans, issues surrounding money are right up there near the top of the list, according to the American Psychological Association’s “Stress in America” survey. Money ranked alongside work and politics as the thing that’s creating the most anxiety these days among our fellow citizens.
A New Way of Thinking
The cure to financial anxiety – “money stress” – is not simply more money. Instead, it’s to adopt a whole new way of thinking about, budgeting, spending and saving money, referred to as “financial wellness,” and described in this article that appeared recently in Forbes magazine. We’ll explain more in a moment, but first it’s worth pausing to consider the huge cost of all the stress and anxiety many of us bear on a daily basis, especially in the area of our money. “Financial stress and anxiety remains a prevalent issue with far reaching implications,” says Forbes author Scott Spann. “The side effects of poor financial health include stress-related illness, decreased work productivity, absenteeism, marital discord, depression and anxiety.” Those with high levels of unmanaged stress caused by debt are more likely to deal with heart problems, and they experience more relationship issues and substance abuse. In other words, Spann goes on to say, “no matter how you interpret the Stress in America survey, personal financial wellness and the future of the country are indeed intertwined.”
Spann describes what Forbes calls the “five myths about Financial Wellness.” We should say at the outset that the philosophy behind this article truly reflects our own here at AgingOptions. As Rajiv Nagaich puts it, “Forbes is really speaking our language. What they’re describing concerning financial wellness is right in line with our LifePlanning principles. Sometimes,” Rajiv adds, “I feel like we at AgingOptions are so far ahead of the pack when it comes to conventional thinking about financial health and retirement planning!” Read on and see if you don’t agree.
Not Just a Slogan
The first of Spann’s five myths is that Financial Wellness is nothing more than a feel-good buzzword – a trendy marketing gimmick, in other words. But this is completely untrue. “Financial wellness,” he writes, “is more than retirement preparedness, credit repair or debt management.” The ultimate mission is “to change lives.” Spann says authentic financial wellness is measured by a combination of factors including our overall sense of financial satisfaction; our actual financial behaviors such as budgeting, saving, and debt reduction; our attitudes toward and knowledge about finances; and our objective financial status (i.e. income, savings and debt load). “The mission to improve financial wellness in America is to help create financially healthy people who are able to weather any economic or political challenges,” says Spann in Forbes. “Financial stress is real and the financial wellness movement is working to counter the negative effects of stress.” He adds that roughly 84 percent of medium to large companies now offer financial wellness programs for employees, which shows that corporate America is getting on board the bandwagon.
Knowledge, Money Don’t Foster Wellness
Myth number two, says Spann, is that All we need is more financial knowledge. “Financial education alone will not change financial lives,” Spann counters. “Financial education opportunities have been around for decades but we still have poor financial behaviors in the U.S.” The goal of financial education has to be action. “The underlying goal is to achieve a positive sense of well-being backed up by actual financial behaviors that help us instead of create stress,” says Spann. Confidence grows when we put knowledge into practice.
Myth number three says All we need is more money. This may be a common belief, but it’s false. “Financial wellness is not a sole function of your income level or overall net worth,” Spann writes. “Perhaps the underlying issue is finding a way to better utilize current resources while seeking a balance between living in the moment and planning for the future.” We say a hearty “Amen!” to that.
Who Needs a Budget?
Myth number four says, As long as you can pay your bills, you don’t need a spending plan. A Gallup survey said that only one American household in three has a budget, which may explain the sad financial state of so many when it comes to savings and debt. But even if you are fiscally solvent, a budget is a valuable tool, says Spann. “Personal spending plans create awareness of whether or not your spending is in alignment with important life goals,” he says. By identifying ways to free up extra money for saving, investing, or paying down debt, you will gain motivation and a greater sense of financial peace of mind.
Finally, here’s myth number five: All financial wellness programs are unbiased. If you’ve listened to our AgingOptions radio broadcasts at all, you’ll recognize this one. “As financial wellness programs have grown across America, product-focused financial services companies have also latched on to this concept,” Spann writes. “Some firms are selling financial products and services under the guise of financial wellness programs. It is important for all industry providers to protect the term,” ideally using an established set of standards to protect the customer. Our caution remains, if you’re working with a financial adviser, make sure you know how he or she is getting paid. You may be getting poor advice while your adviser reaps fat commissions.
It appears there is such a thing as financial wellness, but what about “retirement wellness”? Actually, in a very real sense that’s what we at AgingOptions offer our clients. We treat retirement in a holistic way, combining the critical aspects of solid retirement planning – finances, housing, medical coverage, legal protection and family communications – into one comprehensive plan which we call a LifePlan. With your LifePlan in place, you’ll have the blueprint you need to build the retirement you’ve dreamed of, one that is fruitful and secure. Best of all, you’ll realize your hopes of protecting your assets, avoiding burdening those you love, and escaping the unhappy trap of being forced against your will into institutional care.
Why not take a simple next step and learn more at an AgingOptions LifePlanning Seminar? Join Rajiv Nagaich at one of these highly popular free events. Thousands of people just like you have discovered the power of LifePlanning in this easy and entertaining way. Click here for our Live Events page and select the seminar that’s best for you; then register online to reserve your place. Come learn more about “retirement wellness” at an AgingOptions LifePlanning Seminar near you.
Everyone knows you need a will, yet even in this so-called enlightened age, a surprising number of Americans have never gotten around to preparing one. According to the LegalZoom website, “Approximately 55 percent of American adults do not have a will or other estate plan in place,” a number that has remained fairly constant for the past decade or more. “Among minorities,” LegalZoom reports, “the numbers are higher than in the general population: 68 percent of black adults and 74 percent of Hispanic adults do not have [a will].”
Two Key Steps – and a Third
So, if you’ve taken the time to prepare a will, that’s a decent start, but it’s hardly enough. There’s more you need to do, as you’ll discover in this helpful article on the MarketWatch website, called “When You Write Your Will, Don’t Mess This Up.” The piece was written by lawyer, writer and former IRS investigator Julian Block. He says there are “two chores that most people gladly put off: the first is writing a will – and the second is updating it to reflect changed circumstances.” And, he adds, there’s one more critical decision you need to make (and periodically review): you need to select the right executor.
We hardly need to remind our AgingOptions readers about the importance of having a current will, but in Block’s law practice (and in ours at Life Point Law) we continually encounter people who are either too uninformed or too lazy to get around to preparing one. When Block meets these people, he challenges their lethargy. “I regularly remind them how badly things could turn out if they fail to [prepare a will],” he says. “For instance, their assets might wind up with individuals whom they never intended to benefit or they consider less deserving of their largess than others.” Depending on the size of your estate, dying intestate (without a will or other legal device to allocate your assets) can drain the money you wanted to leave to your offspring, letting your estate dissipate into taxes and legal fees. All of this is frustrating, demoralizing, expensive – and easily avoidable.
Block, writing in MarketWatch, also makes a strong point about the need to ensure that your will, once written, is frequently reviewed to reflect your current life circumstances. It’s an all too common occurrence: someone drafts a will, puts it in the file cabinet or firesafe, and proceeds to forget about it. Meanwhile new children come on the scene, divorces and remarriages take place, family squabbles create emotional distance, and new philanthropic interests replace former ones. Perhaps at some point you moved to another state or had a large rise or drop in net worth. Any or all of these life occurrences can necessitate an update or perhaps a complete re-write of your will. Once again, if you fail to take action now, your heirs will pay the price later.
In the MarketWatch article, author Block spends about two-thirds of his words on a topic that is sometimes overlooked or under-emphasized: selecting an executor. Often the one preparing a will names the family member who seems to be “the logical” choice, frequently the oldest son or daughter, to be the executor; but just because they’re the oldest doesn’t make them well-suited for the task, especially if the estate is complex. Because the executor plays the key role in the settling the estate, writes Block, you should select someone “willing to take jobs that are potentially time-consuming and demanding,” with (we would add) a strong sense of responsibility and attention to detail.
Disorganized People Need Not Apply
To illustrate his point, Block lists some of the key duties an executor will be expected to accomplish:
The executor has t0 assemble and value all of the deceased’s assets. “Executors have to ferret out records for bank accounts, brokerage accounts, tax-deferred retirement accounts and insurance policies, as well as other assets like real estate, art, jewelry and automobiles,” says Block.
Block adds, executors need to “unearth information about debts, mortgages and tax records, and figure out if the person had safe-deposit boxes, made loans to family members or others, or made charitable pledges.”
Executors are responsible for paying all bills and fees, often using paid professionals for some of these tasks which (says Block) “might include the timely filing of the deceased’s final income tax return, federal estate taxes, state inheritance taxes and the estate’s income tax return, along with the payment of any taxes owed.”
After they’ve valued assets and paid bills, the executor distributes assets to heirs and beneficiaries. In our experience, this can be where family quarrels get particularly intense, especially when siblings mistrust one another or ex-spouses become involved.
Finally, the executor is required to submit a full accounting to the court of everything they’ve done to settle the estate.
At every step along the way, the executor can unfortunately make errors than can have serious financial and legal ramifications. If you’re the one choosing an executor, you need to choose wisely. If you’re named to serve as an executor, make sure you get good advice all along the way. As Julian Block warns in MarketWatch, “Many executors belatedly learn that their reliance on the counsel of attorneys, accountants and other professional advisers doesn’t relieve them of responsibility for mistakes.” Select your advisers with care.
Fully-Integrated Retirement Planning
Sound legal planning is important, but when it comes to comprehensive retirement planning, it’s just one facet among many. Yet we often meet people at our seminars or talk with callers on the radio who think they have a “retirement plan” when all they truly have is an outdated will and a rudimentary retirement savings account. At AgingOptions our approach to retirement planning – which we call LifePlanning – integrates your financial and legal preparations with medical planning, housing choices and family communications to ensure that you’ll be able to retire with your assets protected and your family unburdened. Your LifePlan is like a well-drawn road map to take you safely through the twists and turns and ups and downs of your retirement years.
Please accept our invitation to learn more about this revolutionary approach to retirement planning by joining Rajiv Nagaich at one of our popular LifePlanning Seminars. We conduct these in locations throughout the Puget Sound region, so there’s bound to be one convenient for you. Click here for our Live Events page where you can see all the seminars currently scheduled and then sign up for the event of your choice. Join men and women just like you who are taking charge of their retirement future. And age on!
An unnerving article we just discovered in the New York Times asks a penetrating question: could the rise in rates of depression and suicide be somehow linked to increasing use of common prescription drugs, some of which are also available over the counter? This inquiry was prompted by a just-released report showing that more than one-third of all American adults are currently taking at least one prescription drug that lists depression as a potential side effect, and nearly ten percent are taking three or more of such potentially damaging medications.
Seniors Often Misdiagnosed
You’ll find the New York Times article here. We think this is an extremely important article for just about everyone, but especially for those caring for seniors, many of whom are on prescription drugs. If your loved one has begun exhibiting signs of depression, including loss of sleep, loss of appetite, lack of energy or a host of other symptoms, it may be time for a complete review of their list of medications.
Sadly, it’s not uncommon for some physicians to misdiagnose symptoms of depression among their senior patients, instead treating these symptoms as if they were “normal parts of aging.” (The problem of seniors receiving improper diagnoses for depression and other mental health issues was the topic of this recent article on the USNews website. It’s worth a read.) This is one more reason why we at AgingOptions recommend so strongly that senior patients entrust their health care to a geriatrician, a doctor trained to understand the unique medical needs of older patients. Choosing the right doctor can literally be a life or death decision. If you’ll contact us here at AgingOptions we’ll be happy to recommend a geriatrician in your area.
200 Depression-Causing Drugs
According to the New York Times article, there are roughly 200 prescription drugs that list “depression” among possible side effects. Reports the Times, “the list includes common medications like proton pump inhibitors (P.P.I.s) used to treat acid reflux, beta-blockers used to treat high blood pressure, birth control pills and emergency contraceptives, anticonvulsants like gabapentin, corticosteroids like prednisone and even prescription-strength ibuprofen. Some of these drugs are also sold over-the-counter in pharmacies.” The authors of the study, which was reported last week in JAMA, were surprised at how many drugs were on the list, the New York Times article says. “It was both surprising and worrisome to see how many medications have depression or suicidal symptoms as a side effect, given the burden of depression and suicide rates in the country,” the study’s lead author stated.
The point, the article says, is not that taking these medications “causes” suicide or depression among those who are otherwise already healthy. However, researchers found a clear correlation between the amounts of some of these drugs a patient takes and the prevalence of depressive symptoms. The research showed that, among patients taking one potentially depression-causing drug, about 7 percent had depression, compared with the general population where the rate of depression is below 5 percent. Patients taking two or more such drugs had a 9 percent rate of depression, while those taking three drugs or more showed a rate of depression that was more than three times the average, at just over 15 percent.
Correlation Can’t be Ruled Out
The increased risk of depression and even suicide associated with these drugs should make both physicians and patients’ families especially wary. While researchers remind us (with predictable caution) that they can’t definitively link the rise in depression and suicide with increased use of these suspect drugs, it seems foolish to rule out a correlation. “There’s been an increase in suicide, that we know,” one Columbia University professor of psychiatry said. “Does it correlate to the use of these medications? The honest answer is we don’t know. Could it play a role? The honest answer is yes, of course it could.”
As we said above, a geriatric physician is the right medical professional to diagnose and treat the unique physical needs of retirement-age patients. But we all know that there’s more to retirement than staying physically healthy and having the right medical insurance, as important as that might be. Is there a “retirement professional” who can guide you into a comprehensively healthy future? Fortunately, the answer is yes – because that’s what we specialize in here at AgingOptions. Unlike others who approach retirement in a piecemeal way, our approach, called LifePlanning, fully integrates the five pillars of a robust retirement plan: financial, medical, legal, housing and family. When these are working at odds, retirement disaster is a virtual certainty. When these are working together, your retirement is far more likely to be fruitful, secure and rewarding.
Please accept the personal invitation from Rajiv Nagaich to join him at an upcoming AgingOptions LifePlanning Seminar where he’ll share more about the power of a LifePlan. Remember, there’s no cost whatsoever, and no obligation. The information at our seminars may be free – but we think you’ll agree that the value will prove to be priceless. You’ll find all the currently scheduled seminars listed here – then you can sign up online to reserve your place or call us during the week. Our risk-free prescription for retirement security starts with an AgingOptions LifePlanning Seminar. Age on!
So you think you know all there is to know about reverse mortgages? So did we, until we took this reverse mortgage quiz that we found in a just-published article from the highly respected financial website Kiplinger. This quiz was written by well-known retirement writer Jamie Hopkins, Professor of Retirement Income Planning at the American College of Financial Services. The ten-question quiz takes just a few minutes – but it might open your eyes to some of the misperceptions you’re still harboring about the reverse mortgage.
(And in case you hate quizzes, read on. We’ll offer a glimpse at the answers below.)
“A Big Piece of the Puzzle”
“When I talk with consumers and financial advisers about retirement income planning,” Hopkins writes, “the value of home equity is one big piece of the puzzle that is often overlooked. The reality is that home equity is America’s largest retirement asset. For most retirees, it can be nearly twice as much as their investment savings.” Hopkins goes on to say that, even with all the publicity about reverse mortgages, “very few retirees or their financial advisers…know much about how to properly utilize home equity in retirement planning.” This lack of knowledge can be especially crippling to retirees who want to stay in their own homes as they age, perhaps not realizing that the funds to allow that dream to become reality may be sitting right there – untouched – at their fingertips.
“Tapping into home equity must be done thoughtfully and through a well-informed, comprehensive retirement planning process,” Hopkins emphasizes in the Kiplinger article. “When used effectively, a reverse mortgage can allow a homeowner to live a more financially secure retirement.” So with that as a backdrop, let’s run through these ten questions. Test yourself and see how you do – and for more complete information about each question we suggest you click on the link above and take the quiz for yourself.
Are These Statements True or False?
All these questions are either true or false. Here’s question number one. The earliest age at which a person who is the sole owner of a home can enter into a reverse mortgage is 55. This is false: 62 is the minimum age, and if you’re married that minimum generally applies to both spouses. The spouse younger than 62 will typically be shown as the “non-borrowing spouse.”
Question number two: One downside of entering into a reverse mortgage is that the bank takes title and ownership of the home. This widely-believed, often-repeated statement is actually false. You as homeowner still own your home and you keep the title.
Question number three: A reverse mortgage can be used to purchase a home. This is true, under federal guidelines. Remember that the qualifying home must be your primary residence.
Question number four: If the value of your home has increased since you bought it, entering into a reverse mortgage would result in a taxable gain to the homeowner. This is false. Because a reverse mortgage is a form of borrowing, says Hopkins, there are generally no tax implications.
Question five: A reverse mortgage can be used to refinance or to pay off an existing mortgage, and the borrower is not required to make monthly mortgage payments as long as he or she is still using the home as the principal residence. This is absolutely true and is typically seen as the biggest benefit of the reverse mortgage program.
Question six: Once you enter into a reverse mortgage, you no longer have to pay property taxes or insurance costs. This is definitely false, and this belief can be a source of major problems if misunderstood. Taxes and insurance remain your responsibility as homeowner.
Question seven is another frequent source of misunderstanding. If a borrower takes out a reverse mortgage and the home later is worth less than the amount owed to the lender, the homeowner, estate or heirs would need to pay off the additional debt to the bank at the end of the loan. This is false: you and your heirs are protected against a drop in home value, which is a major safeguard built into a reverse mortgage. A qualified professional can explain the implications of this benefit in your particular situation.
Question eight: Reverse mortgages are often more beneficial when set up and used strategically early in retirement, as opposed to being used near the end of retirement as a last resort. This is certainly true, especially when using a reverse mortgage line of credit which grows over time.
Question nine: When it comes to costs, borrowers should know that reverse mortgages have compounding interest on the loan balance and ongoing mortgage insurance premiums. This is true. “A big downside of using a reverse mortgage is that it is still borrowing,” Hopkins writes. There are ways to mitigate some of the costs and interest charges, so getting solid, objective advice is essential. A reverse mortgage is definitely not for everyone.
Question ten is a hypothetical. If only one spouse is a borrower on the reverse mortgage loan, and the other spouse is a non-borrowing spouse, the non-borrowing spouse can continue to live in the home without repaying the loan if the borrowing spouse moves into a nursing home. It turns out that while there may be exceptions, this statement is false. Hopkins explains that a change in the law in 2014 extended protections for eligible non-borrowing spouses to allow them to remain in the home after the borrower died. “However,” Hopkins cautions, “the same protection is not afforded if the borrowing spouse happens to move out of the home and into a nursing home. In that instance, the loan would become due in full.”
Professional Advice Recommended!
A quiz like this can be a real eye-opener. Because there’s so much misinformation out there, for reverse mortgage advice we urge you to sit down with a trusted expert such as Ted Butler, one of the pros we wholeheartedly recommend. But now let us switch gears a bit to offer you one more retirement-related quiz from AgingOptions, a quiz with just two questions. First, “In planning for retirement, is it important to have a solid financial plan, a strong legal plan, a well-crafted medical plan, a carefully considered housing plan, and a clear and comprehensive family communication plan?” The answer is, “Absolutely.” Second question: “Is it essential that they all work together in an integrated way, not as separate, disconnected parts?” As you might guess, the correct response is, “Definitely.” That in a nutshell is why you need a LifePlan from AgingOptions – the only retirement plan we know of that weaves all these critical elements of retirement together. There’s nothing like it.
Please accept our invitation to find out more by joining Rajiv Nagaich at an AgingOptions LifePlanning Seminar very soon. See for yourself – without cost or obligation. For all the details and convenient online registration, visit our Live Events page, or give us a call. And no pop quizzes, we promise. Age on!
By now you’ve almost certainly read or heard about the 2018 Social Security trustees’ report (if you want a link to the real thing you’ll find it here on the government’s website). Released last week, the report painted a fairly bleak – but not altogether surprising – picture of the Social Security program that is an essential pillar of financial security for about 59 million Americans. Because this program is so important to so many people, we wanted to share some perspective with our AgingOptions blog readers that helps paint a clearer picture of the future of Social Security and suggests what a fix might look like.
One Household in Six
We found such a perspective from one of our favorite sources of straightforward financial information, the Motley Fool website. There we discovered this article written by reporter Matthew Frankel called simply “5 Key Takeaways From the 2018 Social Security Trustees’ Report.” Frankel says his article explains “what all Americans should know about the current state of Social Security, and where it could be heading.” With about one American household in six affected in some way by Social Security, the health of this entitlement program – or the lack of it – really is essential information for every one of us.
“The 2018 Social Security trustees’ report was recently released,” Frankel writes, “and it reiterated what we already knew – that Social Security is going to be in serious trouble unless we take action.” But, he adds, “there’s a little more to the story than that.” For example, most people don’t know that Social Security currently has almost $3 trillion in reserves right now – which is the good news in that it buys a little time. But the long-term trends are disturbing, to say the least, and the question seems to be, “When will our political leaders find the political will to fix what’s broken?”
How Bad Is It?
With that in mind, and if like many of us you’re not entirely sure why Social Security is expected to be in trouble and what we could do about it, Frankel’s Motley Fool article offers “five key takeaways from the 2018 Social Security trustees’ report that help paint a clearer picture of the current and future state of Social Security, and what we could do to fix it.” Here are Frankel’s five observations and insights, along with some helpful perspective.
Social Security added $44 billion to its reserves in 2017. This makes the program sound fiscally robust, and it is, says Frankel – today at least. In 2017 Social Security took in nearly one trillion dollars in income (from payroll taxes and earned interest) and spent around $952 billion. The total Social Security trust fund reserve is now close to $3 trillion dollars, money that is being held both as a “rainy day fund” and as a source of interest income.
Social Security is still expected to run out of money in 2034. “Unfortunately,” Frankel writes, “the surplus Social Security produced in 2017 is the last one we’re going to see unless significant changes are made to the program.” How bad will it be? He adds, “For 2018, Social Security is expected to run a $2 billion deficit, and the annual deficit is only expected to get worse from here.” The deficit in the program, with Social Security shelling out more than it takes in, is projected to accelerate rapidly, with the reserve projected to be depleted in about 16 more years.
Costs are exceeding income from payroll taxes, and it’s going to get worse. “The problems with Social Security,” says Motley Fool, “can be simplified as follows: [first,] Americans are living longer lives. [Second,] the massive baby boomer generation is going to be gradually retiring over the coming decades. The effect of this is that not enough people are going to be paying into Social Security, and too many people will be drawing benefits.”
There’s a $13.2 trillion long-term deficit in Social Security funding. The projected deficit over the next 75 years in the Social Security program is getting bigger rapidly – now estimated at $13.2 trillion, up from a projected $12.5 trillion just a year ago. “In other words,” says Frankel, “this means that if we wanted to keep the program’s [benefits] and the payroll tax rate the same, we would need to somehow add $13.2 trillion to Social Security’s trust funds.” Therein lies the dilemma: where will that money come from?
The sooner we try to solve the problem, the easier it will be. This is where the challenge of political will comes into the picture. “Obviously,” Frankel observes, “there’s not $13.2 trillion sitting around somewhere that can be magically added to Social Security’s balance sheet. So, the main ways to fix the deficit remain increasing taxes or cutting benefits.” In our observation, making a smaller course correction now will be far more palatable than waiting until 2034. That’s when the trustees project that the program would demand more drastic and painful adjustments, such as the estimated 23 percent across-the-board reduction in benefits that the anticipated shortfall would require.
Don’t Wait for Uncle Sam
As this debate continues to percolate, we’ll keep you posted on our AgingOptions blog and on our radio program. Meanwhile, we have a strong recommendation for all of you preparing to retire in the not too distant future: don’t wait for Uncle Sam to solve your retirement planning dilemma. Instead, take the bull by the horns and get some good, objective advice so you can build a retirement strategy that is comprehensive, robust, and uniquely suited to your situation. We’re talking about an AgingOptions LifePlan, the only approach to retirement planning that blends the essential elements of a true future strategy together into one complete blueprint: your health, your housing, your finances, your legal affairs, and communication with your loved ones. Don’t procrastinate and place yourself at the mercy of forces beyond your control. Take action today for a more secure life tomorrow.
The next step is simple: join Rajiv Nagaich for a free LifePlanning Seminar at a location that works best for you. You’ll find a complete listing of currently-scheduled seminars here on our Live Events page, where you can also register online. (If you prefer to sign up by phone, please feel free to call our office.) It will be a pleasure to meet you soon.
What is the one illness Americans are most afraid of – the one we fear more than cancer, stroke or heart disease? The answer probably does not come as a surprise: it’s Alzheimer’s disease. But this fascinating article we discovered last year on the website of Kaiser Health News provided a much different perspective on this feared disease and offered extremely valuable insight into how some relatively simple steps can dramatically improve the quality of life for a loved one with dementia. We wanted to revisit insightful article, which was written by Kaiser contributing columnist Judith Graham, because the topic is so relevant today.
A Fundamental Misunderstanding
In Graham’s words, the language we use to describe Alzheimer’s reflects our deep fears and fundamental misunderstanding. She wrote, “People ‘fade away’ and are tragically ‘robbed of their identities’ as this incurable condition progresses, we’re told time and again. Yet, a sizable body of research suggests this Alzheimer’s narrative is mistaken.” The surprising truth is that “people with Alzheimer’s and other types of dementia retain a sense of self and have a positive quality of life, overall, until the illness’s final stages.” This has profound implications for how we interact with and care for loved ones who have dementia.
Far from being isolated inside a cocoon of mental incapacity, those with Alzheimer’s still retain a significant part of their personalities, at least until the disease reaches later stages. “They appreciate relationships,” Graham said. “They’re energized by meaningful activities and value opportunities to express themselves. And they enjoy feeling at home in their surroundings.” The clear lesson is that it’s possible for loved ones and professional caregivers to actively promote engagement and well-being among those with dementia even in the face of memory loss, cognitive impairment, and other symptoms of these complex diseases.
Five Ways to Make a Difference
The Kaiser article acknowledged that late-stage dementia is enormously difficult for everyone concerned. For caregivers, the challenges are compounded by the fact that they typically receive little support, financially or otherwise, and often have to deal with a loved one’s decline virtually by themselves. Nevertheless, about 80 percent of those with dementia are in the mild to moderate stages of the illness, and there is much that a caregiver can do for someone in those stages of dementia to improve the patient’s quality of life significantly. The Kaiser article listed five specific areas in which creative, empathetic care can make a major difference for someone you love, so let’s review them here.
First, focus on health. Don’t assume that someone with dementia is unaware of their physical health and well-being. In the words of the Kaiser article, this means “being free from pain, well-fed, physically active and well-groomed, having continence needs met, being equipped with glasses and hearing aids and not being overmedicated.” Those with mild to moderate dementia also said they wanted some form of cognitive rehabilitation to help them compensate for their memory loss. Caregivers should note that up to 40 percent of people with Alzheimer’s disease suffer from significant depression, so if someone you love appears chronically sad and apathetic, treatment of their depression is probably called for.
Next, foster social connections. One of the tragic side effects of dementia is that it can destroy social relationships because of fear, discomfort and misunderstanding, said Kaiser’s Graham. She quoted one Alzheimer’s expert who says, “The saddest thing that I hear, almost without exception, from people all over the world is that family, friends and acquaintances desert them.” This is a basic social need that just about any one of us has the power to help meet.
Third, you may need to change your communication style. This can go hand in hand with the need to socialize, because, as Graham said, “Not knowing how to communicate with someone with dementia is a common problem.” Experts at Johns Hopkins School of Nursing suggest that caregivers should “speak slowly, simply and calmly, make one or two points at a time, allow someone sufficient time to respond, avoid the use of negative words, don’t argue, eliminate noise and distraction, make eye contact but don’t stare, and express affection by smiling, holding hands or giving a hug.” Sounds like great advice.
Fourth, address some of your loved one’s unmet needs. These needs include some very real physical and environmental dangers and other pitfalls that often get overlooked for dementia patients. For examples, researchers report that a large majority of people with dementia are at risk of falling, and almost two-thirds were shown to have other unmet health concerns. About half of dementia patients studied needed greater involvement in meaningful activities, and a significant number were living in unsafe surroundings not well suited to someone with reduced mental capacity. We need to pay closer attention to the conditions in which our loved ones with dementia are living and look beyond the surface.
Finally, respect your loved one’s autonomy and individuality. Your loved one is not simply his or her disease, experts emphasize – he or she is a whole person. In various Alzheimer’s focus groups, people with the illness said they longed to be “listened to, valued and given choices that allowed them to express themselves” and also “to be respected and have their spirituality recognized, not patronized, demeaned or infantilized.” Many research studies have corroborated this desire on the part of those with dementia “to experience autonomy and independence, feel accepted and understood, and not be overly identified with their illness.”
Number One Advocate
None of this is easy, as you know all too well if you are a caregiver for someone with dementia. Remember, you are likely to be their number one advocate and most significant source of strength, and your top priority may be to help your loved one see that he or she is not going through this journey alone. As we say at AgingOptions, aging is a family affair, and nowhere is that truer than when dealing with the effects of dementia.
Of course, the most important thing all of us need to remember as we age is that we need a solid plan for the future if we’re going to have the type of retirement we’ve always hoped for. Like most people, we’re certain you want to protect your assets in retirement. You don’t want to be forced into institutional care against your will, and you don’t want to become a burden to those you love. Is there a way to plan ahead so that your wishes will be fulfilled? Fortunately, the answer is a confident “yes.” We call our unique concept for retirement planning “LifePlanning.” LifePlanning is uniquely comprehensive because it takes into account all the critical aspects of your retirement future – your financial security, your legal affairs, your housing choices, your medical needs and your family support. A LifePlan is your blueprint to help you build the retirement of your dreams.
It’s easy to learn more, so we invite you to invest just a few hours and attend one of our free LifePlanning Seminars. You’ll find a list of current seminar dates and locations here. Once you’ve made your choice of locations, you can register online or contact us for further details and assistance. It will be our pleasure to meet you and to help guide you into a more secure and fruitful future.
Here at AgingOptions we’ve spoken and written frequently about the pros and cons of hiring a financial planner. As you know if you’ve heard us discussing this topic, we are generally in favor of people hiring a professional to provide solid, objective financial advice, since the landscape can get very confusing when it comes to how to manage your money – particularly in retirement. We have several excellent financial planners we recommend, and if you’re interested we’re happy to share some of those names with you.
Even Pros Need Good Advice
But what about someone who already is a financial planner? That person shouldn’t feel the need to hire an outside professional to do something he or she already knows how to do, right? Actually, the opposite is often true. Just like a lawyer sometimes needs to hire a lawyer and a doctor will one day need advice from another physician, a smart financial planner may very likely decide that some professional input from a third-party source makes for a sound investment, if you’ll pardon the expression. That’s the point of this article that we just discovered on the Forbes website, called “Why I Hired A Financial Planner – Even Though I’m A Financial Planner Myself.”
“In recent years,” writes author and financial planner Roger Ma, “I’ve seen several articles about why hiring a financial planner could be beneficial, even for those in the financial planning profession. My gut reaction to these articles was, that’s crazy talk.” In Ma’s case, he’s a self-described financial junkie who loves “eating, breathing and dreaming about personal finance,” and he had no desire to spend money hiring someone to do something he could easily do himself. However, after some careful thought and reflection, he realized he might be doing himself and his wife a major disservice by continuing to go it alone when it came to their financial strategy. The couple established a clear set of criteria to choose the right advisor (more on that in a moment) and eventually made their choice.
Four Benefits of Hiring a Planner
There were, according to Ma, at least four reasons why they decided to make the investment and hire a planner. We share these with you because we think these benefits have merit. Here’s what Roger Ma and his wife were looking for:
Unbiased Third-Party Insight: “All of us are influenced, to some extent, by our money scripts,” says Ma. “How we were raised and our relationship with money may influence, rightly or wrongly, our financial decisions. By working with an unbiased third party, my wife and I could ensure that past programming was not leading us to make bad decisions.”
Better Communication Between Spouses: Because Ma is in the financial field, he writes that he usually leads the way when it comes to family financial decisions. “While I run every major financial decision by my wife,” he says, “she may not feel comfortable challenging or rejecting any of the strategies because she’s not as fluent in the topic.” But by working with an outside planner “allows both of us to be clients,” Ma adds, and makes it easier for his wife to ask questions.
Avoiding Financial Blind Spots: Even though Ma is an experienced financial professional, he freely admits his knowledge has gaps. “I possess more knowledge and experience in some areas than others,” he says. “Working with another planner ensures I’m not overlooking an important detail just because it’s not my strength.”
Improving His Own Professionalism: By working with someone else, Ma gets the chance to see how he might better serve his own clients. The experience has led him to make some concrete improvements in his practice.
Criteria for the Search
We mentioned above that Ma and his wife went about the search with specific selection criteria in mind. “We went through the same process for choosing a financial planner that I recommend to all of my readers,” he writes in Forbes, looking at education, experience, and types of certifications. They also asked about fees with a special eye on possible conflicts of interest. (We wrote about the issue of financial planners and their sources of compensation in this AgingOptions blog post last month.) Finally, they considered what type of working relationship they wanted, attempting to determine whether or not a particular planner would be a good fit. Ultimately, they made a choice they were both pleased with and the results have been very positive.
Take Charge of Your Plan
We like the approach Roger Ma and his wife took in finding solid professional guidance, because frankly it reflects the philosophy that we practice here at AgingOptions. Ma wasn’t too proud to ask for help. He and his wife entered into the process together. They had their eyes wide open and they knew what kind of relationship they wanted with the planner they chose. And most important, they took action instead of waiting around for something to change. When it comes to solid retirement planning (which is far more than just financial planning) you would do well to follow Roger Ma’s advice and seek out the kind of wise counsel that can ensure your future security, with your finances, health care, housing, legal affairs and family dynamics all properly and comprehensively addressed.
At AgingOptions we call our retirement planning approach LifePlanning. If you’re eager to find out more – without cost – why not do what thousands have done and join Rajiv Nagaich for one of our upcoming LifePlanning Seminars? Invest just a few hours and see if you don’t agree that there’s nothing like a LifePlan to give you true peace of mind for your retirement future. For details and convenient online registration, visit our Live Events page, or give us a call.
If you have a loved one currently living in a nursing home, you may want to check to see whether he or she has been prescribed the drug Nuedexta. If so, your loved one may be receiving a drug that is unnecessary and even unsafe, and the prescription that recommended Nuedexta may have been part of medical fraud.
That’s our take-away from this just-published investigative report by CNN. “Government issues warning about pill pushed on the elderly,” says the title. Insurance companies are reportedly being warned by the U.S. government to be “on the lookout for suspicious prescriptions of a drug being used in nursing homes across the country.” The drug, manufactured by Avanir Pharmaceuticals, is called Nuedexta. Approved for treatment of one particular neurological disorder, the drug is allegedly being pushed aggressively (and illegally) by Avanir sales representatives as a way for nursing homes to control residents, many with dementia, who exhibit disruptive behavior. In several cases patients appear to have received a fraudulent diagnosis so that Medicare or Medicaid will pay the prescription cost.
According to the CNN report, Nuedexta is the only FDA-approved drug prescribed to treat a condition called PBA – pseudobulbar affect – a disorder which causes sufferers to exhibit uncontrollable laughing or crying. The Avanir website says that about 2 million Americans live with PBA, either resulting from neurologic disease or, in some cases, from injury. “Although PBA is not a life threatening condition,” says the company, “it can significantly impact the daily life for those who have or are caring for someone with this condition.” But a CNN investigation published last fall found that Avanir had been “aggressively targeting” nursing homes suggesting they give Nuedexta to frail and elderly nursing home residents in order to control what the staff considered “unruly” behavior. “CNN found multiple examples in which doctors had inappropriately prescribed Nuedexta to dementia patients,” says the report, “using a PBA diagnosis” when there was actually no evidence of pseudobulbar affect. The CNN expose reports, “One Ohio physician who was a top prescriber of the drug was accused of accepting kickbacks in exchange for prescribing Nuedexta and fraudulently diagnosing patients with PBA to secure Medicare coverage.”
Frail elderly patients are at particular risk of the side effects of Nuedexta which can include dizziness, nausea, vomiting and headache. The drug can also aggravate mental confusion and make the patient more prone to dangerous falls. Some patients experience vision problems, irregular heartbeat, fever and chills. Yet one CNN report cited a Los Angeles nursing home in which one-quarter of the residents were being given Nuedexta.
Allegations of Misrepresentation
According to CNN, Nuedexta came onto the drug market in 2011, and it almost immediately came under scrutiny because of the potential for misuse. “Avanir has generated millions of dollars in annual sales from prescriptions of the drug in nursing homes,” CNN reports, “and the federal government has been footing a large portion of the bill” through Medicare Part D. As far back as 2012, insurance companies began raising major concerns about how the drug was being marketed. One insurer, BlueCross BlueShield of Arizona, “expressed concern that the drug-maker was misrepresenting Nuedexta as safe and effective in populations where it had not been adequately studied. ‘We believe that the manufacturer appears to be marketing Nuedexta far beyond the scope of the clinical evidence,’ the company stated in the letter.”
CNN obtained internal emails from Avanir dating from 2013 in which company officials clearly encouraged their marketing staff to suggest Nuedexta for unapproved purposes. One Avanir sales manager told the marketing team the “great news” that a large insurer had removed one of the safeguards against over-prescribing the drug. This action, the email stated, would open the door to prescribing Nuedexta to “4 million additional seniors” and called the decision “a very important win for our company.” (Remember, the condition that Nuedexta is prescribed to treat is estimated to afflict 2 million people in the entire country.)
Company Under Investigation
We noted from the Avanir company website that the criticism and scrutiny appear to have made an impression. In late April, the company launched what they called “a national, multi-channel campaign aimed at raising awareness of Pseudobulbar Affect.” (You can read Avanir’s statement here.) Meanwhile, the Centers for Medicare and Medicaid Services (CMS) issued a cautionary memo to its network last March “[reminding] plan sponsors that Nuedexta is only approved to treat PBA and [stating] that Part D insurers are legally required to ensure the drug is only being covered when prescribed for medically-accepted uses,” CNN reports. Other insurers are taking precautions to prevent fraudulent prescriptions of Nuedexta, and the City of Los Angeles is reportedly investigating Avanir’s business practices.
As we said at the start of this article, if you have a loved one in a nursing home who is taking Nuedexta, it might be time for closer scrutiny. It may be that the drug is being used appropriately – but if your loved one has never exhibited symptoms of PBA, you need to ask some hard questions of the nursing home staff and of your loved one’s primary care physician. This is yet another case where good professional advice from someone trained in geriatric medicine will prove indispensable. As Rajiv Nagaich of AgingOptions recommends, “We tell our clients that having a case manager look in from time to time can definitely minimize these sorts of issues. With the right case manager, your family always has someone watching out for you even when you can’t be on hand.” Contact us at AgingOptions and let us explain how to secure the services of a trustworthy professional care management service that will help protect your vulnerable loved one.
The same hold true with all aspects of retirement planning: if your plans aren’t grounded on solid, objective information, they’re destined to fail. Here at AgingOptions, we take an approach to retirement planning that is different from that of many so-called retirement experts, because we concentrate on the full spectrum of retirement-related considerations: health, housing, financial, legal and family matters. These all must work together, like interlocking pieces of a puzzle, and with a LifePlan in place, they will.
The next step is a simple one: accept our invitation to join Rajiv Nagaich from AgingOptions at a free LifePlanning Seminar. There you’ll learn the power of a LifePlan, and you’ll get many of your retirement questions answered without pressure of any kind. You can click on our Live Events page to select the date, time and location of your choice: then register online or by phone. If you want the right prescription for true retirement security, the answer is simple: a LifePlan from AgingOptions. Age on!