Wednesday, September 26, 2018

Mesothelioma Awareness Day - September 26th

Is Telehealth the Answer Senior Patients Have Been Waiting for?


The process of gaining access and undergoing medical treatment can be unbearable, but as technology advances, the number of treatment options available to patients increase. The current option dujour is telehealth technology, and while it may seem like a fad, the results speak volumes and senior patients are very much on board.

Telehealth: A Definition


According to the Med News Ledger, telehealth, or telemedicine, enables “interactive communication between a patient and healthcare provider at a different place, and supported by audio and video equipment along with integrated medical devices, enables the clinicians to evaluate, diagnose and treat patients remotely.” The global market for telemedicine is expected to reach nearly $64 billion by 2022, led by the United States and Europe. That market will be aided by the growing number of large employers planning to offer telehealth coverage. Of those surveyed, 96 percent plan to offer telemedicine for employees in states that allow it.


Seniors and Telehealth


But what does this burgeoning technology mean for the senior demographic that is largely now out of the workforce? Telehealth means freedom. Through the use of this technology, seniors are able to stay in their homes longer while keeping up to date with their health care needs. This option, in turn, keeps them safe and appeases their concerned loved ones and caregivers. Nine in 10 adults, age 40 and over, report they would agree to the use of telemedicine for either themselves or an aging loved one, according to The Associated Press-NORC Center for Public Affairs Research.

Telemedicine could be a saving grace for the 62 million people lacking access to adequate healthcare services in the U.S. - many of them seniors. For those patients, aid can’t come soon enough. It is anticipated that by 2020 there will be a shortage of as many as 45,000 primary care providers.

The shortage of doctors is a direct result of the growing senior population - which is expected to skyrocket as the baby boomer population ages. “In 2050, the population aged 65 and over is projected to be 83.7 million, almost double its estimated population of 43.1 million in 2012,” according to the U.S. Census Bureau. The senior demographic of 2050 will be better versed in technology and current reports are suggesting that many of them will prefer to “age in place” as opposed to move to an assisted living facility.

This improved autonomy can lead to decreased rates of depression, a common side effect of being uprooted and moved from the place they’ve called home for decades. Telehealth monitoring enabled one senior living non-profit in Pennsylvania to reduce the number of patients moving from a senior living community into nursing homes from 20 to 12 percent. The success here signifies there’s opportunity to further implement monitoring across the country, giving the senior community the ability to age safely in place with proper medical attention.

Telehealth options supplement the rising need for care with easy access to medical services, help save more lives, and lift the heavy burden of travel and other associated costs that are currently on patients. According to an AJMC report, adoption of telemedicine practices “could collectively save U.S. nursing homes $479 million annually by reducing transportation costs related to in-person physician office visits.”

Telehealth and Cancer Care 


Telemedicine offers patients the ability to receive necessary treatment either close to home or in the home. This alleviates the need to travel each week, or even each day, to doctors offices or hospitals that may be hours away. This may be especially useful for those battling rare diseases like mesothelioma cancer, when specialists are needed but are few and far between. Telemedicine enables doctors to collaborate on cases with those more specialized, including those outside their practice, state, or even country. In addition to monitoring and treating the primary disease, other services, including nutritional and psychiatric advice, can be utilized to help patients with all their healthcare needs.

Patients, senior or otherwise, living in areas where access to care is the most scarce could see the biggest impact from implementing telehealth practices. For example, populations most in need of increased access to cancer care include Native American nations, Southern states, and non-urban populations.

Telemedicine has been used in Kansas cancer care since 1995. The University of Kansas Medical Center (KUMC) has two cancer clinics in rural Hays and Horton, Kansas. Telehealth has been leveraged to help with diagnosis, treatment, and follow-up care for patients. Through the use of interactive televideo systems, video cameras, and internet protocol, KUMC oncologists are able to communicate with nursing staff at the clinics.



Telehealth and Chronic Conditions


While improving cancer care is impactful for seniors, a majority of health issues within their demographic stem from chronic conditions. The National Council on Aging (NCOA) reports that more than 92 percent of older adults have at least one chronic disease. Fortunately, telehealth can be used effectively in disease management practices. Studies have shown that patients with diabetes, hypertension, asthma, and congestive heart failure have had success using telehealth to service their continuous care needs.

In particular, one study found that through the use of telehealth for patients with congestive heart failure decreased hospital readmission. Remote monitoring using telehealth technology can alert medical care teams if chronic symptoms worsen and allow for immediate intervention which can improve outcomes. The monitoring also enables physicians to receive a more robust, and accurate, medical history to inform changes to care plans.

There is still more to do to streamline telehealth and remove other barriers to entry that currently prevent patients from using these services. One of those barriers is the financial cost associated with receiving care.

For the senior demographic specifically, a large barrier to telehealth use is the knowledge gap. According to a study conducted by HealthMine, “almost 90 percent of seniors recently surveyed said they either don’t have access to telehealth through their Medicare plan or they don’t know if they have it.”

The lack of awareness shows that the chief problem is not that seniors are against using the technology, but that healthcare providers need to emphasize the positives of this option and assist patients in becoming acclimated to the digital systems.

Promising Use of the Health Technology


Even with there being more work to do, roughly two-thirds of Americans in 2015 were willing to speak with their primary care physicians via video. Doctors who were surveyed asking the same question had nearly identical responses. In general, interactions involving the patient-centric way of communicating have increased dramatically, from about 350,000 visits in 2013 to an expected 7 million this year.

Put simply telehealth can reduce tedious wait time, save both patients and doctors money, reduce rehospitalization of patients, provide peace of mind for caregivers, and offer patients more autonomy.

For the sake of all patients, every advancement should be thoroughly investigated, including blossoming technologies like telehealth. Using all the tools possible, including emerging treatments and modes of implementing them, can hopefully improve quality of life, patient prognosis, and lead to better outcomes for all seniors.


Sources
http://mednewsledger.com/news/telemedicine-market-global-insights-and-trends-2018/9847/

https://www.forbes.com/sites/leahbinder/2018/04/16/regulators-cant-seem-to-tamp-down-telemedicine-and-thats-a-big-sign-of-change/#3746d68b5429

https://www.insurancejournal.com/news/national/2018/06/07/491490.htm

https://www.nejmcareercenter.org/minisites/rpt/physician-shortage-to-quadruple-within-decade/

https://www.census.gov/prod/2014pubs/p25-1140.pdf

https://www.cnbc.com/2014/01/13/telemedicine-keeps-seniors-out-of-nursing-homes.html

https://www.ajmc.com/contributor/julie-potyraj/2016/04/telemedicine-a-game-changer-for-senior-healthcare

https://www.mesothelioma.com/mesothelioma/

https://onlinelibrary.wiley.com/doi/full/10.1002/cncr.23229

http://www.cancernetwork.com/oncology-journal/teleoncology-extends-access-quality-cancer-care

https://www.ncoa.org/wp-content/uploads/FactSheet_HealthyAging.pdf

https://mhealthintelligence.com/news/telehealth-will-only-benefit-seniors-if-they-know-its-available

Blog posting provided by

Rachel Lynch, Press and Media Coordinator, Mesothelioma Cancer Alliance

Society of Certified Senior Advisors


Monday, September 17, 2018

Seven Top Services Medicare Doesn’t Cover



The surprising array of health services Medicare won’t cover, and how to get what you need without blowing a bundle.


Every day, 10,000 Americans turn 65 and begin Medicare coverage. At last, they have health care coverage for life! But what many don’t realize is the array of services they’ll still have to pay for on their own.

Original Medicare consists of two parts, A and B. Part A covers hospital stays, skilled nursing, hospice and some home health services. However, it does come with a $1,340 deductible per benefit period, and benefits are capped. 

Part B covers doctor visits, outpatient services (think flu shot) and medical equipment. Singles who bring in less than $85,000 (double that for married couples filing jointly) a year pay $134 a month with a $183 deductible. Typically, you pay 20 percent of services after the deductible is met. Be aware that Part B premiums are based on tax returns from two years prior (your 2016 return for Medicare benefits in 2018). 

Prescription drug coverage is provided through Part D, or you can opt for a Medicare Advantage Plan (also known as Part C) through an insurance company that will cover Part A, Part B and Part D.

Despite all the things Medicare covers, it is not a head-to-toe plan. The average couple who retires at age 65 will wind up spending another $280,000 on health care throughout the rest of their lives. Here are the gaps you’ll need to watch out for:

Vision 


Medicare will cover glaucoma, cataracts and macular degeneration. But for the routine vision checks most of us require, you’ll be paying out of your own pocket. Ditto for eyeglasses and contacts. Initial exams can cost $200, with repeat exams averaging $125. Glasses from the neighborhood eyewear store can be an eye-popping $200-$400.

Cover vision costs. For help with the cost of eye examinations, check around for the best deal. Some opticians run specials, such as a free exam with an eyewear purchase. Costco and Sam’s Club offer inexpensive exams that may justify the price of a membership. Check your local Walmart for the cost of an eye exam, too. Don’t forget about a local university with a program for opticians; they may offer extremely low-cost service in return for student practice with a real client.

Online stores may have much better prices than brick-and-mortar shops. Check Eye Buy Direct for their frequent buy one, get one specials. Zenni Optical can ship you a pair of glasses for under $12, and you can add options like anti-scratch coating. Warby Parker lets you try on their frames at home for free before you buy. 

To order online, you’ll need to have not only your prescription for lenses but also eye size, bridge size and temple length. If you have a pair of glasses you already wear, you can likely find the numbers printed on the frame. Or, use the handy guide at Frames Direct to get the measurements.  

Hearing


Half of seniors above age 75 have disabling hearing loss, but you’ll have to hand over greenbacks for hearing aids since Medicare doesn’t cover them. And hearing loss is not something you want to let go, because your brain loses its ability to interpret the signals sent by your ears as you lose your hearing. Wait too long, and hearing aids won’t help. 

The average price of just one hearing aid runs about $2,300, or up to $20,000 for specialized models. Ouch! The FDA is in the process of evaluating and rating personal sound devices, which sell for much less. Be aware that some of these devices are junk, but look at our recommendation for a good one in the paragraph below.

Cover hearing aid costs. Some Costco stores and health fairs offer free screenings, but that doesn’t help with the cost of hearing devices. However, a recent study found Sound World Solutions CS50+  personal sound amplifier to be nearly as good as an expensive hearing aid, although it costs only $349 online. Check out the full study results to find other devices that performed nearly as well.


Dental

PACE Program for Eligible Seniors Covers Costs


The Programs of All-inclusive Care for the Elderly (PACE) offers medical and social services to needy seniors, typically those who are eligible for both Medicare and Medicaid benefits. If you are eligible and choose to enroll, a team of health professionals will provide coordinated care. Generally, this team becomes your primary health care providers, and network options are limited.

For many participants, the prime advantage of this comprehensive care is remaining in their community instead of in a nursing home. Because program financing is capped, health care providers are able to provide all services the participant needs, regardless of whether or not they’re covered under Medicare or Medicaid.

PACE is administered under Medicare, but varies by state. Also, participants have to meet the following criteria:

Age 55 or older

Live in the service area of a PACE                organization

Eligible for nursing home care

Able to live safely in the community

Visit the website to find specific information for your state. 

The average cost per senior for annual dental care is a whopping $685, and specialty visits will tack on more. Nearly a quarter of seniors ages 65 to 74 have severe dental disease, quite likely because dental care requires paying out of pocket. Medicare doesn’t cover preventive cleanings and x-rays, nor fillings or root canals. If you need dentures, you’ll have to cover them, and ditto for oral surgery to combat gum disease. 

Medicare does cover treatments that are essential before someone can undergo another procedure that is covered. For example, extracting a decaying tooth prior to having open heart surgery. Yes, that’s it, so keep your toothbrush and floss handy!

If you have a Medicare Advantage plan, you may have some coverage for routine visits to an in-network dentist. Advantage plans are all different, so contact your insurer to find out if you have a dental plan. Additionally, some Medicare/Medicaid dual-eligible plans offer limited coverage.

Cover dental costs. You may be able to qualify for treatment at a local dental school for a reduced price since students will be working on you. You can also see if your dentist will give you a cash discount or provide a payment plan. For cleanings, you can go to a new dentist and take advantage of advertised special deals for first visits. The latest research shows you really only have to visit once a year to get the same benefits provided by recommended twice-yearly cleanings. 

Finally, consider traveling to get care at a lower price. Medical tourism for dental care is fairly common, with top destinations including Mexico and Costa Rica. Both countries accept U.S. dollars, and you may even be able to get reimbursement from a Health Savings Account if you have one. It’s easy to search for a dentist online. If you’re still nervous, search for one who attended an American or Canadian dental school, and check their reviews.

Long-term care


Custodial care (also known as “assisted living”), the routine care that usually pushes many older adults into nursing homes, is not covered under Medicare. This is a big one, since a 2017 Genworth Cost of Care Study found the median cost of a private room in a nursing home is about $97,500 and the same room in an assisted-living facility costs $45,500. With average retirement income for all Americans over 65 averaging $31,740 per year, you can see the math doesn’t add up. 

Home care (for companionship, light housekeeping and cleaning, etc.) for seniors who are aging in place is also not a covered benefit. 

Cover long-term care costs. Not everyone is going to need long-term care, but what if you do? There’s no way of telling ahead of time if you’ll get lucky, or break a hip and end up in senior living. You can buy a long-term care insurance policy that will help cover costs. Premiums average $3,560 annually for a couple in their 60s to get a policy with payouts of $150 daily, which is less than the $220 daily average expense. One caveat is that this coverage is usually obtained well before you need it, while you’re still insurable.

Check if you qualify for VA benefits as a former military personnel or a family member of one.  Finally, you may need to spend down your benefits to qualify for Medicaid, which covers you in certain facilities. You may be wise to consult an attorney regarding how to preserve wealth; doing this as early in the process as possible may give you more options.

Home health may be covered under Medicare, either as an inpatient at a skilled nursing facility (SNF) or as an outpatient. Home health always involves a skilled provider such as an occupational, physical or speech therapist, or a nurse, and this care may be limited to a number of sessions.

Medical care outside the U.S. 


You’re on that dream vacation in Australia, and you trip over the wastebasket in your hotel room. Or a shark bites your arm. Or that salad you ate yesterday is causing severe distress. Doesn’t matter; Medicare doesn’t cover you abroad. Heart attack? You’re not covered. Need to be airlifted from your rafting expedition? Not covered. 

Cover care overseas. A Medicare Advantage plan often covers emergencies worldwide, but may not pick up the tab for routine care. If you have a basic Medicare plan (Parts A and B), you can purchase an optional Medigap policy for travel. A 65-year-old male would part with between $159 and $236 for a plan that would handle up to $50,000 while you’re outside the U.S., or add on an additional standalone plan for more coverage.

Before you buy a plan through Medigap, check out travel insurance that is offered through a plethora of insurance companies. Investopedia offers a short tutorial on travel insurance options with a few recommended plans just for seniors to get you started. 

Observation


Say you tweak your knee and go to the hospital, which admits you for observation for a few days. Afterwards, you need rehab for your injury. Rehabilitation involves skilled nursing care, which is covered under Part A if you’ve been admitted to the hospital for at least three days. But if they only admitted you for observation, you’re out of luck and rehab will come out of your wallet. 

Cover rehabilitation. Always ask the hospital to admit you. In some cases, they may refuse. Be aware that going to the hospital and even spending the night does not always mean you’ve been officially admitted. Read more about your hospital status and Medicare coverage here. For about $35 (and up) per month, you can get a hospital indemnity plan that covers up to $600 per day for a certain number of days.

Alternative treatment


If you count on massage, acupuncture or chiropractic treatments to keep you in optimum health, don’t expect Medicare to foot the bill. Medicare doesn’t reimburse for your Chinese herbs, either. However, the word is that some Medicare Advantage plans may cover services such as naturopathic therapies in the future. Before paying out of pocket, always check with your insurer to see if a service is covered. 

Cover alternative treatment. Massage schools are a great way to get cheaper treatment. Many offer student massages once a week. Most massage companies have package plans for a reduced rate, or get to know your favorite therapist and ask discreetly if they offer massages for a reduced rate at their house or yours. Ask your chiropractor or acupuncturist if she has a reduced cash price. Lastly, invest in a foam roller and see if you can go longer between sessions, or replace a session with a yoga or Pilates class covered by Silver Sneakers.  

In sum, the most important thing you can do before you schedule a procedure is check with Medicare, or your Medicare Advantage insurer, to see if a procedure is covered. Secondly, check around for deals before you buy services or aids. Finally, make sure the hospital (which should be in-network if that’s a requirement) is coding you as “admitted” and not “observation.” It’s a good idea to have a friend or family member aware of your needs so you have an advocate to accompany you.

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












Famous & 65

September 1 John Zorn, musician



Think you’ve never heard of him? John Zorn has racked up hundreds of album credits as a performer, composer and producer in a broad range of music genres, from classical, to rock, through jazz and even surf music and metal!

He’s also been lauded by Down Beat as “one of our most important composers.” Zorn arranges, composes and produces records, in addition to playing sax, pipe organ, drums, double bass, keyboards and a little clarinet, too. He even established his own record label, Tzadik, in the 90s.

Tzadik has allowed Zorn to promote new musicians outside of the mainstream, as well as a prolific catalog of his own recordings. He tours all over the world, often performing at festivals, and continues to compose for concerts, opera and film.



September 11 Tommy Shaw, musician and singer (Styx)


Guitarist, singer and songwriter Tommy Shaw got his start playing with local bands in his native Montgomery, Alabama. When vocalist/guitarist John Curulewski abruptly left Styx right before a nationwide tour, Shaw was called in to audition. Once they listened to his demo tape and heard Shaw could sing the high harmony for “Lady,” he was hired. “The guitar never came out of the case,” he recalls.

Shaw wrote and sung on six of the band’s eight singles written before 1979. He wrote “Renegade” and “Blue Collar Man” as well as singing “Sing for the Day.” Shaw also wrote “Mademoiselle,” “Shooz” and “Fooling Yourself (The Angry Young Man).” But it was his promotion of “Come Sail Away” (written and sung by Dennis DeYoung) that got the band noticed nationally.

Ironically, it was when the DeYoung hit “Babe” premiered in 1979 that the band began to fracture. Shaw was loyal to the band’s progressive/hard rock roots, and he hated catering to pop radio. He also detested the DeYoung-staged Kilroy Was Here tour, even though it was during this time he wrote his only Top 10 hit, “Too Much Time on My Hands.”

Eventually, the band broke up and Shaw recorded as a solo artist, opening shows for The Kinks and Rush. But eventually Styx reunited and Shaw joined in on and off as he also performed with his band Damn Yankees. Shaw is married to his third wife, Jeanne Mason, and is a strict vegetarian.


September 12 John Williams, American archer (1972 Olympic gold) 


John Williams is the only person, ever, to hold all three archery world titles at the same time! No wonder he pulled the bow for the first Olympic archery medal for the U.S. in 52 years. How did he get his start?

Naturally, he was part of the famed “Shooting Williams Family.” I quote: “Like so many others from his generation, he spent time at the local archery range with his mom and dad.” Hmmm. I got an archery set as a kid and promptly sailed one over the fence where our neighbor was relaxing on a lounge chair. Ended my career right there.

But Williams began shooting in the men’s division when he was 14 and just killed it. In 1984, he was named an Olympic coach, and ran with the torch in 1996. He also worked as a product manager for Yamaha Corporation’s archery division.



September 16 Jerry Pate, golfer


When you win the U.S. Open as a rookie like Jerry Pate did in 1976, it’s hard to go much higher. He had enjoyed a great amateur career, and played on winning U.S, teams for the 1975 Eisenhower Trophy and the Walker Cup. He managed to tie teammate Jay Haas for low amateur at the U.S. Open that year, just before turning pro.

After his Open win in 1976, he also edged out Jack Nicklaus to claim the Canadian Open title. His dominance in the sport led to his selection as Rookie of the Year and Co-Player of the Year. But it’s always hard to stay at the top. Six more tour victories came between 1977 and 1982, including several titles around the world. His last big victory was the Tournament Players Championship in 1982, which Pate celebrated by tossing course designer Pete Dye and the PGA tour chief into a lake next to the 18th green, before jumping in himself.

Shoulder injuries curtailed Pate’s career. He became a broadcast analyst and went into business with a golf course design firm and turf and irrigation company. Not one to rest on his laurels, Pate returned to the University of Alabama for his bachelor’s in administrative science, graduating alongside his daughter, Jenni.

September 27 Benjamin Gene Brown, runner (1976 Olympic gold)


Benny Brown is remembered for running the second leg in the 4x400 Men’s Relay at the 1976 Olympics, when the team won gold. Brown won the 1975 NCAA Men’s Outdoor Track and Field Championship at 440 yards for UCLA, then placed fourth in the U.S. Olympic Trials to qualify for the team.

Brown was an active participant in the U. S. Corporate Games and a part-time coach for Cal State Fullerton’s track team while working for Hughes Aircraft Company. Brown was killed in a car accident at the age of 42.

"He was one of the greatest quarter-milers that ever lived," said Jim Bush, Brown's former UCLA coach.

"He got very mad at me once," Bush said. "I put a slower runner in the mile relay and Benny got the baton when he was 50 yards behind the leader. He caught him and won the race. He told me after, 'Don't you ever do that again.' I told him he ran the fastest time he ever ran the 440 [yards]. Everyone just laughed. This is a great and sad loss."


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









Sources:
Wikipedia.org 
http://articles.latimes.com/1996-02-03/sports/sp-31863_1_olympian 
http://www.archeryhalloffame.com/John%20Williams.htm
Blog posting provided by Society of Certified Senior Advisors
www.csa.us

Looking at People over 100 for Clues to Longevity


Veritas is studying the genes of very old people to figure out how they manage to avoid the diseases that fell their counterparts.


Veritas Genetics is interested in extremes. The company is taking a look at the outliers of the human experience, whether it be for memory, old age or other skills. It wants to know if there’s a genetic component to living an exceptionally long time.

The biotechnology start-up, situated north of Boston, can map the human genome for a price: $1,000. That’s nothing compared to what Apple founder Steve Jobs paid only seven years ago. While battling pancreatic cancer in 1911, Jobs shelled out $100,000 to sequence his genetic code.

That kind of economy enables Veritas to study people like Nelson Dellis, who has won the U.S. memory championship four times. That’s interesting news considering how many people are coping with memory loss from aging and disease. The company has also worked with former NASA astronaut Scott Parazynski and free diver William Trubridge, who can dive more than 330 feet deep on a single gulp of air. 

"I think studying these extreme cases is a really interesting approach," said Robert Green, a medical geneticist at Brigham and Women's Hospital and a consultant to Veritas. "In some ways, the notion of extremes is so fundamental to what we have learned and ever learned about in medicine."

One of the company’s areas of study is extreme old age. Headed by Veritas’ co-founder and chief scientific officer Preston Estep, the team has collected DNA from over 50 people who are more than 110 years old.

"We want them to be as old as possible," Estep said. "But we also need a large enough sample to get a sufficient statistical power."

With only an estimated 1,000 such people in the world, Estep has begun to study those who’ve lived at least 105 years. Another interest is in families where the siblings have all become centenarians. Participants don’t have to pay anything, thanks to a collaboration with the Personal Genome Project. That company is working to sequence and publish the medical records and genome data from 100,000 volunteers.

One barrier to the research is the difficulty finding birth records for some claiming to be at least 100. Birth certificates were not as common then, especially in certain areas around the globe.

Estep can’t say what they’ll discover. That comes with the territory. However, in the recent past scientists have taken data from two women with exceptionally low LDL cholesterol and found a rare genetic mutation common to both that spawned a drug imitating the effects of the mutation. Who knows? Studying genetics may eventually provide the clue to longer, healthier lives.


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







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

Online Budget Planners Save Money and Time



Money manager apps can make your life easier. We take a look at several different managers and tell you which one we think is best for various tasks.


Do you still sit down with a pencil and a sheet of paper to make your budget, calculator at your side? Have you thought about switching to one of the computerized budget systems, but figured it would be too much of a hassle, or no better than your old system? Think again.

There are various free or inexpensive tools and apps to help you pay your bills, save money or even plan and maintain your personal budget and track your investments. Thanks to online banking, they’re quick to set up and easy to use. Plus, they have an array of security features you can view.

Whether you’re a seasoned pro at managing your money, or a newbie taking control of your finances  for the first time, an online money management system will make your life easier. These tools are a whole lot simpler than trying to fill in a spreadsheet by yourself, and the pages are already set up. 

Mint


Our overall winner is the wildly popular (for good reason) Mint. It performs a broad variety of tasks with minimal hassle for the user. 

Billed as a “personal financial management service,” Mint can import all of your bank and brokerage accounts in one place, as well as monthly bills (such as utilities, rent or mortgage) and various sources of income. You create a picture of your income streams (required minimum distributions, Social Security, small jobs, consulting, etc.) and also your anticipated monthly expenses. 

Mint enters your expenses from credit cards and bank withdrawals, cashed checks and online payments. They automatically appear in a related category, which you can change if needed. For instance, it wasn’t groceries you bought at the supermarket, but gas for your car. It’s easy, and you can tell Mint to always place something in a particular category, such as ongoing payments to a local clinic as “charity” instead of “health care.” 

In the Overview tab, Mint shows your financial health in a snapshot. On the left are bank accounts, brokerage accounts and the net worth of your car and home (regularly updated with a number from Zillow). Financial accounts are updated every time you log in. Bills and your current credit score are in the middle, and on the right you’ll find a line-by-line picture of your budget, with a vertical stripe indicating how much of the total allotment you’ve already spent. 

It’s simple to eyeball your budget for overages and savings. If you’re under your budget on any item for the month, it appears in green. Meet your expected expense, and it appears in yellow. Go over, and see the result in red. If you spend $20 on a category where you’ve budgeted $60, a third of the grey line will fill with green. 

Mint boasts a robust platform. Your credit score is enhanced with six categories, broken out to show how much they impact your score, how you’re doing in each and what you could do to improve. Reporting is another win for Mint. A colorful pie chart breaks down spending in every category for any period you choose. Not sure you’re claiming all your business purchase deductions? Click on that category for the year to double-check. Wonder if you’re really spending more on pedicures now than three years ago? Check it out. Caveat: Mint only knows what you’ve been spending since you’ve been using Mint. It can’t retrieve previous information. 

One more feature sweet as tea in Georgia is the one that allows you to save for specified long-term goals. Maybe it’s a savings account for your granddaughter’s college education, or a trip for you to Prague, or both. Enter them in the goals budget, and Mint will tell you how long it should take to achieve each. Save more or less, and Mint tells you how you’re doing. Your goals appear in a box on the budget page that automatically lists the monthly savings needed as expenses, so you’re not tempted to cheat. 

To top it off, Mint is absolutely 100 percent free. It works on the web, Android and iOS, so you can always access your account. Security with the data you’re sharing is tight; you can read about how Mint protects your information here. It can even handle two-factor authentication.

Mint is dang good, but it’s not perfect. What’s not to like? While it is a broad program that is easy to use, it’s barely supported. It claims it offers email support, but feedback from users is doubtful at best. Mint was acquired by Intuit (think TurboTax) in 2009, and since then techies bemoan the difficulty entailed in getting a response from the company. This means that if you encounter a problem, you may need to paddle your own way out. And innovation has come to a virtual standstill since the buyout. But with millions of users, it’s likely you’ll sigh with relief every time you launch the program and know you don’t have to check in with every bank, broker and biller to know your financial health ever again.

EveryDollar


Can You Trust the Credit Score on your Budgeting Service?


Budgeting tools such as Mint show you what they say is your credit score, and even update it automatically. The score impacts how much you’ll pay to finance a car or get a home equity line of credit (HELOC) for home improvements.

With so much riding on it, we wondered if it’s the same score you’d get by asking the big three credit companies, Transunion, Experian and Equifax. Everyone is entitled to a free annual report from the companies to monitor any false reports or information that’s out of date.

“The score that Mint provides is a VantageScore or an Experian Score, which are competitors to FICO,” according to Thomas Eyssell, associate dean and director of graduate studies in the Department of Finance and Legal Studies at the University of Missouri – St. Louis. “The VantageScore and FICO scoring algorithms are somewhat different and can provide different scores.”

In fact, Eyssell suggests, the systems have five basic differences.

  • Scoring. Although both gather similar information to determine a score, they collect it in different ways.
  • Requirements. If your credit history is short (under six months), you won’t have a FICO score, but you may be able to prove credit worthiness with your VantageScore.
  • Late payments. FICO treats all late payments the same, while Vantage dings you harder if you were tardy on the mortgage.
  • Credit inquiries. Say you’re car shopping, and several dealers have made hard inquiries into your credit worthiness. Both FICO and VantageScore bundle these inquiries (which count against you), but FICO uses a 45-day period, whereas VantageScore only allows two weeks.
  • Low-balance collections. FICO ignores unpaid balances under $100. VantageScore doesn’t overlook any amount until it’s paid off.

As a researcher in credit score accuracy among older adults, Eyssell recommends ordering the annual credit report as a precaution. His studies show that many seniors have inaccuracies on their credit reports they never suspect.
Email support is standard on the free EveryDollar platform, or you can pay $99 a year for their Plus service that comes with a phone call from a real person. 

EveryDollar is the birth child of vaunted money manager Dave Ramsey, he of the frugal habits and aversion to debt like it’s radioactive. So it’s a bit surprising that you can buy the Plus version with a credit card, and link either platform to credit accounts. Maybe Dave saw the light of cashback cards, every tightwad’s friend when they are paid off monthly. At any rate, you can connect all of your financial accounts to EveryDollarPlus. However, they’re not on the main screen. 

The initial release of EveryDollar is sparse on reporting features. That may change with future versions as users provide feedback. Where EveryDollar shines is in the ease of its budgeting tool. Broad categories and subcategories are listed on the screen for you, so you scroll through without failing to account for Rover’s annual vet visit or Susie’s trip to the dentist. All you have to do is punch in numbers to get your budget in place. There’s also a place for income, so money coming in and money going out appear on the same page. Can you do it all in ten minutes like the site claims? Yes, according to the majority of users.

One other way EveryDollar beats Mint is in the quality of its design. Maybe it’s just because Mint hasn’t had a facelift in so long, but EveryDollar has a fresh appeal that you may find engaging. On the other hand, many of us resent it when a “free” offer lures us into its costlier cousin. It’s hard not to think that at $99 a pop every year, Ramsey is the big winner here.

You Need A Budget (YNAB)


At $5 a month or $50 for a year, you’ll have to put YNAB in your budget expense category. For those who favor a very hands-on approach, the cost may be worth it. YNAB claims that it can help you find money you may have missed, because it forces you to categorize every expense yourself, rather than doing it automatically like Mint. 

Each day (or however often is necessary), you’ll import and assign a tag to each expense. The idea is that you’ll stay focused and disciplined because you have to account for every dollar. YNAB is also serious about protecting your data, and you can find their security protocols here.  

YNAB doesn’t anticipate monthly expenses like Mint does. Instead, you start with how much money you currently have and then begin importing transactions. The app will only import them for you if you ask it to. The basis of YNAB is a zero-sum budget, accounting for every last dollar. It may be a good choice for someone having issues with regularly going over budget. Rather than anticipating your budget, YNAB takes it a day at a time and forces you to make adjustments as you go. Mint allows you to track expenses with minimal effort after setup, while YNAB buries your nose in every expense. 

YNAB has a tool to help you save for goals, but it works a little differently than the one in Mint. For YNAB, you choose one of three options: saving a specific total amount, saving enough to achieve your goal by a certain date, or choosing an end date and goal amount to allow YNAB to tell you the amount you’ll need to save per month to succeed. This sounds doable until you realize YNAB won’t, say, automatically calculate the dollar amount of interest on a credit purchase you’re paying off. 

Another difference between YNAB and Mint is their focus. Mint shows you your total financial status, while YNAB focuses like a laser on your monthly budget and spending. YNAB won’t show you your credit score, nor will it tabulate your net worth or value hard assets such as real estate or a car.

Like Mint, YNAB works on various platforms, including the web, Android and iOS, so you can access it from a desktop computer, laptop or your smartphone.

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







Sources:
https://www.nerdwallet.com/blog/finance/budgeting-saving-tools/
https://scottalanturner.com/everydollar-review-everydollar-vs-mint-comparison/
https://lifehacker.com/budgeting-software-showdown-mint-vs-you-need-a-budget-1764607246
https://www.ftc.gov/faq/consumer-protection/get-my-free-credit-report 
https://www.usatoday.com/story/money/personalfinance/2017/12/21/fico-vs-vantagescore-5-differences-you-should-understand/964591001/
https://www.youneedabudget.com/
Blog posting provided by Society of Certified Senior Advisors
www.csa.us

How the New Tax Law Influences Charitable Giving



The new tax law is a game changer for taxpayers. There are several things to consider, whether you’re making a small gift or willing your entire estate. 


The Tax Cuts and Jobs Act makes it harder for many average Americans to claim the tax deduction for charitable contributions. Although the deduction for donations hasn’t changed, you must itemize to be eligible to claim it, and the bar has gotten higher.

The new law eliminates the personal exemption, but standard deduction amounts for 2018 will increase substantially to $12,000 for individuals, $18,000 for heads of household, and $24,000 for married couples filing jointly and surviving spouses. An additional standard deduction of $1,300 for the aged (65 and older) or the blind also applies.

To deduct charitable contributions, you’ll need to itemize your deductions instead of taking the standard amount. In essence, your itemized deductions should be more than your standard deduction. What constitutes a qualifying expense for itemizing? Here are the most common Schedule A itemized deductions, followed by how the Tax Act revises them:

  • Mortgage interest. Beginning with loans originated on 12/15/17, you can only deduct the interest associated with up to $750,000 mortgage debt, down from $1 million. Older loans are grandfathered in. Home equity loan interest is no longer deductible.
  • State and local taxes. Sales, real estate and income taxes have lost their full deductibility. They are now subject to a $10,000 cap on any combination of state and local taxes.
  • Charitable giving. There are no major changes to charitable giving rules, although it’s now more difficult for the majority of tax filers to claim a charitable gift deduction, as outlined in this article.
  • Medical and dental costs. The adjusted gross income (AGI) threshold was lowered for 2017 and 2018, when itemizers can claim unreimbursed eligible medical expenses that exceed 7.5 percent. The threshold climbs back to 10 percent in 2019.

While the personal exemption has disappeared, the higher new standard deduction will make a tough hurdle to clear for many taxpayers. A recent congressional report anticipates the new law will cut in half the number of homeowners using the mortgage deduction, from 32.3 million in 2017 to an estimated 13.8 million in 2018. Similarly, the number of homeowners who itemize is expected to drop from 46.5 million last year to 18 million in 2018.

For those able to itemize, donations to charity have minor changes. Cash gifts are now deductible up to 60 percent of gross income (previously 50 percent), and gifts of stock remain deductible at up to 30 percent of income. You may still use charitable deductions for up to six years before they are lost.



How to Pick a Charity

The way you evaluate a charity is likely all wrong.

Take it from Dan Pallotta, who raised $108 million for HIV/AIDS research, and another $194 million to fight breast cancer. After bad press about how much money was spent on overhead to put on their cycling and walking events, his organization closed its doors.

“Three hundred fifty employees lost their jobs because they were labeled overhead,” says Pallotta in his revolutionary TED talk. Worse, the charities lost one of their biggest fundraisers. “This is what happens when we confuse morality with frugality.”

Pallotta says the way we’ve been taught to think about charity is dangerously unhelpful, particularly the use of a single yardstick—overhead expenditures—as the sole or most important evaluator.

“The things we’ve been taught to think about giving and charity and the nonprofit sector are actually undermining the causes we love … Our social problems are massive in scale, our organizations are tiny up against them—and we have a belief system that keeps them tiny,” says Pallotta, author of the book Uncharitable. “We have two rulebooks—one for the nonprofit sector and one for the rest of the economic world. It’s an apartheid.”

Don’t ask about the size of their overhead, says Pallotta. “Ask about the size of their dreams.”

Pallotta advocates that you think of yourself as a philanthropist, no matter the size of your donation. Over time, your small gifts will make an impact. Begin with a cause you want to influence, and find out who is doing the best work on that problem.

Start with a broad search and narrow it from there, Pallotta advises. You can use websites like GreatNonprofits.org, Philanthropedia and GiveWell.org  to begin your search. Use them, he says, but don’t rely on them.

Interview your top two or three candidates. Call and ask for a tour or meeting; development departments exist to build donor relations. Ask what progress the charity is making toward its goals, and what metrics it uses to measure that progress. But if the problem it’s attempting to solve is big and difficult, consider Jonas Salk a year before he discovered the polio vaccine: dreaming big, but empty-handed.

“Overall, for each charity I give to, I ask myself if I believe in their business model and if I feel they have a bold future ahead of them,” Pallotta says.

Charitable Donors Have Options

There are several tax strategies that may help you continue to benefit from charitable giving, even if you can’t itemize. Certain strategies keep income off your return, allow you to itemize periodically or return income to you.

  • Bunching or bundling your itemized deductions. If your qualified donations over a year don’t put you over the standard deduction bar, try giving double that amount every other year. This may be enough to put you over the limit for itemizing every other year.
  • Gifts that provide income. You may wish to make a charitable donation while you still need income. A charitable gift annuity or charitable remainder trust may be a good solution. These gifts require more substantial funding, which may allow you to itemize in the year they’re created. However, only a portion of the contribution is deductible since you will receive income for years or throughout your lifetime. Such a gift may be funded with cash, real estate or stock.
  • Choosing the right assets to give. Which assets you donate can be very important. During your lifetime, consider giving highly appreciated assets such as stock. You’ll avoid taking a tax hit for capital gains on the appreciation, while still claiming the full value of the assets as a charitable contribution. Such gifts can also be used to fund a charitable gift annuity or charitable remainder trust, and will postpone the recognition of the capital gain, which may generally then be paid in smaller amounts over several year.
  • Donor-advised funds. This method allows you to contribute a large sum in one tax year to create or add to an existing donor-advised fund. That may enable you to itemize if the gift is big enough. In years where you’re unable to itemize, you can ask the fund administrator to make charitable distributions. Donor-advised funds don’t cost a lot to establish and maintain. You can find out more about them by contacting a charity you wish to assist, or through financial services firms that administer the funds, such as Fidelity or Schwab.
  • Charitable rollovers or qualified charitable distributions. If you are 70 ½ or older and take required minimum distributions (RMDs) from one or more retirement accounts, you can ask the plan administrator to make a distribution directly to a charity. The distribution won’t be added to your taxable income, but you also won’t receive a deduction for a charitable contribution. The charity gets more, because the money isn’t taxed; you don’t lose if you couldn’t itemize that year anyway.
  • Estate gifts: charitable bequests and beneficiaries. Charitable gifts upon death can impact the causes you support. There are many ways to gift part of your estate to a cause. They include: creating an extra share for charity, bequeathing a specific dollar amount or item of property to charity, and designating a percentage of your estate to charity by naming it as the full or partial beneficiary of a life insurance policy, bank account, investment account or any account that transfers by beneficiary designation. Listing a charity as the beneficiary of a traditional IRA account, which can be broken into several smaller accounts for convenience, passes the money to the charity tax-free. Heirs must pay tax on these inherited accounts.

Wealthy taxpayers can benefit from a nearly doubled lifetime estate and gift tax exemption. It went up from 5.49 million per person last year to an estimated $11.2 million, with inflation adjusted for future years. Double those numbers for married couples filing jointly.

Disclaimer: The information here has been condensed from several sources. It is not meant to be construed as tax, investment, financial planning or legal advice. Please consult with your personal advisors before making any charitable giving decisions.

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







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

MYTH BUSTER: Too Old to Learn?



Discover the truth about your aging brain.


Charles Betty earned his Ph.D. after completing a 48,000-word thesis on the reasons elderly expats living in Spain return to the United Kingdom. Ho hum, you say? Betty was 95 years old and a D-Day veteran who earned the Legion d’Honneur for his service. Not to mention, he finished the course while caring for his 93-year-old wife.

He’s not alone. Great-grandmother Willadene Zedan finished high school in 1943, then received her bachelor’s degree 60 years later for her new career as a doctor’s assistant. Mary Fasano became the oldest Harvard grad at the age of 89. Charlie Ball cut his education short to enlist for WWII, but became the oldest Arkansas Tech alumni as an 89-year-old grandpa.

Then there’s Wally Taibleson, who first went to college at the age of 70 and has since gone on to earn a bachelor’s and three master’s degrees, the last at age 90. “As long as you’re learning,” he says, “you’re not old.”

How Brains Age


The traditional thinking was that brain connections developed at a quick pace throughout childhood, reaching an apex in the early 20s. Cognition reached a plateau around middle age and then began an inevitable decline. Scientists today know that picture is false.

The brain changes continuously throughout our lives. There’s never a time when mental abilities simply hold steady. Instead, certain cognitive abilities weaken as we grow older, while others become stronger.

On a physical level, the hippocampus becomes smaller over time, and the myelin surrounding nerve fibers wears away, slowing the connection speed between neurons. This is what erodes your ability to retrieve information you know, and encode new data.

On the flip side, the branching of the dendrites (extensions of nerve cells) increases, strengthening connections between distant parts of the brain. This allows older adults to better make connections between diverse sources of information. Seniors are superior at seeing the “big picture,” and can understand the global implications from various sources. This skill may be the foundation of the proverbial wisdom of our elders. Think of it as being better at seeing the forest while having a harder time finding the leaves.

Aging Brains Retain Learning Plasticity


Lifelong Learning Benefits Older Adults

When we talk about slowing down the loss of cognition, studies are beginning to show some results. As an example, obesity in midlife may increase brain aging by an additional 10 years, and consuming sugary drinks accelerates brain aging. Recently, high blood pressure has been strongly linked to reduced cognition in later life.
Generally, there are six habits that various studies suggest slow brain decline:

  • Keeping physically active
  • Pursuing intellectually stimulating activities
  • Getting plenty of good sleep
  • Managing stress
  • Staying socially active
  • Eating to keep healthy

What can help you tick several of these off your list at one go? Any one of a number of programs that offer mental simulation with social interaction.
Start with your local colleges or universities; they often let seniors audit classes for a small fee, or even free. The Osher Lifelong Learning Institute (OLLI) offers courses geared to older adults, without exams or grades. Road Scholar has an extensive array of inexpensive travel/learning programs all over the world. The Freebird Club is like Airbnb, but only for seniors, and is always accompanied by social interaction with your host. You can also volunteer your time with seniors in various ways, while enjoying conversation and serving the greater good.

Older brains may be just as adept as younger ones at learning tasks, according to a study from Brown University. However, the more mature brains of older study participants used a different area for learning than their younger counterparts. The study contradicts a widely-held belief that as we get older, our brains lose the flexibility required to learn new tasks.

Younger learners exhibited plasticity in the cortex, where neuroscientists anticipated seeing it. What surprised researchers was that older participants showed a notable change in the white matter of the brain. The axons, or “wiring,” sheathed in myelin transmitted signals more effectively.

“We think that the degree of plasticity in the cortex gets more and more limited with older people,” said Takeo Watanabe, Ph.D., the Fred M. Seed Professor at Brown University, and a co-author of the study. “However, they keep the ability to learn, visually at least, by changing white matter structure.”

Learn Like a Baby


A new theory suggests that the only hindrance to learning as we age is the way we learn. Toss aside conventional attitudes about declining cognition and start learning like you did as a child, said Rachel Wu, psychology professor at University of California, Riverside. Her paper, “A Novel Theoretical Life Course Framework for Triggering Cognitive Development Across the Lifespan,” in the journal Human Development advocates a return to specific learning strategies and habits of broad learning.
"We argue that across your lifespan, you go from 'broad learning' (learning many skills as an infant or child) to 'specialized learning' (becoming an expert in a specific area) when you begin working, and that leads to cognitive decline initially in some unfamiliar situations, and eventually in both familiar and unfamiliar situations," Wu said.
The author defines broad learning as learning that incorporates the following factors:

  • Open-minded, input-driven learning (learning new patterns, new skills, exploring outside of one's comfort zone)
  • Individualized scaffolding (consistent access to teachers and mentors who guide learning)
  • Growth mindset (belief that abilities are developed with effort)
  • Forgiving environment (allowed to make mistakes and even fail)
  • Serious commitment to learning (learn to master essential skills, persevere despite setbacks)
  • Learning multiple skills simultaneously


Stem Cells May Be Key to Future Brain Aging


Recently, the big brains at the Albert Einstein College of Medicine in New York found that, at least in mice, stem cells in the brain’s hypothalamus probably control the rate of aging throughout the body.
"Our research shows that the number of hypothalamic neural stem cells naturally declines over the life of the animal, and this decline accelerates aging," says Dr. Dongsheng Cai, Ph.D., professor of molecular pharmacology at Einstein. "But we also found that the effects of this loss are not irreversible. By replenishing these stem cells or the molecules they produce, it's possible to slow and even reverse various aspects of aging throughout the body."

By injecting stem cells directly into the brains of old mice, aging was slowed down or even reversed. Researchers said this was one step toward retarding the aging process and treating diseases related to getting older.

SuperAgers


A recent study done by the Northwestern University Feinberg School of Medicine in Chicago tested a group of older adults, all more than 80 years old, who exhibit exceptional memories, as sharp as healthy people half their age. The study compared these SuperAgers with a control group similarly aged. The brains of SuperAgers shrink at a slower pace than their peers, and appear to endow them with greater resistance to memory loss.

"We found that SuperAgers are resistant to the normal rate of decline that we see in average elderly, and they're managing to strike a balance between life span and health span, really living well and enjoying their later years of life," says Emily Rogalski, associate professor at the Cognitive Neurology and Alzheimer's Disease Center (CNADC) at the Northwestern University Feinberg School of Medicine.

Ongoing studies are attempting to discern what, if any, biological factors might affect the maintenance of memory in advanced age.

Keeping Your Brain Healthy


Today, we know that just as we should look after our heart health, we need to take steps to maintain healthy brains as well. Reading Senior Spirit may be helping protect your memory right now, according to results from the Mayo Clinic Study of Aging.

Participants who used a computer at least once a week were 42 percent less likely to develop memory and thinking problems than those who rarely logged on. Activity participation in general was an indicator of brain health as well, according to the long-running research on about 2,000 men and women aged 70 and older. Here’s what the study found:

At least once a week               Reduced risk

Computer use                             44 percent

Reading magazines                    30 percent

Crafts (e.g., knitting)                 16 percent

Playing games                            14 percent

“These activities may enhance synaptic connections in the brain and induce or promote new connections,” said study author Ronald Petersen, M.D., director of the Mayo Clinic Alzheimer’s Disease Research Center. He adds that research is increasingly finding that lifestyle factors may help strengthen the brain to allow it to withstand disease.

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







Sources:
https://www.telegraph.co.uk/news/2018/07/27/d-day-veteran-becomes-oldest-person-awarded-phd-british-university/
https://superscholar.org/10-oldest-people-to-earn-a-degree/
https://www.health.harvard.edu/mind-and-mood/how-memory-and-thinking-ability-change-with-age
http://www.hearingreview.com/2014/12/study-finds-older-brains-learn-well-young-brains/
https://www.medicalnewstoday.com/articles/319185.php
https://www.health.harvard.edu/mind-and-mood/challenge-your-mind-no-matter-what-your-age
https://www.aarp.org/health/healthy-living/info-2016/how-to-improve-memory-photo.html#slide1
https://www.sciencedaily.com/releases/2017/05/170503131907.htm
Blog posting provided by Society of Certified Senior Advisors
www.csa.us