Search our Blog

Search our Blog

Tuesday, December 18, 2018

The Right Stress Can Lengthen Your Life

If there’s one thing we think we know, it’s that stress is bad for us. But what if that just isn’t true?

The startling truth gleaned from recent studies is that some forms of stress are very good for us. It appears that Nietzsche was right when he said, “That which does not kill us, makes us stronger.” Our biggest problem is a lack of stress. However, the type and quality of stress we are under defines whether it will help or hurt us.

Human beings evolved over millennia in a world that bears little resemblance to the one we inhabit today. Food shortages and changes in temperature were common as our species evolved, and daily physical exercise was a given. Today, most of us have an abundance of food that we eat in climate-controlled environments. We can limit our movement from bed, to the refrigerator and onto the lounge chair.

This modern utopia created in the name of progress has spawned an explosion of health problems. Obesity, diabetes, heart disease and hypertension are the rewards of our cushy lifestyle. We have managed to remove the stressors that ensured optimal health.

Stressed Cells are Healthier

A team of researchers at the Salk Institute have found a way to remodel mitochondria via short-term stress in order to generate fewer toxic byproducts. These byproducts cause the mitochondria to deteriorate over time, so lessening their number should enable scientists to find new approaches to fight aging on a cellular level.

"The novelty of this study is that we've generated a model in which we can turn off antioxidant production in mitochondria but in a reversible way," says Salk Professor Gerald Shadel, the senior author of the paper. "So we were able to induce this stress for specific time windows and see how cells responded.”

Mitochondria power cells by converting food into chemical energy. In the process, a chemical known as superoxide is created. Superoxide is critical to cellular function, but too much of it can be toxic. So mitochondria also produce an enzyme known as superoxide dismutase (SOD) to convert the superoxide to a less toxic substance.

A group of mice whose SOD enzyme had been turned off briefly to trigger stress in mitochondria looked the same as genetically identical mice at four weeks of age. But researchers discovered a surprising difference. The stressed mice had more mitochondria with less superoxide buildup and higher levels of antioxidants than the control mice. In other words, the stressed mice were healthier, at least from a cellular point of view.

The team found that the stressed mice had developed unexpected molecular pathways that reprogrammed the mitochondria to produce fewer toxic molecules, while at the same time stimulating the cells’ antioxidant capacity.

Shadel, who holds the Audrey Geisel Chair in Biomedical Science, adds, "We are excited to test if the unique mitohormesis signaling pathways we will elucidate in this new mouse model can be targeted to prevent common age-related disease like cancer, Alzheimer's and heart disease.”

Hunger Games Aside, Calorie Restriction is Good for You

Does anyone recall this dialogue from the movie Sleeper, where doctors of the future are discussing a patient?

Dr. Melik: This morning for breakfast he requested something called "wheat germ, organic honey and tiger's milk."

Dr. Aragon: [chuckling] Oh, yes. Those are the charmed substances that some years ago were thought to contain life-preserving properties.

Dr. Melik: You mean there was no deep fat? No steak or cream pies or... hot fudge?

Dr. Aragon: Those were thought to be unhealthy... precisely the opposite of what we now know to be true.

Dr. Melik: Incredible.

Alas, current scientific studies are not supporting banana splits for breakfast.

We’ve known for decades that restricting calories in mammals leads to a longer lifespan. Now, the results of the first trial with healthy humans starting at a normal weight are in. Cutting calories by 15 percent over two years slowed down aging and metabolism. Consuming fewer calories cut down on oxidative stress, which is linked to cancer and diabetes as well as several neurological conditions that tend to crop up in old age, such as Parkinson’s and Alzheimer’s.

"Restricting calories can slow your basal metabolism, and if by-products of metabolism accelerate aging processes, calorie restriction sustained over several years may help to decrease risk for chronic disease and prolong life," says lead author Leanne M. Redman, associate professor of Clinical Sciences at Pennington Biomedical Research in Baton Rouge, Louisiana.

While the study had a fairly small sample of 53 men and women aged 21 to 50, the results were true regardless of what they ate. Subjects lost an average of nearly 20 pounds, but noted no adverse effects, including anemia, excessive bone loss or cessation of menstruation. Conversely, participants enjoyed improved moods and health-related quality of life.

"We found that even people who are already healthy and lean may benefit from a calorie restriction regimen," Redman says.

Several factors influence metabolism, but current theory supports that slower metabolism provides the most benefit for healthful aging. Slowing down metabolism through calorie restriction leads to more efficient use of energy and a longer lifespan.

If restricting calories for a longer life interests you, check out the Calorie Restriction Society. The rest of us may have to resign ourselves to a shorter life.

Good Stressors

On a more practical level, several stressors have been identified that can help you live a better life today. These are specific and short in duration rather than the chronic, all-encompassing stressors associated with negative outcomes.

The best way to extend an animal’s lifespan (including that of humans) is by calorie restriction. (See sidebar). Reduce food intake, and not only does lifespan lengthen, but it triggers a cellular response that increases resistance to chronic diseases and inhibits the aging process. One way this works is by reducing inflammation. Science has found that inflammation accompanies the early stages of many chronic conditions.

The inflammation induced by exercise would seem to indicate that it’s better to be sedentary. But in spite of this short-term effect, the more enduring result of exercise is a strong anti-inflammatory effect. Interestingly, when you take the antioxidants vitamin E and C before a workout, the beneficial effects go away. The body needs the mild irritation caused by exercise to derive therapeutic benefits.

Like people, plants also have had to adapt to the environment. Unlike humans, a plant can’t move to get away from stress. Dangers are many, including UV radiation from the sun, hungry bugs and herbivores, and fluctuations in temperature, rainfall and soil nutrients. Plants have had much longer than humans to adapt differing responses to these stressors we have in common.

It’s no coincidence that about half of all drugs approved during the last 30 years are sourced directly or indirectly from plants. Morphine (1826) and aspirin (1899) are a pair of plant-based remedies still in use today. Consuming plant foods can help us resist disease, but our modern diets contain far fewer plants than those of our hunter-gatherer ancestors. Furthermore, instead of wild food, we eat an abundance of factory-farmed produce with the resistance bred out or genetically modified.

Add Good Stress

Make sure your doctor approves any changes before you switch up your routine. There are several ways to kick-start your mitochondria. Try one or several to find out what works for you.
  • Decrease the number of calories you consume. Studies show that stretching out the time you don’t eat can be helpful. Instead of breakfast at 7 a.m. and a late-night snack, you could try eating dinner at 6 p.m. and then fasting until breakfast.
  • Put more vegetables and fruit in your diet. Organic produce is preferred for low pesticide levels, and look for non-GMO produce.
  • Do something physical every day. Hunter-gatherers traveled long periods at a slow pace, interspersed with short intervals of intense exertion. Mimic this stressor with exercise, such as a long walk with sprint intervals. Also, take your vitamins any time except before you exercise.
  • Turn down the heat, or run some cold water at the beginning or end of your shower. Spend time outdoors no matter the season. 

Click below for the other articles in the December 2018 Senior Spirit


Blog posting provided by Society of Certified Senior Advisors

The Free Tax Prep Service Millions Don’t Know About

The IRS partnered with tax preparation specialists to provide an outlet for free services to people with low and moderate incomes. Few use it, and companies such as Intuit and H&R Block are profiting from their involvement. 

Americans spend more than $1 billion a year in tax filing fees that they don’t need to. That’s a conservative estimate from independent nonprofit ProPublica after it delved into the Free File system  supported by the IRS. And the very companies that offer their services gratis may be making a killing by up-selling and obfuscation due to lack of oversight. Even so, Congress appears poised to codify the system.

In the Beginning

As the internet age dawned at the turn of the century, the IRS created a no-cost electronic filing system for taxpayers with moderate incomes ($66,000 for 2018) or less at the request of the Office of Management and Budget. With its hands full trying to convert to an online system of its own, the IRS appealed to the tax-prep industry for help. Soon, it had an agreement with heavyweights H&R Block, Intuit (developer of TurboTax), and 10 others to form the Free File Alliance (FFA). 

Members of the Alliance (aka the Consortium) would offer free tax preparation services to about 70 percent of Americans at no cost, and the IRS vowed to “not compete with the Consortium in providing free, online tax return preparation and filing services to taxpayers.”

Fifty million tax returns have been processed through the system since its inception in 2003, saving users close to $1.5 billion in fees. That sounds substantial until you do the math and realize that represents about 3 percent of eligible returns. 

Many taxpayers are simply unaware the program exists. 

“I don’t have an advertising budget,” said Tim Hugo, executive director of the FFA, who agrees the program needs more awareness. He argued that it’s the IRS’ responsibility to publicize the program. “The companies are already donating the services. It’s a philanthropic endeavor.”

Critics counter that low participation is exactly what the FFA is hoping for. The agreement keeps the IRS from developing a direct filing option or a return-free option such as those available in many other countries, which the FFA has lobbied against

Deceptive Practices

But it’s well documented that FFA companies use the service as a “free-to-fee” gateway for paid services. Indeed, less than half of those who used the service in 2014 and qualified for it in 2015 took advantage of it. 

That figure may reflect negative experiences with the Free File program. But the data indicates otherwise. Of 2014 users of the software who then didn’t use Free File (but were eligible) in 2015, more than half used the non-Free File version of the same software they’d used to file the preceding year. This pattern appears to reflect the practice of software companies marketing a paid version of their program to taxpayers who filed with them using Free File the previous year. 

In fact, FFA companies routinely email taxpayers a year after they filed with them using Free File. The email says the preparer has their information on file and the taxpayer can click a link to use their services again. But the link routes the client to software they must pay to use. 

Worse yet is how the companies appear to violate privacy laws. 

Federal law requires tax preparers to solicit and receive “knowing and voluntary” taxpayer consent prior to disclosing or using their tax return information for any reason, including marketing paid services unrelated to that return. 

When users select “Turbo Tax All Free” from the IRS Free File homepage, they land on Intuit’s “Turbo Tax Freedom Edition” website. After as little as a single question regarding income, the user is switched to a “Create your account” page to input their email and phone number. They may ignore the tiny, faint lettering below that says by pressing the button to create an account, they agree to terms of use that strip them of the right to file a lawsuit, seek a trial by jury or group claims in a class action suit. All this before they have input the information for their return.

Practical Considerations

You may still want to save some money and take advantage of the free software. If you do, start here. Just be aware that “Trying to navigate the Free File sites, is a bit like living in the Wild, Wild West,” according to taxpayer advocate Nina Olson. 

Sometimes, tax prep companies throw a wrench in the works by using very similar names for different (but similar) products. Intuit offers a “Free Edition” of TurboTax that takes care of federal 1040EZ or 1040A forms at no charge, but charges for state returns. However, you can get the Freedom File version dubbed “Freedom Edition” that does both federal and state returns gratis. And you won’t find Freedom Edition on TurboTax’s homepage.

Then there are the different eligibility requirements among the various providers. They vary according to income, age and state of residence. In theory, the alliance coordinates the requirements in a way that will cover 70 percent of taxpayers under at least one company’s plan. For example, this year TurboTax offers Free File to anyone who earns less than $33,000 or qualifies for the earned income tax credit. You might need to use H&R Block’s plan that allows for an AGI of $66,000 or less … but only for those 50 or younger. 

Visit their website to find other IRS programs offering free tax returns.

Congressional Support

Congress found one thing it could get behind in a bipartisan way. The “Taxpayer First Act,” which includes various provisions to assist consumers—and a provision to make Free File permanent—passed the House in April 414-0.

“It’s a great program that helps save the government money and do free tax filings for people who can’t afford it,” said a spokesperson for Rep. Peter Roskam, R-Ill.

Intuit and H&R Block are standing by the program. They can trumpet the millions of dollars their companies have spent supporting and promoting Free File, as well as programs such as Volunteer Income Tax Assistance. Intuit recently began promoting no-cost filing known as Tax Time Allies

The old adage of “buyer beware” doesn’t quite fit these free-at-the-outset services. But it’s a good idea to navigate the internet carefully and use the IRS site, not an email from a tax prep provider, to file each year.


Blog posting provided by Society of Certified Senior Advisors

When Seniors Argue: Finding the Cause

When an older adult becomes argumentative, you may think they're just getting irritable, but we now know there could be underlying factors that need to be addressed.

Jean finds herself arguing with her mother all the time. They had always had a good relationship, but since her mother was hospitalized following a fall, that bond has deteriorated. Jean has to help her mother more now, which only seems to make her resentful. Her mother refuses to let Jean help her bathe, and when Jean tried to clean out her kitchen cupboards, her mother got hostile. Her siblings, who live elsewhere, can’t figure out why Jean is having problems when Mom is always so nice to them. 

Age can bring about many challenges, including more arguments. There can be a variety of root causes, including physical and mental conditions. If you are a caretaker or spouse, you will probably be the first to notice these symptoms.

Sometimes, it’s a change in tone. An older adult’s comments contain more sting than they used to, or a couple who has spent decades in relative harmony starts to have regular disagreements. Perhaps a senior who has enjoyed a good argument in the past becomes louder and loses the reasoning they used to have. 

Therapists and others working with older adults say the first step is to find where the problem originates. 

Cognition Influences Mood 

Increased anger could be one of the first signs of mild cognitive impairment (MCI), a precursor of dementia or Alzheimer’s, says Dr. Lisa Gwyther, director of the Duke Center for Aging Family Support Program and an associate professor in the department of psychiatry and behavioral sciences. 

Dr. William Dale, chief of geriatrics at the University of Chicago Geriatrics Medicine, concurs. Pay attention if someone says, “‘Gee, Mom seems more argumentative or withdrawn than the last time I saw her,'” Dr. Dale cautions. “There is good evidence that the earliest signs of cognitive impairment are often emotional changes”—anger, anxiety, depression—“rather than cognitive ones”—memory, abstract thought.

It’s a diagnosis that is more and more common. In fact, 1 in 6 women and 1 in 10 men past the age of 55 will develop dementia in their lifetime, according to the Institute for Dementia Research and Prevention. 

Suspicion and paranoia are hallmarks of mild cognitive decline. They lead to feelings of distrust and accusations that may be far from the truth. Jean’s mother may suspect her daughter is trying to remove food from her house, or take away her clothes while she bathes. The most rational adult can imagine similar scenarios if they are under the influence of cognitive decline. 

Dr. Gwyther recalls another dispute where a wife was angry that her husband didn’t want to participate in the holidays, and declared he was being stubborn and lazy. But the truth was quite different. Aware of his slipping memory, he was anxious about remembering names and faces. Out of embarrassment and fear, he was trying to hide his potential failures. 

Hoarding can be a sign of cognitive impairment, too. The hoarder may fear running out of money, or having everything taken away. 

It doesn’t make the diagnosis any easier when MCI can come and go. “There are good days and bad days, good hours and bad hours,” says Dr. Gwyther. “Alzheimer’s and dementia don’t start on Tuesday—it’s a slow insidious onset.”

How to Fight Fair

A caretaker’s relationship with their client can be difficult when mental or physical fitness decline. If you’re the child as well, old hurts may come back to haunt you. How can you move past raw emotion to bring your best self to the situation?

Put the past in the past. You learned how to argue when you were young, and those patterns stick with us over time. Take note of how you react to your parent, and work to be the adult in the room. “Fake it until you make it” is a good way to start. Play the part of the calm, confident child whose feathers can’t be ruffled.

Focus on the present. Declaring, “You’ve always liked Larry more than me!” is not going to resolve the problem at hand. Neither will it solve old grievances, so let it go. Much better to say, “I know Larry visits more than I do, but that’s because I’m paying your bills and making your doctor appointments. I love you just as much.”

Address the specific problem. “I can’t believe you’re treating Dad so badly. How can you do that? What’s wrong with you?!” These remarks are no way to solve a problem. Instead, explore causes and solutions. “Are you worried about being able to stay in your home? Let’s talk about bringing in some help for you and Dad so you can stay here. Is there anything else worrying you?”

Offer a solution. “Mom, you never take your pills when you’re supposed to!” Exclamations such as that only assign blame. It’s much more helpful to say, “Mom, I see it’s getting hard to remember to take your pills. Can I set alerts on your phone to help you remember? Or would it be easier if I put a note on your breakfast table and another one on the bathroom mirror? What do you think?”

Physical Changes Alter Disposition

At the start of this article, we mentioned that Jean’s mother had recently been hospitalized. Physical ailments of any sort can upset emotional equilibrium. 

“Most men get angry at what’s happened to them when they get ill, spouses get angry and scared when he’s not what he used to be—so they fight,” explains Dr. Nancy K. Schlossberg, professor emerita of counseling psychology at the University of Maryland and author of “Overwhelmed: Coping With Life’s Ups and Downs.” Chronic diseases can lead to chronic mood changes. In fact, some doctors argue that diabetes is so often accompanied by depression that it is part of the disease. 

Other changes in circumstances can bring on depression or anger. Retirement, a move, loss of autonomy and shifting roles can trigger fear that is expressed as hostility.

How to React

It can be much easier to blame an older adult for these changes than to understand them. 

“Part of the trap for the caregiver is the idea that you have to do it all, and the guilt you feel when you cannot live up to it,” says Dr. Gordon Herz, a psychologist in private practice in Madison, Wisconsin. Not surprisingly, resentment can soon follow, Dr. Herz adds, because it is hard to acknowledge that, “‘this is too much for me.’”

One way to improve the relationship is to get an ally on your side. A friend, doctor or pastor can give you perspective and perhaps intervene with your parent. Because you will always be the child no matter how old you are, your parent may listen better to someone else. A doctor can “prescribe” in-home help, and a friend can wield gentle influence. 

Talking it over with a parent can lead to compromise and a successful outcome. Your parent may balk at the idea of something as personal as help in the bath, but agree to have someone make meals or clean the house. Once she realizes that getting help isn’t the end of her independence, she may be willing to allow more intimate assistance. 

Hiring household help can take some of the burden off of you and enhance your relationship with your parent. If you are not spending every moment filling pillboxes, cleaning and scheduling appointments, there’s suddenly time to enjoy a meal together or listen to stories from your mom’s childhood. The result can put both the senior and caretaker at ease.

Click below for the other articles in the December 2018 Senior Spirit


Blog posting provided by Society of Certified Senior Advisors

Working Past 100: Anthony Mancinelli

The oldest barber in the world still goes to work 40 hours a week. He started his career when Warren Harding occupied the White House.

Anthony Mancinelli began working as a barber when he was 11 years old, and a haircut cost a quarter. The year was 1922, and Mancinelli had emigrated with rest of his family three years earlier from Naples, Italy. 

“I have some customers, I cut their father, grandfather and great-grandfather — four generations,” said Mancinelli, who has six great-great-grandchildren and charges $19 for a haircut nowadays. 

He still shops for himself, does his own laundry, and pays his bills. When the shop he was working at cut his hours several years ago, he switched to another local salon where he could put in a full week. At first, the receptionist ignored his application because of his age, but he applied again. Owner Jane Dinezza was impressed with his ability.

He has adapted to a wide range of hairstyles over the years. “I cut them all,’’ he says, “long hair, short hair, whatever was in style — the shag, the Buster Brown, straight bangs, permanents.”

Mancinelli lives on his own since his wife of 70 years died 14 years ago. He visits her grave every day before coming in to work. He drives in to work, where “He won’t even let anyone sweep up his hair clippings,” says his son, Bob Mancinelli, 81. “Some of his older customers, he helps them in the chair. He’ll say to an 80-year-old guy, ‘Listen, when you get to be my age. ...’ They love hearing that.”

A veteran of World War II, Mancinelli has belonged to American Legion Post 1976 for 75 years, where he typically orders a whiskey sour. He’s been the choice for grand marshal of the New Windsor Memorial Day Parade more times than he can count.

“He never calls in sick,” Dinezza says. “I have young people with knee and back problems, but he just keeps going. He can do more haircuts than a 20-year-old kid. They’re sitting there looking at their phones, texting or whatever, and he’s working.”

Since being recognized as the oldest working barber by Guinness World Records in 2007, he has been asked many times what his secret is for his steady hand, trim build and health that allows him to still trim the bushes in his front yard. 

Mancinelli avows that he’s never smoked or been a heavy drinker. However, longevity does not run in his family and he’s never been a fan of exercise. “I eat thin spaghetti, so I don’t get fat,” he jokes. Somehow, he has never needed glasses and takes no regular medication. 

“I only go to the doctor because people tell me to, but even he can’t understand it,” he said. “I tell him I have no aches, no pains, no nothing. Nothing hurts me.”

“It’s just amazing that he still works full time,” says stylist Jen Sullivan, 20, who works next to Mancinelli. “Weekends here can get crazy — even I get tired of being on my feet — but he just keeps going.”

Schedule a cut with Mancinelli at Fantastic Cuts in New Windsor, N.Y., about an hour north of New York City.

Click below for the other articles in the December 2018 Senior Spirit


Older Adults Need Newer Cars to Continue Driving

Many adult children worry about their parents’ capacity to drive. New car technology may be the answer. 

One of the hardest decisions any adult child has to make is telling a parent they shouldn’t drive anymore. For the senior, the loss of independence and inability to get to social functions, doctor visits and grocery shopping can lead to depression and isolation. It is a major blow on the list of small indignities that aging often brings.

Adult children may take the keys in good faith when all Mom really needs is as low-tech as a new prescription for her glasses. Recent innovations in driving technology are game changers. Carmakers know that the population of older drivers is growing, and they are designing vehicles to help seniors stay behind the wheel longer.

Statistics on Older Drivers

Consternation over the ability of seniors as a whole to drive may be over-hyped.

By 2025, a quarter of drivers will be 65 and older. A recent study found these older drivers to be 16 percent likelier than drivers 25 to 64 years old to cause an accident, so there is increased concern as parents age. (However, it’s important to note that drivers under 25 are 188 percent more likely than adult drivers to cause an accident.) Additionally, older drivers are several times more likely to suffer a fatal injury when they are in an accident.

Interestingly, one of the reasons older drivers tended to be so much safer than their much younger cohorts was that they change their driving habits to make up for diminished competence. This self-regulation included not driving at night, staying off the road during peak traffic hours and sticking to familiar streets. Many older drivers voluntarily removed themselves from the driving pool, thus leaving more competent seniors as drivers.

Furthermore, drivers’ risk declined as seniors got older. The group over 70 was the least likely of any age group to cause a crash, and half as likely as the group over 55. The study concluded that the pool of drivers becomes more competent with age due to the least capable taking themselves off the road. 

Finally, the study concludes that “because older drivers drive comparatively little, the risk they pose to overall traffic safety is actually much lower than that of other drivers, even though they are likelier to cause an accident when they do drive.”

Determining Driver Safety

While the above numbers may put a few minds to rest, there is plenty of cause for concern if Mom drifts into neighboring lanes, or Dad starts running stop signs. 

Driving involves a complicated mix of physical, mental and sensory skills. The risk involved in poor driving is not only to oneself, but to others as well. The Commission on Law and Aging, in partnership with the American Psychological Association, has produced a trio of books on capacity assessment—one for lawyers, one for judges and another for psychologists. 

The psychologists’ handbook addresses the functional component of driving ability, with an emphasis on finding supports and accommodations. Never ask if the person “has capacity,” but rather ask “does the person have capacity with support.” Would a higher seat or pillow, pedal modifications or a new set of eyeglasses fix the problem? Only then can an assessment be made for flexibility, strength and knowledge of the rules of the road.

Another piece of the driving puzzle is health. Does the driver have muscular or skeletal problems, a possibility of strokes or psychiatric disorders? Dementia can impact not only memory, but also spatial concepts and the judgment needed to safely drive. Family members need to investigate if the problem is temporary, or reversible with the right medication or therapy.

Finally, any assessment must address cognitive ability, which includes attention and processing speed, but also peripheral vision and the ability to multi-task. Reduced cognition may be temporary and/or reversible. Cognitive abilities can be influenced by poor sleep, prescription medications and substance abuse. Resolving these issues may return the person to many years of safe driving.

Is a New Car the Answer?

There are plenty of technologies in the newest crop of cars that could help many seniors stay on the road. The same modifications that make driving easier for all of us can be a particular boon to older adults.

The following six features in particular are designed to cut down on accidents:

  1. Rearview camera with guidelines. All models 2018 and later have to come equipped with a rearview camera, but some come with guidelines to gauge how close you are to an obstacle. For added security, consider a system with a birds-eye view of the car that uses multiple cameras for a 360-degree picture.
  2. Lane departure warning. This feature triggers a warning beep to alert you when you’ve strayed out of your lane. Upgrade the option to include lane-keeping assist, which nudges the steering wheel back toward the appropriate lane.
  3. Blind spot monitoring. Every car has a blind spot on its right rear side.  With blind spot monitoring, your car will alert you when a vehicle approaches on either side. Small lights on the sideview mirrors turn on to warn if there is a car in your blind spot.
  4. Curve speed warning. Modern traction and stability control systems are enhanced with this addition, which automatically slows the car’s speed by up to 10 mph if it detects that the car is taking a curve too fast.
  5. Automatic and adaptive headlights. Modern cars turn headlights on automatically depending on exterior lighting conditions. Adaptive headlights take it to the next level by extending visibility on curves or going up hills. The light beam swivels left and right, up or down to maximize your line of sight.
  6. Crash mitigation. An upgrade of standard cruise control to adaptive cruise control allows sensors on the car to detect vehicles in your path and adjust your car’s speed to maintain a safe distance between vehicles. Some systems include warnings when you are getting too close to another car, and use automatic braking to bring your car to a halt if you don’t react quickly enough.

Evaluating Senior Driving

With so many factors affecting driver safety, it can be difficult or impossible to know if it’s time for Dad to give up the keys. Sometimes the sibling who sees a parent most is the first to realize there are problems. Dad might insist that his driving is perfectly fine. Brothers and sisters might back up Dad, and tension among family members may escalate.

Relinquishing the right to drive is a whole lot easier if the senior agrees that it’s time. But that’s a lot easier said than done. Luckily, there is somewhere to turn for help.

Keeping Us Safe is a nationally recognized “enhanced self-assessment program” for older drivers to evaluate road safety. The company offers a three-hour session performed in the senior’s home that includes an on-road driving exercise and a variety of written exercises for cognition and memory, according to the website.

The driving portion is done in the older adult’s own car, on streets they are familiar with. In addition, the administrator is trained in how to calmly discuss their observations in what is termed a “learning conversation” that includes input from family and friends, as well as the senior.

Results are not shared with the DMV, but are given to family members in a written report. Such a program could be the missing link between the family and the older adult, helping the senior to evaluate his own skills in a low-pressure environment where family members are not present.

Another path is the Smart Driver course offered by AARP. For a reasonable cost ($25 in Colorado), drivers can brush up on safe driving practices, skills and strategies. Defensive driving and local traffic laws are covered. Plus, you can learn proper vehicle maintenance and safety checks.

Even better, adults over 50 who complete the course are eligible for a reduction on their auto insurance premium in most states. The course is offered in certain regions and online, with more than 90 percent who have finished it saying they would recommend it to a friend.

Which Car is Right?

“It’s not about taking away the keys based on age, it’s about function,” according to Elin Schold Davis, coordinator of the Older Driver Initiative of the American Occupational Therapy Association. The current approach is “to support people to enable them to drive as long as possible.” For seniors who just need some adaptations, she recommends a $400 consultation with an occupational therapy driving rehabilitation specialist. 

“There’s no such thing as the best car for an older person,” says Jacob Nelson, the director of traffic safety advocacy and research at AAA. “What matters are the features, and the features appropriate for one older driver are not necessarily appropriate for another.”

AAA offers help for seniors shopping for a new car by offering a site that categorizes makes and models of vehicles in a variety of price ranges.  The site outlines vehicles that can help older adults with different needs.  

Drivers with vision problems can search for a high-contrast instrument panel with large number and letter displays, an auto-dimming rearview mirror and side mirrors with glare reduction. 

Schold Davis counsels people to “plan to spend time choosing a car and select the latest built-in safety features you can afford.” While “not all safety features are alike car-to-car,” she says finding the right car is different for each person. Her top goal for seniors: “Decrease the likelihood of a crash and cushion against serious injury should a crash occur.”

Barring some dementias or serious conditions like advanced vision loss, “the diagnosis of a medical condition should not determine whether it’s safe for someone to drive,” Mr. Nelson said. “What does matter is how you manage your condition—whether, for example, you have diabetes and keep your blood sugar under control to prevent a blackout.” 

By getting Mom a new car, maybe you can put off questions about her driving for years. Who knows, by then a self-driving car may make the discussion about taking away car keys a thing of the past.

Click below for the other articles in the December 2018 Senior Spirit


Blog posting provided by Society of Certified Senior Advisors

Famous & 65

December 6 Thomas Hulce, American actor

An unlikely actor, Tom Hulce was born in Detroit to a father who worked for Ford Motor Company (although his mother was briefly employed as a singer). Hulce knew he wanted to act from an early age, and attended the Interlochen Arts Academy and North Carolina School of the Arts.

He debuted opposite Anthony Perkins in Equus on Broadway in 1975, but he’s best-known for his film roles. He took the part of student Lawrence “Pinto” Kroger in the 1978 classic Animal House.

But his most acclaimed role came in the early 1980s when he beat out the likes of David Bowie, Mikhail Baryshnikov and Sennett Branagh to play Mozart in the film version of Amadeus. His performance earned a nomination for Best Actor at the Academy Awards, where he was beat out by none other than his co-star, F. Murray Abraham.

Hulce got a second Best Actor nomination in 1989 for his role as an intellectually challenged garbage collector in Dominick and Eugene. He went on to play numerous parts for television and film, in addition to maintaining a presence on the stage. In 1996, he was cast in his first animated venture, speaking the title role of Quasimodo in Disney’s The Hunchback of Notre Dame.

Shortly afterward, he retired from acting and turned to producing, where his two epic efforts include The Cider House Rules and Talking Heads, the latter of which won a slew of awards. His most recent effort is The Seagull.

December 8 Kim Basinger, American Actress

You’d never guess that Kim Basinger was so shy as a child, she would faint if asked to speak in class! Luckily, she was able to overcome her insecurity by her teens, when she became the Athens, Georgia Junior Miss. The daughter of a model, Basinger starred with her mom in a Breck shampoo ad before enrolling at the University of Georgia.

She soon decided to take up an offer from Ford Modeling Agency, leaving for the Big Apple, where she made $1,000 a day as a top model. In spite of the big cash payout, she says she never enjoyed modeling. “It was hard to go from one booking to another and always have to deal with the way I looked. I couldn’t stand it, I felt myself choking.”

Basinger has had so many starring roles, it’s hard to chose her best. She was a Bond girl in Never Say Never Again, and starred in the erotic 9 1/2 Weeks. Her performance in The Natural garnered a Golden Globe, but the film with the most commercial success was Tim Burton’s Batman, where Basinger played photojournalist Vicki Vale.

More recently, Basinger took on “passion project” I Dream of Africa in 2000, saying she “cried for hours” when she left Kenya. Unfortunately, moviegoers cried foul after seeing the film, awarding it a miserable 10 out of 100 on Rotten Tomatoes. But the indomitable actress followed that bomb with an acclaimed performance in 8 Mile opposite Eminem and Brittany Murphy.

Bassinger has been married twice, to her makeup artist and then to Alec Baldwin, but she’s been single since 2002. A vegetarian and animal rights supporter, she filmed anti-fur ads for animal welfare group PETA and has lobbied against the Asian dog meat trade.

December 9 John Malkovich, Actor and director

Malkovich is a founding member of the Steppenwolf Theatre Company in Chicago, and sooo much more! He won an Obie in 1980 when he appeared in True West, then nabbed an Emmy for his Broadway debut as Biff in Death of a Salesman a few years later. Critical acclaim has followed Malkovich throughout his career, continuing with an Academy Award nomination for his feature film debut with Sally Fields in Places in the Heart.

Malkovich portrayed the sinister and sexy Valmont in 1988’s Dangerous Liaisons, where a fling with Michelle Pfeiffer on the set put an end to his marriage of six years to Glenne Headly. But Pfeiffer didn’t last; Malkovich met longterm partner Nicoletta Peyran in 1989.

Malkovich went on to act or direct in a plethora of films such as Ripley’s Game, Dr. Jekyll and Mr. Hyde, and Being John Malkovich, but many people have no idea he spent 10 years working in southern France (he speaks fluent French), or that he lost millions of dollars in Bernie Madoff’s Ponzi scheme in 2008.

Finally, as a true Renaissance man, Malkovich created his own fashion company, Mrs. Mudd, which has released two collections designed by the actor/director.

December 13 Ben Bernanke, Economist 

As chairman of the Federal Reserve from 2006 to 2014, Ben Bernanke was a central figure in the America’s Great Recession and its recovery.

As a youngster, Ben taught himself calculus (his school didn’t offer it) and scored a jaw-dropping 1590 out of 1600 on the SAT. Not surprisingly, he was valedictorian of his high school and a National Merit Scholar. Bernanke enrolled in Harvard for undergrad and got a Ph.D. from MIT in 1979. His dissertation (Long-Term Commitments, Dynamic Optimization, and the Business Cycle) sounds like the perfect subject matter to prepare him for his future role.

Bernanke landed in a pot of hot water for his failure to anticipate the financial crisis of 2008. The New York Times noted that Bernanke "has been attacked for failing to foresee the financial crisis, for bailing out Wall Street, and, most recently, for injecting an additional $600 billion into the banking system to give the slow recovery a boost.” Stock guru Jim Cramer nailed the Feds with his famous rant that the economy was on the verge of a nosedive and “they know nothing!”

A whistleblower provided documents in 2010 that Bernanke overruled staff recommendations not to bail out insurance giant AIG. However, senators from both sides of the aisle claimed the move averted even worse problems. What is less controversial is the role Bernanke played in the subsequent economic recovery, using quantitative easing to slowly boost the market, over a period of years, back to its former highs.

Click below for the other articles in the December 2018 Senior Spirit


Blog posting provided by Society of Certified Senior Advisors

Friday, November 16, 2018

You May Control Your Risk for Alzheimer’s

New research shows that each of us may have more control over the likelihood of getting Alzheimer’s than we thought.

When Margaret Daffodil Graham, 74, heard that a local hospital was on the lookout for people with hypertension to volunteer for a study, she jumped on the opportunity. Like over 100 million Americans, Graham suffers from high blood pressure, a condition she’s been treating since her 30s. She figured that being in the study would get her blood pressure monitored at shorter intervals, and perhaps reduce her risk for developing heart disease or stroke.

Unbeknownst to Graham, the study would be benefiting much more than her heart. The Systolic Blood Pressure Intervention Trial (dubbed SPRINT MIND) was designed to see if dramatically lowering blood pressure could influence the risk of cognitive decline, including symptoms associated with Alzheimer’s disease.

The results are in, and provide evidence that lowering blood pressure has the benefit of also reducing risk for mild cognitive impairment (MCI), brain decline that may precede dementia, and probable dementia. Graham and others who participated in the study were taken aback by the results.

“It never occurred to me that controlling my blood pressure could protect me from dementia,” says Arthur Lane, 89, another participant in the study. “I think this is wonderful.”

Drug Treatments Prove Ineffective

Dementia is a concern for older adults around the globe, and rightly so. More than 150 million of them will be affected by it by 2050. Dementia is a broad term that describes a group of symptoms associated with a decline in memory or other thinking skills severe enough to impact everyday life. Types of dementia include Alzheimer’s, Lewy Body and vascular.

Until now, researchers had little to offer when it came to positive steps to take to fend off cognitive decline. It was known that genes play a role in who gets dementia, and that age was a factor, but neither of those are under anyone’s control.

Accordingly, research has centered on drug treatments to battle the disease. But every anticipated breakthrough thus far has failed. With billions of potential dollars at stake, major drug companies have spent heavily on research, to no avail.

 “The data are pretty soft on a lot of things,” says Dr. Ronald Petersen, director of the Mayo Clinic Alzheimer’s Disease Research Center, “so that was discouraging for the field and discouraging for the general public.”

Top Ways to Lower Blood Pressure Without Drugs

Although study participants were able to make use of medications, there’s plenty you can do to keep your blood pressure in a safe range without resorting to drugs. From the Mayo Clinic, here are 10 ways to maintain a healthy blood pressure:
  1. Watch your weight. Blood pressure rises right along with your weight. Excess pounds can disrupt breathing while you sleep (sleep apnea), raising blood pressure even higher. Losing even a little weight can help. You’ll reduce blood pressure by about 1 mm Hg with every 2.2 pounds you shed. Generally speaking, a man’s waist should measure 40 inches or less, and a woman’s 35 inches or less.
  2. Make Exercise a Habit. Thirty minutes of exercise a day can take 5 to 8 mm Hg off of your blood pressure. However, that number will go right back up if you quit exercising, so being consistent is key. Walking, swimming, cycling, dancing – it doesn’t matter what you do. Interval training, or short bursts of high-intensity training, is effective. So is strength training for more powerful bones and muscles. The best option may be to combine all of these activities to keep your routine fresh and interesting.
  3. Eat a healthy diet. Skip the processed food aisles in your grocery store and hug the perimeter, where you’ll find fresh fruits and vegetables. Try the Dietary approaches to Stop Hypertension (DASH) diet, which is low on saturated fat and cholesterol. Also, boost potassium intake to lessen the effects of sodium on blood pressure.
  4. Cut down on sodium. People with high blood pressure can see a reduction of 5 to 6 mm Hg by cutting sodium intake even a little. Sodium is almost always added to processed foods, rather than occurring naturally. Read labels to avoid products, such as soup, with added sodium. Put the salt shaker away; one level teaspoon of salt contains 2,300 mg of sodium. Pump up the flavor with herbs instead. If you can’t go cold turkey, reduce the amount of salt over time while your taste buds adjust.
  5. Limit alcohol intake. Men should limit themselves to two drinks a day, and one for the ladies to lower high blood pressure by 4 mm Hg. Over imbibing can actually send you in the opposite direction, raising blood pressure by several points. It may reduce the effectiveness of blood pressure medications, as well. One drink is 12 oz. of beer, five oz. of wine or 1.5 oz. of 80-proof liquor.
  6. Quit smoking. Every cigarette pops your blood pressure for many minutes, but quitting reduces your risk of heart disease and other health factors. It also takes away smoke-induced bad breath, smelly clothes, tar-stained teeth and a host of other nuisances.
  7. Rein in the caffeine. Looks like this one’s debatable and you may be off the hook. Yay! Caffeine may have little to no effect on habitual consumers. The ones who need to watch out are those who rarely take it in, as their blood pressure may zip up 10 mm Hg with a java jolt.
  8. Reduce your stress. Stop laughing. One method is to focus only on what you can control, and make plans to solve the problems. Another is prioritize time for yourself every day, even if it’s 10 minutes. Finally, research shows that an attitude of gratefulness is good for others and good for you. Smile and give thanks.
  9. Monitor your blood pressure and visit your doctor regularly. Home monitoring lets you know if your program is working, and will alert you if it goes awry. Blood pressure monitors are relatively inexpensive (here’s one for $30) and available without a prescription.
  10. Get support. Family and friends can offer encouragement and support. You can also contact outside groups to find others with practical tips to boost your morale.


It looks like that is all changing. The study offers the most hopeful evidence yet that people may have control over their risk for dementia. Funded by various agencies at the National Institutes of Health, the trial results were presented in July and drew immediate responses from Alzheimer’s experts.
“It’s one of the first real demonstrations of a lifestyle modification having an impact on late-life cognition,” says Petersen, who was not involved in the study.

The aim of the trial was to lower systolic blood pressure to a target of 120 mm Hg or lower over 3.2 years among a group of people with cardiovascular risk factors. High blood pressure is generally defined as a systolic pressure of 130 or greater. Pressure of 120 to 130 is considered elevated, while normal pressure is 120 or less.

Lowering blood pressure alone reduced the risk of mild cognitive impairment by 19 percent and probable all-cause dementia by 17 percent in study participants who achieved 120 mm Hg or less. No amyloid-targeting investigational drug has ever approached this magnitude of benefit. However, Dr. Sanjay Kaul at Cedars Sinai cautions that it’s not as impressive as it sounds. Kaul calculates that the absolute risk reduction was only 1.34 percent for MCI.

The results do “not represent a robust effect,” says Kaul. “However, this has to be interpreted in the context of lack of treatment effect on this outcome with currently available interventions and the relatively short duration of treatment exposure. So, promising data, but not the whole enchilada, as spun by trial investigators.”

The good news gets better. The class of drugs used to lower blood pressure had no effect. Cheap generics performed just as well as name brands. Men and women were equally benefited, and race had no impact. Finally, lowering systolic pressure in those older than 75 provided just as much benefit as it did for younger test subjects.

The rigorous, randomized study involved a sizeable group, including 9,300 elderly adults with heart problems or at risk of developing heart disease. Participants were randomly told to lower their systolic pressure to either less than 120 mm Hg or less than 140 mm Hg. The group was tested over an average of three years on different cognitive abilities, including memory and processing new information.

Lead study author Dr. Jeff Williamson reports that biologically, it doesn’t seem like blood pressure would affect dementia. He makes a comparison between air pressure in your tires, and blood pressure: neither should be too high or too low. “Over time, high blood pressure can damage the walls of very fragile arteries that deliver blood to the brain and other organs,” he says. “And that can produce some of the things we see associated with dementia: inflammation and small strokes.”

Time will Tell

While the study could only make conclusions about a reduction in probable dementia, that doesn’t mean that reducing blood pressure won’t affect the disease. Dementia can take many years to develop, and because the study only covered a three-year span, the results are not in. Furthermore, you should check with your doctor before lowering your blood pressure. One side effect of over-aggressive blood pressure reduction is an increased risk of falling.

Still, it’s the first time a large study has shown we may each have some control over whether or not we get dementia.  “This provides great encouragement for people to say, yes, make sure your blood pressure is well controlled, because right now, it’s one of the things you can do,” says Williamson. “This opens the door to testing more interventions.”

Blog posting provided by Society of Certified Senior Advisors

Managing Someone Else’s Money

Many children or trusted friends of older adults wind up managing their assets, but many don’t know if they’re doing a good job. Here’s an overview to get you on the right track.

A lot of older Americans wind up needing assistance with their financial assets, according to researchers. The skill needed to manage money is different from most daily functions because it relies on cognitive skills.

“Most older adults want to live independently for as long as possible. The problem is, it’s hard to live independently if you have difficulty managing your medications or finances,” said study coauthor Dr. Alex Smith of the University of California at San Francisco.

Many Seniors Need Help with Money

Smith and his colleagues analyzed data on 9,434 men and women available from the long-term U.S. Health and Retirement Study. Over 10 years, they found that 2,824 people, or 30 percent, developed difficulty managing their finances. Approximately a third of the original group died before demonstrating difficulty.

Among people at the relatively young age of 65 to 69 when the study began, nearly a quarter (23 percent) developed problems over the next decade.

“We don’t help people anticipate the fact that they may lose these abilities,” said Dr. Holly Holmes of the University of Texas Health Science Center at Houston, who wasn’t involved with the study. “We assess them when the abilities are already gone, and people often don’t have a plan in place. We rarely counsel 65-year-olds about their risk and how to plan for it.”

What the study couldn’t measure was loss of function about which the participants were unaware, since the answers were self-reported. “The elephant in the room is that this study covers self-reported losses of function, so the rates are actually much higher for those who don’t realize they’ve lost their abilities,” according to Dr. Mark Lachs, director of Cornell University’s Center for Aging Research in New York City.

Free Guides for Fiduciaries

The Consumer Financial Protection Bureau provides guides tailored to the needs of four different fiduciary capacities:

Additionally, because fiduciary powers and duties vary from state to state, there are six state-specific money management guides. The six states (Arizona, Florida, Georgia, Illinois, Oregon and Virginia) have high populations of older adults. They also offer set of tips and templates for creating your own state-specific version.

Each guide is available as a PDF or can be ordered for free in quantities up to 200. 

What Caregivers Should Know

If you’re the one who steps in to help a loved one manage their money, there are many things you should know. One caveat is that it’s always easier to plan ahead. If your loved one is using the ATM and balancing their checkbook now, it may be possible to add a trusted name to their checking account. In the event of stroke or another emergency, that person can step in. It’s essential to have another name on the account if the loved one has been diagnosed with a progressive disease, such as dementia.

Although a joint account is usually the easiest way to make payments and track expenses, there is risk involved. Most fraud on older adults is committed by a family member (see sidebar). Creditors of either person can try to collect from the account. If either person dies, the money automatically belongs to the other account holder. Some banks will allow you to have a convenience account that allows another person to write checks and make deposits and withdrawals, but will not give them ownership in the event of death of the other account holder.

A caregiver can also help set up automatic, online payments for telephone, cable, utilities, mortgage, credit card and other payments. It’s wise to make a simple budget to monitor income and expenses.

Investments and bank accounts should also be monitored. Mint is one free resource that is both easy to use and capable of aggregating investment and banking information along with having a robust budget platform.

In the event that your loved one is uncomfortable allowing a friend or family member access to financial information, money-management programs can help. Find one at the National Association of Area Agencies on Aging.


Whoever is managing the money should be transparent and above reproach. Decisions should be made in the exclusive best interest of the account holder. Here are some guidelines for caregivers who manage money:

  • Always act in the best interest of your loved one.
  • Use the memo field to record what every check is for.
  • Never, ever borrow from the account.
  • Do not use the account to pay for anything that also benefits someone else. For example, your loved one’s account shouldn’t fund a car purchase that will take her to the doctor but also transport you to work.
  • An open-book policy is the best for establishing trust. Give other family members access to the books, and provide bank statements to assure them you are being a good steward.

Financial Fraud Often Committed by Family Member

About 1 in 20 older adults reports being financially abused by a family member in any given year, according to research funded by the U.S. Justice Department. It may involve stealing money or taking over assets without permission. Financial exploitation causes seniors to lose almost $36.5 billion per year, according to one estimate from financial services firm True Link Financial. Many of these cases never are brought to court because families don’t want to air their dirty laundry or send a member to jail.

Money is only part of what is lost when the perpetrator is a family member or trusted caregiver. Some people lose their home, says Kathleen Quinn, a senior advisor and past director of National Adult Protective Services Association. Being victimized by someone trusted can lead the older adult to lose their ability to count on others, making her withdrawn and vulnerable to further victimization. Studies show financial abuse raises the risk for depression and suicide. “This is obviously about more than just money,” says Sarah Barnard, a social worker who manages an elder abuse prevention program at WISE & Healthy Aging, a nonprofit social services organization in Santa Monica, California.

If you suspect someone is financially abusing someone you love, contact Adult Protective Services, local law enforcement or the senior’s financial institution.

Making It Legal

Your loved one should choose someone they trust to be the legal guardian of their assets, or fiduciary, while she is still healthy. This can only be done while the person is still completely competent. There are four ways to become a fiduciary:

  1. Power of Attorney (POA). A durable power of attorney assigns power to another to make financial decisions in the event of incapacitation. POA must be granted when your loved one is of sound mind, and it can only be revoked in sound mind. If no one has a POA or trust, the family may have to spend time and money in court to file for guardianship.
  2. Trustee. In sound mind, your loved one can elect to transfer assets to a revocable living trust and name a trustee. If she becomes unable to make sound decisions in the future, the trustee acts to keep the trust’s property safe. This can include moving items to a safe-deposit box, maintaining insurance policies, making careful investment decisions and paying taxes. Because it is revocable, as long as your loved one is of sound mind and the trust allows, she can elect to change or terminate the trust.
  3. Government fiduciaries. Appointed by a government agency, these fiduciaries manage monthly benefit checks, such as Social Security or military pension payments.
  4. Court-appointed guardians.  A court may step in and appoint a guardian or conservator if it finds that someone cannot manage their money or property alone. The guardian is required to act in the best interest of the protected person, in addition to reporting regularly to the court. Guardians must prepare accountings of income and assets, along with details about how the money is being spent.

What to Do about Conflicts

Money has the amazing ability to create conflict, even among the most civil of families. Siblings are particularly vulnerable to its temptations as they deal with the ongoing loss of a parent to dementia or impending death. Nip this problem in the bud by reaching out to siblings and other interested parties before they voice a complaint. Offer to show them the record books, explain purchases, and answer any questions. If they aren’t satisfied, ask a family counselor, mediator or social worker who consults with families in your situation to step in. A list of mediators is available from The Association for Conflict Resolution.

If there is no one who wants to take over a loved one’s finances, or if the family dynamics don’t favor that solution, your best bet may be to consider a daily money manager/management (DMM) program. These versatile programs can do everything from reminding someone to pay a bill to taking over financial management. Daily money managers pay bills, balance checkbooks, maintain a budget, organize bank statements, track receipts and tax return documents, and even figure out medical bills. Start your search at the American Association of Daily Money Managers, which has an ethical code for members.

Remember to take your time and use caution when hiring a DMM, because they are not regulated by law. Get referrals, and ask the following questions:

  • What is your experience as a daily money manager?
  • What are your credentials?
  • How much do you charge, and what is included in the fee?
  • Is there a minimum charge per visit? a minimum of visits per month?
  • Can you provide references?
  • What will happen if you get sick or go on vacation?
  • Are you bonded and insured?
  • Will you work with your client’s professional advisors, such as her lawyer and accountant?

Remember to monitor accounts, even when you’ve hired a money manager, even though it’s annoying.

Click below for the other articles in the November 2018 Senior Spirit

Older Adults Without Children: A Growing Group

As more baby boomers head into retirement without children, they’re networking and finding a variety of ways to navigate old age just fine, thank you very much.

Former teacher and librarian Batya Lewton, 82, never married or had any children. She lives in New York and wondered who would take care of her as she grew older on her own.

“You have to think in advance; you can’t assume that people are going to know what you want done for yourself, or how you want to be taken care of, whether you want to stay in your home or not,” she said. “It’s important that people who you care about and who care about you know exactly what you want.”'

So eight years ago, Ms. Lewton granted power of attorney to two of her friends who live in the same apartment building. They are both listed as executors on her will, and she’s given them information regarding her funeral. She wants to stay in her apartment until that day comes. She knows just about everyone, and many are elderly like herself.

Other childless couples and singles are banding together in cohousing for people of all ages. People like Nancy Squires, 58, the owner of an I.T. company near Washington. Her biggest fear is being put in a nursing home. She’s been saving for retirement over decades, and now she talks with her friends about moving in together.

“I love the idea of a communal living arrangement with separate spaces and shared expenses,” she said. “Not like in the ’60s. More of a 21st-century model, like a large farm where someone has horses, another raises/trains dogs for others, some of the people might coordinate an organic garden, some might cook gourmet dinners a few times a month. It’s all about really living to your fullest without eating dinners alone — unless you want to, of course.”  

Although children typically provide nearly 70 percent of long-term care for their parents, a 2012 study found that only 3 percent of parents thought their children would care for them if they became ill. 

“While it’s great to have kids who are available to help, there are a lot of complications with having kids around,” said Audrey K. Chun, a doctor who is also a medical director at the Martha Stewart Center for Living at Mount Sinai Hospital, in New York. “A lot of the dynamics, decisions that have to be made around the end of life, disagreements that arise between siblings, what mom or dad may have wanted, can be very emotional. Many of my patients without kids are interested in not wasting resources at the end of life — when it’s their time, they don’t want unnecessary suffering, or to be a burden on society. They want to die naturally. Because they don’t have children to advocate for them, they’re much more open and direct about that.”

It’s always important to plan for retirement, but for those without children around, the task may be even more critical. You can’t always count on friends to fill in the gaps.

Planning for Old Age

“You have to build the infrastructure around yourself to compensate for the fact that you don’t have family,” says Ken Moraif, senior advisor at Money Matters, a financial planning firm in Dallas. Put together a team that includes both friends and paid professionals. 

A recent survey found 53 percent of childless seniors had no one to call if they were bedridden. Another concern is finding a ride to the doctor. It may be time to reconsider your living situation. One option is to move to an apartment building for seniors, where residents can use the buddy system to help each other out. 

You may need to look for connections in your own community. Join a church, seek out your local senior center, or find a regular opportunity to volunteer. If you already have a group of friends, consider starting a breakfast group. One former teacher meets with friends six mornings a week. “It gives us something to look forward to in the morning,” says 83-year-old Wilbur Repp. If someone doesn’t show up, other members will check to make sure all is well. 

Making those connections well in advance of when you need help is key. Help out other community members by driving them to appointments, weeding the lawn or delivering food when they’re sick. “One 89-year-old may drive and another may not,” says Edwin L. Gaskin, a financial planner and founder of Your Financial Architects, a financial advisory firm in Elkridge, Md. “It’s really important to establish those relationships before you need them,” he says.

Linda Adler, founder and CEO of medical advocacy and consulting firm Pathfinders in Northern California, suggests that people carry a laminated card with the name and number of their doctor, along with current medications and dosages. She says, “I don’t want my clients to be anonymous when something bad happens.”

Figure Out Your Finances

Inheritance is another factor that should be in place long before it’s needed. Many childless adults choose favorite charities for donations. Former teacher Wilbur Repp built up a sizable housing portfolio in retirement. He decided that when he dies, his 30 buildings will be sold and the proceeds used for scholarships to further the educations of local students. “I don’t have any pressing heirs for my estate,” he says. “It’s for the student who is overlooked in the classroom. There’s always two or three like that.”

 Repp turned to a colleague in a local charitable group to dispose of his assets. This job should always go to someone you can trust, but that varies from person to person. Elder law attorney Michael Amoruso has clients who tapped long-term neighbors for the job. Others may name a sibling, or a niece or nephew. 

You’ll need to name a health care power of attorney for medical decisions, and a financial power of attorney for your assets. It doesn’t have to be the same person. In fact, naming more than one individual provides checks and balances and spreads out the work. One option is to hire a monitoring service such as EverSafe‎ to monitor accounts in order to provide protection against fraud and I.D. theft.

Not everyone has such an abundance of assets. Many in reduced circumstances have to think outside the box. When Elaine Bearden, 61, lost her job as a technical writer, she decided to become a landlord. “At this stage of life, my resources are thin,” she says. Bringing boarders into her home will help defray expenses and create a network of others to turn to when someone needs help.

Elder Orphans Connects Childless Older Adults

Shuttling the 125 miles from her home in Dallas to attend to her aging parents in West Texas over six years, Carol Marak realized how much help she might need as time went on. Marak, now 67, is one of a growing number of “elder orphans” who are childless older adults. In February 2016, Marak started the Facebook group Elder Orphans to connect with people in a similar situation and share concerns and ideas about how to manage without children to help out. Currently, the group has more than 8,000 members.

There are many people aging without a spouse or children, it turns out. Dubbed “solo seniors,” they represent close to 22 percent of adults age 65 and over. The group is growing. In 2010, 12 percent of women age 80 to 84 were childless, but that number is estimated to swell to 16 percent for the same age group in 2030, according to a report by AARP.

To join Marak’s group, you must be age 55 or older, unmarried and without children close-by. Members ask and give advice about revocable trusts, leaving the world of work, and what to cook when you can’t look at another frozen pizza. “It’s been impossible in my current life to find folks who can understand what I’m facing being 64, never married, no kids, nephews or other relatives in my life,” one poster wrote. “I foolishly counted on my ‘family of friends’ to be around in senior years, but they all have spouses, kids and grandkids, plus oodles of other relatives, and tell me they are too busy to be involved with me.”

Maintaining Control over End-of-Life Decisions

If you become incapacitated, a durable power of attorney can step in to make sure your wishes are carried out. This agent needs to be chosen when you are fully capable of making decisions. Otherwise, the court system will appoint a legal guardian for you. “You lose total control,” says Amoruso, who serves as president of the National Academy of Elder Law Attorneys.

Another method for keeping some control regarding your future care is to purchase long-term care insurance. The median cost of a home health aide hovers around $4,100 a month , while a semi-private room at a nursing facility runs about $7,148, according to the 2017 Genworth Cost of Care Survey. Financial advisors say that those with more than $2 million of investable assets can self-insure against this risk, but anyone with less ought to weigh their options. 

As we age, our ability to make sound financial decisions often deteriorates. A daily money manager can pay bills, collect tax documents and even assist with medical claims. Social worker and daily money manager Barbara Boustead has several childless seniors as clients in Madison, WI. She prefers not to become financial power of attorney, although some do. One client in her 90’s is still sharp, but has failing eyesight due to macular degeneration. 

Solo aging doesn’t mean you have to go it alone. “In our society, we tend to put so much value on being independent,” says Anne P. Glass, a gerontology professor at the University of North Carolina Wilmington. “I would argue that you’re better off being inter-dependent, especially as you get older.”

Click below for the other articles in the November 2018 Senior Spirit

Health – You May Control Your Risk for Alzheimer’s