Being is Meaningful Work

For many years, my mantra has been, “Meaningful work, paid or unpaid, through the last breath.” For most of that time, I’ve been thinking about work as purposeful doing.

During the last 20 years since I shifted my professional focus on life-work planning from youth to older adults, I’ve wanted to counter ageism by showcasing the productivity and potential of older adults who are teaching and learning, doing and caring for themselves and others. The Census Bureau described all of us under age 16 or over 65 as “dependents.” It seemed important to show a different perspective. Whatever their age, people who were doing meaningful work that tapped their skills and interests – whether paid or unpaid — were benefiting both themselves and their communities.

So at age 69, in 2001, I completed my PhD in Minnesota with a survey report on “Productive Aging in Rural Communities.” We quantified the economic value to the community of the time devoted by age 55+ adults to employment, volunteering, and caring for grandchildren and sick/disabled adults. We also asked people about their health and how they were feeling about themselves. In these rural communities where both younger workers and aging services were sparse, older adults were often the only ones around to do what was needed. Older adult productivity was extraordinarily high and along with it, the health, positive attitude, and self-reliance of older adult residents.

Those survey results nudged me to start organizing education and advocacy to support self-determination, creative expression, and meaningful work for and with older adults. Since then, I’ve co-founded three older adult networks to raise awareness about our potential and cultivate leadership for positive aging: the Vital Aging Network, the SHIFT network, and the global Pass It On Network.

This year, whether because of my age (85) and stage of life or because of the tensions that appear to be growing in this splintered world, I’ve been hungry to hear about the changes that people are perceiving both in the world around them and within themselves. During my recent visit to the Seattle area, my daughter responded to my need and convened a Circle of wise women who voiced some deep questions for all of us to ponder:

• How can we create a future that will be worthy of the potential of human life? By what narrative are we going to live and die that will take the cosmos into account?


• Am I ready to step up to my real life? As an artist, am I ready to spin the yarn of the new realities and still express the nature of belonging and sense of home?


• What does it take to show up full-hearted with people different from me? To bridge differences and become a peacemaker? To find spaciousness?


• How can we step up as women with heart, soul and body? Will we have our posse at our back to support us?


• What are the stories that we will leave for the future to find? What will hint of our deep past? How will l deposit things that will be useful? We are Thresholding!

As stated by one of the wise women, Christina Baldwin, co-founder of The Circle Way and creator of Peer Spirit Circles, “The Circle is a sacred container where magic happens.”

I am trying to make changes to live my learning as time goes on.

And where are you in the process of living this life?

	- By Janet M Hively, PhD
Jan Hively is a social entrepreneur who has co-founded three non-profit networks for older adults to share their strengths and help each other, themselves, and their communities since she earned her PhD at age 69 in 2001 with a dissertation on Productive Aging. Her global Pass It On Network is based in Paris with its co-founder and International Coordinator, Moira Allan.

Mesothelioma and the Risk for Seniors

Cancer is a difficult subject to talk about. It is invasive, draining and life changing and most everyone personally knows someone who has been affected. However, fear of the disease cannot dissuade from important conversations about risk, prevention, and next steps.

The fact of the matter is cancer is a disease of the aging. “The cumulative risk for all cancers combined increases with age, up to age 70” with about 50 percent of cancer cases found in those 65 and older. That number is expected to increase to 70 percent by 2030 as illnesses that formerly caused death at a young age gain better treatments or are cured altogether, meaning people are living well into their 70s, 80s and 90s.

But age does not mean you have to be submissive to an eventual cancer diagnosis. Chances of cancer are much lower if you live a proactive, healthy lifestyle. What you’ve heard is true; consistent exercise, avoiding heavy alcohol consumption, and limiting your intake of red meats do reduce the risk of cancer diagnosis. Prevention is key!

It is important to maintain those good habits as a senior for the benefit to your overall health, however, you should also be aware of the life you led in your younger years and how that may be affecting your health today. For example, if you smoked as a young adult before realizing the unhealthy side effects, your chance of lung cancer may be higher than non-smokers’ as it is estimated that 45% of those diagnosed were former smokers.

Similarly, you should be aware of any past workplace exposure to hazardous chemicals. According to the CDC, “Based on well-documented association between occupational exposures and cancer, it has been estimated that 3-6% of all cancers worldwide are caused by exposures to carcinogens in the workplace,” which equates to between 45 and 90 thousand new cancer cases each year.

One such environmental toxin is asbestos. A natural mineral and known carcinogen, asbestos exposure is the cause about 80 percent of mesothelioma cancer cases. The material was used in the many industrial jobs until limited regulations were put in place throughout the 1970s and 80s. It may seem unlikely that you will ever need to know this information, however, it is especially important for aging men to understand the risks associated with mesothelioma.

What You Should Know about Asbestos Exposure and Your Risk of Cancer

Through much of the 20th century the material asbestos was used in thousands of products from insulation and brake pads to clothing and kitchen appliances for its incredible heat and fire resistant properties. However the connections between asbestos and the respiratory conditions mesothelioma, lung cancer and asbestosis soon became apparent and the avoidable risks to blue-collar workers and their families outweighed the benefits. It is estimated by the National Institute of Health (NIH) that 11 million people were exposed to asbestos between 1940 and 1978, much of that comes from workplace exposure.

Industry employees most exposed are firefighters, construction, shipyard and automotive workers, and asbestos miners. Because those industries are male dominated, men are about five times more likely to develop mesothelioma than women, however there are many instances of spouses and children being diagnosed from secondhand exposure. It should also be noted that port cities and Rust Belt states show higher rates of mesothelioma mortality at two to four times the norm.

Because of a long 20-50 year latency period (the time between exposure and noticeable symptoms), 80% of those diagnosed with mesothelioma are 65 or older with an average diagnosis age of 75 for males and 72 for females. (Note these numbers are considerably higher than the average statistic for all cancers above). Please consult a doctor if you are experiencing symptoms and believe you may have been exposed to asbestos, especially if you fall into the high risk categories of occupation, location, age or gender.

Earlier Diagnosis Leads to Longer Survival

The good news is, though instances of cancer are on the rise, an overall increase of cancer survival rates, including mesothelioma, is attributed to better prevention, detection and treatment methods. Mesothelioma is a cancer often associated with a late diagnosis and low survival rate. The average life expectancy for a mesothelioma patient is 12-21 months after diagnosis and between 5 and 10 percent of mesothelioma survivors lives at least five years after diagnosis. However, early detection is especially important as there is a strong correlation between the age and stage at which diagnosis occurs and survival. One study showed individuals diagnosed with pleural mesothelioma at the age of 65 lived on average eight months longer than those diagnosed at 75 or older. Similarly, catching the cancer at Stage I rather than Stage IV can add years to your life.

Often times general mesothelioma symptoms like chest pain, fatigue, nausea, hoarseness and difficulty swallowing are thought to be the result of other respiratory illnesses, and thus a test for mesothelioma cancer happens very late in the process. Alerting your doctor with knowledge of symptoms and awareness of possible exposure maybe save your life by catching the cancer early.

Additionally, diagnostic and treatment options are improving everyday. One way to detect mesothelioma is through a blood test that identifies biomarkers in the bloodstream. New studies have found a biomarker protein called high mobility group box protein 1 (HMGB1) that can amazingly identify those who have been exposed to asbestos and have a high risk of developing mesothelioma, but have not yet done so. Another example is a non-invasive breath test that was recently developed that has a 90% accuracy rate allowing for effective diagnosis at a treatable stage of the cancer. New precision medicine and immunotherapy are seeing early successes in clinical trials. An ongoing study at Baylor University is testing the effectiveness of using immunotherapy, an immune system boosting treatment based on genetics, as a neoadjuvant (before surgery).

The Best Defense Is a Good Offense

As with any illness, prevention is the more effective “cure.” Although many researchers and scientists are working hard everyday to find a true cure for cancer, that accomplishment may still be years in the making. Until then, there are steps we can all take to try and prevent a future cancer diagnosis.

	- By Emily Walsh
As the Community Outreach Director at Mesothelioma Cancer Alliance, Emily Walsh builds awareness about asbestos and mesothelioma, an aggressive and rare cancer that affects about 3,000 people in the U.S. each year. MCA is an organization dedicated to providing reliable and current information and resources for those with mesothelioma and their loved ones.

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Sources

“Age and Cancer Risk: A Potentially Modifiable Relationship,” National Center for Biotechnology Information, U.S. National Library of Medicine.

“Cancer Prevention: 7 Tips to Reduce Your Risk,” Mayo Foundation for Medical Education and Research (MFMER).

“Malignant Mesothelioma” American Cancer Society, Inc.

“Malignant Mesothelioma Mortality — United States, 1999–2015” Centers for Disease Control and Prevention

“Occupational Cancer” Centers for Disease Control and Prevention.

“Reducing Your Risk” LUNGevity Foundation.

“U.S. Federal Bans on Asbestos” United States Environmental Protection Agency.

“Mesothelioma Life Expectancy” Mesothelioma Cancer Alliance.

“2016 in Review: Recapping Mesothelioma Research” Mesothelioma Cancer Alliance.

When A Lifelong Friend Tells You They Are Gay

Many older Americans are finding themselves in flux lately when it comes to societal changes. Political differences are pitting lifetime friends against one another. Other friends are divorcing after decades of marriage. Heck, even gay rights aren’t called gay rights anymore; they are LGBTQ rights (lesbian, bisexual, gay, queer and transsexual). How is one supposed to react to these changing times?

Social issues like race and sexual preference are a hot button that can really get people going. While more and more Baby Boomers and those from generations before that are changing beliefs they’ve always held, some are still clinging to them tightly. Others are stuck in the middle, just trying to make sense of things. But seriously: What do you say to a friend is widowed and then tells you he’s been gay all his life so he’s moving in with his boyfriend now?

You’re not alone if you feel a bit overwhelmed and unsure of how to act around others these days. And you’re not alone if you are one of the ‘others’ whose life is being lived more freely than in the past.

Those Who Identify as LGBTQ Are Increasing

Among the difficulties that many older Americans will face – beyond disproportionate levels of poverty and depression – is LGBTQ acceptance. By most standards, this part of the older population is only just now becoming accepted by portions of the populace. In fact, older adults are struggling the most with these issues of acceptance.

According to the American Psychological Association, there are currently more than 2 million Americans over the age of 65 who identify as LGBTQ. Caitlyn Jenner is among those who are most well-known.

Jenner came out as being transgender when she was 65 years old. Her name then was Bruce Jenner, a well-known Olympic, gold-medal-winning, decathlete who first blew onto the world stage in the 1970s. For decades, Jenner lived another life away from cameras – a secret life as a woman. The admission that she was transgender created quite a stir in the news and on social media, and when Jenner completed the transformation from male to female in September 2015, it was really all anyone could talk about.

Some agreed with Jenner’s decision to finally be true to who she is. Others condemned it with questions like, “How can anyone who has been a man all his life suddenly decide he wants to be a woman?” The answer, though, isn’t as simple as some might believe, but the decision – and all of the upheaval that goes along with it – might be more common than you realize.

People like Jenner hide their true selves from even their closest friends in order to be accepted by society so, for them, the public ‘coming out’ is not sudden for them. But when they do begin to express themselves to others, they face the possibility that longtime friends will abandon them.

How you react to a friend’s disclosures is a personal decision but it’s important to understand that, whether it’s divorce or a gender change, the people you know are still the same people you have grown to love and trust through the years. It wouldn’t be strange, though, for you to feel that longtime trust has been betrayed because of confidences your friend has held in.

It might help to look at the situation from their perspective: Your friend has found the courage to trust you enough to finally share something they have wanted to for years. Whatever has kept them from revealing themselves – whether that’s religious belief, embarrassment, fear of reprisal, etc. – has now left. An often decades-long personal struggle is difficult to overcome for the one in the battle; no one expects the one just learning of the battle to suddenly accept the news.

Not all older Americans who identify as LGBTQ are as high-profile as Jenner, but all will face much of the same discrimination she did – many from their own peers. The problems they experience as they open up their lives may only be the beginning of years of discrimination for them.

Acceptance After a Lifetime of Belief

It’s not just sexual orientation issues that older Americans struggle with, of course. The Silent Generation and even Baby Boomers were raised during a time when race relations where difficult. Growing up with watching the struggles that non-white races – and even women – went through to gain equality, people’s belief systems were fed from all sides.

Today, racial lines are blurred, as more people refuse to see color and instead look beyond skin to see what’s inside. Interracial marriages are commonplace now, for example.

In the end, say experts, anyone can learn tolerance and acceptance for almost any issue that might divide them from those they know.

Denise Spivak, Senior Director of Programs and Outreach for LGBTCenters.org says, “Always focus around first recognizing and accepting whatever bias, stigma, discrimination, etc. that one has and then committing to addressing it. Then the work of educating yourself, overcoming things that were taught to us/ingrained in us when we were young, learning more about the people you think you know all about, realizing that in many cases you already have friends, relatives, co-workers, employees, neighbors, etc. that fall into those categories that cause you discomfort (or fear).”

“Even though we all have our differences, at the end of the day we are all human beings. We all have our own basic set of beliefs, but at the core of most issues of bias, stigma, hate, discrimination, etc., is a basic lack of understanding, knowledge, and fear of the unknown. For older people, it can mean a lifetime of beliefs and feelings being changed, but it’s possible. The minute one is willing to open their mind and their heart, amazing things can happen.”

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Sources

“The LGBT Aging Issues ,” American Society on Aging.

“Resources,” LGBT Centers, Denis Spivac.

“10 Ways to Fight Hate: A Community Response Guide,” February 2010, Southern Poverty Law Center.

“The Senior Audience: Large, Growing, and Diverse,” July 2011, Public Health Agency of Canada.

“Lesbian, Gay, Bisexual, and Transgender Aging,” American Psychological Association.

“LGBTQ Seniors Face Discrimination in Long-Term Care,” Anna Gorman, October 2016, PBS Newshour.

“LGBT Seniors Are Being Pushed Back Into the Closet,” David R. Wheeler, August 2016, The Atlantic.

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

What is Hospital Discharge Planning?

Senior care veterans know that most families are in a time of crisis when they start looking for senior supportive services. One of the most common instances is after an acute stay or procedure at the hospital. Often it is during the discharge planning process that seniors and their families find these supportive services. Successful discharge planning can be the difference between a successful and disastrous senior living transition.

What Is Discharge Planning?

First, here are some basics on the process. Discharge planning happens while you are in the hospital. Hospitals that participate in Medicare and Medicaid are required to provide discharge planning, although what that looks like varies depending on the size of the hospital and your level of need.

Discharge planning can include a range of activities such as: (1) scheduling follow-up appointments with primary and specialist physicians; (2) setting up home supportive services; (3) ordering supportive products like wheelchairs and oxygen tanks; (4) arranging short-term respite stays at senior living communities; (5) evaluating the patients prescription coverage and coordinating other insurance-related issues; (6) directions on health conditions and how to manage them at home, and (7) resources and education on supportive services and programs once you transition out of the hospital.

Discharge planning ends when you leave the hospital. Ideally, at that point, arrangements have been made for transitional care into a senior community or at home.

Why Is Discharge Planning Important?

Discharge planning may seem trivial after the drama of a hospital stay. Depending on your needs, it can be as simple as prescriptions and written instructions for follow-up care. In many cases, however, hospitalization is only the start of the journey. If you have suffered a stroke, for example, you probably have a lengthy and complicated recovery ahead of you. The transition home is even more complex if you have multiple health challenges. In these cases, discharge planning is critical to make sure everything you need is in place when you return home. Good discharge planning can improve the coordination of care, make your recovery easier, and decrease the chance that you will need to be re-hospitalized.

Who Provides Discharge Planning?

Most discharge planning is done by a nurse or a social worker on staff at the hospital. Social workers are uniquely positioned to provide effective discharge planning for a number of reasons. They are able to assess and address all of their patients needs, including but not limited to medical needs. They work as part of a multidisciplinary team that includes doctors, nurses, and other health professionals. The social worker acts as the patient’s liaison to that team and coordinates information and the efforts of that team on your behalf. She is your voice in the hospital. These social workers can also convene meetings that include you, your family, and hospital personnel to discuss your illness, treatment, and plan for care once you leave the hospital. They can help you and your caregiver become your own best advocate, since once you leave the hospital you will in effect be your own care manager.

Social workers also have a strong grasp of local resources and services. They have lots of connections in the community. This means they can help link you with a range of services including financial resources, caregiver support, meal delivery, and other services you didn’t even know existed. They can also connect you to a community-based social worker who can continue to help you after you leave the hospital.

Discharge planning is an important part of any hospital stay. If you are hospitalized, make sure you ask to speak to the social work discharge planner to ensure your transition home is as smooth as possible.

	- By Amanda Toler Woodward, PhD
Amanda Toler Woodward, PhD is an Associate Professor in the School of Social Work at Michigan State University. She does research on services and supports for older adults including racial and ethnic disparities in access to services and international comparisons of service systems.

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Sources

“Social Work Profession,” National Association of Social Workers.

“Hospital Discharge Planning for Elders,” Seniorly.

“Transitional Care for Rehabilitation” Seniorly.

“What is Respite Care?” Seniorly.

A version of this article, Hospital Discharge Planning for Elders written by Amanda Woodward appeared in Seniorly’s Senior Living Resource Center.

An Incomplete Story

As a filmmaker and video producer I’m always looking for the story at the heart of every subject. With regard to aging in America I’ve found a fatal flaw. There’s something missing. There’s a disconnection in the plot. I’ve heard experts talk about how Baby Boomers aren’t comfortable with getting older and how they struggle with retirement and refuse to let go of adulthood. They then go on to talk about the problems that could likely occur when this demographic reaches old age and needs to be cared for. What? It’s like the record skipped. There seems to be a few scene’s missing in this story (almost an entire act). What happens between the end of the adult paradigm (work, careers, parenting etc.) and eventual old age?

Limited Vision

We’ve all read the headlines about the impending crisis of how and where the Baby Boom generation will be cared for as they age. Concerns over eventual overwhelming health care costs and diminished quality of life in outdated nursing homes are very real. These issues require bold new solutions and radical ideas but are secondary to the most profound issue facing “boomers” as they cross the threshold from adulthood into the 3rd phase of life. There is something missing. A key to living a full and purpose filled life.

Identity

Who are we when we transition out of our adult lives and careers? What can we look forward to in this new frontier of longevity? We struggle to drag our adult persona forward with us as we age only to find that many of those elements don’t fit us anymore. Our culture does not provide us with a functional image of who we can become as we take on the role of “senior” in our county (a title that is in great need of replacement). The media is filled with messages of denial. “All of the experts on TV are anti-aging gurus” says geriatrician Dr Bill Thomas. We are told to stay young, turn back the clock and never grow old as if growing older is something we should and could avoid. This is a false image created by a youth-centric culture that does not value the gifts of longevity.

The question of identity is put succinctly in the title to Connie Goldman’s book Who Am I Now That I’m Not Who I Was? We struggle with this time in our lives because we know we are moving away from something but we don’t have a clear view of what we might look forward to. There is a new identity yet to be forged by the generation most associated with cultural change. A realistic identity built on an authentic paradigm for the years after adulthood and pre-old age, a span that is growing exponentially. Within this new paradigm exists tremendous potential for growth, development, transformation and the cultivation of a lifetime of experience into wisdom and perspective. There is a unique opportunity for transformation not possible in earlier stages of life. In the words of Dr.Thomas “This is the greatest change in the life of a person since puberty and brings with it the opportunity to become new again.” What will be our true identity as we age? How can we explore our own knowledge and wisdom and join with others to bring valuable insights and perspective to a world in need?

The Whole Story

Denial and anti-aging messaging are the placeholders for the missing pieces in this script and we deserve to experience the complete story. As our focus has become limited to youth and productivity we have forgotten the valuable role of the elder in our homes and in our culture. If we choose to remove our blinders and address our fears of being older we can discover what it means to live our complete lives from beginning to end. Within this image we can develop a new role of elders in our society, a substantial role with unique gifts of great value. As we restore and refine the role of elder we will begin to find purpose and meaning in all parts and phases of our lives and clarity about who we are and who we can become as we age. With this clarity we will be free to dream of new options for living and then bring those dreams to fruition. I believe that with a new and authentic image of what life after adulthood can be the issues related to housing and healthcare will be effectively addressed and new opportunities for living will be created.

Our Challenge

What will be our part in the development of this new stage of life? How will we take on the false messages of aging and replace them with images of living more authentically as we grow older? How can we serve the aging ‘boomer” population and their families more effectively and help them discover the many gifts of long life? As advocates for better aging how can we bring our professional expertise to the table in new ways and help forge a new image of what life can be after adulthood. Former NPR reporter and author Connie Goldman said, “It is a gift to live a long life…aging is an adventure!” New pathways to success could be found in being valuable guides on this journey as we explore the growing frontier of longevity. Here’s to an exciting and rewarding expedition! It’s going to make a terrific story!

	- By David Carey
David Carey is a video producer with Show & Tell Group and filmmaker with The Aging Film Project.

Secrets To A Long Life

“I’ve got a truck out there and it runs just like I want it, so I just keep it.”

Behind the wheel of a decades-old blue-and-white two-tone Ford pickup, Richard Arvin Overton, the oldest living WWII veteran in America, is confident and clear-eyed. “I like to drive myself because other drivers, they drive crazy!”

An Army veteran, he joined the service in 1940 and fought in the western Pacific from 1944 to 1945. He’s made Austin, Texas, his home his entire life – all 111 years of it.

“If it’s your time to go, that bullet’s gonna getcha,” he says. “If it ain’t your time to go, that bullet’s goin’ over your head. It ain’t gonna hit ya.”

He shared, “I still walk, I still talk and I still drive.”

How does he do it? Among his secrets to longevity are these gems:

• Don’t fool with a credit card. Pay cash.


• Smoking cigars just makes you feel better. But don’t inhale.


• Don’t feed a cat too much; he won’t eat a rat.


• Anytime you wake up – even if it’s 1 or 2 in the morning – just get up.


• If you give up, you’re through!

“I may give out, but I never give up.”

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Sources

“109-Year-Old Veteran and His Secrets to Life Will Make You Smile – Short Film Showcase,” YouTube. 2017-04-25. Retrieved 2017-07-10.

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

E-Readers Can Bring Back Your Reading Habit

E-readers offer a host of benefits to those who suffer from low-vision or arthritis issues, but many older Americans still prefer an old-fashioned paperback.

Did you get an electronic reader (e-reader) for Christmas? Is it still in the box? If it is, you’re probably not alone. Many older adults prefer to avoid technology for as long as possible, and if that’s you, that’s OK. Even if the kids expect it and all of your friends are doing it, there’s nothing that says you have to give in to technology. But before you give up on it completely, there are some things about that e-reader that you might want to know.

Maybe you’re not tech-averse, but you’ve heard stories about how difficult e-readers are to use, or how they can cause eye strain. However, you are intrigued by that little device and the fact that maybe it will make it possible for you to read again. The good news is, using an e-reader might be easier than you thought.

E-Readers Versus Paperbacks: Which is Better?

According to PEW Research Center, only about 19 percent of Americans over the age of 65 own an e-reader. In part, this is because older adults are adopting multi-use tablets instead of single-use e-readers. Another reason more older adults don’t own e-readers, however, is a life-long love of the printed word. Nothing beats the experience of cracking the spine on a brand-new paperback book, inhaling the musty scent of the pages combined with the sharp twang of the ink, and settling down to enjoy a really good story.

Paperbacks still have their place; the tactile nature of a book is its greatest appeal. E-readers, on the other hand, also have some benefits.

• You can keep an entire library on an e-book. Most have enough storage capacity to hold thousands of books.


• You can download books from your local library. You can use the e-reader’s internet capabilities to access your local library system, reserve books and automatically download books to your e-reader. This feature – particularly during winter months when weather is bad – can keep you reading even when you can’t get out of your home.


• You can adjust the font size and page colors of most e-books. This makes it easier for people who suffer from vision problems to continue reading long after a paperback is feasible.


• E-books are lighter and often easier to manage than a paperback. If you suffer from arthritis that makes it difficult or painful to hold a paperback book for long periods of time, an e-book might be a good solution to allow those marathon reading binges that you love.


• The e-ink technology (a special electronic ink that makes screens easier to read) found in many of today’s e-books makes it possible to use them indoors or out. As an added bonus, many e-books are now waterproof, so you can still read by the pool, at the beach or in the tub without fear of damaging the unit.


• E-books are actually easier to read than books. Experts once believed that e-readers caused eye strain, but studies now show that the opposite is true, especially for models that use e-ink technology. Researchers have found that e-books reduce eye strain, and in turn, may improve mental function in older adults.

Despite the similarities and differences, there is no one option that’s better than the other. If you love reading a paperback book, and it still works for you, then that is absolutely the option you should choose. But don’t write off e-readers completely, because there may come a time when an e-book offers you the ability to continue reading where a paperback will not.

Choosing the Right E-Reader

Maybe you don’t have an e-reader hidden away in a box, but you want one. What features should you look for? First, consider how you want to use the device. Will you usually only read indoors? At night or during the day? Some e-readers are better designed for indoors, some for outdoors; some have features that make reading at night impossible. Ensure you know how you plan to use the device, because that will determine the features that you need.

Next, look for something that is comfortable to use. Try a few different e-readers to find one that’s the right size and weight for you. E-readers come in various sizes, ranging from around 6–12 inches. The larger an e-reader, the heavier it will be, but the tradeoff is that larger devices offer more screen real estate for those who need larger type.

Look for ease of use, too. Most e-readers are either touch-screen or have two or three buttons to operate them. Look for a device that has buttons that are comfortable for you to use. Also, check out backlight options if you plan to read at night, or look specifically for e-ink technology if you plan to regularly use the e-reader outside.

Finally, talk to someone who can show you how the e-reader works – both for reading and purchasing books – before you buy it. Ask them to walk you through the features. Grandchildren are a great resource, and e-readers give you an opportunity to connect with younger family members. Don’t have grandkids? No problem. A good salesperson will be able to help you find an e-reader that’s comfortable and easy to use.

If you love reading, but have found that it’s getting harder to read printed books, consider an e-reader. They offer many benefits you won’t find in a paperback, and will allow you to keep reading the stories you love.

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Sources

“Seniors Gravitate Towards E-books?” Michael Kozlowski, February 2013, E-Reader.

“E-readers for Seniors,” Spring 2010, Urban Libraries Counsel.

“PEW: More Seniors Own Tablets or E-readers than Smartphones,” Sam Kirkland, April 2014, Poynter.

“Senior Citizens Lead the Charge Toward the Adoption of E-books,” Rich Steeves, February 2013, TechZone360.

“The Tech Devices Seniors Love,” Kimberly Barnes, Senior Lifestyle.

“Technology Use Among Seniors,” Monica Anderson, May 2017, PEW Research Center.

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

Earn a Certificate of Completion & CEUs Online

Last Chance for 2017!
Earn a Certificate of Completion and CEUs Online

It’s not too late for CSAs to register for any of the four online courses offered by American Society on Aging (ASA) and USC Leonard Davis School of Gerontology. For each online course completed CSAs can earn a certificate of completion from USC and elect to receive 10 CEUs from the Society of Certified Senior Advisors.

ASA and USC are especially excited to present two new five-week online courses, Elder Mistreatment: Understanding Abuse and Neglect - and - Elder Mistreatment: Prevention of Abuse and Neglect. Packed with relevant research and practical information, the courses explore all aspects of elder mistreatment with a focus on research-based communication, assessment, prevention and intervention models. They are especially applicable for direct service professionals of all levels, given the complex and intimate nature of your work with older adults.

Additionally, the American Society on Aging is offering Managing Health and Chronic Conditions in Older Adults which identifies common health issues and examines strategies of care. Demography, chronic disease and self-care management, dementia and mental health issues, and medication management are all explored.

All three courses, plus Fundamentals of Gerontology, will be offered August 28, 2017 to September 29, 2017, the last chance for 2017! You can take one course or all of them, depending on your individual professional development needs. They are flexible.

Click here for more information, course video clips, and to register. Not an ASA member? Use Code "USC7" at registration to save $60 on the professional member rate. Or, choose the non-member rate for $630 which will include a Green ASA membership.

The American Society on Aging (ASA) is excited to support the work of Certified Senior Advisors (CSAs) and invites you to take advantage of these professional educational opportunities in 2017.

Famous & 65

Look Who’s Turning 65

July 1—Dan Ackroyd

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Which picture to use of the unforgettable Dan Ackroyd – him as a Conehead? A Belushi Brother? A Ghostbuster? Ackroyd, a Canadian-American actor born in Ottawa, Canada, has so many comedic personalities that it’s impossible to pinpoint for which one he is most beloved.

Often the straight man in any comedic duo, Ackroyd can be deadly serious: Grandson of a Royal Canadian Mounted Police officer, he studied criminology and sociology during college and still rides shotgun with the Ontario Provincial Police. He also holds an advisory commission with the police department in Payne City, Georgia. Perhaps that explains his love for the role of Jack Webb in the modern-day update of Dragnet.

Here are some little known facts about Ackroyd: He was born with complete heterochromia (one eye is blue, one eye is green) and syndactylism, a condition in which there is partial or total webbing of two or more fingers or toes; he was diagnosed with Tourette’s syndrome and Asperger’s syndrome; he is a big fan of paleontology; and he supports MUFON, a UFO study group.

“The entertainment business is not the be-all and end-all for me,” he has said. Wife Donna and his three daughters must be very glad of that.

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July 16—Stewart Copeland

Stewart Copeland is probably best known as the drummer for the American band The Police, but prior to joining that group, he was known as musician Klark Kent. Playing all instruments himself, he recorded a series of singles that were released between 1978 and 1980. (You can find those tracks on a 1995 CD called “Kollected Works” under his super-pseudonym.)

Many say The Police sound the way they do not because of Sting’s melodies but because of Copeland’s aggressive yet subtle drumming style. His unique sound is derived from days spent listening to rhythmic tunes in the Middle East as a youngster when his father was a British diplomat.

“I’ve got Arabic music in my blood,” Copeland explains. Still, he reminds everyone, “People are disappointed when they hear my American accent because they regard The Police as an English band, but I’ve clung to my American-ness all the way.”

Casual fans might not know that, beyond The Police, Copeland has also been involved in music projects with bands and performers such as Gizmo, Oysterhead, Peter Gabriel, Tom Waits and even Snoop Lion. In addition, the nimble-fingered drummer has done scoring work for movies including Wall Street, Highlander 2 and Babylon 5. During his days with The Police, he became a videophile and shot constant Super 8 video footage of the band’s activities. That footage turned into Everybody Stares, a classic documentary about the band.

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July 17—David Hasselhoff

Most people recall David Hasselhoff from one of two popular television series during the 1980s and ‘90s: Knight Rider and Baywatch. But the American actor, born in Baltimore, Maryland, actually began his acting career in the ’70s as a soap opera actor on The Young and the Restless, portraying Dr. Snapper Foster.

Of German descent, Hasselhoff parlayed his Knight Rider fame into a successful European singing career. In 1989 – just before his Baywatch days – he released a single that remained number one on the German record charts for an astounding eight weeks. “Looking for Freedom” was that nation’s soundtrack to the Berlin Wall tumbling down. Hasselhoff famously performed the song atop the wall on New Year’s Eve 1989 wearing a piano-keyboard scarf and a leather jacket covered in motion lights.

Since then, Hasselhoff has become one of the most recognizable faces on television and around the world. The success of Baywatch – particularly through its syndication deals – made him a multimillionaire. His wicked sense of humor has led to self-parodies in both movies (Sharknado flicks come to mind) and television (The Twins: Happily Ever After?), which tickle fans with comic charm.

Hasselhoff does have some regrets in life, however. “I find it a bit sad that there is no photo of me hanging on the walls in the Berlin Museum at Checkpoint Charlie,” he laments. A man of shameless self-promotion, the Hoff is a crowd-pleaser any way you slice him.

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Source: Wikipedia

FAMOUS & 65 is a featured article in the Senior Spirit newsletter.

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

Aging in Place: Does It Make Sense to Plan to Stay at Home?

It’s a common choice to stay in your own home through the later years of life. But does it make sense to age in place, or is assisted living a better option?

According to the Population Reference Bureau, the number of Americans over the age of 65 is expected to more than double by 2060 to over 98 million people. This Silver Tsunami, as it’s been called, brings with it an entire set of challenges, like where older Americans want to spend the last years of their lives. For some, the answer is to age in place – stay in their own homes.

Aging in place is a choice that many older Americans are making, because it’s not only more comfortable, but it seems to make financial sense. However, it’s wise to look at both options – aging in place and moving to an assisted living facility – before making any decisions.

Comparing Options

At first glance, aging in place seems to make the most sense. You stay in your own home, with a few modifications, and continue life as it’s always been. Depending on your current home, however, those modifications can be much more costly than expected. Alert-1 estimates the average annual cost for an assisted living facility in the United States is around $42,600 per year, but the actual cost can fluctuate to more than $100,000 per year, depending on the state you live in.

For example, many homecare agencies charge $25-$35 per hour to assist you. At those rates, it doesn’t take very long for in-home care costs to soar higher than the cost of staying in an assisted living community. A typical assisted living community in the Seattle area, for instance, averages $150-160 per day.

Three Tips for Finding a Certified Aging in Place Specialist The National Association of Home Builders (NAHB) has created special educational requirements for builders who are capable of building or remodeling homes with mature adults in mind. Certified Aging in Place Specialists (CAPS) may be homebuilders, remodelers or even healthcare workers who are dedicated to helping you remain in a familiar environment during the later years of your life. To find the right CAPS professional, here are three tips to remember: Use the NAHB’s list of CAPS professionals. CAPS professionals have been trained in the unique needs of older adults through a partnership the NAHB created with several other organizations, including the AARP. Graduates of the CAPS program are listed on the NAHB website. Ask lots of questions. A CAPS professional will not only look at your home and recommend changes, but they can also address your concerns about aging in place. Ask questions about upgrades, renovations and even professionals who specialize in helping you maintain your lifestyle. Find a CAPS professional who fits your style. It’s important to seek out the right person to help you plan for your later years. Spend time with a CAPS professional, and if you find your personalities clash, don’t be afraid to find someone else. It’s your future; be comfortable with the person who will help you design it.

Alternatively, aging in place means making changes to the structure of your existing home. In addition, it’s important to consider the cost of having a homecare agency come in later on to help you if, say, you can’t move around your house easily.

To prepare your home for the aging process, you can make some simple and fairly inexpensive changes, including:

• Installing grab bars and supports: $100-$300;


• Installing lever door handles: $150-$450;


• Building a ramp: $1,200-$2,500;


• Installing a curbless, modular shower: $2,000-$15,000 or more;


• Widening doorways and corridors: $500-$20,000;


• Lowering cabinets and sinks: $10,000-$15,000.

You will not need all of these changes, which is why it’s important to consider hiring a Certified Aging in Place Specialist (CAPS) to help determine which changes you should make.

There are also other costs to consider when looking at aging in place. For example, if in-home care is needed, the average cost can range between $980 and $3,800 per month. The amount depends on whether you need basic assistance with bathing and household chores, or whether you need skilled nursing professionals to visit regularly.

In some cases, insurance will help pay for in-home care expenses. The real difference, then, is in the one-time expense of upgrading your home to allow you to be as comfortable, and independent, as possible.

When and Where to Start

If aging in place is your choice, then it helps to understand the best ways to get started. An article in the Washington Post points out that most Americans begin making necessary changes well before they turn 65. Some make simple changes, like swapping out round door knobs for levered door handles and installing mobility-friendly showers, while others choose to build or purchase a home that already has these improvements.

The key is to start small. Adjustments like comfort height toilets, under-cabinet lighting and roll-out shelving are small expenditures that will mean less stress on your body and more convenience both now and in the future. Then, as funds allow, you can strive for the larger, more expensive renovations like widening doorways, installing a lift or elevator and even investing in technologies like robots and voice-activated home controls.

The possibilities are endless when it comes to making home improvements that will allow you stay in your own home as long as possible. The key to making aging in place affordable is to start as soon as possible and make incremental changes. Don’t wait until there is an accident or health issue that makes the changes a pressing requirement.

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Sources

“6 Thing You Must Know About Aging in Place,” May 2015, Kiplinger’s Personal Finance.

“Fact Sheet: Aging in the United States,” January 2016, Population Reference Bureau.

“Senior Living Options & Costs,” November 2012, Alert1 Blog.

“3 Reasons Why Aging in Place May Not Be Cheaper,” August 2016, MyLifeSite.net.

“Aging-in-Place Options Most Popular with Baby Boomers,” Tim Savoy, March 2016, The Washington Post.

“Aging in Place Versus Lifecare Community: How to Compare the Costs,” Senior Care Advice.

“Aging in Place: Facilitating Choice and Independence,” Fall 2013, Office of Policy Development and Research, U.S. Department of Housing and Urban Development.

“Measuring the Costs and Savings of Aging In Place,” Fall 2013, Office of Policy Development and Research, U.S. Department of Housing and Urban Development.

“The Real Cost of Aging,” Jeff Anderson, August 2016, Senior Living Blog, A Place for Mom.

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

Understanding and Preventing Knee Replacement Surgeries

More - and younger - Americans are getting knee replacements today than ever before. It’s an alarming trend, so it’s important to learn why this is happening and how you can prevent knee problems that require surgery.

According to the Arthritis Foundation, knee replacement surgeries have increased by 188 percent over the last 10 years in Americans aged 45–64. These surgeries are not easy procedures, either. They require weeks of recovery time, and some patients report having residual pain for as long as a year after the surgery.

So, what’s causing the rise in knee replacement surgeries and what can you do to avoid needing it?

Why the Increase in Knee Replacements?

Overall, the Arthritis Foundation found that the number of knee replacement surgeries rose about 120 percent over the last decade for adults between 45 and 84 years of age, with the largest uptick among baby boomers. Many myths try to explain that increase. For example, some people assume that activities such as running and high-impact exercise wear out the joints, causing pain. However, researchers have conducted many studies on the long-term effects of running, and all have shown that it does not damage the joints. In fact, some studies show that running strengthens knees and prevents future pain from worn joints because it increases the cartilage layer that protects the knee.

Three factors seem to drive the increase in knee replacements in baby boomers. The Centers for Disease Control (CDC) estimates that the top cause for the increase is obesity. Americans are heavier now than they ever have been, and the extra weight can prematurely wear the joints, damage ligaments and reduce mobility, which can contribute to bad knees.

The second reason for the increased number of knee replacement surgeries is that baby boomers are more active than previous generations, and they’re not willing to wait for knee pain to become debilitating before opting to have surgery. The Orthopedic Institute of Pennsylvania (OIP) points to arthritis or genetics – which is often a determining factor in osteoarthritis – as the third cause of knee replacement surgeries. Osteoarthritis cannot be prevented, and can cause debilitating pain.

Preventing and Prolonging Knee Replacement

While knee replacement surgery might seem like an easy fix to a painful problem, it’s actually more involved and painful than most older adults realize. Unlike hip replacement surgery, patients report prolonged swelling, bruising and pain during recovery and longer recovery times. Orthopedic physicians recommend waiting as long as possible to have the surgery because, as with any surgery, there can be complications. Also, the average life of a replacement is about 20 years. Because baby boomers are opting for surgery sooner, they will likely face a second surgery during their lifetime.

The Truth About Knee Surgery Sometimes, there’s just nothing that can prevent knee replacement surgery. Margie Dutcher, a retired clinical advocacy nurse from St. Petersburg, Florida, is currently recovering from such a surgery. “I have an entirely new joint – my right knee was completely replaced,” she says. “Nothing that I did caused this or could have changed all this, unfortunately.” Her diagnosis prior to surgery was tricompartmental arthritis, complicated by a torn meniscus and bone spurs. “Rehab starts the same day as surgery,” explains Margie. “I got to my room from recovery about 4:30 p.m. and the physical therapist was there waiting for me. With his assistance and the walker, we walked to the door. I had therapy twice a day in hospital and then three times a week at home. Now I am going to outpatient therapy twice a week. I do specific exercises 2–3 times a day at home in between outpatient visits.” The recovery mindset is the same one everyone should have as they age, she says: Keep moving and stay active. “As long as I do that, I will be back to my swimming and bike riding in due time.”

A better option is to start sooner in preventing problems that may occur later in life. Even for genetic problems, like osteoarthritis, there are a few strategies that can help prolong the onset of knee pain and problems. Check with your doctor before beginning any new strategies.

• Exercise: Experts suggest walking or other low-impact exercises, but if running is your passion, you can continue to do it. Just remember that regular stretching and warm-ups are part of exercise, and you should take caution to reduce the risk of injuring your knees.


• Maintain a healthy weight: Carrying extra weight stresses all of the body’s joints, especially the foundational joints like the ankles, hips and knees. Even a few extra pounds can increase the stress on your joints during normal daily activities.


• Get up and move: If you work in a sedentary job, be sure to get up and move around frequently. Inactivity actually creates more knee problems, so use the 2-hour rule. At a minimum, get up every two hours and spend five minutes or more walking around to get your blood flowing. This also helps lubricate your joints and relieve stiffness.


• Remember your age: Some baby boomers want to continue exercising and participating in sports with the same enthusiasm and intensity as they did during their younger years. Exercise is good for you, but as you age, it’s easier to overdo it and put undue stress on your body. Take your age into consideration and appropriately scale back your activities to help reduce the likelihood of injury.

If you do experience knee pain, try to prolong surgery as long as possible. Often, a combination of physical therapy and pain management can reduce or control the discomfort associated with degenerative knee issues.

Discuss your options for prolonging surgery with your orthopedist. The doctor may be able to perform lubricating or pain management injections that can put off the need for surgery for years. It may not be necessary to wait until the pain is debilitating, but waiting as long as possible reduces the likelihood that you’ll have to suffer through knee replacement surgery a second time.

Knee replacements are not simple surgeries. They’re invasive and painful, and will require weeks to months for complete recovery. The basics – exercise and weight management – will go a long way toward preventing or prolonging the need for a knee replacement.

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Sources

“Should I Really Worry About My Knees?” Susan Paul, September 2015, Runner’s World.

“How to Prevent Knee Pain in Old Age,” February 2017, Arizona Pain.

“Questions and Answers About Knee Problems,” March 2016, National Institute of Arthritis and Musculoskeletal Skin Diseases.

“9 Things No One Ever Tells You About Getting a Knee Replacement,” Aviva Patz, July 2015, Prevention.

“Knee Replacement and Revision Surgeries on the Rise,” Linda Rath, Arthritis Foundation.

“Why More Americans are Getting Knee Replacements Nowadays,” Katie Osborn, September 2015, Money.

“The Lowdown on the Uprise of Knee and Hip Replacements,” Kim Klugh, May 2012, Orthopedic Institute of Pennsylvania.

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

The Ultimate Guide to Financing a Tiny House for Seniors

A tiny house is a small house that is very carefully designed in order to have everything you might need including a kitchen, bathroom, living area, and bed in as little as 100 square feet. According to The Tiny Life, a leading resource for those who live in tiny homes, the average tiny home is 186 square feet, but they can be as large as 500 square feet - much smaller than the typical U.S. house which, according to the Census Bureau, takes up over 2,600 square feet.

While there are definitely challenges to living in such a small space, tiny houses aren’t just dwellings - they’re part of a movement that was started by people who wanted to live simple and minimalistic lives. Many of these people were also overwhelmed with the cost of buying a normal sized home and wanted to live debt-free and not pay rent.

The Price of the Tiny House Dream

According to The Tiny Life, the average cost to build a tiny house is just $23,000 if it's built by the owner. While some tiny homes can range in price up to $60,000, building a tiny house is much cheaper than building a normal sized home. That translates into the fact that around 60% of people who live in tiny homes have no mortgage.

This has made the tiny house movement particularly attractive to seniors, many of whom are looking to downsize and live within their means on limited incomes. Around two out of every five tiny home owners are above the age of 50 years old.

The Difficulties of Financing a Tiny House

While many people might dream of living in a tiny house, there are often road bumps along the way for many would be tiny home owners. One of those road bumps is securing financing. Tiny homes are often built on wheels in order to avoid having to comply with local building codes which would make their construction either impossible or prohibitively expensive. This also enables tiny homes to be portable and to be kept on properties where secondary dwellings are not permitted.

But that makes getting a mortgage for a tiny home often impossible. Very few lenders will offer mortgages on tiny homes if they are not built on a foundation. So, how do tiny house owners pay for their homes?

Manufacturer Financing and RV Loans

A very limited number of tiny home builders offer direct financing on tiny homes. Among the builders who offer financing is Tumbleweed Tiny Home Company which offers RV loans on their products. Some tiny house builders will also allow you to spread out your payments over a period of months rather than pay a lump sum.

What you'll be more likely to find, are tiny house manufacturers who have gotten certified as recreational vehicle manufacturers. By doing so, these builders and manufacturers allow you to qualify for an RV loan in order to finance your tiny home. An RV loan is often easier to get approved for and has lower rates than other types of tiny house financing. That's because RV loans are secured loans where tiny home or RV would act as collateral in case you were unable to pay your loan.

Personal Loans

If your home builder isn't certified as an RV manufacturer or if you want to build your tiny house yourself, then a personal loan is a great option for paying for a tiny home.

To qualify for a personal loan, you must have a good credit score and income. The amount you'll pay in interest will depend on your personal financial situation, how much you're borrowing, and the terms of the loan. Typically, a personal loan would be more expensive than an RV loan because it’s not a secured loan, but the difference can often be minimal.

Should You Use a Credit Card?

Some seniors have a hard time qualifying for either an RV loan or a personal loan, particularly those who are already retired and on a limited income. But does it make sense to finance your tiny house on a credit card? Because of the high interest rates of most credit cards, this could lead to financial issues if you don't have a plan to pay it off.

One option is to get a card with a 0% introductory rate for at least a year. If you have a plan to pay off that balance within the year, then using a credit card might make sense. Otherwise, it's important to be very careful when using a credit card to finance such a big purchase.

Should You Borrow from Your Retirement?

When it comes taking money from your retirement accounts to finance a tiny house, there are a few options. Withdrawals from your 401(k) can sometimes be made without penalties if you’re retired or over a particular age, but the amount you’re able to take out might be limited. There are also options for taking loans from your 401(k).

While some might think the IRA rules around buying a house might apply, that is only the case if your tiny house is built according to code and on a foundation, but there are some circumstances in which you can withdraw your IRA funds.

While borrowing or withdrawing money from your retirement accounts might be possible, it's likely not a good solution. It's important that you speak to a financial planner to determine how it would affect your future income retirement income before doing so.

The Right Solution for You

Ultimately, how you finance your tiny house dreams will likely be based on your particular financial situation, the type of tiny house you want to build or buy, and the kinds of financing you will qualify for. Many seniors will also be able to pay for their tiny houses in cash from the sale of other real estate. Whatever method you choose, you’ll likely love the financial freedom of living the tiny house lifestyle!

	- By Nate Matherson
Nate Matherson is the Co-Creator of a website called LendEDU. Nate enjoys writing about personal finance and helping others learn about their finances.

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Sources

“Tiny House Infographic,” The Tiny Life.

“New US homes today are 1,000 square feet larger than in 1973 and living space per person has nearly doubled,” American Enterprise Institute.

“What Is The Tiny House Movement?” The Tiny Life.

“Can You Use a Personal Loan to Finance a Tiny House?” LendEDU.

“Here’s what happens when you take out a loan on your 401(k)” MarketWatch.

“Can You Use Your IRA to Buy a House?” Investopedia.

With Medicare Interactive Pro, Medicare Rights Makes Learning Medicare Easy

The Medicare Rights Center, the largest and most reliable independent source of Medicare information and assistance in the United States, works tirelessly to ensure access to affordable health care for older adults and people with disabilities through its counseling, advocacy, and educational programs.

Because it can be difficult to navigate the complex world of health insurance, Medicare Rights is partnering with the Society of Certified Senior Advisors to make its comprehensive online Medicare curriculum, Medicare Interactive Pro (MI Pro), accessible to their network of Certified Senior Advisors. MI Pro empowers professionals to better help their clients, patients, employees, retirees, and others navigate a multitude of Medicare questions.

Building on Medicare Rights’ 28 years of health care counseling and educational expertise, MI Pro provides interactive tools to help users learn about the ins and outs of the Medicare program. MI Pro offers a four-level Core Curriculum, with four to five courses in each level. Among the topics included are: “Medicare Basics,” “Medicare Appeals and Penalties,” and “Medicare and Other Insurance and Assistance Programs.”

“With 10,000 baby boomers in America turning 65 every day, the need for more professionals to become Medicare knowledgeable is critical,” said Joe Baker, president of Medicare Rights. “MI Pro is suited to the needs of professionals from diverse fields – including human resources, financial advising, health care, and social work – to educate themselves, train their colleagues, and help their clients navigate the many nuances of Medicare.”

MI Pro is an essential resource for anyone looking to delve deeper into Medicare. It provides exclusive, in-depth Medicare content, interactive features and quizzes, and the ability to keep track of where you left off within each course and complete coursework at your own pace. Structured so that each course level builds on the information learned in previous levels, MI Pro takes its users on a guided learning experience, helping them understand the complexities of Medicare and empowering them with tools to assist others.

To learn more, please visit www.csa.us/Medicare.

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