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.
Memorial Day is our annual reminder that we in the U.S. owe a debt of gratitude to our armed forces veterans that we can never adequately repay. One of the ways we seek to show that gratitude to the millions of men and women who have served in our nation’s military branches is to provide veterans with the medical care they need, not just while they’re on active duty but for the rest of their lives. But according to a recent article, there is one group of vets that is conspicuously under-represented in VA Health facilities: women.
Women and the VA: Many Consider VA Health Care “A Last Resort”
In researching Memorial Day articles for the AgingOptions blog, we encountered this surprising article on a website called MedicalXpress.com. The title grabbed our attention: “Why do women military vets avoid using VA benefits?” Written by University of Massachusetts Professor Elizabeth Evans, the article suggests that women vets are ill-served by the way the Veterans Health Administration currently operates. “Many women military veterans turn to the Veterans Administration (VA) for health care and social services only as a ‘last resort,’ or ‘safety net,’” Evans writes, “typically for an emergency or catastrophic health event, or when private health insurance is unaffordable.” From the tone of the article, it would appear that a significant group of female vets, many of them probably retirees, are not being well cared for.
According to the VA website, the Veterans Health Administration is “the largest integrated health care system in the United States.” The agency operates nearly 1,250 health care facilities, ranging from 170 large, fully-equipped VA Medical Centers to more than 1,000 outpatient sites and clinics. The VA says it serves about 9 million enrolled Veterans each year. However, as Professor Evans reveals in her article, a relatively tiny percentage of those are female vets, and the Veterans Administration knows it has a problem attracting women patients. “While the VA in recent years has made efforts to address underuse of benefits by women,” Evans says, “a 2015 profile of women veterans by the U.S. Department of Veterans Affairs found that fewer than one in three women vets used VA health care.” This compares with about half of male vets.
Women and the VA: Women “Intentionally” Avoiding VA Care
Of course, men vastly outnumber women in the ranks of military vets, yet the number of female vets opting to avoid VA medical care still adds up to a significant number. We checked the federal stats and learned that there are almost 2 million female vets living today in the U.S. If only one third ever visit VA health facilities, that means, of the 9 million vets served by the VA each year, fewer than 700,00o – roughly 8 percent – are women. We wondered why.
“Health care is a great perk for veterans, but women vets are intentionally choosing not to use their VA benefits,” says Evans, who had previously spent time working for the VA in Los Angeles doing advanced postdoctoral research. Along with a team of researchers from the VA and also from UCLA, she interviewed a group of women veterans, publishing her findings in the Journal of Humanistic Psychology. Some of the impediments to wider use of VA health services seemed to center around simple misinformation – but others appeared to run deeper, bringing up painful associations with the women’s unique experiences while serving on active military duty. The biggest barriers:
Poor Indoctrination: Women said they felt little or no connection to services offered by the VA, because benefits were never explained while serving or upon discharge.
Bureaucracy: The perception is widespread that using the VA system is too complex.
Misperception: Many women vets expressed inaccurate beliefs about what health care services they were eligible for.
Unpleasant Association: In Evans’ words, “VA environments [triggered] women’s memories of combat experiences, military sexual assault and other negative military experiences.”
Lack of Safety and Sensitivity: Again quoting Evans, many female vets harbor “perceptions of VA settings as unsafe…and insensitive to the needs and preferences of women, including too little capacity for preventive and holistic care.”
Women and the VA: a Culture Shift and a Better Plan
It does seem clear that, if female vets are going to be served properly, a culture shift at the VA is in order. “Some women vets described the VA health care settings as understaffed, male-dominated and inexperienced with treating women vets, especially those with combat-related trauma,” Evans writes. Others interviewed said they felt “uncomfortable returning to a military-like setting for health care,” and they disliked the environment of many VA facilities, labeling them “more like a military base than a health care setting.” In Professor Evans’ view, “There are small and big things that could be changed to make it a more welcoming environment for women veterans.”
Here at AgingOptions, we understand how frustrating it is to experience the wrong kind of health care, and that’s why we strongly suggest that it’s time for you to take charge of your medical needs. For seniors, the first step is to place yourself in the care of a geriatrician – someone with a thorough understanding of the physical and emotional needs of aging patients. (If you’re receiving care from the Veterans Administration, you’ll find a link here to the geriatric services offered through the VA system.) The right health care professional can get you on the proper course to better health and give you the best, most appropriate advice. Contact AgingOptions and let us provide you with a referral to a geriatrician near you.
Avoid “Retirement Emergencies” with Careful Planning
If you’re ready to take charge of your retirement preparation, the professional team at AgingOptions is ready to help. When you experience our unique and comprehensive approach to retirement planning, which we call LifePlanning, you’ll appreciate just how powerful it is, because with LifePlanning all the essential elements of retirement work together: your finances, your housing choices, your medical coverage, your legal protection, and your family communication. The absolute key to enjoying a secure and fruitful retirement is a good, solid plan, and that means an AgingOptions LifePlan.
We invite you to come join Rajiv Nagaich at a free LifePlanning Seminar where he can tell you more and answer your questions, without any obligation. Invest just a few hours and your eyes will be opened to a new way of thinking about your retirement. For dates, times and locations of upcoming seminars, visit our Live Events page and reserve your place online for the event of your choice. Don’t settle for an unhealthy, inadequate retirement plan! Take control of your future with an AgingOptions LifePlan. Age on!
For several years families looking for nursing home care for a loved one have relied on Medicare’s Nursing Home Compare website. This site provides quality ratings for more than 15,000 facilities nationwide, awarding grades of one to five stars in three evaluation categories – health inspections, staffing levels, and clinical data – plus an “Overall” rating. The system isn’t perfect, but it does help people make side by side comparison of multiple nursing homes quickly and easily. The system is also not without controversy: last week here on the AgingOptions blog we told readers that a chronic shortage of nurses has caused the Centers for Medicare and Medicaid Services to downgrade the rating of more than 1,600 homes. (You can read that story by clicking here.) But it’s the best system around, for now.
Short-Stay Rehab Facilities are Finally Being Rated
There’s one big drawback to Nursing Home Compare: there’s no data available for people in need of short-term rehabilitative care. At least, that used to be the case – until recently. We discovered this just-published article on the Kaiser Health News website revealing some good news for short-stay patients and their families: “For the first time,” says Kaiser’s Judith Graham, “the federal government is shining a spotlight on the quality of rehabilitation care at nursing homes — services used by nearly 2 million older adults each year. Medicare’s Nursing Home Compare website now includes a ‘star rating’ (a composite measure of quality) for rehab services.” These services, typically paid for by Medicare for stays of no longer than 100 days, can include skilled nursing care, physical therapy, and occupational or speech rehabilitation for people recovering from hospitalization. Some 13,800 short-stay rehab facilities are now included in the ratings.
According to Kaiser, the addition of ratings data for short-stay rehab patients has been welcomed by health care experts and by the nursing home industry as a tool to help seniors make better decisions about where to seek post-hospitalization care. “This matters,” says Judith Graham, “because high-quality care can help older adults regain the ability to live independently, while low-quality care can compromise seniors’ recovery.” One Harvard University health care expert noted that previous ratings haven’t distinguished between these two groups of nursing home residents – short-term rehab patients and long-term residents – even though their needs are quite different. “Temporary residents are trying to regain the ability to care for themselves and return home as soon as possible, he noted. By contrast, permanent residents aren’t expecting improvements: their goal is to maintain the best quality of life.”
Short-Stay Rehab Ratings are Valuable – but They Can Be Hard to Find
We tried locating the new ratings for rehab facilities, and after a few tries we found them – but at first it wasn’t easy. The process starts with a visit to the Nursing Home Compare website. Once you enter your zip code or city, you’ll see a list of all the rated facilities in your area. The system allows you to compare three facilities at a time, so once you’ve made your selection, hit the “compare now” button at the top. When you do, you’ll see a new page with six tabs: General Information, Health inspections, Fire safety inspections, Staffing, Quality of resident care, and Penalties. The one you want to select is the Quality of resident care tab. On the left, below the overall quality rating for each facility, you’ll see a short-stay quality rating and a long-stay quality rating.
But the new system offers far more than an overall rating of one to five stars, even though – once again – you have to search a bit to locate the rest of the story. If you click on the words “Short-stay residents” you’ll see 13 specific measures of the quality of rehab care. This allows patients to drill down into details of each facilities’ performance: for example, how many short-term residents were subsequently re-hospitalized, how many developed pressure ulcers, how many experienced falls during their stay, how many were prescribed antipsychotic drugs, and so on. This new addition to Nursing Home Compare provides a treasure trove of data to help families make an otherwise difficult decision – which short-term rehab facility will offer the best care – significantly easier.
Short-Stay Rehab Should Lead to Long-Term Recovery
Published ratings are helpful, but we caution you that they don’t tell the whole story. Many times loved ones have to make a quick decision, selecting a rehab facility with too little time and insufficient information ((we wrote about the problem on the AgingOptions blog last month.) If you can, visit a few facilities and ask these questions:
What are my needs going to be during the post-hospital period?
What kind of help will be needed, and for approximately how long?
What is my anticipated recovery, and what do you think the most difficult parts of it might be?
How will the facility meet my needs, specifically?
What kind of medical care and therapy will I get there? From whom and how often?
A big key is to get information early. One doctor told Kaiser that patients and families should insist on seeing a discharge planner soon after entering the hospital and start the planning process long before discharge date. His advice: tell the discharge planner, “I don’t care about choices: Tell me, what do you think will be best for me.” Be insistent.
When it Comes to Retirement, Think Long Term
Planning for your future as you age involves preparing for decisions like this, and that means good, honest communication with your loved ones and careful preparation to ensure you receive the type of medical care you need. These two elements – family and medical – combined with a solid financial plan, a carefully-crafted legal strategy, and a well thought out approach to your housing needs, make up the key components of an AgingOptions LifePlan, the most comprehensive type of retirement plan we know of. We hope you’ll accept our invitation to spend a few hours and join Rajiv Nagaich soon at a free LifePlanning Seminar near you. It could be the most important and most eye-opening experience you’ll have as you prepare for the retirement you’ve always dreamed about.
You’ll find a calendar of presently scheduled seminars here on our Live Events page, where you can register for the date and time of your choice. Don’t face the future unprepared! You can look ahead with confidence, thanks to the power of an AgingOptions LifePlan. Age on!
We know the feeling well. You’re still working full time, yet retirement is drawing closer every day. The idea of no longer working full time used to seem so strange and so distant – yet now, as more and more of your friends retire, you find yourself counting down the days with a mix of eager anticipation and looming dread. Retirement is like the Great Unknown. How can you adequately prepare for something you’ve never experienced?
The Retirement Transition Sounds Heavenly to Some, Horrible to Others
Fortunately, you’re not alone in your mixed feelings, as this insightful article from NextAvenue reminded us. It’s called simply, “Tips on How to Transition Into Retirement,” and we like the gist of the article because it takes an honest approach to the fact that retirement, with its promise of unlimited free time, can sound appealing, but for some it’s a difficult transition. “After a long time spent in the workforce, retirement can feel like the great unknown,” says the article. “Unlimited expanses of free time sounds like heaven to some people. For others, all they see is a difficult transition period marked by stress, uncertainty and grief.” After talking with several retirees about their experiences, the authors found that, “with a little guidance and some insight, transitioning into retirement can be the smoothest change you ever make, no matter what you think about it at first.” The article then goes on to offer what it calls “Seven Tips for Making the Move into Retirement.”
We should say right up front that these tips aren’t the same as steps in a retirement plan – they’re really more about preparing yourself mentally and emotionally, and for that reason we share them more as helpful food for thought. (We’ll share our recommendation for true retirement preparation, which we call LifePlanning, in just a moment.) But before we take a look at NextAvenue’s seven tips to prepare for retirement, it’s helpful to remember that there is a true “retirement wave” currently underway. You’ve probably noticed that there’s a horde of baby boomers out there who are hitting the end of their full-time work lives right alongside of you – an astonishing 10,000 every day, in fact. (That figure has been corroborated numerous times including in this Washington Post fact checker column from a few years back.) If you’re a boomer contemplating retirement, you have plenty of company.
Seven Tips to Smooth the Retirement Transition
So with that in mind, let’s get back to the NextAvenue article and those seven tips. Here’s a brief summary – check out the article here for more details:
Plan for a longer transition period than expected. You need to cut yourself some slack and expect a few ups and downs. “You’ve never done this before,” says the article. “Inevitably there’s going to be some trial and error until you get this just right.” Whether it takes weeks, months or years to get used to retirement, it’s your transition, not somebody else’s.
Give yourself a breather. The article suggests scheduling a mini-vacation as you enter retirement so you can “take a moment to breathe.” By taking a week or two to relax before you jump into your new routines, “you’ll be better prepared to approach your new life with a clear mind that’s well-rested and ready for the challenge.”
Prime your brain to see this as a new beginning. This mental preparation is an important component in a healthy transition. “Rather than seeing retirement as the end of your career, view it as the beginning of an exciting new phase in your life,” says NextAvenue. This “mind-shift” can include reading retirement-related articles, talking to current retirees about their experiences, taking classes you’ve always wanted to take, or pursuing volunteer opportunities. “There’s so much more opportunity out there these days for older Americans,” says the article. “It’s just a matter of doing your homework and finding out which activities will appeal to you during this new beginning.”
Work on getting fit. This should be a no-brainer, but it’s a vitally important suggestion. Committing (or recommitting) to a healthy exercise routine (with your doctor’s approval, or course) reduces stress, builds self-confidence, and benefits every aspect of your life from attitude to cognitive ability. You’ve always intended to exercise more, right? Now’s your chance.
Maintain friendships. “Your life is about to be upended by your oncoming retirement,” NextAvenue “You can keep one thing constant to ease the stress, however, and that’s your social network.” Friendships reduce stress and provide emotional support, and having a strong social network has been shown to improve physical and mental health as we age. But don’t count on maintaining those workplace friendships one you stop working. “If you’re short on friends because you’ve lost your social network at work, join groups or classes. Shared interests make good friendships, so choose a class or group that’s centered around doing things you love.”
Build a strong mental foundation for change. Retirement represents a huge transition, and it can be one of life’s biggest challenges. Paraphrasing NextAvenue’s words, you’re going to re-create your sense of who you now that you’ve given up your job title. This means you’ll need to develop a strong sense of identity, nurture (or create) a strong social network, and discover a strong personal mission and purpose.
Remember to chase your dreams. Retirement isn’t an end, but a beginning, says the article. “The best way to ease yourself through the transition to retirement is to always remember to chase those dreams” and to “rediscover the world through a new lens.” In other words, be an exploring optimist, not a timid pessimist!
The Retirement Transition is Really about the Right Retirement Plan
What’s our answer to the puzzle of retirement preparation? Rajiv Nagaich of AgingOptions says we can’t allow fear of the unknown to paralyze us. “No matter how old you are or what your circumstances,” he emphasizes, “a solid retirement plan is the answer. Even if you worry that you aren’t prepared or don’t have enough, a LifePlan can show you the way forward toward a better retirement than you thought possible.” Only a LifePlan from AgingOptions weaves together, not just your financial strategy, but all the essential elements that matter most, including legal, housing, health and family. With a LifePlan prepared, fear of the future can be replaced with confidence and a sense of optimism about the new chapter called “retirement.”
If you’re ready to find out more, we invite you to join Rajiv at an upcoming LifePlanning Seminar – a great way to begin the New Year. To see a calendar of these popular free events, visit our Live Events page and register for the location that works for you. It will be our pleasure to greet you and to share with you and your loved ones the power of an AgingOptions LifePlan. Age on!
Averages can be misleading things. If you buy a vacation home based on the “average” temperature, you might be surprised by blazing summers and frigid winters. Baseball fans who put too much stock in batting averages are disappointed when the best players strike out twice as often as they get a hit. When it comes to budgeting for retirement, does it help to know what the average retired household in the U.S. is spending every month? Here at AgingOptions, we hope the answer is yes, and we offer the article described below as Exhibit A.
Retirement Costs: Knowing the Averages can Help You Plan
One of the most frequent questions people ask as they contemplate retirement is, “Will I have enough income to meet my obligations?” To help answer that question, a financial columnist at NerdWallet has written this instructive article which was published very recently. “Let’s Get Real,” the title states boldly: “What an Average Retirement Costs.” Using the most current data from the Bureau of Labor Statistics, NerdWallet writer Dayana Yochim set about to shed light on what “older households,” defined by the BLS as those headed by someone 65 or older, actually shell out every month. While every situation is different, these figures might prove helpful as you project your retirement income needs: if you’ve budgeted a figure that is far below the average, it might caution you that you need to re-think your expectations.
Whenever the topic of retirement finances comes up, we feel compelled to remind our readers and radio listeners of this essential truth. Financial planning is an important part of comprehensive retirement planning, but it’s only one component. For thorough financial planning, we recommend that people sit down with a good professional planner and develop a retirement dashboard, a tool that helps you gauge your financial health at every stage of retirement and make adjustments as required. However, if we’ve said it once, we’ve said it a hundred times: financial planning and retirement planning are not the same thing. In just a moment we’ll explain how a good financial plan becomes a vital component of a comprehensive retirement plan called a LifePlan. If your real goal is to allay your fears and enjoy a secure and fruitful retirement, a LifePlan is the answer.
Retirement Costs: Retirees Spend 20 Percent Less Than Average Households
So let’s cut to the chase: what does NerdWallet say about spending in retirement? “According to the latest Bureau of Labor Statistics data,” Yochim writes, “ʻolder households’ — defined as those run by someone 65 and older — spend an average of $45,756 per year, or roughly $3,800 a month. That’s about $1,000 less than the monthly average spent by all U.S. households combined.” Understanding the spending habits of retirees, and knowing how they differ from the working population, can help you plan for your personal post-work needs. In descending order, the Bureau of Labor Statistics says that retiree spending goes first to housing, then transportation, health care, food, insurance, contributions, and finally entertainment. (For the full BLS report, click here. Stats are from 2016.) Let’s look briefly at each monthly category.
Housing: $1,322. “Housing is the biggest spending category for all age groups — retirees included,” says NerdWallet. This monthly figure includes mortgage payments, property taxes, insurance, utilities, repairs and maintenance, and household supplies.
Transportation: $567. Even though the annualized figure seems high at over $6,800, it’s still one-third less than average households. This amount includes the costs of car payments, gas, insurance and maintenance and repairs.
Health care: $499. This average can really vary from person to person, NerdWallet says, and it’s almost certain to rise with age – at least until age 75, at which time the BLS statistics actually show a slight dip. We assume this figure includes Medicare Part B premiums plus the cost of other coverage, deductibles, and co-pays.
Food: $483. Although every household spends a fair chunk of change on food, retirees spend almost 20 percent less than the average household does. Still, food costs add up.
Personal insurance/pensions: $237. The NerdWallet article says this includes not only insurance policy premiums but also insurance-related deductions for pensions and Social Security from the paychecks of those in the household still working.
Cash contributions: $202. Retirees are actually more generous than the average household, the BLS figures say. As NerdWallet puts it, “Apparently with age comes a greater appreciation of one’s financial blessings.” Retirees report dedicating $2,429 of their annual income compared with $2,081 by the average household.
Entertainment: $197. In this broad category, it turns out that retirees spend about as much per month as 25-34-year-olds, but somewhat less than the average household spending of $243. After all, having fun is supposed to be part of retirement, right?
Don’t Over-Focus on Retirement Costs and Forget True Retirement Planning!
We hope these figures prove helpful, but once again we want to remind you that “financial wellness” does not equal “retirement wellness.” For that you need the type of retirement planning strategy that 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 true retirement peace of mind at an AgingOptions LifePlanning Seminar near you. Age on!
What are you afraid of? Are there things that keep you awake nights or cause your knees to tremble just thinking about them? If you search online for most people’s Top Ten Fears, you’ll find a predictable list: public speaking, flying, snakes, heights, spiders, going to the dentist, and so on. But based on a pair of recent articles we’ve discovered here at AgingOptions, we think a more honest answer to the question, “What are you afraid of?” might be “Running out of money in retirement.”
Retirement Fears Occur When People Lose the Power of the Paycheck
That’s the conclusion we drew as we read this article published very recently on the Forbes website. Written by financial planner and Forbes contributor Joel Johnson, the article makes a predictable point but in a persuasive way. “Common fears among individuals run the gamut from public speaking to an extreme fear of heights to claustrophobia,” Johnson writes. But as people enter retirement, they lose the power of earning a paycheck, and the reality sets in that “what they have saved will be what they live on for the rest of their life. This causes some individuals to be overwhelmed with fear.” The key, the article suggests, is good advice. “Financial advisors, like psychologists and psychiatrists, can be instrumental in helping pre-retirees and retirees face their financial fears head on and provide confidence as they enter a new and exciting phase of their life.”
Let us state at the outset that there’s nothing basically wrong with Johnson’s advice – as far as it goes. Financial planning is an important part of comprehensive retirement planning, which is why we often recommend that people sit down with a good objective planner and develop what we refer to as a retirement dashboard, giving you the ability to gauge your financial health at every stage of retirement and make adjustments as required. However, if we’ve said it once, we’ve said it a hundred times: financial planning and retirement planning are not the same thing. In just a moment we’ll explain how a good financial plan becomes a vital component of a comprehensive retirement plan called a LifePlan. If your real goal is to allay your fears and enjoy a secure and fruitful retirement, a LifePlan is the answer.
Retirement Fears Common to Three-Fourths of U.S. Adults
To get a deeper picture of the financial fears facing retirees and pre-retirees, we took a look at the 2019 edition of Fidelity Investments’ Retirement Mindset Study. Fidelity surveyed more than 1,400 adults ages 25 to 74 to measure their attitudes about their financial health today, and their confidence – or lack of it – in their retirement future. The survey found that 62 percent of respondents feel confident about their present financial health, but 75 percent either have no confidence or only a little about how well they’ll fare financially in retirement. Fidelity’s answer to this crisis of confidence sounds just like Joel Johnson’s observation in his Forbes article: “With all this confidence about their current financial health, why all this uncertainty about retirement?” asks Fidelity. “The answer may be a lack of planning.” Less than one adult in five, according to the survey, has a written financial plan in place for retirement. The biggest reasons why people don’t plan, says Fidelity: they didn’t think they needed one; they didn’t know where to start; and they felt like they were so far behind in preparing for retirement that a plan would make little difference.
Retirement Fears: Four Big Financial Phobias
Revisiting the Forbes article, Joel Johnson lists what he calls the four most common financial fears people have as they peer into their retirement future. Naturally each of these – according to Johnson – can best be dealt with by meeting with a financial planner. The Forbes list of retirement money worries:
Investment Loss. Retirees need to balance the need for security with the need to generate a reasonable return on investment. Too much caution can be just as risky as being too reckless.
Running Out of Money. Johnson calls this “the number one subject that comes up – will I have enough money to live on for the rest of my life?”
Fear of a Major Health Event. Johnson quotes a 2017 survey by the Insured Retirement Institute in which nearly 60 percent of adults ages 50 to 75 feel ill-prepared for a major health event. His advice, which we found simplistic for most middle-income retirees, is to set aside a reserve account to cover healthcare expenses. We think a more comprehensive approach to health care planning is the only reliable answer, something a LifePlan addresses but a financial plan does not.
The Effect of Inflation. Inflation happens as prices rise and purchasing power declines, and it’s a legitimate worry for those on fixed income – especially today when retirement can last 30 years or more. Whatever else you do, make certain you are taking inflation into account in your retirement planning.
The Fidelity survey showed a similar list of retirement worries. Costs of health care and long-term care topped the Worry List, followed by fears about Social Security, concerns about outliving assets, and worries about living on a fixed income. Inflation also made the list.
Retirement Fears Replaced by Optimism – with a LifePlan
Like we said at the outset, focusing all your retirement planning exclusively on finances is foolish. What’s needed is an overarching plan, especially as you approach retirement. Even if you’re certain that your financial needs will be met over the coming twenty, thirty, or more years, there’s more to the retirement picture. For example, do you have adequate legal protection in place, which is far more than a simple will? Is your family fully aware of your hopes and desires as you age and will they be there for you? Have you considered your best options for medical coverage and your best housing plan, so you’re prepared for whatever the future may hold? If this seems like a lot to accomplish, we have terrific news: all these components are part of an AgingOptions LifePlan, a uniquely comprehensive, robust retirement planning strategy. Only AgingOptions offers it.
According to the Fidelity report we cited above, people with a retirement plan in place say they feel “in control,” that they “feel good about themselves,” and that they feel “relieved.” Nine out of ten feel confident about the future. Why not make it your goal this year to experience that degree of confidence? Find out more by attending a free LifePlanning Seminar with Rajiv Nagaich. Let Rajiv show you the process and answer all your questions in a lively, information-packed session – then the next steps will be up to you, with no obligation and no pressure. Visit our Live Events page for a current calendar of seminars, and then register for the date of your choice. Let’s make this the year you really begin the journey toward the retirement you’ve always dreamed of enjoying. Age on!
In what Kaiser Health News calls “a crackdown” on short-staffed nursing homes, the Centers for Medicare and Medicaid Services (CMS) has just downgraded the ratings of one-tenth of the nation’s nursing homes. That’s according to this article recently published on the Kaiser Health News website. The biggest problem area: a chronic lack of nursing staff.
Shortfall in Nursing: More than 1,600 Homes Downgraded
“The federal government accelerated its crackdown on nursing homes that go days without a registered nurse,” Kaiser reports, “by downgrading the rankings of a tenth of the nation’s homes on Medicare’s consumer website, new records show.” According to the article, when CMS updated its popular Nursing Home Compare website in April, the agency “gave its lowest star rating for staffing — one star on its five-star scale — to 1,638 homes. Most were downgraded because their payroll records reported no registered-nurse hours at all for four days or more, while the remainder failed to submit their payroll records or sent data that couldn’t be verified through an audit.”
As anyone who has searched for a high-quality nursing home can attest, the process can be confusing and time-consuming. That’s why CMS began rating these facilities in 2008 using a scale of one to five stars. The nation’s 15,000 nursing homes are rated in three areas: health inspections, staffing, and quality of resident care. But a big change took place last summer when the federal government, in response to concerns about a shortage of qualified nurses and other critical staff, stopped relying on the facilities self-reporting their staffing levels and started requiring nursing homes to submit actual payroll records. The results were alarming. “The records for the first time reveal frequent and significant fluctuations in day-to-day staffing,” Kaiser reported at the time, “with particularly large shortfalls on weekends. On the worst-staffed days at an average facility, the new data show, on-duty personnel cared for nearly twice as many residents as they did when the staffing roster was fullest.”
Shortfall in Nursing Means a Potential Drop in Quality of Care
The most recent Kaiser Health News article suggests that the staffing crisis isn’t getting any better at the nation’s nursing homes. “CMS has been alarmed at the frequency of understaffing of registered nurses,” Kaiser reports, especially on weekends when nurse staffing is considered “particularly anemic.” The reason for the crackdown is simple, in the view of CMS: it’s all about patient health. As CMS reported a few months ago, “Nurse staffing has the greatest impact on the quality of care nursing homes deliver, which is why CMS analyzed the relationship between staffing levels and outcomes. CMS found that as staffing levels increase, quality increases.”
As the Kaiser Health News article explains, because of how the CMS ratings are calculated on Nursing Home Compare, a downgrade in the ranking for staffing doesn’t necessarily translate into a drop in the facility’s overall rating, which is the metric that most people pay attention to. When Kaiser reviewed the overall rating of the 1,638 homes that had seen their staffing score downgraded, they found that 30 percent were still rated as three, four or even five stars. But overall, many nursing homes – slightly more than one-third – saw their ratings drop, which caused a predictable outcry of protest from the nursing home industry. The American Health Care Association, a trade group for nursing homes, accused CMS of “moving the goal posts” by arbitrarily cracking down on staffing levels. Operators also claim – paradoxically, we think – that payroll records don’t necessarily paint an accurate picture of precisely when nurses are on duty.
Shortfall in Nursing: Resources to Help Families
In our July 2018 AgingOptions blog post we offered some excellent resources for families to use when selecting a nursing home for a loved one. For example, we ran across this helpful checklist from the website Caring.com. Medicare offers this 9-page Nursing Home Checklist that you can print and take with you when you visit. Then of course, there are the comprehensive ratings available at Medicare’s Nursing Home Compare website which lets you search and evaluate by zip code. But published ratings and checklists aren’t enough: the key, say the experts, is to visit in person and see for yourself. Families need to evaluate nursing facilities objectively using some of the tools we’ve listed, and talk to residents and their families to get the real picture of what it’s like to live there. This is also a time when you and your family will want to call on the services of a senior housing professional such as the staff at Better Care Management. They help families handle the complexities associated with aging, including in-home care, housing placement, hospitalization and government programs, and they can advocate for your loved one if at any time you suspect he or she is receiving substandard care. Contact our office during the week if you would like more information about their services.
Make Sure the Pieces Fit Together
Housing is a critical element in retirement planning, but it’s only one facet of many that must be taken into account in order for your plan to be truly complete. For example, you may have the best housing plan in place, only to have it derailed by an unexpected medical crisis. This in turn triggers a financial crisis which can precipitate a family crisis. Health, housing, finance and family all have to be considered together, along with the necessary legal framework to help you protect your assets as you age and avoid becoming a burden to those you love. Fortunately, that type of highly comprehensive planning is readily available today, in the form of an AgingOptions LifePlan, an approach to retirement planning that is truly groundbreaking. Please come join us and find out more, without cost or obligation, by attending a free LifePlanning Seminar with Rajiv Nagaich. We offer these highly popular, information-packed sessions in locations throughout the region: you can click here for our current listing, then register for the date and time that works for you. It will be a pleasure meeting you soon at an AgingOptions LifePlanning Seminar with Rajiv Nagaich. Age on!
Picture this: two senior adults are sitting side by side. They’re the same gender, about the same age, and in similar health. One appears sad, downcast, even gloomy – the other is cranky, angry and chronically irritated. Which one would you guess is at greater risk of developing serious health problems?
Anger Management: Anger Causes More Bodily Damage
Most of us might guess that the “sad senior” has the greater risk, since we have learned to associate “sadness” with depression. But a new study described in this HealthDay article suggests that our stereotype is incorrect. It’s true, the article says, that seniors can experience times of profound sadness, especially when a spouse, sibling or friend passes away. “The loss of loved ones can hit the elderly particularly hard,” says HealthDay, “but a new study suggests it’s anger, and not sadness, that may damage the aging body more.”
We can easily imagine why people can become sad as they age. Apart from the loss of loved ones, many seniors find themselves isolated from family. As we get older, we can no longer drive, so there goes our cherished mobility and sense of independence. Physical ailments that we shook off in younger days may become sources of chronic pain, and new maladies that accompany aging can develop over time. But why might a senior become angry? We found this helpful piece on a website called SeniorCaring, published a few years ago, that provided some good answers to that question. Knowing why seniors develop anger problems can help loved ones deal with that anger and hopefully minimize the health risks.
Anger Management a Particular Challenge in Tense Situations
“It’s no secret as we get older, we can become a little more grumpy,” says SeniorCaring. “Seniors can become irritable, stubborn, and downright nasty sometimes. However, it’s important to be able to tell the difference between grumpiness and serious senior anger issues.” As the article states, we all have good and bad days, seniors included, but when especially tense situations arise, spouses and family members need to know how to handle them. “Aging can be a very humbling process, and it’s always good to have someone helping you deal with emotions.” The SeniorCaring article lists three major reasons why so many seniors slip easily into a chronically angry attitude:
They’re frustrated. “As we age, we slowly begin to realize that our mind and body just aren’t what they used to be. Many seniors assume that letting others help them perform daily tasks is a sign of weakness or loss of dignity, so they will often become frustrated and argumentative.” (One source calls this “dependency resentment.”) Seniors also become frustrated and angry when they experience confusion, particularly if they’re in the beginning stages of cognitive decline.
They’re not used to a new lifestyle. Adjusting to retirement is hard for many seniors, says SeniorCaring. They feel restless and resent being forced into a season of inactivity, one in which their regular workplace routine “has been replaced with idleness and uncertainty, which can cause major issues.” Anger can also arise in a senior who resents having to give up their home and move into an apartment or assisted living.
They may be caught up in substance abuse. We were surprised to read that, according to the National Council on Alcoholism and Drug Dependencies, almost half of nursing home residents have a problem with alcohol. Irritability and anger can be early signs of substance abuse, so it’s important to address any drug or alcohol issues immediately. One website called the Addiction Center listed several potential triggers for drug or alcohol addiction among seniors, including retirement; the death of a family member, spouse, pet or close friend; loss of income or financial strains; relocation or placement in a nursing home; trouble sleeping; family conflict; and mental or physical health decline. If a senior loved one starts displaying anger, it could be a warning sign.
In the HealthDay article cited earlier, we read that anger among seniors is much more than a mere irritant: anger can trigger a whole host of serious health problems. Researchers in Montreal surveyed 226 seniors to gauge their levels of anger or sadness. They also took blood samples to look for signs of inflammation, which is increased by anger and has been linked with conditions such as heart disease, cancer and arthritis. Scientists found no correlation between subjects who were experiencing sadness and those with higher levels of inflammation – but among older patients living with anger, inflammation and chronic illness were noticeably more common. Other studies have linked anger to insomnia, digestive problems, high blood pressure, even stroke. Clearly the problem of persistent anger in a senior loved one should not be ignored, especially among those 80 and older. “Younger seniors may be able to use that anger as fuel to overcome life’s challenges and emerging age-related losses, and that can keep them healthier,” said the study author. “Anger becomes problematic for adults once they reach 80 years old, however, because that is when many experience irreversible losses and some of life’s pleasures fall out of reach.”
Anger Management Starts With Better Health and a Solid Plan
Planning for your health needs in retirement is a critical need. We at AgingOptions generally advise that aging men and women are better served by entrusting their health care to a geriatrician, not merely a family practice doctor. The difference is significant, because a geriatrician is thoroughly trained in the unique health care needs of older adults. These professionals will take the time to listen and to evaluate carefully, and you’ll feel like an individual, not a number. We urge you to say good-bye to medicine-by-the-numbers and instead to call AgingOptions this week: we’ll provide you with a list of geriatricians in your area.
If you’re getting serious about planning for your retirement future, we hope you’ll accept the invitation from Rajiv Nagaich of AgingOptions to join him soon at a free event called a LifePlanning Seminar. Rajiv will show you an exciting model for comprehensive retirement planning in which health care, financial security, legal protection, housing choices and family communication are all woven together into one powerful and seamless blueprint. Come discover how to build the retirement of your dreams! You’ll find a calendar of upcoming seminars on our Live Events page – then simply register for the date and time that works for you.
The key to a secure retirement is proper retirement planning, and it’s available to you today from the professionals at AgingOptions. Age on!
An unnerving article we discovered last year in the New York Times asked 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 2018 report showing that m0re 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.
Prescriptions and Depression: Seniors Often Misdiagnosed
You’ll find the 2018 New York Times article here. We think this 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 challenge of properly diagnosing depression and other similar mental health issues was the topic of this related 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 trained doctor who understands 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.
Prescriptions and Depression: 200 Potentially Worrisome 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 at the time 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 Times 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 with a depression rate 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. (These statistics presume that none of the tested patients was taking any anti-depression medication, which would have skewed the results.)
Prescriptions and Depression: Correlation Can’t be Ruled Out
Knowing that there is an 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.”
Our Prescription: the Right Doctor and the Right Plan
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 and 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!
Many people struggle when deciding whether to downsize, age in place, or move to a community. If you’ve made the decision to age in place, there are many aspects of your home that you’ll want to evaluate to ensure your house will accommodate any future needs.
Be sure to work with a contractor to make these modifications prior to needing them—you don’t want to be stuck in a position where you get hurt. Here are some basic modifications to think about to create a more accessible home.
Do you have a front or back porch with stairs? Consider installing a ramp, reducing the hazard of falling or tripping. Additionally, if your bedroom is on the second floor, consider moving to the first floor. Even if you don’t struggle walking up and down the stairs right now, it’s important to think about the long-term if you’re committed to staying at your current home.
Since the bathroom will be used every day, it’s one of the most important aspects of your home to consider. One simple addition is a grab bar next to your toilet to assist you when sitting down or standing up. You could also replace your toilets with ones that are higher up, making it easier to sit down and get back up. If you have to step over something to get into the shower, consider installing curbless showers to eliminate the need to step over anything when entering. Remember, even if it doesn’t seem like it’s a problem now, you want to remove any potential future hazards.
Sign up for home repair insurance to streamline home maintenance. These plans cover repairs and replacements of major appliances and systems, so you can keep your home up and running while enjoying the peace of mind when something breaks. You should also consider hiring help for ongoing household chores, such as cleaning, yard work, grocery shopping, laundry and dry-cleaning delivery. You should also consider setting a regular maintenance schedule with a trusted handyman to ensure you have someone to call if needed.
If you have a hard time reaching the cabinets or maneuver around the kitchen, consider hiring a meal delivery service to ensure you’re getting nutritious meals every day. You can also use technology to dictate shopping lists or get groceries delivered directly to your door. This may not be something you try until you absolutely need to, but it’s an option to keep in mind.
Health and personal care
Consider asking a family member to check in on you a few times a week and ensure you’re doing well. If you struggle getting dressed every day or have a hard time bathing, don’t be scared to hire someone to come in and set you up every day so that you can remain in your home comfortably and safely. In-home care is an option if you want someone to help you with certain things on a daily basis, such as activities that require driving.
When looking at the accessibility of your home, consider making a technology upgrade. With options such as Google Home, Amazon Echo, and HomePod, you can install accessibility in every room of your house to check on things such as the weather or your daily schedule. It would also allow you to call for help if you were to fall and were unable to reach your phone. Set up telemed communications with your doctors and providers and set reminders to tell you when you need to take medication or schedule appointments.
Hallways & Doorways
Ensure doorways and hallways are wide enough to accommodate a wheelchair. Consider removing flooring thresholds to help prevent trips when walking through rooms. Low-pile carpeting is a better alternative and consider removing area rugs as they can lead to trips and falls.
There are many ways to make your home more accessible as you age in place, whether it’s modifying the construction of your home or adding things to make your daily life easier and more manageable. It’s important to make your home as accessible as possible while you’re still able, so that you’re not stuck in a position where you have to leave.
Just last week here on the AgingOptions blog, we offered this article based on a Bankrate.com report warning parents to be careful not to spend so much money bailing their adult kids out of financial problems that they jeopardize their own retirement. Now as a kind of follow-up, we thought it might be helpful to turn the problem around and consider the opposite perspective. What do you as an adult child do if your parent is the one with reckless spending habits, and they keep on turning to you for help?
Mother’s Day Blues: Mom’s Reckless Spending
A few years back this column by financial writer Michelle Singletary appeared in the Washington Post addressing this very problem. It’s titled, “When Your Mom’s Money Problems Become Your Own.” Singletary writes, “What responsibility do you have to take care of financially irresponsible parents in their old age? This is a question I get quite often. I believe that you honor your mother and father. But this doesn’t mean you do so at your own financial peril.” Obviously, this type of situation puts adult kids in a terrible bind, both emotionally and financially. You’re torn between your love for your parent (plus your compassionate desire to help) and your frustration over their reckless spending habits. Meanwhile you probably have a family of your own and are trying to save for your own future. How do you know how far to go to help a parent who is a careless spender?
That was the dilemma faced by a reader who contacted Singletary online. “My mother is a financial disaster,” she wrote. “She doesn’t like working and has struggled to hold anything other than minimum-wage, part-time jobs but loves spending money on shoes, jewelry, restaurants and gifts. My siblings and I warn each other when she asks for money to cover car repairs, insurance bills, or whatever other crisis she can’t afford.” Sadly, this pattern of money mismanagement goes back years. When this reader was a child, the utilities in the home were regularly turned off and calls from creditors were frequent. The reader added. “She would come home with a new pair of shoes while the phone and gas were disconnected. After our home was foreclosed on, she moved in with her mother, allowing her to keep spending while not working.”
Mother’s Day Blues: Mom Refuses to Discuss Finances
Apparently even after the mom inherited a modest sum when her own mother passed away, things didn’t get any better. “We tried to have a talk about putting the money aside and planning for the future, which resulted in her not talking to us for nearly a year,” said the reader. “I have no reason to think she’d change her habits.” Every attempt to discuss budgets is met with immediate and angry rejection. “She seems to think that she’ll simply move in with one of us to be cared for. I’m not inclined to take her in. I can’t afford to support her. I’ve about turned myself inside-out trying to help her in the past.” Clearly this reader, and probably thousands like her, is in a desperate state.
The solution, Michelle Singletary responds, centers on family communication and sibling unity. “There are a lot of reasons people fail to save for retirement,” she says. Singletary advises the reader, “Regardless of the reason your parent is a poor money manager, it may come down to you and your siblings to pick up the broken financial pieces.” This should start, she suggests, with a siblings-only family meeting, not with mom present – at least, not yet. “Think of it as the pre-intervention meeting. All the adult children should be clear about what they can or can’t do to assist. If you have sibling-rivalry issues to work out, try to set aside your quarrels — as best you can — before you meet with your parent or parents. You want your interaction with your parents to be respectful and calm. You want to stay on point.” And, above all, “You also want to present a united front.”
Mother’s Day Blues: Siblings Joining Forces
Ideally, each sibling will be able to do something to assist. “This is the time for siblings to lean on one another,” Singletary writes. “Perhaps someone will be able to cover a utility bill, which, by the way, should be paid directly to the utility company. Maybe someone would be willing to take in the parent(s) if others helped out. Research living options if no one is willing to let them move in.” Then, she says, once you’ve got a plan, set up the meeting. Make it a non-stressful time, not over a holiday or when emotions are running high. (We recommend you contact AgingOpti0ns so we can help guide you through this process – it’s often best if someone outside the family delivers the tough message to a parent.) “Be honest and upfront about what you can offer,” the column concludes. Singletary reminds readers that, if you plan to keep supporting mom or dad financially, you have every right to ask about their budget. “Make it a condition of your assistance. No budget, no information, no more bailouts. That’s the price your parent pays for his or her mismanagement.”
“Finally,” says Singletary, “remember that a fiscally reckless parent is still your parent. Budget for the help you can afford. But don’t let his or her financial sins be your burden. It’s not yours to carry.”
Mother’s Day Blues: Make Sure You Have the Right Retirement Plan
This article is a persuasive reminder of the importance of preparation. When you use the power of an AgingOptions LifePlan to chart the course for your retirement future, you’re also laying the groundwork for a great blessing that your loved ones will experience after you pass on, as they see how well-ordered your affairs have been. A LifePlan blends together financial planning, housing options, legal strategy, medical coverage and a communication plan involving those closest to you – all the essential elements of retirement living. You’ll be able to navigate through all the phases of aging with confidence and security, creating the retirement you’ve always hoped for, and leaving a well-prepared estate behind in the future.
Why not invest a few hours and find out more? We offer free LifePlanning Seminars with Rajiv Nagaich at locations throughout the region. Visit our Live Events page for a current calendar, or give us a call. The key to a brighter future for you and those you love is a LifePlan from AgingOptions. Don’t forget to bring your mom. Age on!