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Wednesday, January 30, 2013

CSA Conference: A chance for aging businesses to catch up on cutting edge research while networking

As owner of SAGE WAVE Consulting, LLC, I have worked across the country helping communities, healthcare, government and businesses to develop strategic plans preparing for the growing aging population.

Being a business owner and having worked across the aging industry, often you, as an aging service provider, have little to no “free time” to keep up with the most current research. Trying to keep your head above water by building clients while maintaining high-quality services is enough to exhaust any dedicated professional!

So, how do you locate and learn respected aging industry research that can help you do your job better? The upcoming CSA Conference: “Building Knowledge and Empowering Networks” (August 7-9, 2013 in Orlando) will help you do just that during a session titled “The Top Aging Industry Research Reports of 2013: Don’t Have Time to Read All the Industry Research? Here is the Condensed Version". The goal of this session is to share as much research as possible and leave you with summaries, links and resources for you to take with you and apply to your needs.

Using the “IGNITE” format (quick, attention-grabbing presentations), this interactive session presented by a panel of cross-industry professionals will summarize critical aging industry research CSAs need to know. Keeping up with current research is imperative in my line of work…whether it be a report from the Kaiser Family Foundation, Met Life Mature Market Institute, AARP, NIA, AoA, ASA, N4A, AGS, GSA, Leading Age, HCAOA, or any of the multitude of university-based aging institutes and professional organizations, I do my best to keep up on recent trends, policies and practices.

During this session participants will learn the answers to the following questions: What research do I need to be aware of to make my business stronger? Why is this research important? Where can I find reputable resources? Each presenter will share their views on multiple reports’ influence on aging industry business trends, directions, products and services.

The following presenters will be coordinating together to ensure we are covering critical information across the aging industry:

• Jane Barton, MTS, MASM, CSA ,Cardinal Life, LLC, President (Healthcare)

• Malcolm Greenhill, CFP, MBA, CSA, Sterling Futures, President (Finance & Insurance)

• Scott Morrison, CSA, BrightStar, President, Multiple Franchise Owner (Homecare)

• Erika Walker, MsED, MBA, CSA, SAGE WAVE Consulting, LLC, President (Cross-Industry)

This session will be an excellent way to find out about what’s happening across the aging industry as well as a great opportunity to build your network. Unlike many other conferences, the CSA Conference brings all aging service sectors together to learn how to make our businesses stronger. See you in August in Orlando!

Blog posting provided by:
Erika T. Walker, MBA, CSA, President and Owner, SAGE WAVE Consulting, LLC

Friday, January 25, 2013

New Tools for Important Conversations

I am so excited that this resource is now available. If you like the Go Wish Cards ( for end-of-life decision making, then you are going to love The Cards I’ve Been Dealt ( They include three different decks of cards to help you facilitate important conversations with your clients. The first deck is called The Daily Activities cards which can be used as a need’s assessment tool to help you discover and discuss what the senior can still do and what he or she needs help with. I will be using The Daily Activities cards in my work because my clients include families who are caring for cognitively impaired seniors and people with disabilities. I really like that the cards use a positive approach to talking about this difficult subject matter.

The second deck is The Wishes and Values cards which contain 50 open-ended questions to uncover what matters most and what brings that individual joy and satisfaction. I can see these cards being used by professionals such as therapists, probate and elder law attorneys, financial planners, etc. who are talking with seniors about building good life plans. The third deck is The Life Practices Cards which include 50 positive aging skills and practices which can enhance senior’s lives. (I need to begin to use the Life Practices Cards since I turned 49 this year and want to get a head start on aging positively.) Also included on the website are worksheets and downloadable tools to use as you navigate these important conversations with your clients.


Blog posting courtesy of Viki Kind.

Viki is a clinical bioethicist, educator and hospice volunteer. Her award winning book, “The Caregiver’s Path to Compassionate Decision Making: Making Choices for Those Who Can't,” guides families and professionals through the difficult process of making decisions for those who have lost capacity.

Thursday, January 17, 2013

Stretch Your Arthritis Pain Away

Excerpts from the November 2012, Senior Spirit newsletter

It may seem counterintuitive that exercise can ease the pain of arthritis, which is most painful when moving, but a whole host of experts are jumping on the exercise bandwagon, including the Centers for Disease Control and Prevention (CDC).

In fact, exercise may be the most effective form of pain control outside of drugs. While encompassing different forms, arthritis is basically inflammation of a joint. With osteoarthritis, the most common form of arthritis, the cartilage around the joint wears out and causes the bones in the joint to rub against each other, creating inflammation and pain.

According to the CDC, 50 percent of adults age 65 or older reported receiving an arthritis diagnosis. Symptoms include joint pain, stiffness, swelling and aching. Not just striking seniors, arthritis is a serious chronic condition affecting 50 million adults in the U.S. and is the nation’s most common cause of disability (CDC publication, Morbidity and Mortality Weekly Report [MMWR Weekly] May 1, 2009).

Other Treatment Options

While no treatment can cure osteoarthritis, a wide array of treatment options may offer some relief: topical pain relievers, taping and bracing the affected areas, oral medication and surgery in extreme cases. Alternative care includes acupuncture and glucosamine, although both regimens have not proved as effective as once hoped. Vitamin D is another option, but the vote is still out on whether this vitamin can lessen the symptoms or the progression of the disease ( Guide).

Research has shown that a diet rich in fruits and vegetables, while low in meats and milk products, can help reduce inflammation and pain in your joints. Other recommended treatments are reducing stress and losing weight. In fact, a recent article in Arthritis Today states excess body weight is a risk factor for the both the development and progression of osteoarthritis. “For every pound of body weight you gain, your knees gain three pounds of added stress; for hips, each pound translates into six times the pressure on the joints. After many years of carrying extra pounds, the cartilage that cushions the joints tends to break down more quickly than usual.”

Focusing on Exercise

In the past, healthcare providers told arthritis sufferers to rest rather than exercise. But today, researchers are finding that movement can actually improve physical functioning in arthritis patients, while alleviating depression and contributing to weight loss. Basically, three kinds of exercises have been found helpful for people with arthritis: range of motion, also called flexibility exercises; endurance or aerobic; and strengthening. Each one plays a role in maintaining and improving your ability to move and function (Arthritis Today):

Range of motion/flexibility: This is the ability to move your joints through the full motion they were designed for and thus relieve the stiffness that leads to pain. With osteoarthritis, pain and stiffness make it difficult to move certain joints outside of a small range, which can make even simple tasks challenging.

Range-of-motion exercises include gentle stretching and movements that take joints through their full span. Doing these exercises regularly—ideally every day—can help maintain and even improve joint flexibility.

Aerobic/endurance: Aerobic doesn’t mean jogging 10 miles but is any exercise that strengthens your heart and makes your lungs more efficient. This conditioning can also give you more stamina throughout the day and help control your weight by increasing the amount of calories your body uses. Water aerobics, cycling and walking are all suitable cardiovascular exercises you can do over age 60. Do aerobic activities at least three times a week for 30 to 60 minutes.

Strengthening: These exercises help maintain and improve your muscle strength. Not only does arthritis take a toll on muscles, but aging also depletes muscle mass. As a result, strength training is needed to build and maintain muscle. In particular, resistance training can help reverse aging, according to the Arthritis Foundation. Use exercise bands, in place of weights, for your resistance training. Other strengthening exercises to include in your routine include dumbbells or weight machines. You can use your own body weight in exercises such as wall squats and push-ups against a wall.

Before starting any exercise regimen, it is important to check with your primary care provider to make sure that you are otherwise healthy enough to engage in the type of exercise you are planning. It may also be beneficial to talk with a professional trainer at your local gym or health club to learn the safest way to use any exercise equipment.

Utilizing Ancient Wisdom

One new exercise that is proving to help arthritis sufferers is an ancient Chinese martial art. In 2009, researchers from Tufts University School of Medicine determined that patients over 65 with knee osteoarthritis who engaged in regular tai chi exercise improved physical function and experienced less pain (Science Daily, Nov. 1, 2009).

Tai chi (Chuan) features slow, rhythmic movements to induce mental relaxation and enhance balance, strength, flexibility and self-efficacy. Physical components of tai chi, described as a mind-body approach, are consistent with current exercise recommendations for osteoarthritis. Researchers believe the mental aspects of tai chi promote psychological well being, emotional satisfaction and perceptions of health that counteract the effects of negative pain. Watch this introductory video.

In the meantime, science is studying other options for treating arthritis, including early detection and diagnosis, as well as genetic factors; and material that promotes the growth of new cartilage. But until new treatments come along, it’s good to know that there are things you can do on your own to alleviate the symptoms.

To download a printable copy of this article, click here!

The Society of Certified Senior Advisors would love to hear from you. If you are suffering from the pains of arthritis, what has helped you to ease away the pain? Please share your story with us!

Blog posting provided by Society of Certified Senior Advisors

Tuesday, January 8, 2013

Educational Webinar: Seniors and the Affordable Care Act

Please join Bob Semro, Health Policy Analyst for the Bell Policy Center in Denver, CO, as he presents the Society of Certified Senior Advisors January Educational Webinar, Seniors and the Affordable Care Act. This event is being held on Thursday, January 24, 2013 at 11:00 AM (PST); 2:00 PM (EST).

This webinar will focus on the impact of the 2010 healthcare reform law (the Affordable Care Act) on American seniors. According to polling from the Kaiser Family Health Foundation only one in four seniors are aware of the two most frequently cited provisions of the law that affect older Americans. In practice, the ACA has 165 provisions that affect Medicare, alone. Some of these provisions add new benefits while others reduce future growth in Medicare spending. There are also additional taxes and fees that may directly impact higher income seniors and baby boomers. This webinar will identify and explain those provisions of the law that most directly impact seniors and the public programs that seniors use. Topics will include:

• The solvency of the Medicare program after the Affordable Care Act

• New benefits
   ◦ Closure of the Medicare Part D prescription drug benefit “donut hole”
   ◦ Preventive services and examinations
   ◦ Early retiree reinsurance program
   ◦ Long term care and the Elder Justice

• New pilot programs

• Medicare spending reductions and their impact on traditional Medicare benefits
   ◦ Payment reimbursements to hospitals
   ◦ Payment reductions and other provisions that will affect Medicare Advantage Plans
   ◦ Payment reductions to home care providers
   ◦ Future spending caps and the Independent Payment Advisory Board
   ◦ Waste and fraud provisions

• Taxes and fees
  ◦ Medicare Part A tax increase
  ◦ 3.8% unearned income tax for high income individuals and couples
  ◦ Excise tax on high value “cadillac” health plans

• Other proposals being considered for Medicare that are not currently in the Affordable Care Act

Bob Semro is a Denver native and worked in the private sector for more than 25 years. He is a graduate of the University of Denver, with a degree in political science. Bob was a project manager for a home-centered pilot health care program for persons with disabilities and served as a Policy Analyst for the Colorado Consumer Health Initiative (CCHI). He is currently the Health Policy Analyst for the Bell Policy Center, a non-profit think tank in Denver, Colorado.

Bob has served on the policy and advocacy committee for the Colorado Alzheimer's Association, the Chronic Care Collaborative and the Colorado Gerontological Society. He was selected as a member of the Vulnerable Populations Task Force for the Colorado Blue Ribbon Commission on Health Care Reform (208 Commission) and the Home Health Care Advisory Committee for the Colorado Department of Health and Environment. He currently serves on the Health Plan Advisory Workgroup for the Colorado Health Benefits Exchange and the All Payer Claims Database Advisory Committee and Data Release and Review Committee.

Webinar Date: Thursday, January 24, 2013
Time: 11:00AM (PST); 12:00Noon (MST); 1:00PM (CST); 2:00PM (EST)
Cost: Free for Members; $49.00 Public


Thursday, January 3, 2013

Investing 102: From Safe to Risky

By V. Raymond Ferrara, CFP®, CSA®

“Investing 101: Even the Mattress Has Risks,” featured in the November isuue of Senior Spirit, talked about the necessity of finding a competent and ethical financial planner, the importance of developing a financial and investment plan and then having the discipline to follow the plan in good times and bad. Now, let’s talk about how different investments might be used. Space does not permit us to talk about all alternatives, nor can we determine which investments are most suitable to you.

Perhaps the most basic investments are also the safest as long as they are Federal Deposit Insurance Corporation (FDIC) insured. These generally include checking accounts, savings accounts and certificates of deposit (CDs). Visit with your banker to understand your personal coverage, especially if you have multiple accounts at the same bank. Multiple accounts do not necessarily provide multiple layers of insurance. Interest rates today are extremely low, but perhaps, like Will Rogers in the 1930s, you are more concerned about the return of your money than in the return on your money.

Another popular conservative vehicle is the use of a fixed annuity with an insurance company. Annuities issued today will generally have an underlying guaranteed return of 2 percent, although the actual percentage paid could be higher because the rate is reset each year. The money grows on a tax-deferred basis. When you withdraw the money from the annuity, the earnings are taxed as ordinary income, and should you withdraw money prior to age 59½, there is a 10 percent penalty. Annuities almost always have a surrender penalty if they are cashed in prematurely. You should generally avoid purchasing any annuity with a surrender period that exceeds seven years. A longer period may cause a liquidity issue, which is especially important for those in retirement.

Government Bonds

Let’s now discuss bonds, which many people consider a “safe” investment. Most bonds are safer than stocks, but not all bonds are created equal. The safest bond is a U.S. government bond, which is backed by the full faith and credit of the U.S. government. As long as the government has paper, ink and a printing press, you will always get your money back. But there is risk involved, as was seen in August 2011 when Standard & Poor downgraded U.S. government bonds from AAA to AA. The longer the term to maturity on a bond, the higher the interest rate paid and the greater the volatility of the bond’s price. When interest rates go down (like they are today), the price of bonds goes up. Conversely, when interest rates go up (as they are likely to do in the future), the price of bonds goes down. Thus, while you own a bond you will see its value increase and decrease over time, but if you hold the bond to maturity, the U.S. government will pay you the face value of the bond. State and local governments offer municipal bonds that are attractive because the interest is tax free.

Other countries also issue government bonds, but those come with their own set of risks. The last several years have been filled with financial difficulties in Greece, Spain, Italy and other countries, so it is important to understand the fiscal condition of any country prior to investing. When you invest in foreign bonds, you must also be concerned with currency risk.

Corporate Bonds

Corporate bonds generally have greater risk than government bonds and come in investment-grade (trust quality) and high-yield options. Large stable corporations are often considered less risky and generally pay lower interest rates. Small corporations or corporations that are in trouble financially offer bonds that are called “high-yield.” Because you are taking a greater risk than with government bonds, corporations must entice you with a higher interest rate. Unlike government bonds, corporate bonds are only guaranteed by the corporation that issues the bond. As seen during the financial crisis, even large firms can be at risk. The most convenient and often safest way for most investors to purchase bonds is to purchase mutual funds and/or exchange traded funds (ETFs).

The difference between stocks and bonds is that bonds are investments in which you loan money to a government or corporation that pays interest on the “loan,” while stocks actually provide ownership in a company. There are no underlying guarantees as to the financial success of the companies in which you have ownership. In particular, most investors should avoid investing in “penny” stocks, which are generally company shares that sell for less than $5 per share. A lot of promoters sell these very inexpensive stocks by promising huge gains. For the most part, the smaller the company, the greater the risk.

Small Versus Large Companies

Most stock investments are categorized by small, medium and large companies, which are determined by the market capitalization of a company (total value of all shares). In most equity portfolios, an investor wants to have a few small stocks, some medium and mostly larger company shares. Although it is commonly assumed that the larger the company, the lower the risk, we have all come to learn that even big companies can have big difficulties.

Most large corporations based in America have a significant amount of revenue coming from overseas, thus helping investors diversify their portfolio through international investing. But, investors will often purchase stocks from foreign companies in an effort to further diversify the portfolio. Foreign investments are divided into mature countries (Germany, England, France, etc.) and emerging countries (China, Russia, South America, etc.). Greater risk exists in the emerging countries. In addition to all of the regular risk associated with owning stocks, there are also foreign currency risks and accounting risks because many countries don’t have the same high accounting standards as the U.S.

Stocks that pay dividends (a share of the profits) are considered more stable and less risky than stocks that don’t pay dividends. When a company makes money, it must use that money to either grow the business by purchasing more equipment, reinvest that money by buying other companies or share some of the profits with investors. Again, the best way for most investors to buy stocks is through mutual funds, which spread the risk of any one stock.

In addition to these common investments, you may mix in other investments like variable annuities, real estate investment trusts (REITs), commodity funds and perhaps some precious metal funds. It depends upon your risk level. No two investors are alike, and you must be careful that you don’t get “cookie cutter” advice.

Visiting with a financial planner, you can determine your investment goals, risk tolerance and asset allocation program. Avoid putting all your eggs in one basket. A diversified portfolio that provides both income and opportunity for growth works best for most people.

Visit, to download a printable copy of this article.

V. Raymond Ferrara, CFP®, CSA, is president and CEO of ProVise Management Group, LLC in Clearwater, Florida (727-441-9022). © November 2012