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 so-called modern view of retirement is pretty straightforward. You start your work life with a series of jobs in your late teens and early twenties. Eventually you settle into your “life’s work” and follow that journey for four decades or so, saving money along the way. Sometime in your late sixties, certainly by age 70, you hang it up, retire, and spend the next ten to thirty years on an extended vacation. Supposedly that’s the idealized path toward which most Americans aspire.
Most Bored Boomers Fail to Plan
But a recent article from the website NextAvenue (one of a growing number of similar articles we’ve read recently) strongly suggests that, when it comes to retirement, our “ladder of success” is leaning against the wrong wall. Written by well-known blogger Gary Foster (his blog is called Making Aging Work), this article should be a wake-up call to the 70 percent of people (Foster’s estimate) who enter their so-called golden years “with absolutely no non-financial retirement plan” – in other words, those who think “financial planning” and “retirement planning” are the same thing. As the NextAvenue article suggests, anyone retiring without preparing for the psychological and emotional changes ahead is in danger of becoming a bored boomer, losing their identity, their sense of self-worth, and even their physical health.
In the article, Foster reports that today’s 78 million boomers are turning 65 at the rate of 10,000 per day. As they do, “boomers everywhere are beginning to discover that retirement, as we’ve known it for decades, needs redefining.” He quotes a 2016 Federal Reserve study revealing that one-third of retirees “eventually reconsider retirement and return to work on either a full or part-time basis,” and he also cites a surprising statistic from a 2017 Rand Corporation report: almost 40 percent of working people 65 or older are one-time retirees who decided to return to the workplace. This trend, writes Foster in NextAvenue, shows the pitfalls of failing to give thought to the “non-financial components of retirement life.” Many retirees discover too late that “those ‘soft side’ elements play a much larger role in retirement than the ‘hard-side’ financial elements where the major planning effort is typically focused leading up to retirement.” We concur one hundred percent.
Bored Boomers Experience Loss of Identity and Purpose
“New retirees typically experience a one- to five-year retirement honeymoon period,” says Foster. During this initial post-employment period, even in the midst of well-earned rest and recreation, some of the major challenges start to emerge – mental, social, physical and spiritual – “that were never discussed or planned for in the offices of their financial planner.” These often include a feeling of lost identity and a sense of boredom due to a lack of challenges in retirement. Social engagement often starts to diminish. Spouses may find that they aren’t on the same page when it comes to lifestyle and spending choices. All of this, says the NextAvenue article, can trigger “depression and physical deterioration because of reduced activity and social interaction and lack of a sense of purpose.” As Foster writes, “Much of early, prime-time retirement is wasted as a result of this lack of non-financial planning.”
Bored Boomers Need Self-Examination – and a LifePlan
So in Gary Foster’s mind, what’s the solution? In the NextAvenue article he lists three ways to help avoid becoming a “bored boomer” in retirement.
“Unmuzzle Your Essential Self” – Foster suggests trying to go back to the things you were good at and drawn to before work life forced you into “cubicle mode.” He says this process of self-examination is “the perfect mental launching pad for resurrecting what really lit you up before social expectations locked you down.” Then look for ways to leverage these skills and passions “back into the marketplace where they will continue to do good.”
“Reintegrate Yourself” – Foster prefers the word “reintegrate” instead of “reinvent,” but the concept is similar. The idea, in the words of a Harvard Business Review article by aging expert Marc Freedman, is to “weave together accumulated knowledge with creativity” in order to “[craft] a new idea” about how your later life might look. A growing number of boomers, Foster says, are discovering in this reintegration process “a path to an energizing, inspirational second career in which income, new meaning and contribution and service intersect.”
“Start a Lifestyle Business” – The third step, says Foster, is to combine the first two steps and create what he calls a lifestyle business – one that generates a desired level of income, provides time freedom so you work when and as much as you want, and is not location-dependent. (He lists some examples which we won’t detail here, but several are internet-based and may require additional training.)
Regardless of the specifics, we like the thrust of Foster’s NextAvenue article. Far too many people approaching retirement give little or no thought to anything beyond financial planning, and so enter retirement woefully unprepared – a fact which has motivated Rajiv Nagaich from AgingOptions for nearly two decades to offer a new approach to retirement planning which we call LifePlanning. A LifePlan is a comprehensive blueprint to help you literally design and create the kind of retirement you’ve dreamed of, one where finances blend seamlessly with legal protection, medical coverage, housing options and family communication. A LifePlan is personalized and individualized to suit your particular needs, desires and values. There’s nothing else in the arena of retirement planning like a LifePlan.
It’s easy to find out more and get your questions answered: accept Rajiv’s invitation to join him soon at a LifePlanning Seminar. These free, information-packed events are held throughout the Puget Sound area. For a calendar of upcoming dates and locations, visit our Live Events page and register online for the seminar of your choice.
You don’t have to be a “bored boomer” in retirement. Instead, a LifePlan gives you the freedom and peace of mind to feel like a recharged, reenergized and reengaged retiree. Let Rajiv Nagaich show you how – and meanwhile, “Age on!”
Here at AgingOptions, we feel we’ve seen it all when it comes to relationships between aging parents and adult children. In some cases, these relationships are wonderful models of love, respect and support; in other families, plagued by bitterness and old wounds, parents and kids are barely on speaking terms or are openly antagonistic toward one another. But we’ve rarely heard of a parent suing their child in court over the issue of support, until now.
Family Breakdown over Parental Support
The case in question is described in this article we recently discovered on the BBC website. It describes a 75-year-old man in Bangladesh who had retired from his tiny business – a clothing shop – with very little income. As a result, he had to rely on his daughter and his estranged son to help him, but the son refused. “After he got married, he changed,” the man told the BBC, “and stopped caring about his parents.” The man said “he had no choice but to pursue legal action against his son” for support. Of course, the son, who works as a banker, rejected the allegation that he had abandoned his father, and accused the father of filing suit under Bangladeshi law just to cause embarrassment and disgrace. In the end, father and son reached a negotiated settlement for a monthly stipend.
“It’s the kind of family breakdown that could happen anywhere,” says the BBC. The father decided his only recourse was to sue his son under Bangladesh’s Parents Maintenance Act, a statute that provides recourse for parents against their children who fail to support them. As the article points out, many Asian countries have such laws on the books, passed in the last two decades to cope with the needs of an aging population. According to the BBC, these laws are largely rooted in the value Asian cultures place on respect for one’s elderly relatives. In Asian societies that traditionally prize family and communal values, these laws act in much the same way as alimony or child support.
Singapore, for example, has a law called the Maintenance of Parents Act “under which elderly parents who can’t support themselves can seek financial aid from their children [by filing] claims in cases where children are capable of supporting them, but fail to do so.” Many cases are resolved through conciliation and never reach the court, but when the tribunal does have to rule, they have latitude to award either a monthly allowance or lump sum. By one measure the law seems to be working: in 2009 there were 200 parental support cases filed in Singapore, versus fewer than 40 in 2017. About half resulted in court-required maintenance settlements.
Parental Support Laws in the U.S.
What about here in the United States? It might surprise you learn, according to this 2017 article on a Florida legal website, that 30 U.S. states actually have laws on the books which pass the obligation of paying for the basic care and needs of an aging parent to their adult children. Some state laws allow parents in need to sue their own kids. “Filial responsibility laws impose a legal obligation on adult children to take care of their parents’ basic needs and medical care,” the website says. “Although most people are not aware of them, 30 states in the U.S. have some type of filial responsibility laws in place.” (Washington State is not one of them, but Oregon and Idaho are on the list.) However, there are big differences in how seriously states take these laws. “Eleven states have never enforced their laws,” says the website, “and most other states rarely enforce [them].” The only state that reportedly enforces its filial responsibility laws “aggressively” is Pennsylvania.
In researching this topic we found a website called Medical Alert Advice where we discovered this explanatory article outlining the provisions under which children could be held legally liable under filial responsibility laws. If all these (plus a few other key provisions) are true, you could find yourself financially liable for a parent’s care, depending on your state of residence:
Your parent is accepting financial support from the state government.
Your parent has a medical or nursing home bill which they cannot pay.
Your parent is considered indigent, meaning the cost of their care is exceeding their Social Security benefits.
Your parent does not qualify for Medicaid.
Authorities believe you as the adult child have the means to pay the bill.
The positive news, according to the website, is that judges have broad discretion in deciding how aggressive to be. “As mentioned above, most states are very lenient with these laws and may not fully enforce them, if at all,” says the Medical Alert Advice article. “If you can demonstrate that you do not have the financial means to pay for your parent’s bills, the court system is generally not inclined to impoverish you by making you responsible for them.”
Parental Support Laws May Be More Rigorously Enforced
Nevertheless, some experts wonder whether filial responsibility laws might draw increasing attention – and enforcement – in the future, as the population ages and support services face increasing financial strain. This article from the website Investment News called these laws “a sleeping giant” that could have a huge impact on paying for long-term care. As the article puts it, even though enforcement of filial laws has been rare to date, “some feel it’s only a matter of time before states start enforcing them more regularly” if their aid programs keep hemorrhaging money. If this should happen, the Investment News article conjectures, the fear that “they could inadvertently stick their kids with a huge medical bill down the road” might finally prompt some people to engage in the kind of long-term care planning they often put off.
But we at AgingOptions believe it shouldn’t take the threat of a lawsuit to get people to plan for their future. No matter how old you are or what your circumstances, a solid retirement plan – in the form of a LifePlan from AgingOptions – is the answer to your future security. Even if you worry that you don’t have enough, a LifePlan can show you the way forward toward a better retirement than you thought possible. There’s no better way to avoid becoming a burden to your loved ones and to protect your assets as you age, because 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 can be replaced with confidence and a sense of security.
If you’re ready to find out more, we invite you to join Rajiv at an upcoming LifePlanning Seminar, and bring your adult family members, too. 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!
It’s a dilemma that almost every family faces sooner or later: an aging parent or spouse can no longer live at home and has to move into a care facility. Sometimes the move into long term care is planned, but often – due to a health crisis, accident, or lack of preparation – it catches families by surprise, leaving them in a panic. With a bewildering array of choices, how do they make the best senior housing decision?
Geriatric Care Managers Give Professional, Objective Guidance
Fortunately, because the issue can be so baffling even under the best of circumstances, there is professional help available: a geriatric care manager. For a better understanding of the role of a geriatric care manager, we suggest this helpful explanation on the Caring.com website. Geriatric care managers (also called “case managers” when they are employed by a care facility) “are usually social workers, psychologists, nurses, gerontologists or others with both training and experience in many aspects of elder care,” the website explains. Families often call in a geriatric care manager when they need a professional, objective assessment of the needs of an aging loved one. If long-term care is the right choice, the care manager helps locate a facility and get the older adult safely settled. When family disputes arise, an all too common reality with emotions high, the geriatric care manager can act as a referee. Sometimes care managers even fill in for family members at doctor appointments. In other words, geriatric care managers are an often-overlooked but critically important member of the family care team.
In fact, the team analogy is common when geriatric care managers describe their work. “The better you work as a team and the more you collaborate with peers and colleagues,” says one 35-year geriatric care veteran, “the better the outcome for the patient.” The team metaphor is particularly accurate because so many adult children are either too busy or living too far away to provide care. “Around 80 percent of my clients are adult children who live out of state or are working,” says another care manager, and are unable to manage the demands of caregiving without major dislocation or severe burnout. Calling in a professional reduces the burden of care and allows adult children to be their parent’s kids, not their caregivers.
Geriatric Care Managers Help Fill Gaps in Senior Care Staffing
According to the Caring.com article, the role of the geriatric care manager is increasingly important to families because so many assisted living facilities and nursing homes are facing chronic staffing shortfalls. “Clinical facility staff often work long hours and could be dealing with manpower shortages,” the article explains, “and communication can get lost in that shuffle.” In a busy care facility, individual patient needs too often fall through the cracks, and part of the task of the geriatric care manager is to visit facilities, talk with staff and close those cracks so the loved one gets the care they need and deserve. Again, this kind of on-site advocacy is critical for many professional families or those separated by distance. “Family caregivers who are working or don’t live nearby, especially find [the care manager’s] support and advice to be a godsend,” says Caring.com.
The expense of hiring a geriatric care manager can be a hurdle for cash-strapped families. Depending on where they live, Caring.com suggests these families turn to local government agencies and charitable groups which sometimes “offer consulting services free or on a sliding scale according to income level.” The cost of hiring a geriatric care manager, which isn’t covered by Medicare or Medicaid plans, typically ranges between $75 and $250 per hour, according to Caring.com, but that cost should be weighed against the benefits and savings that professional care management provides by freeing family members from endless phone calls and emails, keeping loved ones healthier, reducing hospital readmissions, and cutting down on emergency travel when a health crisis occurs.
Questions to Ask a Geriatric Care Manager
Because a geriatric care manager will become a trusted member of your loved one’s care team, it’s important that families ask plenty of questions when selecting one. Besides standard inquiries about references, credentials and experience, Caring.com recommends asking a few additional questions, such as:
Are you part of a practice or a single provider?
Who is your backup when you aren’t available?
What days and hours are you available?
How do you approach conflict within client families?
What services will you provide – and which do you not provide?
Hiring the right geriatric care manager can make a huge difference in the lives of your loved one and your family. We encourage you to contact us here at AgingOptions for guidance in the selection process. We’ll gladly refer you to groups and agencies that can help, including our affiliate, Better Care Management.
Housing, Family, and So Much More
At the same time we also encourage you think carefully about your own retirement future. As we always remind our radio listeners and seminar guests, housing is a critical component of a good retirement plan, but it’s only a part of an overall strategy. You also need to prepare yourself financially so you don’t outlive your money. Then there’s medical insurance and everything that pertains to preserving your health and planning for long-term care. You need to protect yourself and your loved ones with a sound legal framework. Finally comes a step many retirees overlook: you need to communicate carefully with your family to make certain they understand your wishes and will support them. The only retirement planning tool we know of that does all this is a LifePlan from AgingOptions.
If you’re ready for a fresh approach to retirement planning, we invite you – along with parents, spouses and friends – to join Rajiv Nagaich of AgingOptions at a free LifePlanning Seminar, an information-packed few hours where many of your questions will be answered. Visit our Live Events page for a calendar of upcoming seminars, then register for the event of your choice. You’ll be very glad you did. Age on!
Several months ago we were reading financial columnist Michelle Singletary’s column in the Washington Post when something in the article really grabbed our attention – a reader comment buried far down in the column that set off warning bells. We felt this information needed to be shared once again with our AgingOptions blog readers.
Divorce Agreement Cuts Benefits in Half
A reader wrote to Singletary reporting that her husband had retired from the federal government some time ago. He had begun receiving estimated pension payments while the personnel office took their customary period of time (typically several months) to check the records and adjust all the details. Four months after his retirement, much to his shock, he received a letter from the federal Office of Personnel Management notifying him that henceforth half of his retirement pay and all of his retirement survivor benefits would be going to his ex-wife. Apparently, this gent had never read his divorce agreement which clearly stated what his ex would receive once his retirement date rolled around.
Fortunately, this case had a happy ending: the ex-wife had begun receiving her partial payments – completely unexpectedly – but as it happened, she was planning to remarry and wanted no part of the first husband’s benefits. The personnel office was able to get the situation settled in favor of spouse number two after an attorney successfully drafted documents reversing the original divorce agreement. But this does bring up a vital question: is there a way for each divorcing spouse to protect their rights when it comes to divvying up retirement assets such as 401(k) balances, which are often among the largest assets a couple approaching retirement age owns?
Divorce Agreement Requires Careful Decisions
At AgingOptions, our attorneys deal with this issue frequently. In searching for an article we could share with our readers that would answer the question, we found this insightful column on a website called The Balance. “Even while you’re going through the difficulty of a divorce,” this article advises, “you need to make informed financial decisions regarding the division of the property that you and your spouse have accumulated during your marriage.” Because retirement savings, as we said above, are often a couples’ biggest asset, dealing properly with their disposition is vitally important. Sadly, however, this is often done improperly – or not at all. “Even as one of the most important issues, [retirement savings] also tend to be very complicated, subject to tax implications, and often not handled properly because of it,” says The Balance. The solution, this article says, is something called a QDRO, pronounced “Quadro” – a Qualified Domestic Relations Order.
Legally, if your spouse has an employer-sponsored retirement plan, you’re entitled to part of the balance. The converse is also true: if you’re the one with the retirement account, your spouse is legally entitled to a share. “But if your spouse was the primary breadwinner,” asks the column in The Balance, “how do you protect your share of his or her retirement account? What’s to stop your spouse’s employer from paying out the benefits to your spouse or ex-spouse, leaving you with little or nothing? The answer is generally a Qualified Domestic Relations Order.” The QDRO is a court order that tells your spouse’s pension plan how your benefits will be paid out. Under such an order, for example, your share of the 401(k) can be separated out from the original account and deposited into your own IRA or 401(k) without penalty. The word “qualified” means the plan has to be approved both by the divorce court and by the Plan Administrator where you or your soon-to-be-ex-spouse is employed.
Divorce Agreement Also Requires Qualified Counsel
We won’t attempt to go into greater detail here, because the variables involved in a Qualified Domestic Relations Order can quickly get complicated. This is clearly one area where you need to plan ahead and get good legal counsel before proceeding with a divorce. As the column in The Balance says, “Divorce can be costly be in terms of upfront attorney fees and emotional health. But it can also have costly effects on your future financial security. Educating yourself is the first step. But be sure to take the appropriate legal steps to protect your rights and always employ a qualified team to help you do so.” We here at AgingOptions can certainly advise you in this critical area, and through our many regional offices of LifePoint Law, we can serve as your advocate should you prefer. Please contact us and allow us to walk you through the various scenarios in the often-confusing area of dividing assets – both today’s assets and tomorrow’s – in a divorce or separation.
When it comes to walking you through the various scenarios of retirement, that’s a particular specialty of ours. Retirement can also be confusing and complicated, but our desire is to help you make these important retirement planning decisions more manageable so that you can achieve the three most commonly-stated goals people seem to share as they age: to avoid running out of money, becoming a burden to those who love them, and being forced into unplanned and unwanted institutional care. If these are commonly-held goals, why do so few retirees ever succeed in realizing them? Because they fail to plan. We employ a strategy called LifePlanning, in which your finances, legal affairs, housing options, medical coverage and family communications are all woven together seamlessly, each element reinforcing the others. A LifePlan truly is the blueprint that will help you build the retirement of your dreams.
Ready to learn more, without obligation or cost? Then come join Rajiv Nagaich soon at an AgingOptions LifePlanning Seminar. We have several scheduled for the coming weeks, and there’s bound to be one that’s convenient for you. Visit our Live Events page for details and online registration, or contact us for assistance. We’ll look forward to meeting you!
A bathroom should be well-equipped to enable the user to freshen-up properly. Everyone has their own tastes and preferences when it comes to bathroom equipment. However, as you get older, you will need a more accessible bathroom, sometimes with special safety features.
You need to ensure your bathroom is convenient and comfortable for you. At some point, we all lose a little flexibility. You might not be able to maneuver easily, or stand up on slippery tile without some support. In such instances, your bathroom might need some design adjustments. Here are five bathroom design tips should you be planning to spend your later years in your house.
Bathroom on the Main Level
Accessibility is certainly a concern if you live in a storied house. It is important to ensure that a full bathroom is located on the main level of the house, where you or your loved one will be spending most of your time. It should be easily accessible to you even when you are alone.
If it’s within your budget, remodel your main to either include a bathroom if one doesn’t currently exist or convert a powder room into a full bathroom. If that won’t work, you could also consider installing a lift chair, so that you can easily move up and down. If the bathroom is only two to three steps up or down, you could convert the short staircase into a ramp. If none of these are options for you, you might have to consider buying a more accessible home altogether.
Install Grab Bars
Everyone loses stability as we age. You might not be able to walk or stand very firmly. You should have grab bars installed in your bathroom to help you maneuver easily across the slippery bathroom floor. The grab bars will offer much-needed support while you are trying to move around in the bathroom. Consider laying non-slip bath mats along walkways as well.
Remodel the Bathtub and Shower
The bathtub can be dangerous if necessary precautions are not taken. The bathtub should be equipped with an appropriate seat and a non-slip bathtub surface. Perhaps even a side door that allows you to simply step inside (like a shower) would be helpful, rather than risking your balance by stepping over the tall panel.
A shower might need some remodeling as well. Expanding the shower room and its door is important. The door should be wide enough to allow a wheelchair to pass through. The threshold between the bathroom floor and shower should be as low as possible.
Grab bars and anti-slip floors are quite essential in the shower as well.
The shower head should be adjustable, and some low shelves should be added too. All of these aspects will ensure that you can shower with everything within reach.
Remodel the Sinks
The sink might need to be adjusted too. First, it should be placed at a low level, where it’s accessible by a person sitting in a wheelchair. The taps should have lever handle faucets instead of round knobs. Water pressure and temperature should be controlled as well. You do not want scalding hot water splashing about and you should be able to turn it off quickly.
Get in touch with an aging-in-place professional, so that they can inspect your house and advise you on what improvements you should make. You can also seek the help of home repair experts. Your home, bathroom included, should be as convenient and comfortable as possible to help you age gracefully and safely at home.
Retirement is a time for relaxation and for letting go, but it’s not without its worries. One concern many older adults have is regarding finances. You have to adjust to living with a limited income during a time in your life when healthcare costs can be quite expensive.
Thankfully, it’s never too late to develop healthy financial habits. Here are just a few ideas to get you started towards more financial peace of mind.
Save on medications.
Many older adults require regular medication for chronic illnesses like diabetes, arthritis, and hypertension. A simple way to save on drugs is to buy generic rather than brand-name pharmaceuticals. Generics approved by the FDA are “bioequivalent” to their brand-name counterparts but can be significantly cheaper.
Another way to save on medications is to buy online from abroad. Canadian pharmacy referral services like Rx Connected and Canadian Med Center can help by connecting you to affordable medications from countries with stricter drug price regulations. Exercise a healthy degree of caution when you buy online, however. A legitimate and responsible website like Rx Connected will always ask for a prescription; it also only sources drugs from pharmacies and fulfillment centers that have met stringent standards.
Save on healthcare.
Healthcare is often an unavoidable cost, but there are a few tricks to cut corners on spending. For example:
Talk to a nurse via a free helpline for general and minor health questions, who can then determine whether you need higher-level care. Many hospitals and insurance plans across the country offer this service.
Try telemedicine – accessing a doctor through the Internet in the comfort of your own home. This is especially convenient for folks in remote areas or who have mobility challenges. They can be cheaper services too.
Visit your local community health center. These centers offer comprehensive care at a lower cost or even free of charge. You can find one near you by clicking here.
Don’t take retirement as a free pass to eat whatever you want. Keep living a healthy lifestyle; the best way to save on healthcare is to not need it at all
Get rid of extra stuff, and consider downsizing.
Now that the kids are out of the nest, you can start cleaning out all that extra stuff in your house. Consider selling items you don’t need.
Once you get rid of the clutter, you may realize you don’t need all the extra space of a suburban family home. Downsizing to a townhome or even apartment can be a smart decision. Smaller spaces are less work to clean, and you may be able to afford living closer to conveniences like grocery stores and clinics, thereby cutting down on transportation costs.
Use all that extra time to your advantage.
One of the benefits of retirement is all that extra time. Use it to your advantage to save money. For example, cook your meals at home rather than dine out. Cooking can save you a significant amount of money in the long run. Besides, it’s also a fun and rewarding hobby to take up!
Other things you can learn how to do yourself (rather than by hiring someone else) include simple handiwork around the house, yard work, and tailoring. Now is the time to learn a new skill!
Get your affairs in order.
Perhaps one of your chief worries is taking care of your estate. Indeed, estate planning can be an intimidating task many of us procrastinate, no matter our stage in life. However, there’s no better time to start planning than the present moment. If (God forbid) something happens and you become incapacitated, someone else could make choices for you, which I’d doubt you prefer.
You do not need to be extremely wealthy or even at retirement age to plan for your estate. By starting today, you can alleviate stress and have peace of mind tomorrow.
Keep learning about personal finance.
It’s never too late to develop financial literacy. If you put off learning about finances when you were younger, now is a fine time to start! As a retiree, not only do you have more life experience and experience working with money, you also have time to do whatever you please. Of course, make time for leisure, engage in your favorite hobbies, and travel, but do remember that learning can happen at any age. Science suggests that you can even slow down dementia type illnesses by exercising your mind.
Retirement is a period in life to enjoy, so don’t let money worries bog you down. Address issues as early as possible, and you can look forward to many more relaxed days to come.
As if there weren’t enough to worry about in the arena of personal privacy, now comes one more red flag. This just-published article on the Politico website reveals that companies are secretly gathering your health care information and selling it to doctors, hospitals and insurance companies, all without your consent and – for now, at least – with little regulation or oversight.
Data Gathering Being Done Secretly
The practice, says Politico, has been going on for many months, all in an alleged effort to single out patients who might be at higher than average risk of becoming addicted to opioids. “Over the past year,” says the article, “powerful companies such as LexisNexis have begun hoovering up the data from insurance claims, digital health records, housing records, and even information about a patient’s friends, family and roommates, without telling the patient they are accessing the information, and creating risk scores for health care providers and insurers.” The motive – keeping addictive drugs out of the wrong hands – may be noble, but the accuracy of the practice is highly suspect. “While the data collection is aimed at helping doctors make more informed decisions on prescribing opioids, it could also lead to blacklisting of some patients and keep them from getting the drugs they need, according to patient advocates.”
This revelation comes at a time of heightened scrutiny of the problem of opioid abuse, including among seniors. In the words of this 2017 article from the AARP Bulletin, “Americans over 50 are using narcotic pain pills in surprisingly high numbers, and many are becoming addicted.” Tragically, in reporting on the growing opioid crisis, the older end of the age spectrum has often been neglected. “While media attention has focused on younger people buying illegal opioids on the black market,” says AARP, “dependence can also start with a legitimate prescription from a doctor: A well-meant treatment for knee surgery or chronic back troubles is often the path to a deadly outcome.” According to the Bulletin article:
Almost one-third of all Medicare patients — nearly 12 million people — were prescribed opioid painkillers by their physicians in 2015.
That same year, 2.7 million Americans over age 50 abused painkillers, meaning they took them for reasons or in amounts beyond what their doctors prescribed.
The hospitalization rate due to opioid abuse has quintupled for those 65 and older in the past two decades.
Data Gathering Produces Inaccurate Results
So if it’s true that seniors are at risk of over-prescription of opioids, then we should support the kind of under-the-radar data-gathering described in the Politico article, right? Not necessarily, researchers say. The biggest problem, besides the secrecy that shrouds the data-gathering practice, is that the algorithms used to evaluate the risk of a particular patient becoming addicted to opioids – or any other prescription – are not necessarily accurate. “Overestimating risk might lead health systems to focus their energy on the wrong patients,” warns Politico, while “a low risk score might cause a patient to fall through the cracks.” In an effort to reverse the tide of opioid addiction, new rules now require doctors to look up individual patients in a drug database to evaluate “whether a patient in pain can take opioids safely, in what doses, and for how long — and which patients are at high risk of addiction or overdose.” The so-called risk scores created by Big Data companies are being aggressively marketed as a kind of short-cut.
According to Politico, “The practice scares some health care safety advocates. While the scoring is aimed at helping doctors figure out whether to prescribe opioids to their patients, it might pigeonhole people without their knowledge and give doctors an excuse to keep them from getting the drugs they need.” Indeed, as we read in this article from the Kaiser Health News website, worries about addiction may already be making it more difficult to fill legitimate prescriptions for pain-killers. “As concern grows about a national opioid epidemic,” says the article, “some seniors now find it harder to get medications they need from doctors and pharmacies. Some medical practices refuse to accept patients already taking an opioid for pain.” This heightened level of restriction, while well-intended, seems to fly in the face of the doctor-patient relationship.
Data Gathering Keeps Drugs from Those Who Need Them
One geriatrician quoted in the Kaiser article explained it well. Her goal, she said, is to help patients control chronic pain sufficiently enough that they can function well, “because ultimately in older adults, their function and ability to live independently is one of the greatest predictors of health. I have patients who unless they take their opioid really cannot get out of bed. And if that small dose of opioid is going to help them get out of bed and move around their house and cook for themselves, then that is absolutely something worth doing.” This physician put the risk of addiction in perspective. “Their biggest risk is going to be if they stop moving and [decline more]. That’s going to have a bigger consequence on their health than prescribing an opioid at a reasonable dose and with close supervision.”
This issue clearly represents merely the tip of the very large iceberg of data-gathering and privacy. Are we at the mercy of big companies acting in secrecy, using what Politico terms “inaccurate public data” in order to “disempower patients” with “Big Brotherish” ratings systems? It sure sounds that way. Our recommendation for all seniors is that you choose your primary health care provider wisely, and whenever possible that you employ the services of a board-certified geriatrician. He or she understand the unique health care needs of older adults and will give you the best possible guidance in all aspects of healthy living, including pain control. We’ll also keep an eye open for future articles concerning this process of secret data-gathering. As Politico reports, “Congress hasn’t taken up the issue of intrusive big data collection in health care. It’s an area where technology is moving too fast for government and society to keep up.”
There’s No Secret to Solid Retirement Planning!
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. You’ll discover 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 retirement blueprint. It’s the key to building 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.
There’s no “hidden secret” to proper retirement planning – it’s available to you today from the professionals at AgingOptions. Age on!
We love to run across news stories that point out how the simplest of ideas can have a tremendous impact, and that’s how we felt as we read this heart-warming article published recently on the BBC News website. As we at AgingOptions read this story we thought it would be a good one to share with our blog readers. If you’re caring for a loved one with dementia, we think this idea can be helpful – and if it is, we would love to hear about it.
A Small Dementia Whiteboard – with a Profound Impact
The BBC story started with a home care visit by a British general practitioner to a woman with dementia. He noticed that the woman’s adult daughter, in order to calm and reassure her often anxious and agitated mother, had put a small whiteboard in a prominent spot where her mom could always read it. The doctor told the BBC that he saw what was on the whiteboard and thought, “I’ve got to share this. I’d not seen anything like it before in thousands of house visits. It’s caring, reassuring and sensible – it’s just such a simple idea.” He took a photo of the whiteboard and posted in on Twitter, expecting it to appeal only to “few interested colleagues.” To date his tweet has been liked more than 40,000 times, and lives have been touched around the world. Tens of thousands more have responded to the story via other social media sites such as Reddit.
According to the website of the Alzheimer’s Association, Alzheimer’s disease (by far the most common type of dementia) is often accompanied by a sense of unease. “A person with Alzheimer’s may feel anxious or agitated,” says the website. “He or she may become restless, causing a need to move around or pace, or become upset in certain places or when focused on specific details.” Some of the causes are biological, say experts, caused by the inability of many dementia sufferers to process new information and handle stimulus. Many factors trigger anxiety in someone with dementia: changing where they live, spending time in a hospital or nursing home, being surrounded by unfamiliar people, or having someone new as a caregiver. But frequently, says the Alzheimer’s Association, the agitation comes from fear and fatigue: sufferers are “trying to make sense out of a confusing world” and it makes them profoundly uneasy.
Dementia Whiteboard Cuts Down on Anxious Phone Calls
This was the problem with the woman in the BBC report. The daughter explained to the doctor that “that the board aims to reduce ‘anxious phone calls’ made by her mother to relatives.” The items written on the whiteboard were both simple and touching – statements like:
“You are not moving.”
“No one else is moving.”
“You don’t owe anyone any money.”
“You haven’t upset anyone.”
The response to the postings on social media was immediate and surprising. “It wasn’t long before people were sharing whiteboards and ideas of their own,” the BBC article reported. “Many of the stories shared by families and medical professionals alike touched on the anxiety which dementia can cause.” One nurse from Canada reported that one resident where she worked would frequently start crying because he was worried about his children, and he was also afraid he would have to start paying for his meals. A man in Shimla, India, “saw Philip’s tweet and posted the image on Reddit where it has gained more than 112,000 upvotes,” with one user suggesting adding to the whiteboard the statement, “You can use the bathroom whenever you like.” That’s because they knew of one dementia patient who grew anxious and upset because she was convinced she wasn’t allowed to go to the bathroom.
Besides the Dementia Whiteboard, Some Other Helpful Strategies
The whiteboard idea may work for you if a loved one in your care is becoming anxious due to dementia. The Alzheimer’s Association website also adds these helpful suggestions. First, stay calm and positive yourself. Slow down. Keep stimulation and confusion to a minimum, and don’t offer too many choices. Reassuring statements like, “You’re safe here” and “Everything is under control” can help. Let the anxious person know you will stay with them until they feel better. If possible, involve the person in simple activities like art or music to divert their attention. If conditions permit, this might be a good time to take a walk or go for a car ride.
Raising your voice, showing alarm, criticizing or arguing will only make things worse, the Association says. If the anxiety persists or gets worse, make sure you see a physician – or, better yet, a geriatrician – because there may be physical causes such as prescription drug side effects at work. Also, the more you share your experiences with others in the same situation, the more ideas and solutions you’ll find, and you’ll be reminded that you’re not alone. You may want to check out the Alzheimer’s Association’s Community Section for support groups, online forums and other resources to help you.
That kind of support is why the BBC story of the whiteboard is important. As the doctor who first tweeted the story put it, “Dementia is such a heartbreaking subject for so many people and this simple solution to support often elderly relatives has resonated with so many people around the world. The idea has touched people’s hearts.” It certainly touched ours.
Supporting You as You Plan for Your Retirement
When it comes to supporting you in your preparation for retirement, AgingOptions is your very best resource. Unlike other so-called retirement planning services that focus narrowly on only one dimension of retirement, AgingOptions employs a truly comprehensive strategy called a LifePlan that recognizes the reality that each facet of retirement – your finances, your health care, your housing, your legal affairs, and your family communication – is connected with all the rest. They all have to work together, and with a LifePlan in place, they will. We encourage you to come join Rajiv Nagaich at a free LifePlanning Seminar where he’ll explain the process and answer your questions. This could very well be the most important few hours you’ll ever spend when it comes to your retirement plan!
Simply visit our Live Events page for a calendar of upcoming seminars, then register for the date and time of your choice. We’ll look forward to meeting you!
In our technology-driven society, it seems we tend to rely too much on professional health care providers, nursing homes, and digital solutions to solve all of our health care problems – an observation that seems especially true when it comes to senior care. But often the best ideas for healthy aging appear to come, not in the hospital, but in the home. A recent article we discovered on the Kaiser Health News website provides a perfect example.
The Kaiser article by author Judith Graham describes a groundbreaking program out of Johns Hopkins University called CAPABLE. That’s an acronym for the full title, which is a mouthful: “Community Aging in Place — Advancing Better Living for Elders.” Whatever else you call it, CAPABLE is a program, first tested in Baltimore and now available at 26 sites in 12 states, in which low-cost, common sense ideas are being applied to the challenge of helping low-income seniors age safely in their own homes. Best of all, this patient-centered and relatively simple approach works. As Judith Graham writes, “New research shows that CAPABLE provides considerable help to vulnerable seniors who have trouble with ‘activities of daily living’ — taking a shower or a bath, getting dressed, transferring in and out of bed, using the toilet or moving around easily at home. Over the course of five months, participants in the program experienced 30 percent fewer difficulties with such activities, according to a randomized clinical trial — the gold standard of research.” Those results were recently published in the professional journal JAMA Internal Medicine.
As one researcher commented, “If someone found a drug that reduced disability in older adults by 30 percent, we’d be hearing about it on TV constantly.” But CAPABLE isn’t about expensive drugs or technology. It’s about providing low-cost solutions to basic problems faced by low-income seniors. The first CAPABLE study involved 300 adults with an average age of 75, all considered either poor or near-poor. About 90 percent were women and the majority were African American. Members of the study group suffered from multiple chronic medical conditions such as heart disease, arthritis and COPD. In other words, this group included many of the seniors who the health care community finds the hardest and most expensive to treat.
CAPABLE Includes Basic Health and Home Services
Kaiser Health News describes what happened next. “Half of the older adults in the trial received the CAPABLE intervention, which includes six visits by an occupational therapist, four visits by a registered nurse, and home repair and modification services worth up to $1,300” involving things like building ramps and installing grab bars. The control group, by contrast, received 10 visits of equal length from a research assistant, not a medical professional, and were encouraged during and after the visit to “use the internet, listen to music, play board games or reminisce about the past, among other activities.” They did not receive home repairs or modifications. After five months of study, both groups had experienced health improvements, but it quickly became clear that those receiving the CAPABLE intervention did much better. Over 80 percent of participants felt strongly that the program had made their life easier and their home safer, allowing them to live at home with greater confidence, better able to manage daily challenges.
We visited the CAPABLE program website (part of the website of the Johns Hopkins School of Nursing). The people running CAPABLE describe it as “a client-centered home-based intervention” designed to help older adults “increase mobility, functionality, and capacity.” The core services of the program involve an occupational therapist, a nurse, and a handyman, with each service working in tandem with the others so seniors can function safely and effectively at home. By improving “problem-solving ability, strength, balance, nutrition, and home safety, while decreasing isolation, depression, and fall risk,” CAPABLE is intended to keep seniors from having to move into expensive government-funded care facilities. According to the program website, “CAPABLE is unique because it is patient-centric. Success is defined by the patient and measured by a nursing/occupational therapist team. The patient decides on functional goals, such as taking a bath or walking to church, as opposed to medical ones, such as reducing blood sugar or blood pressure level.” As the website says, “In today’s health care environment, improving health largely falls outside of health care facilities. Home is where health is.” We concur wholeheartedly.
CAPABLE Saves $10 for Each Dollar Spent
As Kaiser Health News reports, CAPABLE not only benefits seniors, but “It also turns out to be a cost-effective investment. For every dollar spent on CAPABLE, nearly $10 in combined savings accrues to Medicare and Medicaid, largely because of hospitalizations and nursing home placements that are prevented.” The average cost for a senior to go through the CAPABLE program is $2,825 – far less than half the monthly cost of the average room in a nursing home. So far, driven by that kind of ROI, both Michigan and Massachusetts have adopted a version of the CAPABLE program for some residents. So far, however, foundations and grants have funded most of the work since federal Medicare and Medicaid plans have been slow to adopt the initiative. Efforts are underway to persuade Medicare Advantage insurers to fund CAPABLE since new rules have given these firms latitude to offer their policy-holders a wide array of non-medical services.
As we said at the outset of this article, part of the challenge with programs like this involves weaning ourselves off our addiction to technology and returning to simpler, more effective solutions to health care problems. At least one geriatrician agrees. “As clinicians,” he told Kaiser Health News, “when we see older patients with conditions we can’t reverse, we need to understand we haven’t run out of things we can do. Referring patients to a program like CAPABLE is something that could make a big difference.”
Manage Your Health, Manage Your Retirement
Planning and preparation are essential to making good decisions about all aspects of retirement, because, as we always remind radio listeners and seminar guests, successful retirement involves more than health care and a predictable income. You should also look ahead to the kind of housing choices you’ll want to make in the future. You should think about the sort of legal protection that might be necessary to safeguard your estate and protect your wishes. You also need to take your family into account and make certain they know how you want to live in retirement. Is there one approach that encompasses all these vital facets of retirement? Fortunately, the answer is yes: a LifePlan from AgingOptions.
The best way to learn more is to join Rajiv Nagaich at a free LifePlanning Seminar. There you’ll discover the answer to many of your retirement questions and you’ll gain valuable insight to help you plan for the secure and fruitful retirement you’ve always hoped for. For a calendar of upcoming seminars, visit our Live Events page and enroll in the seminar date and time of your choice. It will be a pleasure to meet you!
As professionals who help people from all walks of life plan for retirement, Rajiv Nagaich and his team at AgingOptions deal frequently with certain issues that are common to many retirees. One of the worries that comes up most often involves financial emergencies and how to handle them, especially when living on a fixed income.
Financial Emergencies “Ruining” Retirement Plans
For that reason, we felt this was a good time to re-visit this article we discovered last summer in USNews. The title is straightforward: it’s called, “How to Deal with a Financial Emergency in Retirement.” According to author Rachel Hartman, concern about how to handle emergencies cuts across all age groups. “Most Americans (55 percent) worry about what they would do when faced with a financial emergency,” says Hartman, quoting a Northwestern Mutual study. However, the stress is magnified exponentially for those on a fixed income. “Unexpected and uncovered emergencies can literally ruin a retirement plan,” says one Connecticut wealth advisor.
Here at AgingOptions we understand the disruption that a financial emergency can trigger, because we’ve witnessed it many times as we’ve spoken with radio listeners and seminar guests. But we have to push the “pause” button before moving on, and point out the obvious: the USNews article, as helpful as it might be, deals entirely (and very narrowly) with finances. For that reason, the article also unintentionally reinforces a point we’ve made repeatedly: a so-called retirement plan that deals only with your money is indeed a recipe for disaster.
The premise behind the USNews article is that your retirement plan can be disrupted by some sort of emergency, but our question is, “What kind of emergency?” Is it actually a medical need, a housing issue, a family concern or a legal matter? All of those can be dealt with ahead of time if you undertake the right kind of retirement planning. We’ll explain more in a moment, but for now the important thing to remember is that a truly comprehensive retirement plan can go a long way toward eliminating (or certainly reducing) the kind of worry that this article talks about.
Eight Recommendations for Handling Financial Emergencies
“If you’re retired and facing a financial emergency,” author Hartman writes, “here are some of the best approaches to gather funds, cover the costs and move forward without going into debt.” She lists eight ideas you might want to consider, some of which, we think, are better than others. For some reason the article omits one idea which we think might be advantageous if you qualify: there’s no mention of a reverse mortgage. That said, here’s a quick overview of the eight USNews recommendations:
Tap easy-to-access funds. Use designated emergency funds first before tapping into a retirement account where you’ll probably take a tax hit and also lose out on earnings.
Remove extras from your budget. You might need a few months – or more – of belt-tightening. The more you understand your budget, the easier it will be to economize.
Examine your bills. The article suggests, “Make a list of your ongoing necessary expenses, such as car insurance and your cellphone bill. If you haven’t negotiated or requested a lower rate in the last year, take some time to reach out.” These negotiated savings can help create space in your budget.
Sell a big-ticket item. The second car, the no-longer-used RV, the boat gathering dust? These can be turned into cash fairly quickly.
Think about re-locating. If downsizing was already part of your plan, a financial emergency might be just the trigger to cause you to take action now, not later – although in our experience its tough (and unwise) making a major move during a money crisis.
Look at life insurance. There may be a long-overlooked cash value hiding in a whole life policy you’ve had for decades.
Understand the tax implications. If you decide to take funds from a 401(k) or other tax-deferred account, make certain you get good advice about the tax implications. There may be ways of reducing the burden, such as splitting your withdrawal over two tax years.
Look for “zero percent” borrowing opportunities. We confess, we’re leery of this suggestion – it seems like a dangerous way to dig your debt hole deeper. The idea is to take advantage of a zero-percent introductory credit card rate, then pay off the balance before interest charges kick in. Frankly, for most people we think this is a terrible idea.
As we said earlier, the one idea completely overlooked by USNews is a reverse mortgage, specifically a reverse mortgage line of credit. As part of an overall financial plan, this powerful tool can provide just the right financial safety net to cover a wide range of unanticipated expenses. It’s not the answer for everyone, but it’s the right idea for many. Contact our office and let us refer you to a reverse mortgage expert who can answer your questions objectively.
Avoid Financial Emergencies Through Proper Planning
We have said it a thousand times and we’ll say it again: comprehensive retirement planning is about more than money. What if you could head confidently into retirement knowing not only that your finances were secure but also that your estate and your loved ones were adequately protected? What if your housing strategy were already thought through so you wouldn’t have to worry about needing to make that unexpected move? What if you knew you had the right medical coverage in place, both for the immediate future and for the long term? All this is possible when you approach retirement the way we do at AgingOptions, using a strategy we call LifePlanning. Not only will finances, housing, health and legal matters be part of your LifePlan, but so will your family, so you know your loved ones will be there for you as you age.
We encourage you to get the facts about LifePlanning so you can open your eyes to the possibilities it represents. Join Rajiv Nagaich at an upcoming LifePlanning Seminar. We hold these free events in locations throughout the area, so odds are there’s one near you. For a complete list of upcoming events, click here to visit our Live Events page where you can register online for the seminar of your choice. If your dream is to retire with a sense of true security and thorough preparation – and be ready for whatever your future may bring – look no further than a LifePlan from AgingOptions. Age on!