Tuesday, June 30, 2015

Retiring Abroad: Look Before You Leap

Retiring overseas can be appealing in so many ways: a place where everything is cheaper, the climate is warmer and the culture is more relaxed. But it’s not for everyone. Adapting to a new culture and surroundings can be challenging.
 

Retiring overseas can be appealing in so many ways: a place where everything is cheaper, the climate is warmer and the culture is more relaxed. But it’s not for everyone. Adapting to a new culture and surroundings can be challenging. “Looking back on our planning and experiences, I've learned that dismantling your life and moving to another country is not for the faint of heart. In fact, it's one of the hardest things I've done,” writes one woman who moved to Costa Rica (Wall Street Journal).

However, the life she describes in this Central American paradise sounds like the one we all dream about:

“Besides doing normal household chores, my days are spent taking long walks, going to the beach (a 10-minute stroll), swimming in one of two local pools, napping, reading and corresponding with family and friends. We're blessed with wonderful neighbors, a mix of native Costa Ricans (called Ticos) and expats from Canada, Belgium, Germany, the Netherlands, Scotland, Spain, Italy, Singapore and the U.S. Especially during the dry season (November through March), parties ("fiestas") are plentiful” (Wall Street Journal).

But others have different experiences:

“I have been living in Chiang Mai, Thailand for six months now. Warm weather, very inexpensive, great food, friendly smiling people, and I am preparing to leave. There is so much good about this place that it has been difficult for me to finally admit that this is not the place I want to spend the rest of my life. I do not fit in. I will never ever learn to speak Thai. As good as everything else is I do not want to feel isolated from everyone else around me, so I have to move on. . . . There are many adjustments and cultural aspects to consider when making such a move and one never truly fits into a foreign culture, from my experience. As Americans, we are always thought of as fat cats by the locals and often targets of opportunities for them” (Top Retirements).

One of the more popular destinations for retirees is Panama, but “living in Panama can be challenging,” says Chris Powers, a U.S. Air Force veteran who runs PanamaForReal.com, one of the more realistic websites about the life of an expatriate (see sidebar). He estimates about half of relocated Americans and Canadians wind up disgruntled with everything from traffic jams in the capital city to the country’s omnipresent bugs (The Globe and Mail). One woman who lived in Mexico for several years says foreigners must adapt to different medical and legal systems, as well as new customs, new holidays and new expectations of polite conduct.

Questions to Ask Yourself

Before making a decision about moving abroad, make sure this is the lifestyle you want. The woman who moved to Costa Rica had several requirements:

“We agreed on 10 criteria in our search for a retirement destination: warm weather, a country with a stable democracy, a four-hour plane ride or less from the U.S., adequate and affordable healthcare, American-friendly, located near or by an ocean, clean and abundant fresh water, affordable housing, a cost of living at least 50% lower than in the U.S.—and good coffee” (Wall Street Journal).

What’s important for you, and what couldn’t you tolerate? Consider these factors:

Convenience. Do you plan to return often to the United States to visit friends and family, or do you want them to visit you? Being close to an airport is important. Similarly, if you need to be near a hospital, you’ll probably want to live close to a big city.

Culture. When you move to a foreign community, life’s daily rhythms are often different. If you don’t like waiting for service, you might not want to move to a country where life is slower. Do you like being in a different culture, or do you want to be around people like you? If the latter, you should find the right expatriate community to join.

Comfort and safety. Some countries aren’t as safe others, while some may be safer than life in the States. Research the security, crime and immigration laws for the country you’re interested in. Similarly, how stable is the government? Are the locals welcoming to foreigners? Are you comfortable in a country where English is not the native language? Are you willing to learn a new language? And don’t forget about climate hazards. Countries that are desirable for their beaches and ocean access can be vulnerable to hurricanes. Other geographies face danger from volcanoes or earthquakes.

Lifestyle. Do you prefer living near the beach or in a thriving town? Are good restaurants and shopping important? Are there certain sports you want to participate in? Do you enjoy the arts, going to the theatre or visiting art galleries?

Climate. Is your potential destination hot, humid or chilly? Does it have a rainy season that lasts several months? How does climate affect your decision? One couple who moved to the beach in Ecuador found it too humid and settled in the mountains.

Resources

The Internet offers a wealth of information about retiring abroad. But the best and most reliable advice comes from those who have actually done it. Expat Exchange is one forum for people around the world to write about their own experiences. Each county has its own forum, so you’ll find articles about countries’ different regions or cities.

Best Places to Retire Based on Climate and Culture

Some of the most popular countries for retiring are in Central and South America, but also Asia and Europe.

Mexico. With its low cost of living, proximity to the U.S. and with a wealth of places to choose from— colonial cities, beaches and resorts towns—this country south of the border is one of Americans’ favorite places to retire. For nearly a century now, Lake Chapala—in the middle of the country—has been home to a huge community of retired expats from the United States and Canada. Depending on where you live, the crime rate has risen to dangerous levels.

Belize. One attraction for retirees is that English is the official language in this Central American country. Belize is known around the world for its beautiful beaches and the ocean (with the second largest coral reef in the world), but if you’re not into water sports, the country may not offer enough.

Ecuador. Named as the No. 1 retirement destination by International Living, this South American country has geography that ranges from snow-capped volcanoes to Amazon jungle to Pacific beaches to the famous Galapagos Islands to sophisticated cities. In Ecuador the weather is always moderate: about 77 degrees Fahrenheit during the day and 50 at night. As one expatriate told International Living: “It’s like we are living in the U.S in the 1950s.” You’re guaranteed a quality of life that just plain doesn’t exist anymore in the States.”

Costa Rica. This Central American country has everything going for it: mountains, rain forests, ocean, volcanoes; a stable government (over 60 years of uninterrupted democratic rule); and modern cities. Costa Rica, however, has its share of violent crime and land title scams.

Panama. No. 2 on International Living’s list, Panama is the only country in Central America with a true First World city (complete with skyscrapers and opera). Unlike some other Central American countries, Panama is a stable democracy with a solid infrastructure, including good roads, an excellent electrical supply and Internet access. Most areas in the country are safe. Panama’s landscape is diverse, including mountains and beaches. (See sidebar for a first-person report about daily life, written by an American who moved there.)

Europe. For those who are drawn to the European culture, Portugal has a comfortable climate, fresh food, ocean beaches, ancient castle towns, fishing villages and a big city, Lisbon. Elsewhere in Europe, France has been touted as a good place to retire because of its excellent and affordable healthcare. While living in Paris is not cheap, some of the more remote parts of the country (and small towns) can offer good value.

Thailand. Thailand has some of the best beaches in the world, lush mountains, beautiful jungles and a laid-back culture. For these and economic reasons, thousands of foreigners have settled here—living everywhere from world-renowned resorts, metropolitan cities including Bangkok and in smaller towns.


Retiring Abroad: Look Before You Leap was featured in the May 2015 edition of Senior Spirit.

Blog posting provided by Society of Certified Senior Advisors


Friday, June 26, 2015

Retiring Abroad: Stretch Your Dollar

Many older adults are finding that their dollar goes further in other countries. Not only is healthcare cheaper, but so are housing and other necessities. While Central and South America's low costs and proximity to the United States have long attracted retirees, many are also heading to distant destinations such as Malaysia, Thailand and the Philippines.
 
 
 
Many older adults, especially those struggling to live on Social Security, are finding that their dollar goes further in other countries. Not only is healthcare cheaper, but so are housing and other necessities.

The number of Americans retiring abroad has increased over the years, by 307,000 from 2008 to 2011, according to Social Security Administration figures on benefit checks sent abroad. And, as many as 3 million U.S. baby boomers plan to retire abroad, according to trade publication the Travel Market Report.

While Central and South America's low costs and proximity to the United States have long attracted retirees, many are also heading to distant destinations such as Malaysia, Thailand and the Philippines. (See “Retiring Abroad: Look Before You Leap” in this issue of the Senior Spirit for a list of the more desirable countries to move to.)

Several countries in Southeast Asia are among the world’s least expensive places to retire. Savings can be found everywhere from the Internet ($12 per month in the Philippines) to rent, phone service, electricity, groceries and healthcare (from US News: Money ).

Even Western Europe, once considered too expensive for most retirees, has become more affordable in recent years, especially away from the major metropolitan areas.
 
Lower Cost of Living

Depending on the country of your choosing, your money can go five times as far as it can in the United States (Fine Retirement). Seniors who retire in countries with a lower cost of living than the United States extol the benefits of living overseas. “[Ecuador is great] for single women who can’t survive on paltry Soc. Sec. payments,” writes one retiree, and another in Ecuador reported that “we average $27 a month total . . . for gas, electricity, water, and trash pickup.” (Quotes from Huffington Post) and International Living.

Affordable Housing

Besides less expensive healthcare (see “Retiring Abroad: Best Countries for Healthcare” in this issue of Senior Spirit), housing prices can be significantly lower in many countries popular with retirees. In Mexico, you can find a nice three-bedroom villa near the beach for as little as $150,000 (Next Avenue). In Costa Rica, you can buy a lovely two-bedroom home on about an acre of land for $100,000-$300,000, according to one U.S. retiree (Wall Street Journal).

Bigger cities can be more expensive. In Panama, one of the more popular destinations for U.S. retirees, housing prices range from $1,415 a month to more than $3,200. However, in small towns, two-bedroom homes can rent for as little as $400 a month (from Panama for Real).

Other Costs

Depending on which country you choose, gasoline can be more expensive. For example, in Costa Rica, you can pay $5 -$6 a gallon. At the same time, many countries offer good and cheap public transportation, so, depending on where you live, a car may not be necessary.

Food costs are often lower if you buy local products. One woman who moved to Costa Rica reported she saved money on her food bill. “We spend about $50 a week on food (for two people). Native fare is rice and beans (about $2 for about two pounds), potatoes, yucca, onions, red peppers and carrots (about 25 cents each). For $1 you can buy three cantaloupes, or two avocados, or four mangos, or three oranges (in season), a watermelon, or a whole pineapple and enough fish to feed two. Two pounds of ground beef (86% lean) or boneless chicken cost about $4. On occasion, I'll splurge, paying about $6 for a bag of Cheetos or miniature chocolates” (from Wall Street Journal).

And you may have to pay far more for anything that needs to be imported, such as electronics or American food and clothing (Money).

Taxes and Other Financial Issue

If you decide to pack up your possessions and move abroad, be aware of financial issues.

Transfer fees. Although Medicare doesn’t travel, your Social Security payments do. Your benefits can be directly deposited to a U.S. bank account. However, foreign banks charge fees for transferring money and converting U.S. dollars to local currency, anywhere from $15 to $100 per transfer. This can add up quickly if you have regular transfers. Research which financial institutions offer the lowest transaction fees and best exchange rates.

Volatile currency markets. Fluctuating exchange rates could affect how much local currency you are able to purchase with U.S. dollars and play havoc with your monthly budget. To protect your budget, you could set aside extra money to compensate for money that you lose if the U.S. dollar weakens.

Taxes. If you’re still a U.S. citizen, you need to pay income taxes to the IRS, including federal and state (unless you establish a residence in a no-tax state ahead of your move). In addition, you’ll likely have to file tax forms in the foreign country in which you reside. However, dozens of countries have tax treaties with the United States, which help limit the effects of double taxation.

In addition, some countries impose heavy taxes aimed mostly at foreigners, for example, a large tax on the sale of your home. To partially mitigate the double-taxation burden, the United States provides a foreign tax credit.

Property. Some countries limit or even prohibit foreigners from owning property. For example, the Mexican constitution bars foreigners from directly owning property within 62 miles of any border and within 31 miles of any coastline (from Kiplinger).

If you want to buy property in these areas, you must do it through a trust that gives a bank title to the property. Make sure you know the ownership laws of the country you are moving to. (Avoid this problem by moving to one of three U.S. jurisdictions—Guam, Puerto Rico and the U.S. Virgin Islands.) Also, be aware that some foreign countries may not have the investment safeguards of the United States.

Travel. Don’t forget about the added expense of trips back to the United States, especially if you need to return often to see family and friends. Living in someplace like Malaysia can be very inexpensive, except when you start adding in the costs to fly back and forth to the States.

Finally, experts recommend that before you decide to retire abroad, check out your destination first by living there for a period of time. You can rent a home or apartment for a month or two, especially in the worst weather season, so you know the worst to expect. Renting will also permit you to get a realistic estimate of your personal cost of living before you make a long-term financial commitment. Do you consider air conditioning a nonnegotiable necessity? You'll pay more for it in South America, where electricity is generally more expensive than it is in the United States.
 
 
Retiring Abroad: Stretch Your Dollar was featured in the May 2015 edition of Senior Spirit.

Blog posting provided by Society of Certified Senior Advisors

Tuesday, June 16, 2015

The Upside of Aging, by Paul Irving

As aging industry professionals, we often find ourselves entrenched in day-to-day business
activities, striving to serve our clients better by keeping up with industry trends. Most of us are very familiar with the industry-specific resources or journals that help us keep track of the latest financial/insurance product, regulation, legal issue, clinical concern, or technology that will help us do our jobs better. One of the benefits of being an advisor is getting access to information that allows us to understand the bigger picture of “aging” outside of our industry sectors. We get an opportunity to learn from other aging industries and other CSAs how to improve and enhance our existing programs and services.


Reading The Upside of Aging, I was reminded that we continue to benefit our clients by staying connected to the big picture. What are respected leaders in the aging industry telling us? How can we help our clients approach aging from one of dependence and disability to one of productivity and potential? Which directions should we be encouraging and advocating for? This newly released book contains a collection of essays that provides creative solutions to a range of aging issues. As a recent review in USA Today states, “The 16 voices, from university deans to nonprofit heads, assembled in this book, weigh in with fresh and even contrarian looks at the positive impact of longer lifespans and the nation’s aging population.” (Hannon 2014). The fact that this book is edited by Paul Irving, president of the Milken Institute, encouraged me to place it on my priority list as a “must read.” The Milken Institute School of Public Health is a highly respected nonpartisan think tank dedicated to improving public health and aging across America. Milken’s report, Best Cities for Successful Aging (Chatterjee and DeVol 2012) is also referred to in this book and is one of my “go to” resources to help communities clarify criteria for advancing their aging services. As a result, in Upside of Aging, I expected to find some new thoughts and ideas which could be shared with my clients and help me to accomplish my business goals. 


I suspect that many of the themes in this book will be familiar to experienced professionals in the aging industry. However, having read a multitude of books on aging issues, it was a pleasure to find such positive perspectives supplementing these ideas. For example, in chapter four, Joseph F. Coughlin, Ph.D., founder and director, Massachusetts Institute of Technology AgeLab, promotes longevity as a gift, not a curse, encouraging aging as a “call to innovate.” He credits the seed of this knowledge to an experience growing up and hanging around with some older gentlemen in a fishing shop near a New York vacation home. According to Coughlin, these older friends, then in their seventies and eighties, taught him something more: learning, living, and laughing did not have to stop at any age. “The example of their spirited lives inspired me to combine my love of technology with institutional engineering to build a career devoted to living not only longer, but better (p. 148).”
 

Now that Professor Coughlin is seeing these innovations come to fruition, he suggests that the bigger challenge will be to determine how our society will deliver these innovations to support the wants and needs of older adults. Who will deliver these products, services and policies? He maps the innovation market as a cross-section continuum by answering the questions,  “Who Delivers Services” and “Who Pays for Services”with answers including the public sector, private sector, and public-private partnerships (p.192). Chapter three, “The Bold New World of Healthy Aging,” takes innovation to the health care sector. Freda Lewis-Hall, Executive Vice-President and Chief Medical Officer, Pfizer, Inc., states, “Breakthroughs from the world’s medical labs will help narrow the gap between our healthiest days and the end of our lives with a medical trifecta—data and diagnostics, new medicines and vaccines, and a surgery revolution—to help deliver the full promise of healthy aging.” Using her words, The doctor will always be in,” Dr. Hall suggests these innovations and directions will provide a good chance that the baby boomers will exceed their life expectancy.

Moving to a broader picture of the business industry in chapter five, “A Longevity Market Emerges,” reminds businesses that they need to adjust their selling from the youth market to their parents and grandparents who have the money and the clout. Dr. Ken Dychtwald, President and CEO of Age Wave, has emerged as a visionary and original thinker regarding the lifestyle, marketing, healthcare, and workforce implications of the longevity revolution. Representing 32 percent of the total U.S. population, Americans over fifty now have a combined annual income of over $3.9 trillion and control 77 percent of the total net worth of U.S. households—nearly $46 trillion of wealth. This vast market awaits. They don’t like to be thought of as old, and seek ways to postpone physical aging. Further dialogue focuses on the fifty and older interest in purchasing experiences—NOT things—and that older adults see themselves as ten to fifteen years younger than their actual age.


The wealth of knowledge and issues discussed in The Upside of Aging is meant to trigger conversation and transformation in the way we view aging. However, I suggest this conversation move to the next level and not only transform our views, but transform our industry. We, as aging industry professionals, have opportunities every day to make that happen. As I reflect on the chapters, it is clear that there are concepts being discussed that should be considered in the development of new products and services such as:
 

• cyclic life plans 
• personalized aging
• nutrigenomics
• the psychology of security and safety
• global aging
• digital health
• age-friendly workplaces
• serial mastery
• sagacity
• the new “Indian summer,” a gap year for grown-ups
• un-retiring
• vocation vacations
• LiLAs (lifelong learning accounts)
• boomer philanthropists
• live-work flexhouse
• visit-ability
• gerotranscendence
 

If you are a visionary and welcome the opportunity to explore new directions, The Upside of Aging should provide tremendous food for thought. •CSA

Erika T. Walker, MBA, MSeD, CSA, is owner and CEO of SAGE WAVE Consulting, LLC, in Greer, South Carolina. She conducts strategic planning with businesses and communities across the country to help them prepare for the growing aging population. She has served as director of the SAGE Institute, and director of geriatrics at Greenville Hospital system. Contact her at 864-313-9691, or visit www.sagewave.net. The Upside of Aging, by Paul Irving was recently published in the Winter 2015 edition of the CSA Journal. 


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

Thursday, June 11, 2015

Senior Centers: Their Relevancy and Impact on the Social Needs of Older Adults

Senior centers offer meaningful activities for a diverse group of seniors, and can be an important element in their lives. Staying relevant to a changing older demographic will be a challenge.



“We do not quit playing because we grow old, we grow old because we quit playing.”
 — Oliver Wendell Holmes

As the baby boom generation ages, the challenges of meeting their needs become more complex not only because of their numbers but also because boomers are a heterogeneous group. 

Senior centers have developed over the past half-century based on different models and different missions. These multipurpose centers have evolved into places where older people can improve or maintain many aspects of life all in one place. They not only offer meaningful activities that promote successful aging for a diverse group of seniors, but also provide an important source of referrals, which keeps them connected to the community. However, this very diversity has also created debate over what functions senior centers best perform. On one hand, they provide services for those in need; on the other hand, they provide recreational activities for people who are healthy and economically self-sufficient (Krout 1989). This has led to the question of which services are most needed and which populations should be the focus of programs and services.

This article offers information about senior center participants and reinforces the important role of senior centers in providing activities that promote successful aging. The findings come from a previous study that examined various aspects of participation in senior centers. Specifically, the study investigated who participates, how different people used the center in various ways, and explored what participants gained from attending. Senior center attendance can be viewed as a continuum, ranging from limited activity to intense involvement (Ferraro and Cobb 1987; Krout 1988), which not only varies across individuals but for a given individual over time. From a multi-method approach—
participant observation, interviews, and surveys—it was found that a senior center can be an effective institution if it creates a unique space and an unordered approach to activities on a continuing basis. This allows different types of seniors to benefit, regardless of their health, economic situation, and level of involvement.

The Belongingness Hypothesis and Why Senior Centers are Still Relevant

Baumeister and Leary (1995) offer one supposition as to why older people might desire enhanced activity to develop and maintain friendships. Their belongingness hypothesis argues, “human beings have a pervasive drive to form and maintain at least a minimum quantity of lasting, positive, and significant interpersonal relationships (p. 497).” The two features that fulfill this drive are frequent personal interactions with others, and interactions that are temporally stable, including concern for each other’s welfare. Further, they found the lack of belongingness is “linked to a variety of ill effects on health, adjustment, and well-being (p. 497).”

The literature on benefits of social interaction for older adults touches on this subject. Research has consistently found there to be a positive association between social relationships and well-being ( Pinquart and Soerensen 2000; Street et al. 2007; Burge et al. 2007; Stevens et al. 2006; Tomaka et al. 2006). More specifically, findings suggest that friendship is an important predictor of well-being for older people because it helps alleviate feelings of loneliness and keeps them from being socially isolated (Aday, Kehoe, and Farney 2006; Payne et al. 2006). Therefore, if social relationships are important predictors of well-being, and tend to decline over the life course, it is important to understand how older adults deal with the changes that affect their ability to age successfully.

Senior centers can offer a place for social interaction on many different levels, including involvement in activities and classes, or through volunteering. In addition, because there are different levels of social involvement, various types of people can fill their need to socialize, whether they are retired and looking for a new community, are still working but want to meet people and learn new skills, or have never worked and enjoy the social camaraderie through the activities. Finally, a senior center can provide a place for those individuals who want to interact with peers who share similar interests, experiences, and beliefs.

Leisure Activity Promotes Successful Aging

The concept of successful aging suggests that both cognitive and behavioral factors can be used to optimize the health of older adults and assist them with adapting to change (Kahana and Kahana 2003). More specifically, successful aging includes the ability to maintain a low risk of disease and disability, high mental and physical function, active engagement with life, and be continually challenged. In general, successful agers are those who focus on things that are meaningful and important to them (Beisgen and Kraitchman 2003).

Leisure activity can be an important behavioral factor that has the potential to optimize health and well-being of older adults (Payne et al. 2006). Earlier studies of leisure examined effects on health, life satisfaction, and psychological well-being. Multiple studies found that the higher the frequency of participation in leisure activities, the higher the life satisfaction (Bevil et al. 1993; Hawkins et al. 1992; Payne et al. 2006).

Other studies examining specific types of leisure activities provide greater insight into understanding what types of activities affect psychological well-being. Brown and colleagues (1991) reported that improved well-being was significantly related to social, informal, household, and outdoor activities. Similarly, Dupis and Smale (1995) found that activities such as personal hobbies, crafts, social contact, and swimming were significantly associated to higher ratings of psychological well-being. Guinn (1999) found that older adults who participated in activities that allow self-expression enable them to help others, provide social interaction, and exhibit increased well-being.

Research has consistently found that multipurpose senior centers provide an ideal environment for leisure activities (Aday et al. 2006; Beisgen and Kraitchman 2003; Cambell and Aday 2001; Fitzpatrick et al. 2005; Turner 2004). They offer a wide range of social, health, and educational activities for their participants that provide opportunities for them to age successfully. Therefore, it is important that senior centers continue to provide diverse programs that can maximize the benefits of the participant.

Who Participates in Senior Centers?

It is essential to know the characteristics of the general older adult population. By knowing who they are, senior centers can then serve them effectively. Each cohort shows certain inclinations of a lifestyle that are particular to the influences that shaped their formative years. More specifically, these preferences shape the interests, needs, and behaviors of what participants will want from a senior center (Beisgen and Kraitchman 2003).

The social agency model suggests that senior center programs were designed to meet the survival needs of the more disadvantaged individuals, who are more likely to need and use the senior centers. The voluntary organizational model suggests that senior center activities offer opportunity for self-expression and recreation, and thus, are more likely to attract participants who are self-sufficient and more active in their communities (Schneider, Chapman, and Voth 1985). Studies consistently find that both models play a role in senior center participation. The social agency model is more likely to be associated with lower income participants who attend more frequently and primarily for social needs. The voluntary organization model is most likely to be associated with higher income participants who attend for longer durations and mostly for recreational activities (Ferraro and Cobb 1987; Fitzpatrick et al. 2005; Jirovec et al. 1989; Krout 1988; Sabin 1993).

Local samples often have distinct personalities and characteristics depending on the place. Therefore, results from one senior center may not be representative of the broader population. Despite this, by knowing who the typical participants are in an area allows for the senior center to provide appropriate services and programs that are specific to that population. 

Variation in Levels of Participation

The different levels of participation are measured by frequency, duration, stability, and amount of activity involvement (Krout 1989). The frequency of senior center attendance refers to how often an individual attends the center.

There are three different variables that measure duration of attendance. First, is how long the participant has been attending the center, measured in terms of months. The second, measures how long they usually stay at the center each visit. The third variable measures how long they usually socialize with others at the center when not in an activity.

Stability of attendance refers to changes over time in the frequency of attendance—whether the level has stayed the same, increased, or decreased. Amount of activity involvement refers to the number of different activities a participant is involved in at the center.

Overall, there is a large amount of variation in the frequency, duration, stability, and amount of activity involvement at senior centers. The levels of involvement continuously change depending on the types of activities that are offered at the center, the availability of the participants, and what the participants want to gain from attending activities at the center.

What Services Matter and What Do Participants Expect to Gain?

Services provided that are deemed important, and specific gains from attending senior centers vary by participant. In terms of service information, the survey asked how important it was that the senior center provides the participant with information about specific services (health care coverage, where to get legal help, employment opportunities, nutritional advice, social services, transportation services, volunteer opportunities, long-term care, home services). Respondents’ replies suggested that information about the following services is considered to be important to them: health care coverage (65 percent), where to get legal help (60 percent), nutritional advice (60 percent), volunteer opportunities (54 percent), and long-term care (50 percent). Overall, there are four services in which information from the senior center is not important to the participants—employment opportunities, social services, transportation services, and home services.

The various types of gains are grouped into five categories—social, psychological support, physical health, activities, and spirituality.

Social factors include making new friends, belonging to a group, and maintaining friendships while at the center. All three areas are important to the participants: 86 percent feel it’s important to make new friends, belonging to a group is important to 84 percent of the participants, maintaining friendships is also important to 79 percent of the participants.

Psychological support consists of bereavement, relaxation, support with problems, and improving mental health. Out of these four factors, relaxation (85 percent) and improving mental health from attending activities at the center (70 percent) are considered important to the participants. Bereavement (59 percent) and support with problems while at the center are not important to participants (53 percent).

Physical health includes improving physical health, staying physically active, and eating healthy meals. Of these, staying physically active (84 percent) and improving physical health (79 percent) are important to the participants. Eating healthy meals at the center is a close split with 51 percent considering it to be important and 49 percent saying it is not important.

Activities consist of learning new ideas/skills, having fun, someplace to go, and keeping busy. All four areas are important to the participants: 94 percent want to have fun when at the center, 87 percent are interested in learning new ideas/skills, 75 percent like having someplace to go, and 73 percent use the center as a way of keeping busy. 

Spirituality includes helping with spiritual beliefs, and 70 percent of the participants did not think it is an important part of the senior center.

The top five things people want to gain from participating at a senior center are having fun (94 percent), learning new ideas/skills (87 percent), making new friends (86 percent), relaxation (85 percent), and belonging to a group (84 percent). However, 50 percent or more of the participants say that all of the factors listed are important except for “support with problems,” “bereavement,” and “helping with spiritual beliefs.” These results illustrate that they want to gain different things when attending the senior center and involvement at the center can benefit them in various ways by providing a large assortment of activities. 

The findings regarding services that actually matter to participants, and knowing what they expect to gain, have significant value for professionals in the field. For policy makers, this data can provide important information about how they can effectively continue to support the senior population (Krout 1988, 1989). It can also assist practitioners in identifying needs of participants, and thus facilitate the selection of appropriate programming and staffing for the future. 

With the baby boom generation now entering retirement age, ideas of what a senior center should include will change. Therefore, senior center professionals will need to continue to study who these participants are and why they participate. In addition, they will need to be able to respond to the interests of current and future participants by continuing to develop and change as this generation grows older. Advances in our understanding of senior center participation are necessary, not only if we want to continue to appropriately serve current participants, but also to attract new ones. •CSA


Lisa A. Rill, Ph.D., received her doctorate degree in sociology at Florida State
University (FSU). Her specializations are health and aging. Dr. Rill currently works as
a research associate at the Claude Pepper Center at FSU, where she conducts research on various aging topics. She can be reached at drlisarill@gmail.com.

Senior Centers: Their Relevancy and Impact on the Social Needs of Older Adults was published in the Autumn 2013 edition of the CSA Journal. 

Friday, June 5, 2015

Stories That Inspire: The Senior Pops Orchestra: Finding Harmony in Long Island



Grassroots efforts often lead to improved quality of life. Many benefit from the vision of a few. Two local musicians from Long Island had a vision back in 1979 and the community has benefited ever since. The Senior Pops Orchestra of Long Island was created as a vehicle for senior citizen musicians to express their lifelong musical creativity, bringing entertainment and culture to the Long Island community.

The sixty-member volunteer groups’ mission—To bring the Joys of Music to the Senior Community and the community at large free of charge—has evolved into an intergenerational orchestra with musicians of every age. Retired music teachers and musicians retain a quality of life by engaging in creative activities and sharing their talents with the community. Ranging in age from twenty-something to octogenarians, they express an “amazing connection even though they may have thirty years between them.” Older members bring years of incredible experience and younger members bring a sense of vitality. Evelyn Carlin, a cellist, applauds the orchestra for its support after her husband died in 1991. “It saved my life and became a part of my social life.” She holds the distinction of being with the orchestra the longest—thirty years. 

Eleven months of the year, the Senior Pops Orchestra meets every Wednesday for practice. Committed to professional-level music and playing a dozen free concerts at Long Island parks, the membership comes with a priceless bonus: a supportive community. According to hired conductor, Stephen Michael Smith, “The musicians check in with each other, let people know at rehearsals if someone is sick, and watch out for each other.” Smith says he is not only proud of the orchestra’s sound, but inspired by the players who produce it. 

Even with recent setbacks due to a fire in December 2013 at their rehearsal site, the orchestra continues to thrive. Losses estimated at $43,000 included the group’s inventory of percussion instruments, a digital piano, and musical arrangements dating to 1979. Insurance and community support helped them to bounce back. Long Island’s Senior Pops Orchestra is a great model of a grassroots effort germinating into a field of great experiences. Watch the following video and check out www.seniorpops.org for more information on the Senior Pops Orchestra. •CSA

VIDEOLINK: http://www.newsday.com/long-island/nassau/music-lovers-bandtogether-in-senior-pops-orchestra-1.5317043

VIDEOLINK: http://seniorpops.org/Members.html

Erika T. Walker, MBA, MSeD, CSA, is owner and CEO of SAGE WAVE Consulting, LLC, in Greer, South Carolina. She conducts strategic planning with businesses and communities across the country to help them prepare for the growing aging population. She has served as director of the SAGE Institute, and director of geriatrics at Greenville Hospital system. Contact her at 864-313-9691, or visit www.sagewave.net.


Stories That Inspire: The Senior Pops Orchestra: Finding Harmony in Long Island was recently published in the Winter 2015 edition of the CSA Journal. 


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

Wednesday, June 3, 2015

The Spirituality of Money: Understanding the Meaning of Prosperity and Abundance

How people think about money determines whether or not they achieve prosperity.


Once upon a time, there were three things people didn’t talk about in public—money,
religion, and politics. So let’s talk about one of them. Money. Money brings up so many emotions and beliefs for so many people. Many years ago, a survey was conducted by the University of Michigan that in essence, wanted to know what effect money had on people’s lives. There were three major findings:

1. What do people worry about the most? Money!
2. What makes people the happiest? Money!
3. What makes people the unhappiest? Money!

The common denominator in all of these is the way people think about it. Author Criss Jami says, “Ultimate prosperity is one’s value within. It takes a man of depth, morality, and charm to be envied yet without a sign of wealth or romance. A passion to prove such inner worth is his permission to achieve whatever he desires.” He is right. Ultimate prosperity is one’s value within. It is our energy and thinking around money that matters most, and creates it or doesn’t. 

If you constantly think about what is lacking in your life, you tend to solidify that belief system and thus fulfill the very thing you don’t want. Your faith is based on your belief about life, God, and money. So if your energy around money and finances is always about lack, then you will tend to create that in your life. Faith is based on your values and belief. Religion is the system you choose to express that faith. 

I recently taught a class in my church community on prosperity, based on the book, Spiritual Economics by Eric Butterworth. The author’s premise is that money is energy, and is based on your thoughts about it. I asked the class one simple question: “When I say
the word money, what feeling or thought comes to mind?” The first answer given by a student was, “Never enough.” Others shared such thoughts as: hard to get; those who have it get more; I have always been poor; and fear of not being able to pay bills. And one student said, “Money is based on my thought that if I think I can’t have or get it, so it is!” The majority of the class participants were older adults. You could feel the energy of fear, worry, and anxiousness in their responses. One in the group said, “I am worried about outliving my money.”

Some people think that it is a sacrilege to talk about money in a spiritual context. They are quick to quote Scripture: “Money is the root of all evils.” Actually, this is the most misquoted of all biblical passages. What Paul really said is, “The love of money is the root of all evils” (1 Timothy 6: 10). Money is innocent. It is the love of money, the mind set in which you use money, that’s the cause of much limitation.

But you could turn it around and say that the right attitude toward money is the root of all kinds of prosperity. It is just such misquotations of the Bible that give rise to the confused dualism about money in the religions of the Western world. On the one hand, riches have been condemned as dangerous to our spiritual growth. On the other hand, churches need money for their support and have welcomed the affluent—both subjecting them to sermons about the evils of wealth, but expecting them to make the substantial gifts that subsidize the church’s programs. How can money, at one and the same time, be a sought-after necessity of life and yet be the handicap to one’s spiritual growth? How can money be evil when no one can do without it? 

What is Money?

So then, what is money? Economists have had trouble defining it other than in terms of the function it performs. British economist Sir Ralph Hawtery says:

“Money is one of those concepts, which like a teaspoon or umbrella, but unlike an earthquake or a buttercup, are deniable primarily by the use or purpose in which they serve. Money is not real wealth at all. Rather it is a device for measuring wealth. Money is an enabling symbol. It is a tangible representation of intangible universal substance, which enables you to provide food, shelter, clothing, entertainment, books, leisure, and security against want. How does it do this? You do not build your house out of paper dollars and you don’t eat coins.”

Money is an enabling symbol that gives rise to faith and trust, credit and cooperation, which starts the flow of activity. Round and round it goes in a system we call the economy. But in back of all of it comes the basic substance of life, harnessed and directed by the activity of faith. 

Money passes through your hands many times a day. It may be little if you should happen to be on welfare or living on social security, or it may be millions if you are a person of wealth. But you are constantly buying and selling and earning and spending. Money is an extension of the person who uses it. Your thoughts and feelings color it, making it filthy lucre or blessed divine substance. If you think positively and creatively about your money, you actually multiply its effectiveness. If you criticize and depreciate it, you actually tend to dissipate and repel it.

An affluent businessman and friend once told me that prosperity is a way of thinking and being—not something you get. Affluence literally means abundant flow. My friend and I think differently about money. I was raised in a poor family with a clear message that we did not have enough to go around and that people with money were somehow bad. My friend was not that way. When I asked him about his affluence, he said, “I expose myself constantly to wealthy ideas—think prosperity, think substance, think affluence. I have learned that my life will be influenced for good or ill by the kinds of thoughts that rule my mind.” So I got busy looking and taking an inventory about how I think, feel, and believe about God and money and it has made all the difference. I believe that God wants us to be prosperous and happy. We are born to be rich or inevitably to grow rich by the use of our faculties. Lack and limitation of any kind are aberrations in an opulent Universe. Any person who is lacking is in some way living in opposition to the Universal flow!

Charles Fillmore, co-founder of the Unity School of Christianity, said, “It is a sin to be poor. When we establish ourselves in the consciousness of God, the whole Universe moves to flow into us with its abundance of life and substance.” The spirituality of money is not just about having things. Author and motivational speaker, Wayne Dyer, puts it this way. “When you are able to shift your inner awareness to how you can serve others, and when you make this the central focus of your life, you will then be in a position to know true miracles in your progress toward prosperity.”

Thoughts and Attitudes about Money

The word prosperity comes from the Latin root that literally translates as “according to hope” or “to go forward hopefully.” Thus it is not so much a condition of life as it is an attitude toward life. The truly prosperous person is a fully functioning person. Prosperity is a way of living and thinking, and not just about money or things. Poverty is a way of living and thinking, and not just a lack of money or things. We have been erroneously conditioned to believe that our lives are completely shaped by what is happening around us and to us. But life is lived from within-out. It is not what happens “out there” but what we do or think about what happens. How you think and feel about the economy in general and your financial affairs in particular will unvaryingly determine what you experience.

Thinking this way eliminates using fear tactics about money with an older adult. Some financial professionals use fear in their selling of products and services, with comments such as “If you have a major illness you are going to run out of money.” God responds
according to your feeling and thinking about money. So if you are having negative feelings around money and prosperity, God can only work through what you think and feel. The biting truth is that God will make you prosperous and successful in all ways if you do
not make it too hard for Him. We have often done an injustice by creating God as a judgmental being who gives wealth and blessings to some and not to others. God is not a being with qualities or attributes, but is rather the good itself coming into expression as life, love, power, and wisdom.

God is the allness of ever-present substance in which we live, move, and have our being. And this is the subtle but vital important key on which the entire structure of spiritual economics rests. The word substance comes from the Latin substare, which means
“stand under.” There is a substance standing underneath everything. We are not just acted upon by God, but we are the activity of God expressing life. Faith doesn’t influence God “out there” to send riches to fill our needs “down here.” Faith is the spiritual capacity by which we may form and shape this ever-present basic element of Spiritual Substance. 

In a challenging economy, we sometimes think that  money somehow disappears. You could lose all your assets in a financial crisis, but you can never lack substance. Those who keep consciousness that the Divine flow is ever centered within them, have faith that limitless substance will find expression through them in the form of creative ideas, ingenuity, the will of work, and the security of work opportunities. That is an economy that never goes away. I believe that the Universe owes you a living. You are a creative expression of the Universe with the responsibility to let it shine. Although the world owes you nothing, you owe the world a life. But in all the many ways in which you apply
yourself to the world, the Universe owes you complete support. Your fortune begins with you. You are a living magnet, constantly drawing to you the things, the people, and the circumstances that are in accord with your thoughts. As professionals, we must remember
how powerful we are when we put our minds to it. Whatever your needs may be, the answer is not to get God to give you more through some Divine sleightof-hand process, but rather to uncover and release yourown concept of prosperity.

Life is not a game of chance Your fortune is not influenced by caprice. It is determined by the shape of your consciousness. Money, prosperity, affluence, and God meet in one place,—your heart and mind. The great writer, Henry David Thoreau, said, “If one
advances confidently in the direction of his dreams, and endeavors to live the life which he has imagined, he will meet with a success unexpected in common hours.”

The secret of true prosperity is finding our security through our connection with the spiritual world. Advisors will encounter seniors with fears about money and their assets. Advisors can alleviate their clients’ fears by helping them understand that their thinking
sets the stage for their prosperity. Billy Graham stated it well: “If a person gets his attitude toward money straight, it will help straighten out almost every other area in his life.” •CSA

Norman Bouchard is a much sought after international author, educator, and speaker. He is also the former vice president of the Society of Certified Senior Advisors, and is a minister with United Centers for Spiritual Living.

The Spirituality of Money: Understanding the Meaning of Prosperity and Abundance  was published in the Autumn 2013 edition of the CSA Journal.

Wednesday, May 27, 2015

Retiring Abroad: Best Countries for Healthcare

As many seniors think about retiring abroad, a big concern is how much they will have to pay for quality healthcare. Fortunately, certain countries provide healthcare that is less expensive than in the United States but often just as good.


As many seniors think about retiring abroad, a big concern, especially for those with fewer resources, is how much they will have to pay for quality healthcare. Fortunately, certain countries provide healthcare that is less expensive than in the United States, but often just as good. Often these countries’ doctors have trained in the United States, and hospitals commonly offer the same high-tech equipment and cutting-edge treatments.

Most of these retirement-friendly countries have a two-tier health system. The public government-subsidized side, available to both citizens and foreign residents, is low cost. But even the private healthcare system is less expensive than in the United States. In fact, costs are so low in some places that foreign residents simply pay out of pocket. In others, residents mix and match public and private systems to get the most for their dollar. Some countries require an immigrant to show evidence of adequate funds before moving to the country, but each country differs, so check the country’s immigration website.

Traveling? Remember your medical records, prescriptions and insurance

For those who are traveling rather than retiring overseas, it’s best to be prepared. If you have a medical condition and run out of your prescription, will a foreign pharmacy be able to fill an American prescription? If you have an accident and need to see a doctor or go to the hospital, do you know how your insurance will cover that?

Here are some suggestions when planning for your trip:
  • Travel with your daily medications, not in the pharmacy container, but in a day-to-day container. Take enough for a few days in your carry-on luggage and put the remainder in your suitcase. 
  • Take a list of all your medications. Include the dosage, when you take it and for what condition. Include over-the-counter drugs and any herbal supplements. 
  • Make a comprehensive list of procedures and/or surgeries that you have had. 
  • List your allergies and reactions. If you require a procedure that uses an intravenous dye, shellfish is an important allergy to note. 
  • Tell your medical insurance carrier that you are going out of the country. They will give you specific instructions in case something happens, along with an international phone number to call. Keep this information close at hand with your medical lists/records.
  • Write down phone numbers for physicians and emergency contacts. 
  • File a HIPAA release form with a family member or friend, so if you become seriously ill while traveling, they would be able to obtain information or act on your behalf.

These suggestions are a proactive approach to travel, and if something unexpected happens, they become vital.


Contributed by Margaret Dutcher, RN, CSA
Best Places for Healthcare

International Living asked experts to score healthcare in countries that are popular with expatriates. For its 2013 Healthcare Survey, the organization first wanted to know what is available and if the hospitals are modern, well-equipped and affiliated with well-respected international hospitals. Is there a good network of clinics? Can you find the drugs you need? The survey also looked at the quality of care and how well the staff is trained. Do the doctors stay on top of the latest treatments? Will you find the right specialists? How long will you have to wait for appointments? Does the country have national standards for accepted practice? Finally, the survey asked about healthcare costs. Based on its research, International Living offered its choices for countries with the best healthcare:


Costa Rica. Healthcare here—in both the public and private systems—is considered among the best in Central America. The cost forCaja, the country’s universal healthcare system, is determined by your income but generally only runs $30 to $90 per person per month, which covers everything from prescriptions to doctor visits to testing to surgeries. The public health system has a large network of clinics and hospitals throughout the country. But while emergencies are treated right away, wait times for routine procedures can be up to several months. As a result, many expatriates use a combination of the public and private healthcare systems. In the private system, wait times are practically zero and doctors are very accessible.

The costs for most procedures are as little as half the U.S. rate. A visit to a general practitioner can run $50 to $60, for instance, and $80 to $100 to see a specialist. House calls are an extra $20 to $30. While the rates are low enough to pay out of pocket, you can get low-cost private insurance through the government-affiliated Instituto Nacional de Seguros. Annual premiums are in the low $2,000s for those aged 55 to 65, up to the $5,000 range for those aged 76 to 80. Several hospitals are affiliated with U.S. hospitals, and many Costa Rican doctors were trained in North America and speak some English.

Malaysia. Considered one of the world’s busiest medical-tourism hot spots, Malaysia’s quality of care is equal to or better than care offered in most Western countries. Malaysia has seven internationally accredited hospitals, and doctors usually speak English. Because Malaysia has no medical schools, doctors are trained overseas, usually in Europe, Canada, Australia or the United States. A check-up at the doctor’s office costs $16, the same price as a house call. Visiting a specialist can cost as little as $4—usually it’s $16. A hip replacement that costs $80,000 in the U.S costs $20,000 in Malaysia. A facelift that is $20,000 back home costs $4,000 here. And a serious operation like heart surgery, which can set you back up to $180,000 in the States, is around $14,000 here.

The state of Penang, one of the most developed and economically important states in the country, as well as a thriving tourist destination, has six government hospitals and nine private hospitals. National health-insurance plans charge premiums of about $400 to $1,000 a year per person, and private health insurance is also available.

Panama. Panama boasts the best healthcare in Central America. Many specialists speak English and are affiliated with international medical associations. Panama City’s “big four” major hospitals are all affiliated with U.S. hospitals. Punta Pacífica, the newest of the “big four,” is affiliated with Johns Hopkins and is Latin America’s most advanced facility.

Most medications found in the United States are available in Panama. An inhaler that costs more than $50 in the States is $7, and no prescription is needed. Although Panama has a public-health system, inexpensive local insurance provides low-cost access to the city’s first-rate hospitals. You can also get hospital-membership plans that offer substantial discounts on everything from consultations to surgeries. Membership costs vary, but they are generally less than $150 a month for a couple.

France. France’s universal healthcare system, in both the public and private systems, is excellent and affordable. The public side pays around 70 percent of most medical costs, including doctor’s visits, hospital stays and lab tests. Most French residents also buy insurance through a private insurer, called amutuelle, to cover all or part of the remaining costs. Foreigners must show proof of health insurance to get a residence visa for France.


In the public system, expect to pay about $45 to see a doctor and about $78 to see a specialist. A private hospital will cost approximately $156. Waits to see a doctor or specialist in France aren’t usually more than a week or two, though it depends on the hospital and the procedure you need. Mutuelle coverage normally costs 50 to 100 euros a month per person.

Uruguay. This South American country offers high-quality, affordable healthcare. Medical equipment is modern, and doctors are highly trained—in the country but also in the United States, Germany and Brazil. Although a public healthcare system is available, most choose a hospital plan called a mutualista, in which you become a member of a hospital and go there for all your healthcare needs. You make monthly payments to the mutualista and also pay a small co-pay when you see a doctor or have a medical test. One hospital’s $185-a-month healthcare plan requires only a $7 co-pay for a doctor visit or physical therapy session.

One drawback is that most of the staff and many doctors in Uruguayan hospitals speak only Spanish. On the plus side, it’s easy to find good medications, both generics and brand-name drugs. Medication costs depend on your hospital plan; many offer a 50 percent discount.

Mexico. Mexico has both a universal healthcare system and private healthcare. The public system has clinics, hospitals and pharmacies all over the country. However, the quality of the facilities can vary, and wait times can be long. But the top rate is only $300 a year or so, and all treatment is free—including prescriptions. Doctors in the public system are less likely to speak English well.

In the private system—especially in the larger clinics and hospitals—many doctors speak fluent English and were trained in the United States, Canada or Europe. Many private hospitals are affiliated with hospitals abroad. In fact, at least two U.S. hospital groups own hospital chains in Mexico. There are also several excellent Mexican chains, whose hospitals are modern, well-equipped and much less expensive than their U.S. counterparts. A healthy individual of 60 or so should expect an annual premium of about $2,500-$4,000, depending on deductibles and other factors. At Mérida’s Star Médica hospital, a mammogram cost $60 (out of pocket) and a bone-density scan was $80.

Ecuador. Expatriates praise Ecuadorean doctors who “put the patient first” and take time with their patients—up to 45 minutes for an office visit. In Ecuador’s major cities—Quito, Cuenca and Guayaquil—English-speaking doctors are fairly common, because many have gone to medical school in the United States. These three cities are also where you’ll find Ecuador’s most modern hospitals and most of the medical specialists. Costs are low—about 10 to 25 percent of what you’d pay in the States. For major surgeries, the cost is often less than 10 percent. While most healthcare consumers pay out of pocket, health insurance is available, and private hospitals offer health plans. Ecuador also has a public healthcare system, which does not allow choice of doctors and you must sometimes wait weeks for appointments. However, coverage is comprehensive, with no deductible.


Retiring Abroad: Best Countries for Healthcare was featured in the May 2015 edition of Senior Spirit.

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