Wednesday, January 28, 2015

Social Security and Medicare Figures for 2015

New figures announced - The Social Security Administration (SSA) has announced that Social Security and SSI beneficiaries will receive a 1.7% cost-of-living adjustment (COLA) for 2015. According to the SSA's announcement, after the COLA, the estimated average monthly retirement benefit payable in January 2015 will be $1,328.

The Centers for Medicare & Medicaid Services (CMS) has also announced next year's Medicare costs. The standard monthly Medicare Part B premium will be $104.90 in 2015, the same as in 2014. However, beneficiaries with higher incomes (individuals with taxable incomes of more than $85,000 and couples with taxable incomes of more than $170,000) will pay more than $104.90 per month because they must pay an income-related surcharge.

Other important Social Security and Medicare figures are listed below.

  • The amount of taxable earnings subject to the Social Security tax (called the maximum taxable earnings limit) will increase to $118,500 from $117,000 in 2014.
  • The annual retirement earnings test exempt amount for beneficiaries under full retirement age will increase to $15,720 from $15,480 in 2014. If a beneficiary has earnings that exceed the exempt amount, $1 in benefits will be withheld for every $2 in earnings above the exempt amount.
  • The annual retirement earnings test exempt amount that applies during the year a beneficiary reaches full retirement age will increase to $41,880 from $41,400 in 2014. If a beneficiary has earnings that exceed this amount, $1 in benefits will be withheld for every $3 in earnings above the exempt amount.
  • The amount of earnings needed to earn one Social Security credit will increase to $1,220 from $1,200 in 2014.
  • The Medicare Part B deductible will be $147, the same as in 2014.
  • The monthly Medicare Part A premium for those who need to buy coverage will cost up to $407, down from $426 in 2014. However, most people don't pay a premium for Medicare Part A.
  • The Medicare Part A deductible for inpatient hospitalization will be $1,260, up from $1,216 in 2014. Beneficiaries will pay an additional daily co-insurance amount of $315 for days 61 through 90, up from $304 in 2014, and $630 for stays beyond 90 days, up from $608 in 2014.
  • Beneficiaries in skilled nursing facilities will pay a daily co-insurance amount of $157.50 for days 21 through 100 in a benefit period, up from $152 in 2014.

This information was provided by:
Robert Riedl CPA, CFP, AWMA
Endowment Wealth Management, Inc (Multi-Family Office)
Appleton, WI
Phone - 920-785-6011
Website - www.EndowmentWM.com



Blog post provided by Society of Certified Senior Advisors
www.csa.us

Tuesday, January 20, 2015

The Way Forward: Exercising for Life


Exercise has always been important. But today, it's critical in the health and well-being of older adults. 


Gladys Chelte started exercising after retirement. The incentive to finally start and stick with it came from watching her husband’s health decline. “After my husband and I retired, his health problems got progressively worse. I decided I needed to do something to keep in better shape so we could stay in our home. I started an exercise plan. I knew I had to at least try.”

Finding the motivation to embrace fitness paid off for Chelte. “By the time I am done exercising—even if I really didn’t want to—I feel so much better and it just lifts my spirit,” she says. 


Seventy-year-old Connie Balcom is an ACE (American Council on Fitness) certified senior fitness instructor. Her impetus to prioritize exercise and to teach came from her father’s premature death. “He was the kind of guy who always meant to make time for exercise--but didn’t” she says.

Balcom knew she wanted to teach people like her dad who hadn’t exercised in quite some time, didn’t know what exercise meant, and just never got around to it. “A lot of us haven’t exercised since we were kids, but exercise is really the key to independence
and better health,” she says.

The Experts

As a nation, we began researching exercise and promoting fitness through group sports to young people in the 1950s. The 1970s saw a push for cardiovascular workouts through activities like basketball, running, and aerobics programs. Messaging of the 1980s and 1990s centered on activities like walking and dancing as options for moderate-intensity workouts (U.S. Department of Health and Human Services et al. 2012). Now, as those children and adolescents of the 1950s who received the first public message about the benefits of exercise are retiring and settling into their golden years, we know so much more. 

Today, we know that even light to moderate exercise is enormously beneficial for health and independence. In this age of information, the most advanced studies on health and cost benefits of fitness are readily available. Whether looking to the World Health Organization, the Centers for Disease Control and Prevention (CDC), National Institute of Health, American Cancer Society, Alzheimer’s Association, or the AARP, the data consistently boils down into one message: exercise is undeniably good for you. According
to the CDC, “Regular physical activity is one of the most important things a person can do to stay healthy (CDC 2009).”

Yet, only one-third of all aging Americans exercise (Jacobsen et al. 2011).

Research shows that regular exercise helps manage chronic disease like Type-2 diabetes, cancer, stroke, heart disease, osteoporosis, arthritis, and dementia. It reduces medical costs, fights depression, and prevents illness. Exercise impacts healing and recovery and can be used as a tool to extend treatment benefits and stop the revolving door to hospital readmission (CDC 2009).



The Continuum of Care: The Care Provider

Michael J. Foley, M.D., a general surgeon with the Affinity Medical Group in Oshkosh, Wisconsin, says that we cannot ignore the fact that the majority of Americans do not exercise on their own because “those are the people we see again and again in the
health care system.”

“The relationship between fitness and health is undeniable. Individuals who stay active and exercise after they retire stay out of the hospital, have fewer illnesses, and live in their homes longer,” he notes.

As the Affordable Care Act (ACA) switches to a system that pays based on quality of care or value from one that previously rewarded for volume, Dr. Foley sees the opportunity for the entire continuum of care to use tools like exercise for better health outcomes, to
extend treatment benefits, and to stop the revolving door to hospital readmission.

Dr. Foley points to what has been learned about exercise in relationship to dementia and Alzheimer’s as evidence.

• In 2008, the University of Washington’ s Dr. John Medina wrote in his book, Brain Rules, that you can cut your lifetime risk of Alzheimer’s by 50 percent and your risk of general dementia by 60 percent with regular exercise (Medina 2008).

• An April 2013 Finnish study found that thirty minutes of exercise in the home each day can result in 50 percent fewer falls, less hospitalization, and reduced medical costs for someone already living with Alzheimer’s or general dementia (Pitkala et al. 2013).

• A July 2013 study undertaken at the University of Maryland concluded that exercise may be the best medicine for Alzheimer’s because “no study has shown that a drug can do what we showed is possible with exercise (Smith et al. 2013).

 “We can’t just look to pills or surgery to make people better in every situation,” says Foley. “The time has come to deliver exercise as a part of care. We don’t need more research. We need application across every level.”

On the Continuum: The Physical Therapist

Sara Bryan, rehab director for Orthopedics at Gentiva Health Services in Minneapolis/Saint Paul, Minnesota, is a true believer in exercise. Like Dr. Foley, Bryan has a growing concern that the continuum of care does not currently put enough emphasis on exercise as a key factor in wellness. “When benefits end and we leave the home, exercise usually stops, and health fails again. There is a gap in care that we need to address as a system.

“Complying with exercise and activity as part of a lifestyle change is necessary for long-term success, to keep these patients from going back into the hospital, or from having another fall,” Bryan says. As a solution, she is looking for stronger partnerships with providers, home care, and the family. They need to be a part of ensuring that tools are used and the plan is followed.”

The Continuum of Care: Home Care

Home care is undergoing major transformations largely because of licensing, the ACA, dementia, and Alzheimer’s, and the overall growth in the aging population. It is also starting to deliver exercise as a part of care. 


Right at Home has embarked on a nationwide pilot project to determine best practices for adding fitness to its care offerings. ComForcare recently completed a fitness pilot and is adding exercise as one of its tools available in its dementia care program. Visiting Angels
is rolling out an extensive dementia care program this summer to all of its franchises and will incorporate fitness as one of its main tenets.

Bonnie Reid, Director of Program Development for Visiting Angels Home Care, is putting together that dementia care program for the entire corporation. She designed her program to include fitness because “you can’t just have a dementia care program that helps the brain but ignores the body. Our clients are whole people. The research about dementia and exercise is real. It is a great way we can help our clients and their families and be a stronger partner with others in care.”

Some individual business owners are moving faster than their corporations by adding fitness to their care services. SYNERGY HomeCare franchise owner Brian McDonald knows that the home care industry can be a bigger partner in wellness, and he knows his clients will benefit.

“The basic premise of in-home care is to help people remain independent and spend their golden years in their own homes. In-home care has a unique opportunity to help people stay active. This is not about going to a gym or raising barbells over your head. This is about staying active,” McDonald says.

The Way Forward

Dr. Foley tells his patients, “The possibility for up to a 30 percent improvement in longevity or your ability to care for yourself when you are active is real. You can start exercising when you are sixty, sixty-five, seventy, seventy-five—whatever it takes to keep you active and where you want to be in your life.” When asked about patients who do not exercise, Dr. Foley says, “I tell my patients that they don’t have to be out there running 5Ks or marathons, lifting heavy weights at a gym, or being a body builder. They just need get their engine running, move consistently and often, and keep those muscles and bones strong.”

He emphasizes that all of us should be working toward the same goal of improved quality of life, and exercise has to be part of the equation. Advisors and other professionals who work with older adults are in a position to advise their clients on the merits of exercise,
and encourage them to begin an exercise program. •CSA 



Beth Commers has spent most of her career in college athletics, education, government,
and politics. As co-owner of FOG LLC (For Our Grandparents) she worked with a team of experts to create the Independence Home Fitness Curriculum to help older adults re-engage with fitness. Contact her at bethcommers@fog-llc.com or visit www.forourgrandparents.com. 

The Way Forward: Exercising for Life was recently published in the Summer 2014 edition of the CSA Journal.



Blog posting provided by Society of Certified Senior Advisors

Friday, January 16, 2015

Eating Well: Best Diet for Older Adults


 As you get older and want to maintain your health, it is important to focus on the kinds of food you need for your body type and any medical concerns and not just how many calories you consume or achieving an ideal weight. For example, older people who don’t get enough of the right nutrients can be too thin or too heavy. Some may be too thin because they don’t get enough food, while others might be overweight partly because they get too much of the wrong types of foods. Likewise, people with certain medical conditions might find it necessary to limit certain types of foods or follow a specific diet (e.g., no concentrated carbohydrates, low sodium, low fat, low cholesterol, low potassium).

Problems with Malnutrition

Malnutrition is a real problem for older adults. A recent study showed that more than half of American seniors seen at emergency departments are either malnourished or at risk for malnutrition. Of those who were malnourished, more than three-quarters said they had not been previously diagnosed with malnutrition, the study authors found (HealthDay News). Malnutrition, which can be caused by eating too little food, too few nutrients and digestive problems related to aging, can lead to fatigue, depression, weak immune system, anemia, weakness, and digestive, lung and heart problems, as well as skin concerns.

Older adults may eat less often or eat only those foods with a distinctive or strong flavor. As we age the intensity of taste and the ability to identify different tastes diminishes. While older people tend to maintain the ability to detect sweet taste, we have more difficulty detecting sour, salty and bitter tastes. Other factors that affect taste include dentures, medications and smoking, while problems with digestion and medication interactions can also affect our diet.

As we get older, calorie needs change due to more body fat and less lean muscle. Less activity can further decrease calorie needs. The challenge for older adults, especially for those who are overweight, is to meet new and higher nutrient needs than when younger yet consume fewer calories. For example, older adults require increased calcium to stay bone healthy. The answer to this problem is to choose foods high in nutrients in relation to their calories. Nutrient-rich foods supply vitamins, minerals, protein, carbohydrates, fats and water and keep your muscles, bones, organs and other parts of your body healthy.

Beyond getting enough nutrients, eating the right foods may reduce the risk of heart disease, stroke, type 2 diabetes, bone loss, some kinds of cancer and anemia. If you already have one or more of these chronic diseases, eating well and being physically active may help you better manage them. Healthy eating may also help you reduce high blood pressure, lower high cholesterol and manage diabetes.

As we get older, digestive secretions diminish markedly. Adequate dietary fiber, as opposed to increased use of laxatives, will maintain regular bowel function and not interfere with the digestion and absorption of nutrients, as occurs with laxative use or abuse.

How Many Calories a Day?

The National Institute of Health (NIH) provides guidelines for how many calories an older adult should consume.

A woman over age 50 should consume daily about:

  • 1,600 calories if her physical activity level is low (only performs activities associated with typical day-to-day life)
  • 1,800 calories if she is moderately active (walks the equivalent of 1.5 to 3 miles a day at 3 to 4 miles per hour)
  • 2,000 to 2,200 calories if she has an active lifestyle (walks the equivalent of more than 3 miles a day at 3 to 4 miles per hour)
A man over age 50 should consume daily about:

    • 2,000 to 2,200 calories if his physical activity level is low (only performs activities associated with typical day-to-day life)
    • 2,200 to 2,400 calories if he is moderately active (walks the equivalent of 1.5 to 3 miles a day at 3 to 4 miles per hour)
    • 2,400 to 2,800 calories if he has an active lifestyle (walks the equivalent of more than 3 miles a day at 3 to 4 miles per hour)
Best Foods to Eat

People of all ages need more than 40 nutrients to stay healthy. With age, it becomes more important that diets contain a sufficient amount of calcium, fiber, iron, protein and vitamins A, C, D and folic acid. Because no one food or pill provides all of the nutrients, it’s best to eat a variety of foods to get the full spectrum of nutrients. (Colorado State University Extension.)

The NIH provides a diet that is a mixture of nutrient-dense foods that are low-calorie. It contains vitamins, minerals, complex carbohydrates, lean protein and healthy fats.

Vegetables, Fruits and Grains

Vegetables, fruits and grains offer important vitamins and minerals to keep your body healthy. Most of these foods have little fat and no cholesterol. They are also a source of fiber, which can help with digestion and constipation, and may lower cholesterol and blood sugar.

They also provide phytochemicals—natural compounds such as beta-carotene, lutein and lycopene—that can promote good health and reduce the risk of heart disease, diabetes and some cancers. In addition, vegetables, fruits and grains contain antioxidants, including vitamins C and E, which can protect cells in the body from the damage caused by oxidation. Antioxidants are thought to promote health and to possibly reduce the risk of certain cancers and other diseases.

Vegetables. Healthy choices include broccoli, spinach, turnip and collard greens, as well as other dark, leafy greens. Aim for lots of color on your plate as a way to get a variety of vegetables each day—for example, tomatoes, carrots, sweet potatoes, pumpkin, red peppers or winter squash.

Fruit. To make sure you get the benefit of the natural fiber in fruits, choose whole or cut-up fruits. Choose fresh, frozen, canned or dried fruits and go easy on fruit juices.

Grains: Any food made from wheat, rice, oats, cornmeal, barley or another cereal grain is a grain product. Approximately one ounce of grain foods counts as a serving. This is about one slice of bread, roll or small muffin. It also equals about one cup of dry flaked cereal or a half-cup of cooked rice, pasta or cereal. At least half (3 ounces) of the grain foods you eat per day should be whole grains, which are a major source of energy and fiber, rather than refined.

Other whole grains include popcorn, brown rice, wild rice, buckwheat, bulgur and quinoa.

Protein

Protein helps build and maintain muscle and skin. As we age, protein absorption may decrease, and our bodies may make less protein. However, this does not mean protein intake should be routinely increased, because of the general decline in kidney function. Excess protein could unnecessarily stress kidneys.

Sources of protein include meats, seafood, beans, nuts, seeds, and tofu. When buying meats, which also provide B vitamins, iron and zinc, choose lean cuts or low-fat products, because they provide less total fat, less saturated fat and fewer calories than products with more fat.

For instance, 3 ounces of cooked, regular ground beef (70% lean) has 6.1 grams of saturated fat and 230 calories. Three ounces of cooked, extra-lean ground beef (95% lean) contains 2.9 grams of saturated fat and 164 calories—and more protein, too, 19.46 grams of protein vs. 21.94 (from the U.S. Department of Agriculture’s Agricultural Research Service).

Beans, including pinto beans, kidney beans, black beans, chickpeas, split peas and lentils, tend to be low or lower in saturated fats, and provide fiber. Another source of protein is nuts and seeds.

One egg, one-fourth cup of cooked dry beans or tofu, one tablespoon of peanut butter or a half-ounce of nuts or seeds equals 1 ounce of meat, poultry or seafood. Be aware that peanut butter and nuts are very high in fat, though mostly good fat, so should be eaten in moderation.

Dairy products

Older adults need 1,200 mg of calcium a day. Low-fat or fat-free dairy products, including milk, yogurt and cheese, provide calcium and vitamin D to help maintain strong bones, as well as protein, potassium, vitamin A and magnesium. Nondairy sources of calcium include broccoli, almonds, kale, canned fish such as salmon and sardines, and calcium-fortified tofu or soy beverages.

Choose sweet dairy foods with care. Flavored milks, fruit yogurts, frozen yogurt and puddings can contain a lot of added sugars—empty calories that provide little in the way of nutrients.

Salmon, sardines and tuna provide vitamin D, while some cereals and juices are fortified with extra calcium and vitamin D.

Fats

Your body needs some fats for energy and for healthy organs, skin and hair. Fats also help your body absorb vitamins A, D, E and K and provide essential fatty acids, which your body cannot make on its own.

On the other hand, fat contains more than twice as many calories as protein or carbohydrates, and increases your risk of type 2 diabetes, heart disease and other health problems, so you should aim to limit fats to 20 to 35 percent of your daily calories. For instance, if you eat and drink 2,000 calories daily, only 400 to 700 of the calories should be from fats.

The number of calories from fat in a serving of packaged foods is listed on the Nutrition Facts label of the package (see sidebar, “How to Read the Nutrition Facts Label”).

The best fats are polyunsaturated and monounsaturated fats from vegetable oils such as soybean, corn, canola, olive, safflower and sunflower. Polyunsaturated fat is also in nuts, seeds and fish.

The worst kinds are saturated fats and trans fats, which increase the risk for heart disease. You should consume less than 10 percent of calories from saturated fats, which are found in red meat, milk products, including butter and palm, and coconut oils. Common sources include regular cheese, pizza, grain-based desserts such as cookies, cakes and donuts, and dairy desserts, such as ice cream.

Processed trans fats are found in stick margarine and vegetable shortening and are often used in store-bought baked goods like pastries, crackers and candy and in fried foods at some fast-food restaurants.

To help you choose the right foods, MyPlate for Older Adults offers examples of good food choices and physical activities for older adults who want to stay healthy.

Sources

“Eating Well Over 50,” Helpguide.org

Nutrition and Aging,” Colorado State University Extension

“Malnutrition Threatens Many U.S. Seniors Seen at ERs,” August 13, 2014, Medline Plus



Eating Well: Best Diet for Older Adults was featured in the
November 2014 Senior Spirit Newsletter.

Blog posting provided by Society of Certified Senior Advisors
www.csa.us

Tuesday, January 13, 2015

Oldest-living Quadriplegic Advocates for Disabled

 
coffee break
 

Wally Dutcher’s accomplishments would be impressive for any one: serving on or starting various organizations that advocated for the disabled, running a successful business, designing his own homes as well as accessible sailing docks and starting a swim program for young people.

But the fact that Dutcher, 78, is the oldest living quadriplegic, according to the Guinness Book of World Records, makes his achievements even more noteworthy.

When Dutcher was 19, he had a diving accident in a pool while enlisted with the Navy. Far from being discouraged about the spinal cord injury that radically changed his life, the young man saw his accident “as a challenge rather than a defeat.” At that young age, “I didn’t know what was in store in the future.” He started an occupational therapy program with others. “You just learned to deal with it,” he says.

In his college years, he studied architecture, broadcasting and business, and was able to use all three skills, although probably not in the way he originally intended.

The St. Petersburg, Fla., resident’s design accomplishments include a bowling stick to help disabled bowlers; a prototype accessible workstation for the city’s libraries; accessible lecterns for the City Council Chamber; three of his own homes, using the principles of Universal Design, which focus on creating structures that will be adaptable to any need; and accessible docks for the Sailing Center in St. Petersburg, which are considered the finest small-venue accessible sailing venue in the world. “Of course, like most everything I’ve done, I didn’t know a thing about what was needed in the design [of the docks],” he says, and learned by observing the current platform that provided poor access for disabled who wanted to sail.

He used his business skills to manage several companies, including mutual funds and a cabinet manufacturer, leading it through its growth to become a 165-employee, $6 million company in 2½ years.

With his broadcasting skills, he officiated at swim meets around the state for 13 years. His young daughter could swim all four strokes as a young girl, but St. Petersburg didn’t offer a year-round program for swimmers younger than 13-14 years old who weren’t involved in high school swim teams, so Dutcher organized other parents and went to the city with a proposal. The result was a swim club that not only became the main resource for lifeguard staffing for the city’s six pools but a breeding ground for new swimmers who wanted to move into a year-round program. In the process, his daughter became a world class swimmer and received a four-year college scholarship for her efforts and achievements.

Dutcher accomplished all this, including raising a daughter with his wife, while in a wheelchair. He is able to feed himself, use the phone (with hand controls), type on a computer (using an adapted pencil to push down on the keys) and drive a van since 1981, when wheelchair-accessible vans first came out. This independence allowed Dutcher to start working.

His advocacy work for the disabled included helping start the National Paraplegia Foundation (now the National Spinal Cord Injury Association); helping start and serving on the St. Petersburg’s Committee to Advocate for Persons with Impairments; helping organize and manage the National Alliance of the Disabled, a virtual online national, cross-disability, grassroots organization; and organizing Caring & Sharing Center for Independent Living in St. Petersburg and serving on its Board of Directors.

Yet, he says, his proudest work in advocacy was pursuing a complaint through the Department of Justice for 11 years to get a 26-block stretch of a street in St. Petersburg more accessible for the disabled. “Every time I travel on it I get a smile.”

His honors include nomination by New Mobility magazine, along with notables such as Stephen Hawking and John Hockenberry, for the “Person of the Year” award; a profile in Roll Models: People Who Live Successful Lives After Spinal Cord Injury and How They Do It by Richard Hollicky; and the St. Petersburg College Alumni Association 2006 “Alumni of the Year.”

When Dutcher first attempted to educate the world about the difficulties of being in a wheelchair, it was before the Americans with Disabilities Act mandated accessibility. If you wanted to get into a restaurant or store that didn’t have accessible ramps or other modifications, you had to confront the owner, which Dutcher wasn’t afraid to do.

“I want to do business with you but can’t get in there,” he would tell the owner. Sometimes the business owner would figure something out, such as taking him through the kitchen or using the freight elevator. He remembers the staff of an Atlanta restaurant leading him through an emergency exit corridor, which was more of tunnel used for storage space and was filled with spider webs.

He told business owners that “’If you don’t want to [provide handicapped access], I won’t patronage your facilities, and I’ll tell the rest of my friends about it.”

Modest about his achievements, Dutcher says the biggest hurdle for him in being disabled is having to ask for help to do something he was able to do before his injury, like putting a charger on a car or opening up the battery compartment.

When Dutcher is asked what made him survive and thrive to become the longest-living quadriplegic, he first says that he’s only labeled such because his daughter submitted the documents, even though he knows of at least one other quadriplegic who exceeds him by 1½ years.

And, he says, he had an advantage that other disabled people didn’t: his Navy service reaped veterans’ compensation, which provided the wheelchair and an accessible van with air conditioning (important for those with spinal cord injuries who can’t afford to lose body heat). He can afford to live in a house he designed and has enough money to pay for caregiving, while other disabled people with less means end up in institutions. He points out that the government will pay for institutional care but not for caregiving or transportation that would keep them independent.

Yet, Dutcher is proud of the fact that he was able to pay back the generosity of taxpayers. He ran a company with 162 employees. “I paid taxes, people I employed paid taxes, bought things from stores that paid taxes. And the circle gets larger, like throwing a rock into water.”


Oldest-living Quadriplegic Advocates for Disabled was featured in the October 2014 Senior Spirit Newsletter.

Blog posting provided by Society of Certified Senior Advisors www.csa.us.

Friday, January 9, 2015

Meet CSA, Amy Carrick

Amy CarrickAs a college student, I wanted a job that would allow me to be independent and not worry about living paycheck to paycheck. I majored in Computer Science with a minor in Economics figuring these would be good financially. I had a heavy focus on Math as well. This led to a first career in banking with the Federal Reserve, Pittsburgh National Bank and Integra Financial (both now PNCBank). Then, a 15 year career at Verizon Wireless. I thought I loved my job!

About six years ago, I was laid off with a package. I didn't know what I wanted to do but knew it wasn't working in Corporate America. I thought accounting or web design but quickly realized I needed to differentiate myself.

At about this time, my parents needed more help, but I was the child 500 miles away. So I started to help pay the bills. I quickly realized I could make this my new career. I wanted more than to just spend a company's money to put lots of technology into a store. I wanted to give back to society. Seniors were a natural fit for needing help and for appreciating it!

After I got my first couple clients, I began studying for the CSA exam. I wanted a good foundation in aging and I knew I had none! I now am able to guide seniors and their families when safe living or health concerns arise. This can be uncharted territory and they are often panicked. I help build budgets and find the resources. I coordinate the team to bring a new normal to the chaos.

After obtaining my CSA designation, it took me a whole additional year to find the American Association of Daily Money Managers. Yes, there were others doing exactly what I was doing! I am now the first and only certified Professional Daily Money Manager® in South Carolina.

I currently coordinate the senior visitation team for my church and I regularly offer seminars to teach people about exploitation and how to protect themselves. The problems are rampant and I try to be a resource for families and seniors alike.

I have great satisfaction in knowing that those without family or where there are trust issues, can be confident that I will protect their financial affairs. It could be anything from recommending financial planners or attorneys to helping them find alternative housing choices. I get pulled in when exploitation is suspected. From there, I follow the case through to resolution which has included working with detectives and solicitors. It is very fulfilling to watch the client relax when they know money has been returned!

Every client is unique which means different needs and levels of involvement. Here are a couple examples:

  1. I have helped when a client died overseas. I had to figure out how to get luggage off a ship and back to the states. It was cumbersome and frustrating at times. But the client's wishes were to get the contents back, whatever it took.
  2. One of my first clients did not know her net worth or whether she had health insurance. She was recently evicted. I opened six years worth of mail to assess her situation. I found her a financial advisor and helped her find long term housing with stable meals and medicine management.
The key is knowing what they need, who is the support team and how to monitor without taking control. My level of involvement evolves over time. I enjoy each senior encounter. I have learned patience and listening skills along the way. I have learned how to be candid with a caring message.

People need to hear the tough answers but being able to provide solutions and work-arounds will defuse the stress of the changes they face. My world is now so different from building high tech stores and I really do love it!

Amy E. Carrick, MBA, CSA, PDMM
Owner, Carrick Consulting, LLC
For those who Can't, Shouldn't or Don't want to pay their own bills



Amy Carrick was featured in the November 2014 Senior Spirit Newsletter.
Blog posting provided by Society of Certified Senior Advisors www.csa.us.

Monday, January 5, 2015

Chinese Food to Go

Last night I spent an hour volunteering with an organization called Bessie’s Hope at a nursing home in downtown Denver. Walking onto the floor of the nursing home, the odor was definitely not sweet, the look was dated and the amenities were minimal. My assumption was that the patients had no means and were probably all covered by Medicaid.

Before we were to meet with the patients, there was a training we all went through so we would know what to do and say. I know some, if not all of us, felt awkward and uncertain. My volunteer group was lead into the living room where 13 patients were all seated, mostly in wheelchairs. 

Our facilitator, Linda Holloway, co-founder of Bessie’s Hope and granddaughter of Bessie, lead us through a series of introductions, songs, dances, questions to ask and be asked, all ending with a hug train and a snack.

This might sound corny, embarrassing and pointless, but nothing could be farther from the truth. I got to know John and that he was a crop farmer all his life, never had more than a couple years of high school, and was of German descent. Then there was Nancy who had the best sense of humor, and Paul who was from Boston and did not like to dance, but loved to toboggan in the snow when he was a kid.  Henry was a resident for only 2 months and was getting acclimated. He told me he loved to go sledding when he was a child and had grown up in Colorado. Henry has outlived all of his relatives and has no visitors. As I was directed through the program facilitated by Linda, I asked what his favorite Christmas gift was as a child and he replied that he did not have one. I decided to improvise and ask what would he like to get this Christmas and he said that he did not want anything. I asked, “What is your favorite food?” Henry’s face lit up and he said without hesitation, “Chinese, chicken chow mien”.

I held hands, danced, sang and gave hugs to all under the guise of doing something nice for others, but the reality is that they did something wonderful for me. 

It is a challenge to raise money for senior focused charities in the US. Senior causes do not look sexy, evoke cute, warm and fuzzy emotions, nor do they generate the public awareness that a natural disaster does. Charitable giving dollars go primarily to religious organizations, education and human services. Children’s charities have mass appeal to the general public, especially during the November/December holidays.

Let’s start to raise awareness about the charitable organizations who serve older adults from all over this country. Post your favorite senior focused charity from your area.
No one should be lonely, feel unloved, hungry, homeless or without proper medical care.  Our seniors deserve to be treated with respect and compassion. Consider taking one hour of your time and go visit an older adult who might not have any visitors. With their permission, take their hand, look into their eyes, ask them their name and then tell them yours. The rest is magic.

I think getting some Chinese food to go is in my future and Henry’s!

Judy Rough, CSA
Certified Senior Advisor
Board Member, Bessie’s Hope
December 16, 2014


Blog posting courtesy of Judy Rough, CSA
Provided by Society of Certified Senior Advisors

Monday, December 29, 2014

Figuring Out Long Term Care Costs

While most retirees say they plan on living out their years at home, a large percentage end up in assisted living or nursing homes. How much can you expect to pay for long-term care? A look at average costs and stays can provide a rough idea.


A lot of financial advisors warn that retirees aren’t financially prepared for a long future existing only on Social Security, that they haven’t saved enough, that medical costs will eat more out of their budget than they think and that they aren’t prepared for long-term care. Although most retirees say they plan to live out their remaining years at home, a large percentage end up in assisted living or nursing homes. In fact, according to the Centers for Medicare and Medicaid Services, a majority of people over age 65 will require some type of long-term-care services, and more than 40 percent will need a period of care in a nursing home.

Retirees or those about to retire who want to figure out what long-term care might cost them can make an educated guess, based, of course, on averages. The MetLife Mature Market Institute’s market survey for 2012 found that:

  • The national average daily rate for a private room in a nursing home is $248, while a semiprivate room is $222, up from $239 and $214, respectively, in 2011. That’s about $81,000 annually for a semiprivate room.
  • The national average monthly base rate in an assisted-living community rose from $3,477 in 2011 to $3,550 in 2012. That would equal $42,600 a year.
  • The national average daily rate for adult day services remained unchanged from 2011 at $70.
However, costs can vary widely depending on the state and region of the country where you live (see sidebar, “Differences among States”). It’s also important to remember that different states require—and different facilities offer— varying baselines of level of care, so one place might offer nothing more than three meals a day plus activities, while another facility includes providing medicines, for example, in its base rate. This is especially important regarding assisted-living, which is not federally regulated.

 
Differences among States
Average costs for long-term care vary widely by state and region of the country and by private versus semiprivate room. The MetLife Mature Market Institute’s market survey found the daily price of a semiprivate room could range from a low of $138 in Louisiana to a high of $678 in Alaska. In this sampling of state prices from around the country, it is important to remember that cities generally are more expensive than rural areas. While Illinois’ rate is low, for example, the Chicago area’s rate is much higher.
Alabama

$182
Arizona

$182
California

$235
Connecticut

$362
Florida

$223
Idaho

$199
Illinois

$175
Maine

$257
Nebraska

$163
New York

$344
Oregon

$228
Texas

$139
Differences by Sex, Marital Status

Long-term costs for long-term care also vary by sex and marital status. For example, single women, on average, live the longest in nursing homes. Below is a comparison of the average length of stay in a nursing home (from Long-term Care Association's 2008 LTCi Sourcebook):

Female

2.6 years
Male

2.3 years
Married

1.6 years
Single/never married

3.8 years
Widowed

2.3 years
Divorced/separated        2.7 years

Average Stays for Long-term Care

The average nursing home stay is 28 months, according to the government's latest National Nursing Home Survey (“How to Pay For Nursing Home Costs,” U.S. News & World Report). The average stay for assisted-living residents is 27 months, according to Kiplinger.com

Other organizations break down the long-term care figures differently (Alzheimer’s care, continuum of care). The National Clearinghouse for Long-Term Care Information makes it simpler. On average, a 65-year-old today will need some form of long-term-care services for three years, according to Kiplinger.com.

Figuring Out the Total Costs

To determine the average amount a person would have to pay for long-term care, you can extrapolate from the data:

  • Cost of semiprivate room in a nursing home for average 28-month stay: $186,480
  • Cost of assisted living (base level) for average 27-month stay: $95,850 
If the average stay is three years for long-term care, your long-term care costs would be some combination of those two figures. Of course, if you need more assisted-living care than basic care, the cost goes up. If you’re a woman, you will probably pay more because you will live longer.

Another factor to throw into the mix is the average age of residents in long-term care. The median age of residents in nursing homes was 82.6 years; in assisted living, 86.4 years, according to MetLife.

If you’re wondering if you will live that long, the Social Security Administration provides calculations. For example, a man reaching age 65 today can expect to live, on average, until age 84.3, while a woman turning 65 today can expect to live, on average, until age 86.6.

Where Will Money Come From?

A recent Wall Street Journal article (“10 Things Retirees Won’t Tell You,” Sept. 21, 2014) said that nearly 60 percent of people over 55 who haven’t yet retired have saved less than $100,000 for retirement. So where will an individual find the approximately $200,000 needed for long-term care?

While Medicare does not pay for assisted living, it will help pay for nursing home care for up to 100 days if certain conditions are met (from Senior Home):
  • A senior is currently receiving Medicare Part A (Hospital insurance) benefits and is therefore 65 years or older or has been formally diagnosed with renal failure.
  • An in-patient hospital stay of three or more consecutive days (three midnights) has been made within the past 30 days.
  • A physician has determined that skilled care and/or rehabilitation is medically necessary due to a current health condition.
  • The skilled services required are provided in a facility that has been certified by Medicare.

  • Specifically, Medicare will provide 100 percent coverage for skilled nursing costs for the first 20 days of a nursing home stay. From day 21 through day 100 of the benefit period, the patient is responsible for paying approximately $130 per day. At any time, if the patient is no longer making progress, Medicare will stop paying, because this is considered a rehabilitation, not long-term care benefit.

    Medicare also pays for care at home, involving skilled nursing care and therapy, although certain restrictions apply. Even paying for home care yourself is less expensive than nursing homes and assisted living.

    Another option is long-term care insurance, which pays for assisted living, nursing homes and at-home care. However, only 10 percent of the elderly have a private long-term care insurance plan (National Bureau of Economic Research). Other sources for long-term care financial help are Medigap (supplemental policies for Medicare) policies and/or veteran’s benefits, but these policies only pay 20 percent of the charges that Medicare does not pay.

    If people in need of long-term care don’t have the financial resources and/or don’t have a long-term care insurance plan, who will take care of them? It turns out that most (78 percent) who need some kind of care are being taken care of by family and friends.
    According to the Caregiver Action Network, “The value of unpaid family caregivers will likely continue to be the largest source of long-term care services in the U.S., and the aging population 65+ will more than double between the years 2000 and 2030, increasing to 71.5 million from 35.1 million in 2000.”

    For many older people, one strategy for long-term care might be to start investing in relationships with family and friends.

    Figuring Out Long Term Care Costs was featured in the November 2014 Senior Spirit newsletter.

    Blog posting provided by Society of Certified Senior Advisors www.csa.us.