Monday, June 24, 2019

Understanding RMD Withdrawals

It’s critical to have a firm grasp of required minimum distributions and some related tax strategies that won’t run afoul of the IRS.

Tax-deferred retirement accounts are a great place to tuck away money for your later years. Your dollars can grow without having to pay Uncle Sam, and the power of compounding works to your advantage. But don’t forget that the tax man cometh, and the IRS will be looking for its share of your retirement pot once you turn 70 1/2.

How Soon RMDs Start

Required minimum distributions (RMDs) are the federal government’s way of getting their share of your tax-deferred investment vehicle. Whether you have a traditional individual retirement account (IRA), simplified employee pension (SEP) account or a SIMPLE IRA, you must begin required withdrawals according to the IRS schedule or face stiff penalties. The distribution counts as income for the tax year in which it is taken.

To simplify, we’ll refer only to your traditional IRA in this article. (You paid taxes on your Roth IRA when you put money in the account, so there are no RMDs on a Roth). Check out this publication for IRS rules on all tax-deferred investments.

You have a choice of taking your first withdrawal during the year you turn 70 1/2, or waiting until April 1 of the following year. Then, you must take a specified distribution annually. Some people like to wait until the following year, because they have just retired and their income is substantially reduced the next year. But not everyone should wait until the last possible date for their first withdrawal.

The tax implications could be significant. If you wait to take your first distribution the next year, you will have another withdrawal to make for that year. Taking out two RMDs in one year could kick you into a higher tax bracket, and may create or increase taxation of your Social Security payment. See the sidebar “Your Birthday Determines When RMDs Begin” for further clarification.


You should also note that the first money out of your tax-deferred retirement account in any given year is considered to be the RMD, and it cannot be rolled over. You may choose to take out additional funds after you take your RMD, but whether they are for a 60-day rollover payable to you, a Roth conversion, or any distribution from an employer plan such as a 401(k), 403(b) or a pension, your RMD must be paid out before moving any other funds out of your IRA.

So, if you have funds in your employer’s 401(k) plan, you would have to first take your RMD from the 401(k) before moving the balance to an IRA. 

Your Birthday Determines When RMDs Begin

The month you were born sets the date for your first RMD.

  • Those born in the first six months of the year, from January through June, will usually begin RMDs the year they become 70 years old.
  • Those born in the last six months of the year, from July through December, will generally start taking RMDs the year they turn 71 years old.

However, it’s not quite that simple. The government allows you to wait to take your first RMD up until April 1 of the year after you turn 70 1/2. But the downside is that you’ll be required to take two RMDs that year, your first RMD and the RMD for that year. 

For example, if Diane turns 70 on February 21, 2019, she will be 70 1/2 on August 21. Diane must take her first RMD in 2019, but she can wait as late as April 1, 2020 to remove the initial amount. However, she will also need to take her second RMD in 2020, and it must be taken by December 31. Both amounts count as income in the year they were taken out of her IRA.

As another example, Tom turns 70 on September 7, 2019. He will be 70 1/2 on March 7, 2020. He will be required to take his first RMD in 2020 but could wait as late as April 1, 2021. However, he will also have to take a second RMD for 2021 by December 31 of that year.


You should also note that the first money out of your tax-deferred retirement account in any given year is considered to be the RMD, and it cannot be rolled over. You may choose to take out additional funds after you take your RMD, but whether they are for a 60-day rollover payable to you, a Roth conversion, or any distribution from an employer plan such as a 401(k), 403(b) or a pension, your RMD must be paid out before moving any other funds out of your IRA.

So, if you have funds in your employer’s 401(k) plan, you would have to first take your RMD from the 401(k) before moving the balance to an IRA.

How to Calculate Your RMD
The IRS RMD Worksheet will work for most account owners. Your married status is determined on January 1 of each year. The worksheet uses the Uniform Lifetime Table to figure out how much you must remove.

If your spouse is the sole account beneficiary and is more than 10 years younger than you, you will make slightly lower RMDs by using the required Joint Life and Last Survivor Expectancy Table. You can use the IRS RMD Worksheet that applies to your special situation.

Use this handy RMD calculator to compute your mandatory minimum distribution from a traditional IRA. Combine the balances of all your traditional IRA accounts on December 31, 2018, but leave out any Roth IRAs. The calculator asks for your primary beneficiary and date of that person’s birth to automatically use the correct table.

As a service to their clients, financial advisors and brokers commonly calculate and even automatically distribute RMDs from their client’s account.

Tip: Remember that the beneficiary or beneficiaries listed on your account(s) supersede a will. If your ex-husband is still the beneficiary on your IRA, he’ll inherit the money. It’s the same for life insurance, so make sure your intended recipient is the one listed on your account.

Penalties and Payments

Should RMDs Start Later?

In the fall of 2018, President Trump asked the Treasury Department to review the rules surrounding RMDs. Updating the life expectancy tables, which was last done 16 years ago when Americans lived on average more than a year less than today, makes sense, although Congress is required to make the change. But few older adults would benefit much from slowing the amount they must withdraw from their IRAs and 401(k)s.

Current RMD requirements combine the life expectancy of the account owner with that of an imaginary beneficiary 10 years younger. This makes for generous assumptions. The life expectancy of someone who is 70 is more than 27 years; that’s far longer than the reality.

The relatively few people with large defined contribution assets used as estate planning vehicles would come out well from such changes. Many are not so fortunate. To meet their living expenses, a lot of retirees with small accounts already withdraw more than the IRS requires. They wouldn’t see any benefit.

Almost half of retirees report less than $100,000 in retirement savings. If 1.6 years are added to life expectancy tables, someone with $137,000 in retirement funds and in the 10 percent income bracket would save $27.60 annually. Hardly a windfall.

At around the same time, the House considered eliminating RMDs on employer retirement plans with balances under $50,000. It seems like a worthy idea, but it wouldn’t make much difference for most account holders. RMDs on that size of account are fairly modest to begin with, and are often depleted to pay for living expenses.

The IRS has waited, sometimes decades, for money from your tax-deferred account. When RMDs are due, the tax agency will make sure you comply by making the penalty so onerous that you dare not do otherwise. If you fail to take distributions, or if the distributions you do take are not enough, you will owe a 50 percent flat rate excise tax on the difference. Ouch.

To take an RMD, you can remove money from any of your traditional IRA accounts in any way you like, as long as it adds up to your RMD. You can take equal percentages from several accounts, or a large amount from one, less from another, and nothing at all from remaining accounts. The IRS doesn’t care, as long as the correct amount is taken. You are also free to take more than the RMD in any year.

Tax Strategies

Many retirees need the money from their RMD for living expenses. However, some individuals with higher net worth or a high proportion of funds in a traditional IRA may not need the entire RMD amount. For these people, it’s important to strategize to keep taxes on the withdrawals as low as possible. Here are some options to discuss with your accountant.

  • You must use all of your traditional IRA accounts, including rollover IRAs, SEP IRAs and SIMPLE IRAs, to calculate your RMD. But you have the option to take the money out of any one or a combination of the accounts. You can choose to remove the money from the IRA that has the highest fees, limited investing options or a concentration in a single stock. You can also trim from accounts to re-balance and maintain your desired allocation.
  • RMDs in traditional IRAs and 401(k) plans are calculated and withdrawn separately. Each 401(k) RMD must be taken separately as well. If you’re still working when your first RMDs become due, you may be able to wait until April 1 of the year after you quit working to take the RMD from your current employer’s 401(k). If your current employer allows it, you may be able to roll over funds in your other 401(k)s and existing IRA Rollover accounts to your current plan, thus putting off RMD withdrawals.
  • Make sure your administrator doesn’t automatically withdraw RMDs proportionately from each of your investments. Doing so could cause stocks or funds to be sold at a loss. Usually, you can elect to take your RMDs from cash, and the administrator will send you an alert ahead of time if you need to liquefy assets. 
  • You can transfer up to $100,000 of income tax-free directly from your IRA to charity each year after you turn 70 1/2. This is called a qualified charitable distribution (QCD) and it counts toward your RMD. The transfer must be made directly from your IRA to the tax-qualified charity. Instead of the IRS taking a share in the form of taxes, the charity gets 100 percent of your money. This includes any church contributions.
  • Any money you’ve previously rolled over from a traditional IRA to a Roth avoids future RMDs, although you must pay taxes in the year of the rollover. If you roll over a traditional IRA after age 70 1/2, you must take the RMD for that year first.
  • Money invested in a qualified longevity annuity contract (QLAC) is removed from your RMD calculation. You may invest the lesser of up to a quarter of the balance in your traditional IRA accounts or $130,000. Although it can be done at any age, most invest in their 50s or 60s, and choose to begin receiving payments in their 70s or 80s (but no later than 85). However, if you die before payouts start, you won’t receive a dime, unless you’ve opted for a version. This type of contract offers smaller payouts for you but includes a sum for your heirs if you pass away before your payouts reach your initial investment.
  • In-kind transfers are permitted to satisfy the RMD. If you have investments in your retirement account that may be difficult to sell, consider transferring them in-kind to a non-retirement account. You will still owe the taxes on the distribution but this option allows you to stay invested in the security. And because you paid taxes, the cost basis on the investment in the taxable account will be reset on the day of the transfer.
  • If any of your IRA contributions were made with non-deductible contributions, a portion of your withdrawal will be tax-free. You are required to keep track of your tax basis on IRS Form 8606


Blog posting provided by Society of Certified Senior Advisors

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Friday, June 21, 2019

The Power of Art

Creative engagement for older adults has positive psychological, social, cognitive and physiological impacts.

One way to improve the health of older adults is to get them involved with art. Studies continue to show a correlation between the artistic engagement of seniors and improved outcomes for their physical and mental health.

Art Improves Health

Self-reported data from the 2014 Health and Retirement Study demonstrates how the arts can combat hypertension, as well as cognitive and physical decline. Study participants also reported that engaging in artistic pursuits helped them increase socialization with family and friends while improving their level of activity and engagement in the community.

The socialization aspect of making art is profound when you consider that isolation often increases as we age, leading to loneliness and depression — which is now understood to be a public health crisis. Loneliness is as lethal as smoking 15 cigarettes a day, according to the Foundation for Art and Healing.

Participation in any form of art — including painting, pottery, dance, music, poetry, drama or oral history — has positive implications on older adults’ health. These are the findings of the Creativity and Aging Study led by Dr. Gene Cohen. His research confirmed that older adults who engaged in the arts improved their physical health, had fewer visits to their doctor, required less medication and reported fewer falls than those who didn’t.

More than 60,000 older adults have participated in the History Alive and Legacy Art Work programs since 2005. National Taiwan University Professor Peishan Yang reports that participants have shown decreased rates of loneliness and depression, improved mood and confidence, higher morale, and greater hand dexterity, all of which translated into improvements in many areas of their lives.

The Benefits of Expressing Yourself Through Art

A recent article in Geriatric Monthly  by Barbara Bagan, Ph.D., ATR-BC, details  positive outcomes, in addition to improved physical health, that artistic outlets can provide for older adults. She explains that art can:

  • Aid in relaxation, anxiety and depression
  • Give feelings of control
  • Improve communication and socialization (which are very important)
  • Encourage humor and playfulness
  • Improve cognition
  • Offer sensory stimulation
  • Foster a strong sense of identity
  • Bolster self-esteem
  • Nurture faith
  • Reduce boredom

Dementia Barriers Crossed Through Art
The process of making art can be a powerful antidote to the walls that dementia often builds. When verbal communication becomes difficult or impossible, art can provide a pathway that speech no longer travels.

Art Therapist Dr. Raquel Stephenson, program coordinator for Art Therapy at Lesley University, has seen this with her own eyes many times. A non-verbal student in one of her painting classes may suddenly become intensely engaged as they touch, smell and feel the paint. “Where Alzheimer’s disease slammed shut the door of communication, art therapy opened up a new window,” she says.

It’s the process that matters, according to Stephenson, who has founded several national and international art therapy programs. “When people take the risk of making art with others, it builds community, which is therapeutic,” she says. “Making art allows this community-building to happen quickly and more powerfully.”

Anne, 91, moved to a small group home after being diagnosed with Alzheimer’s. Her daughter hired an art therapist to visit, and the therapist and Anne listened to music, painted and laughed together as Anne found the sense of playfulness her dementia had stolen. She was able to complete four paintings before she died, humorously entitling one, “Yellow, Yellow Catch a Fellow.”

Hidden Talent 

A rural Alabama saw miller, Lester Potts became a respected watercolor artist after joining an art therapy program at a local daycare center. Potts had never shown any artistic talent before being diagnosed with Alzheimer’s in his later years.

“Two Friends Photo” by Lester E. Potts. Works available here. Proceeds benefit art therapy charity.

“Dad’s creativity had profound positive effects on him and our family,” says his son, Dr. Daniel C. Potts, who founded Cognitive Dynamics after his father’s death “to bring these therapeutic opportunities to others in like circumstances. The mission of the organization is to improve quality of life for those with cognitive impairment and their caregivers through the expressive arts and storytelling.”

Barriers to Participation

In spite of all the documented benefits of art in the lives of older adults, age brings a host of roadblocks to participation. Common problems include the lack of a program nearby, difficulties in getting to a venue, poor physical health, and the absence of a friend or partner with whom to participate. 

Various groups are stepping in to fill the gap. Local organizations in urban communities, such as New York City’s Elders Share the Arts (ESTA), provide programs for thousands of people. 

Many more participate through outreach programs originating in institutions. The Art Institute of Chicago’s Art Insights program offers visits to retirement communities, bringing the arts to older adults who can’t visit the museum itself. 

The institute also partners with Well Connected and Telephone Topics, using a telephone to reach even the most isolated senior. You can find telephone programs for older adults, including programs in Spanish, through DOROT’s University Without Walls.

Successful Aging

In the book “Successful Aging,” the authors discuss the three supports of a good life in later years: low risk of disease, high mental and physical functioning, and being actively engaged in life. Art activities can help skew each of these in a positive fashion. Current research repeatedly supports the inclusion and enhancement of art involvement for older adults. The prescription for good health ought to include artistic endeavors.


Blog posting provided by Society of Certified Senior Advisors

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Tuesday, June 18, 2019

Designing for Older Adults

Older adults who weren’t a part of the technological revolution in their youth may need design adaptations to encourage tech adoption.

More than 59 percent of older Americans use the internet, and 78 percent have a cellphone. Surveys show that they want to engage with technology and enjoy its benefits. But rarely are products designed with older adults in mind.

Tech adoption among older adults is concentrated in those with the most education and income. With 10,000 baby boomers entering the 65-and-up category every day, it’s an unparalleled marketing opportunity. However, developers need to keep in mind that 80 percent of those over 65 have chronic conditions, and age often affects vision, fine motor skills and cognition.

Health, Aging in Place Top Desires

Older Americans identify a pair of areas that they feel would be made better with technological innovation: health and aging in place.

On the health care front, there are already a bevy of products to assist seniors. Smart pillboxes alert the user when it’s time to take medications, and medical alert systems are standard in care facilities. Fall detection has taken a giant leap forward with Apple’s iWatch. Remote patient monitoring devices abound, and health tracking apps and devices have become routine.

It’s no secret that older adults prefer to stay in their homes as long as possible. Technology is increasingly able to help support that goal through personal response systems, smart doorbells and motion-sensor lights that provide added security. Keyless locks, smart thermostats and smart detection devices eliminate the need for constant monitoring of the home environment.

Web Accessibility Guidelines

However, all of these products are generally designed by younger generations, often for younger generations. When it comes to designing for older adults, the web is ahead of the game.

In June 2018, the latest Web Content Accessibility Guidelines (WCAG) were officially recommended by the World Wide Web Consortium (W3C) to make web content more accessible, primarily for those with disabilities but including all users and devices, such as smartphones.

There are four essential principles in the latest guidelines:
  • Perceivable. Information and interface components must be presentable to users in ways they can perceive.
  • Operable. User interface components and navigation must be operable.
  • Understandable. Information and the operation of the user interface must be understandable.
  • Robust. Content must be robust enough that it can be interpreted reliably by a wide variety of user agents, including assistive technologies.
Professionals who work with older adults would do well to check if their own websites are easy for seniors to find and navigate.

Start at the Beginning

Thankfully, recent years have brought many best practices to the web. Developers are sharing what they’ve learned about designing for an older cohort with less exposure to tech overall and numerous physical limitations. While not everyone will grow hard of hearing or become crippled with arthritis, the trick is to create a design that meets the needs of as broad a group as possible. 

One designer writes that her first hurdle was to avoid assumptions. She detailed what she learned on UX Planet, a dot organization (.org) “resource for everything related to user experience.” 

She writes that designers need to realize seniors “may not understand things like scrolling or search functionality.” They may also fail to recognize common abbreviations and acronyms. Icons and symbols won’t be as clear, so always pair them with text on a plain background. A good practice is to involve older adults from the beginning to test design and function. Their feedback can be much more useful than what a designer thinks is optimal.

For instance,  a hamburger menu can be confusing. Say what? Wikipedia explains that a “hamburger menu” is the same as a “hamburger button, so named for its unintentional resemblance to a hamburger.” Its function is to toggle a menu or navigation bar collapsed behind the button with what appears on the screen. It’s better to use clear signposts to return along your route, and to include a prominent home button.

Fonts and Color

Many designers stress the need to use a sans serif typeface (one that lacks the tiny flourishes at the ends of letters such as L [serif] vs. L [sans serif]). This page is typed in Calibri, a sans serif typeface. Avoid using multiple fonts (style, size and weight of typeface).

As we age, our lenses may become hard and allow less light to enter the eye. Cataracts or macular degeneration may worsen vision. Blues become harder to distinguish and should be avoided for important elements. Color should not be used to convey a message. Check designs with online visual impairment simulators and convert designs to gray scale to check for legibility.

Designs can also offer personal adaptations. Many older adults like to be able to increase the font size. Some with certain visual impairments can benefit by changing a page from black letters on a white background to yellow letters on a blue background.


Simplification can be vital for many seniors. It’s easier to slowly make changes on a site to allow users to adapt, and to make the information on each page cover a defined set of information that doesn’t require scrolling. 

Older users can have a hard time seeing and touching the correct button when they’re small or placed close together. It can happen to anyone. (How many times have you accidentally hit the wrong button and deleted something?!). 

Computer “breadcrumbs” are useful. Just like Hansel and Gretel, electronic breadcrumbs can help us find our way home.

Adaptations for Dementia Help All

While designing a site for Dementia Diaries, a project detailed in this month’s Coffee Break section of Senior Spirit, designers aimed for the highest accessibility on a tight budget. Users and contributors would have every stage of dementia, which is more likely as people age. 

Web developer Rory Gilchrist built a site where people with dementia could record their own stories and read the stories of others. What he learned has implications that reach far beyond this population. 

Gilchrist found key lessons covering:
  • Content
  • Layout and navigation
  • Colors and contrasts
  • Text and fonts
  • Images
  • Multimedia use
Extensive points on each of these topics are available in an article in Smashing magazine, which is well worth reading in its entirety. 

As a final note, Gilchrist reminds developers not to shy from announcing that a website has made every attempt to be dementia (or senior) friendly. It can be a welcome relief to find a resource that is simple to navigate and easy to read!



Blog posting provided by Society of Certified Senior Advisors

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Sunday, June 16, 2019

Coffee Break - Dementia Diaries

A groundbreaking project records the experiences of people with dementia, promoting the voices of those who live with the disease.

We need to educate society that dementia touches many people in many different ways. We need to dispel the myths. Dementia is everyone’s business. —Anne MacDonald

Dementia Diaries is a project recording the voices of people across the United Kingdom who are living with dementia. Anyone can read or listen to current posts by clicking on the photo of the desired diarist, making it seem almost as though you’re sitting across from the person at home, listening to a piece of conversation. In fact, there’s a page where you can meet the current diarists and Listen to archived audio diaries.

Volunteer to Transcribe

Anyone can assist in the Dementia Diaries project by helping to transcribe audio diaries. You don’t even have to sign up! Simply navigate to the volunteer page and follow the simple instructions.

You can do one conversation, or as many as you like. You don’t need to commit to further transcriptions, but can simply return to the site to help out whenever you feel like it. There is a tab at the top for audio diaries that need transcribing.
Everyone from activists to artists have joined the project to contribute their views. While many people seek to provide the best experience for a spouse or patient experiencing dementia, this site is different in that it is exclusively available to those who have been diagnosed with the disease. Although people in the United States are unable to contribute, any English speaker can access the site and offer feedback and reflections, available at the end of each post.

Dementia Content is Diverse

Diarists are not limited in subject matter, so readers can find snippets on a variety of topics. Some recent posts covered death and dying with dementia (should a person be able to choose when to die?), how dementia affects one contributor’s ability to support others and a compilation of gardens in celebration of National Gardening Week.

A range of emotions are exposed as contributors argue for consistency of care, express gratitude for small acts of kindness or ruminate on daily difficulties. Naturally, there are posts that tend toward despair (Carol’s “This last month has been dreadful for me!”) but you don’t have to look far to find a wide range of themes.

Navigate to the Key Themes page to find topics of interest, such as family and friends, diagnosis, memories and daily challenges. All of the headings listed apply to those living with dementia in the U.S. Even the health and social care listing has relevant concerns, despite socialized health care in the U.K. Readers have only to browse entries such as “Dory educates her taxi driver” or “Can people with dementia self-manage?” to realize that there are a plethora of universal themes across the pond.

Readers have the choice of following one contributor, or pecking through posts from a variety of diarists. Someone with dementia may want to take their journey with a contributor who shares a similar age, sex and viewpoint, for example.

About the Project

Because it can become difficult to master technologies as dementia progresses, contributors can use their own mobile or land line phones. 3-D printed handsets that are intentionally as simple to use as possible are also available.

“Our shared aim is that by opening up our lives to the public we will improve understanding of the diverse experiences of living with dementia and how communities and services can best offer support,” according to information on the site.

The project is an arm of the Dementia Engagement and Empowerment Project (DEEP) and designed by non-profit communications agency On Our Radar. The effort is currently funded jointly by the BIG Lottery Fund and Comic Relief.


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Friday, June 14, 2019

Famous and 65

Look who's turning 65 this month

June 15 - James Belushi, comedian and actor

James Belushi, the younger brother of famed actor and Blues Brother John Belushi, earned his comic and acting chops on his own right. He played the title role in the sitcom According to Jim, after an early start on the iconic Saturday Night Live from 1983 to 1985. Belushi acted in a wide variety of films from the 80s to now, including About Last Night, The Principal, Red Heat, K9, Curly Sue, Once Upon A Crime, Last Action Hero, Jingle All The Way, Wag The Dog, and Less Than Perfect.

Belushi was born in Chicago to an Albanian immigrant father and a mother who was the daughter of Albanian immigrants from the same small town. He got a degree in theater and arts, then followed his older brother to The Second City theater group in their hometown. He joined Saturday Night Live in 1983 and got a breakthrough with The Man with One Red Shoe in 1985.

Belushi is also a talented musician. In 2003, he paired with Dan Aykroyd on the album Have Love, Will Travel, which spawned a tour. He continues to appear nationwide as Zee Blues in current version of the famed Blues Brothers. He also released a book in 2006 entitled, Real Men Don’t Apologize.

June 15 - Paul Rusesabagina, Rwandan hotel manager and humanitarian

Paul Rusesabagina’s selfless actions saved more than a thousand people and inspired the movie Hotel Rwanda.

One of nine children born to a Tutsi mother and a Hutu father, Rusesabagina’s first ambition was to become a minister. He married in 1967 and moved to Cameroon to study at a seminary. A friend asked him to apply for an opening at a local hotel, leading Rusesabagina to promotions and trips to Europe to study hospitality management.

In 1992, he was given the job of assistant manager at the Diplomates Hotel. April, 1994 saw the explosion of tension between ethnic Tutsis and Hutus in Rwanda. It began as a political division, and was fully inflamed with the assassination of the prime minister and other powerful government figures. Hutus and Tutsis hunted each other down, committing genocide.

Rusesabagina fled to a sister hotel, where he sheltered his family and hid 1,200 Hutu and Tutsi refugees. This was no small feat; more than a million Rwandans died in the fighting. Four of his eight siblings were still alive at the end of the combat, and this was considered relatively lucky.
Rusesabagina and his family now live in Texas and maintain a home in Belgium. He is a humanitarian activist on a global scale and has won many awards for his work.

June 19 - Kathleen Turner, actress

Maybe you first saw her in the movie Body Heat, or it could have been in Romancing the Stone or Prizzi’s Honor, both of which earned Kathleen Turner a Golden Globe Award for Best Actress. Besides her numerous film credits, Turner was twice nominated for a Tony Award for Broadway roles as Maggie in Cat on a Hot Tin Roof and Martha in Who’s Afraid of Virginia Woolf?

Brought up in a strictly conservative Christian household, Turner’s acting ambitions were roundly discouraged by both parents, but especially her father. Known for her husky voice that could beckon or boss around, the Missouri phenomenon attended the American School in London due to her father’s job in the foreign service.

Her father died the same year she graduated from the London school, and Turner wound up at the University of Maryland, where she studied theater and received a bachelor’s degree in fine arts. She entered her professional career on the soap opera The Doctors, landing her first film role just three years later.

Turner had a brilliant career until the early 90s, when pain from rheumatoid arthritis left her barely able to walk. Just as her age started to work against her, medication for the arthritis robbed her of her trademark good looks and caused her to put on weight. She says she started getting offers to play “mothers and grandmothers” in her forties.

Turner has championed Planned Parenthood since the age of 19, and continues to support various charitable causes.

June 19 - “Taz” Tasmanian devil cartoon character

Animated cartoon character “Taz” appeared in five shorts before Warner Bros. Cartoons boarded up shop in 1964. Voracious and surly, it has been suggested that the character was inspired by movie idol Errol Flynn. The real Australian marsupial looks nothing like Taz and walks on four legs, but it is ferocious and a hearty eater.

Taz first appeared in 1954’s Devil May Hare, where he stalks Bugs Bunny. With an IQ on the level of Bugs’s other nemesis, Elmer Fudd, Taz is more of an irritation than a threat. His character mostly growls and grunts, rarely speaking, yet is able to read and write. An oft-repeated gag portrayed Bugs looking up “Tazmanian devil” in a dictionary to see what it eats, and being relieved that rabbits aren’t listed, only to have Taz enter and find rabbits in the book, or write “rabbits” on the list himself.

The character nearly met an early death. The head of Warner Bros. animation studio ordered Taz to the cutting room floor after his film debut, thinking parents would frown on his violent nature. But when no new shorts came out, the studio head asked what was going on with the character, saying he had “boxes and boxes” of letters from people waiting to see more of Taz. More shorts were soon made.

Taz has had a resurgence in the last 20 years, appearing on television and in marketing schemes.

June 22 - Freddie Prinze, comedian and actor

Born Frederick Karl Pruetzel, Prinz changed his name to become the “prince” of comedy since Alan King already had the superior title. He starred in the successful sitcom Chico and the Man from 1974 until his death three years later.

Prinze made the rounds at clubs in New York City, where he grew up. He made it onto Jack Paar Tonite, but got his big break in 1971 on The Tonight Show. He was the first young comedian Johnny Carson picked to have a chat during his first appearance on the show. Prinze would later guest-host the show several times.

Prinze could also sing, and counted Tony Orlando as one of his best friends. He roasted greats such as Muhammad Ali and Sammy Davis Jr., and in 1975 he released his own comedy album, Looking Good. A few months before he died, Prinze had penned a $6 million contract for five more years with NBC.


Blog posting provided by Society of Certified Senior Advisors

Wednesday, May 29, 2019

The Shingles Vaccine Controversy

Reactions to the Zostavax shingles vaccine inspired dozens of lawsuits, and now the CDC recommends rival Shingrix. But should you get it?

Shingles is a painful viral infection that causes a rash, usually as a mass of blisters wrapping around the right or left side of the torso. A million cases of the disease occur in the U.S. every year, and the risk rises with age. Shingles is caused by the same varicella-zoster virus that triggers chickenpox. Once you’ve had chickenpox, the virus remains dormant in nerve tissue and can reactivate in the form of shingles years later. Anyone who has ever had chickenpox can come down with shingles. Many experts anticipate that half the population over age 80 will develop shingles.

Approved by the U.S. Food and Drug Administration (FDA) in 2006, Zostavax shingles vaccine was recommended to those 60 and older. The live vaccine is given as a single injection in the upper arm. But many who got the shot say it gave them shingles, or non-shingles related injuries, due to the live virus in Zostavax. Hundreds of product liability claims are pending against drug maker Merck & Co. from those who got the vaccine. Plaintiffs allege that the vaccine caused them to develop a more severe, painful and less treatable form of shingles than the one they were trying to avoid, as well as other auto-immune disorders. 

Chickenpox Exposure Affects Shingles

Before children were routinely vaccinated for chickenpox, exposure to the disease helped protect adults who had already had it from developing shingles. Many countries have previously avoided universal vaccination against chickenpox in childhood because of a belief that the rise in shingles cases would outbalance the dip in chickenpox disease. This is one argument against vaccinating children for chickenpox. 

In the U.S., Gary Goldman, Ph.D., served as a research analyst for the Varicella Active Surveillance Project in a cooperative project with the CDC from 1995 to 2002. He believed having chickenpox in a population protected against shingles. In his resignation letter, he stated that “When research data concerning a vaccine used in human populations is being suppressed and/or misrepresented, this is very disturbing and goes against all scientific norms and compromises professional ethics.” In 2005, Goldman published a paper giving evidence that shingles is suppressed naturally in human populations by repeated exposure to naturally occurring chickenpox. 

However, while experts used to think this asymptomatic boosting lasted up to 20 years, a recent study by researchers from the Universities of Antwerp and Hasselt (Belgium) shows the protection only endures for two years. The only age group that appears to show an uptick in shingles cases when a population vaccinates children against chickenpox is 31 to 40-year-olds. Therefore, scientists have concluded that the benefits of the chickenpox vaccine for children outweigh the risks. 

"We were surprised to find that re-exposure to chickenpox is beneficial for so few years and also that the most pronounced effect of vaccination on increasing cases of shingles is in younger adults," says lead author Dr. Benson Ogunjimi. "Our findings should allay some fears about implementing childhood chickenpox vaccination," he says.

Vaccine Hesitancy

Recently, vaccine hesitancy joined air pollution and obesity at the top of global health threats prioritized by the World Health Organization (WHO) in 2019. Vaccine hesitancy, or skepticism, is a novel inclusion. It reflects a growing mistrust of recommended vaccinations, likely spurred by shared media accounts. But scholars like Amesh Adalja at the Johns Hopkins Center for Health Security in the United States say that vaccines are an important control and vaccine hesitancy belongs on the list.

"If you'd done that list 100 years ago it would have been all infectious diseases. The reasons why it's not is because of vaccines,” Adalja says. “People didn't have the luxury of dying from diabetes, obesity, cancer and cardiovascular disease. Vaccines are probably one of the greatest technologies to have impacted on human health.”

A measles outbreak in the U.S. recently highlighted the “anti-vaxxer” phenomenon. Measles is a potentially deadly disease that can cause pneumonia and encephalitis. The respiratory disease is extremely contagious. You can get measles just by being in a room where a person with measles has been, even if that person left up to two hours before.

Some teens are turning to social media site Reddit for advice after parents refused to get them vaccinated as children. The teens are worried about catching a preventable disease, and also don’t want to be responsible for potentially passing that disease along to someone who cannot get vaccinated for health reasons. Fellow users have offered support in the form of everything from links to scientific articles to Go Fund Me campaigns to pay for shots.

As with all health matters, it’s important to seek out reliable sources of information with strong scientific backing when considering vaccinations.

Shingrix Vaccine

In 2017, the FDA approved a new vaccine for shingles, Shingrix, that is 90 percent effective at protecting against the virus. Developed by GlaxoSmithKline, Shingrix is different from most other vaccines, including Zostavax. Shingrix is made from a single protein that comes from the outer shell of the herpes zoster virus, rather than a weakened form of the whole virus. And the vaccine contains something called an adjuvant that helps your body fight the virus.

As people get older, their natural immunity declines, leaving them more susceptible to disease. This is often when the dormant chickenpox virus attacks, causing stabbing pain and flu-like symptoms.

A new study included more than 15,000 people in 18 countries who got two doses of the vaccine, two months apart. Participants were from Europe, North America, Latin America, Asia and Australia.

"The second dose of the vaccine is important to ensure long-term protection," says lead researcher Professor Tony Cunningham from the Westmead Institute for Medical Research. "The efficacy is approximately 90 percent for all age groups, even for those over 70 years of age.

"This is quite remarkable because there are no other vaccines that perform nearly so well for people in their 70s and their 80s. We are seeing results comparable to those of childhood vaccinations. What's particularly exciting, though, is that 90 percent of recipients had an increased immune response sustained across the three-year duration of the study.”

The study authors anticipate that protection will endure “much, much longer” than four years with the addition of the second recommended vaccine dose, given two to six months after the first.

CDC Switches to Shingrix

The Centers for Disease Control and Prevention (CDC) has promoted the use of Zostavax for years in spite of drawbacks. According to the manufacturer product insert, Zostavax “does not result in protection of all vaccine recipients. The duration of protection beyond four years after vaccination with Zostavax is unknown.” Studies found a significant decrease in vaccine effectiveness one year post-vaccination, and by nine years, Zostavax offered no protection. According to the CDC, Zostavax was effective in reducing shingles by about half (51 percent) in adults age 60 and over.

As of 2018, the CDC dubbed Shingrix the preferred vaccine for shingles. Additionally, the longer protection time of Shingrix caused the CDC to change its starting recommendation from age 60 to age 50 for the newer vaccine.

However, Shingrix comes with a downside. It’s more likely to cause unpleasant side effects than Zostavax, according to Dr. Kathleen Dooling, a medical officer in the division of viral diseases at the CDC.

“One of the important things is to go into this vaccination knowing that you’ll probably have some side effects after and be prepared for those,” Dooling says. “The advice we’ve been giving people is that if you plan to get the vaccine, in the day or two afterwards, don’t plan any big, strenuous activities. For example, don’t plan a big gardening project ... don’t plan your big golf game for that period.”

Your arm is likely to be sore in the day or two after vaccination. Eighty percent of people reported injection-site pain, redness or swelling. You may also experience general flu-like symptoms such as tiredness, nausea, headache, shivering, muscle aches and fever. Taking an over-the-counter medication for pain would be “a reasonable thing to do,” Dooling says.

Three percent of “adverse events” related to Shingrix and reported through the Vaccine Adverse Event Reporting System were serious, out of about 3.2 million doses administered in the first eight months of the new vaccine’s use. It’s “not different from what we would expect for any new vaccination,” according to Dooling.

Who Should Get Shingrix Vaccine

People who are in good health age 50 or older should get vaccinated with Shingrix, according to the CDC. While you can’t get shingles if you’ve never had chickenpox, more than 99 percent of Americans over the age of 40 have had the disease. People should get the Shingrix vaccine even if they’ve gotten the Zostavax shot in the past or have already had shingles.

It’s important to get a second dose of Shingrix within two to six months after the first shot. It may trigger another bout of side effects, and those could be different than any you got from the first shot.

Shortages of the vaccine have been reported. If you’re in doubt, visit a vaccine locater website to find a location near you that has the vaccine in stock.

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How to Protect Your Money from Medicaid

Long-term care can decimate an estate unless you protect yourself ahead of time.

Many people are crossing their fingers that they won’t need long-term care (LTC) when they get older. But “someone turning age 65 today has almost a 70 percent chance of needing some type of long-term care services and supports in their remaining years,” according to the U.S. Department of Health and Human Services.

And that care doesn’t come cheap. The cost of a private room in a nursing care facility averages $7,698 per month, or more than $92,000 per year. That amount is “ruinously expensive,” according to the New York State Court of Appeals. Yet few people are aware they have options and rights when it comes to LTC planning and Medicaid.

Medicaid is Payer of Last Resort

Medicare does not cover LTC. Payment for LTC must come from your own pocket, long-term care insurance (if you’ve purchased a policy, kept current on payments and qualify under the policy’s terms) and Medicaid.

Medicaid coverage of nursing home costs is means-tested. Often, by the time people qualify for Medicaid, their assets are depleted. Any inheritance they hoped to leave loved ones is gone, and they are without financial security if they end up moving out of the care facility.

As an example, New York has a relatively generous income allowance for Medicaid. Those 65 and older may have no more than $15,150 in assets (some other states put this limit at $2,000 or less). Income may also factor in. The annual income limit in New York for an older adult is $10,100.

There’s an important catch regarding assets. Medicaid has a look-back provision which lets the government review transfers of assets for up to five years before the Medicaid application. If it finds a transfer that was not exempt, the applicant may become ineligible for Medicaid for a defined penalty period.

Asset Protection Trusts

To qualify for Medicaid, you may place assets, such as your home, in an irrevocable trust. These assets legally no longer belong to you, but are controlled by an independent trustee. You can designate a spouse or other loved ones to inherit the assets of the trust upon your death. While you lose control of the trust’s principal, you can use assets in the trust during your lifetime.

This method of asset transferal has benefits compared to simply giving the assets away with strings attached, such as specific conditions. For starters, you don’t have to rely on an individual’s trustworthiness (such as hoping that person won’t turn around and kick you out of the home). You won’t be left in the cold by having your home taken away if an individual incurs a debt or liability that exposes that person’s assets to debt collection. There won’t be complications over who owns the house or whether or not you can stay in it because an individual got divorced or predeceased you. And the individuals will receive a step-up in basis for assets like a house when it is placed in a trust, meaning they won’t have to pay capital gains on the difference between what you paid for it and what it is worth when you die.

Also, if your home in such a trust is sold while you’re still alive, the proceeds will not count toward your Medicaid eligibility. Be aware that a revocable, or “living” trust, does not offer this protection. Assets in a revocable trust are still considered to be your property.

Further, irrevocable trusts are subject to the five-year Medicaid look-back period.

Finding a Medicaid Facility

Medicaid traditionally pays only for nursing home care, not assisted living, unless a state has a waiver for that option. At any rate, your biggest hurdle may not be asset protection but finding a facility with openings that also accepts Medicaid. Facilities that pass inspection may choose to designate a small percentage of beds for Medicaid patients. Other facilities may elect to take only private payers.

Many facilities are requiring a period of private pay, typically from 18 months to four years, before accepting Medicaid payments from residents. Thus, residents must have enough assets to be able to make it through this spend-down period before they can rely on Medicaid to cover their LTC costs.

The Medicaid contract typically offers payment that is considerably lower than (sometimes less than half) the private pay rate. Thus, nursing homes are disincentivized to accept Medicaid residents. It’s not uncommon for families to place dozens of calls in an attempt to find a care provider for their loved one.

The Medicare site has a feature that can tell you if a nursing home accepts Medicaid.

Income Trusts

When you apply for Medicaid, an income limit is enforced. If your income exceeds this amount, the excess has to be managed appropriately in order for you to get and keep Medicaid eligibility.

Qualified Income Trusts (QITs), also referred to as Miller Trusts, are useful in states where an income cap does not allow spend down on your own care to comply with Medicaid limits. QITs are irrevocable trusts designed to hold excess income with disbursements managed by a trustee.

Period Income Trusts (PITs) are similar to QITs, but for disabled individuals whose surplus income is pooled and managed by a nonprofit. The nonprofit organization functions as the trustee. PITs are not for estate planning. Funds that aren’t used will stay with the trust for charitable use.

Private Annuities and Promissory Notes

Many times, older adults unexpectedly require long-term care when they have either transferred assets within the look-back period or still hold meaningful assets. Divesting these assets within the look-back period automatically triggers a penalty. The penalty time period is the number of months someone is ineligible for Medicaid. The penalty is calculated by dividing the value of assets by Medicaid’s regional monthly rate for nursing home care.

A 2006 law allows you to preserve some assets while still qualifying for Medicaid by using a private annuity or promissory note to pay the nursing home over a shorter penalty period. It’s a bit confusing, so an example will help demonstrate how it works.

Jane has a bank balance of $300,000 when she suddenly needs nursing home care. She’d like to pass some of those assets on to her daughter, Susan, but she doesn’t think she can because she is way past the look-back period. She figures all she can do is spend down her assets before applying for Medicaid to cover her care.

Jane is correct in thinking that if she gives the $300,000 to Susan, she will be penalized by Medicaid. If the average cost of a nursing home room in her area is $5,000 a month, then that would make Jane ineligible for the full five year look-back period. All of her assets would be spent on her care, and none would go to Susan.

However, if Jane gives Susan $150,000, the penalty period changes to 30 months. With her remaining $150,000, Jane can buy a private annuity or promissory note that will provide a monthly income of $5,000. She can use this income, combined with her Social Security check, to pay for nursing home care during the shortened penalty period. When 30 months have passed, she’ll be in the nursing home with Medicaid coverage and Susan will be able to keep $150,000.

It may not be as good as what could be achieved if Jane had planned ahead, but it’s a great strategy to pass along some assets in a pinch.

Caregiver Agreement

This strategy can work well in a situation where you want or need extra services above and beyond what a nursing home provides and Medicaid covers. A family member or friend can get income this way, and you can get care from someone you know and trust. Payment for these services removes that amount from your countable resources.

To pay a caregiver in advance, you must have a pre-determined agreement in place that adheres to specific rules.

  • The agreement defines the services that the caregiver will provide and the hours she or he will work. 
  • You have figured the payment using a reasonable life expectancy and valid market rate for services.
  • The caregiver has to keep a daily log of services provided and hours worked, as well as written invoices.
  • When the patient dies, the caregiver must pay back unearned funds to Medicaid in an amount up to that which Medicaid paid for the patient’s care. 

Spousal Transfers and Refusals

Between spouses, Medicaid allows transfers that are not subject to a look-back period or any penalty. Thus, a classic strategy is to place assets that are in the name of the spouse who needs care into the name of the well spouse.

Some states allow spousal refusal. In this case, the well spouse refuses to provide financial support for the spouse who needs care, enabling that spouse to qualify for Medicaid. However, when Medicaid begins providing services it will pursue contributions from the well spouse. Sometimes, Medicaid does not seek its rights, and in others, it will settle at a discount. Reimbursement to Medicaid will always be lower than paying the inflated private pay rate that would have been charged.

Elder Law Attorney Critical

The final step is to contact an elder law attorney who specializes in Medicaid. While it is important to familiarize yourself with various strategies for asset protection, only a specialist can ensure your plan is the best available option for your situation.

To complicate matters, each state has its own system for Medicaid services with unique rules that you must adhere to. It’s critical that a qualified elder law attorney draw up documents that comply with state and federal laws to ensure asset protection.

A good attorney can also prevent a relative with the best of intentions from gifting a Medicaid recipient money that could result in disqualification from the program.

Also, Medicaid rules change often. An elder law attorney will be aware of recent modifications and can keep you informed of future changes that may affect your plans.

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As We Age, Healthy Sleep Without Prescription Drugs

Numerous surprising new products help restore and improve slumber for older adults who don’t want to resort to drug therapy.

Many seniors have trouble getting to sleep or staying asleep. As we age, insomnia increases due to various factors, including the use of caffeine, tobacco and alcohol; poor sleep habits; medications; and disease.

Particularly as we enter our 50s and beyond, the amount of slow-wave sleep we get decreases. This occurs even if we are still getting a good eight hours of sleep a night. Slow-wave sleep is also called “deep sleep.” It’s considered to be important for memory consolidation and processing. Studies of sleep deprivation with human volunteers suggest that the most important function of slow-wave sleep is brain recovery from the daily stress of mental activity.

Insomnia is the inability to experience restorative sleep, and it’s a problem for about half of adults over the age of 60 in the U.S. Insomnia may result from an inability to fall asleep, or multiple episodes of wakefulness during the night. It can even happen if you wake too early and are unable to get back to sleep. Whatever the cause, insomnia leads to a feeling of exhaustion and “brain fog” the next day.

Primary insomnia is a condition that arises independently, but older adults often tack on secondary insomnia due to medical conditions or the side effects of prescription medications.
Sleeplessness should not be taken lightly. The condition has been linked to depression, anxiety and other psychiatric disorders. New research even points to sleeplessness as a cause of cognitive dysfunction, diabetes and Alzheimer’s. Researchers have found that the protein deposits that are characteristic of this cognitive disease may clear during deep sleep.

Try This First

You may be able to modify your habits and/or environment to get a better night’s rest without resorting to drugs or technical sleep aids. Altering even one of these may be the key to improved rest, so make sure you can tick off each item before you give up. Even if you need further adjustments, you will have created a solid foundation.

Behavioral modifications:

  • Don’t nap during the day.
  • Don’t use your bed for activities like reading or watching TV.
  • Exercise every day.
  • Avoid alcohol, tobacco and caffeine, especially within four hours of bedtime.

Environmental modifications:

  • Keep the bedroom very dark at night.
  • Keep the bedroom quiet.
  • Make sure the temperature and humidity are conducive to sleep.
  • Use comfortable bedding.
  • Get plenty of light exposure during the day.

What About Marijuana

More and more people of all ages are beginning to consider marijuana for various health issues. Of course, your doctor should approve any drug before you try it. Cannabis has a reputation for helping users fall asleep. Two of the main components of marijuana are cannabinoids and terpenes, both of which affect slumber.

Cannabinoids, including CBD, are being studied for their beneficial effects on depression, anxiety, Alzheimer’s and Parkinson’s, among others. They also appear to help induce sleep. THC, the product that gives the “high” associated with marijuana, has sedative effects. Recently, it’s been found to improve breathing during sleep (potentially helpful for sleep apnea). Studies also seem to show that THC increases time spent in slow-wave sleep.

Terpenes are the tiny molecules in marijuana that create its distinctive smell and taste. They also occur in many other plants, fruits and flowers. Among the many terpenes, several have been shown to have sedative effects. Some terpenes improve mood by elevating serotonin levels, and others reduce anxiety and stress, or ward off depression.

For a more complete discussion of marijuana and sleep, see a blog on the topic by Dr. Michael Breus.

Alternative Answers for Better Sleep

There is a plethora of pills that doctors prescribe to help induce or extend sleep. Check this list of pharmaceutical sleep aids. However, many older adults want a better solution because they don’t want to risk unwanted drug interactions with medications they are already taking. Others simply don’t want the risk of side effects from prescription drugs, and are looking for an alternative. Indeed, there are several recent developments to counter sleep-onset insomnia that look appealing.

Ebb Insomnia Therapy.  Created by a doctor, this device “gently cools the forehead” to a temperature within a therapeutic range to reduce abnormal elevations in frontal cortex metabolism that can inhibit sleep. It’s FDA-cleared for primary insomnia, and can calm “racing minds” that prevent restful slumber. A randomized, placebo-controlled study of 106 adults showed significantly reduced time to get to both Stage 1 and Stage 2 sleep (the two stages of light sleep). A licensed physician or nurse practitioner has to write a prescription for a patient to get the device.

Nightingale. If troublesome noises are a problem, Cambridge Sound’s Nightingale may be the answer, even if you’ve tried other noise machines. Dual units work in tandem to create a sound curve, immersing the room to mask disruptive noises. Because there are two speakers, the brain can’t locate the source of the sound, making it more effective than traditional machines that mask noises. Nightingale is not regulated by the FDA, nor is it reimbursable as therapy. It is available without a prescription.

Kortex. This general wellness device combines virtual reality (VR) with neurostimulation that “stimulates the brain to produce serotonin and melatonin while lowering cortisol” to enhance sleep. Born from the Fisher Wallace Simulator medical device, the Kortex is designed for the everyday consumer who needs help getting to sleep. Less than 1 percent of patients were found to suffer any side effects in trials, and these were minor, such as temporary headaches and dizziness. There are also no contraindications with medicine, and you don’t need a prescription to get one.

2breathe. Leveraging the known benefits of slow breathing and soothing music, this smart device and app pair guided breathing with a wireless respiration sensor and realtime coaching technology. Personalized, adaptive guiding tones from the user’s breathing have been shown to reduce neural sympathetic activity within minutes — with absolutely no training. Research on device-guided breathing technology has demonstrated stress reduction for cardiovascular therapy, and now for mitigating insomnia. It is not FDA-regulated but comes with unlimited customer support.

Dreampad. As the Dreampad plays music through vibration that travels to the listener’s inner ear, it triggers a relaxation response. The music is specifically designed for sleep, helping release the listener from anxiety-based circular thoughts. Supported by research with adults and children, it works for those with minor sleep issues as well as people who have tried cognitive behavioral therapy without success. In a Columbia University Medical study, the Dreampad notably achieved statistically significant results in the areas of nighttime awakenings and deep sleep. As a relaxation tool rather than a medical device, it is not FDA approved but may be reimbursable.

Meditate Yourself to Sleep

If technical gadgets don’t interest you, try mindfulness meditation. A study on mindfulness meditation to enhance slumber in the Journal of the American Medical Association revealed that meditating was more helpful for middle-aged and older adults than learning better sleep habits. It turns out that meditation evokes a relaxation response, making it easier to get to sleep.

“Mindfulness meditation is just one of a smorgasbord of techniques that evoke the relaxa-tion response,” says Dr. Herbert Benson, director emeritus of the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine. The opposite of the stress response, learning the relaxation response can help overcome depression, pain and high blood pressure. Dr. Benson notes that many sleep disorders are linked to stress.

Mindfulness meditation involves concentrating on your breathing to pull your mind away from racing thoughts and into the present moment, evoking the relaxation response. The study found that 20 minutes of meditation every day achieved results. It should be done sitting up or moving (such as with yoga) to avoid nodding off! And it’s easy to learn.

First, choose a calming focus. This can be your breath, a sound, a short prayer or word. If you picked a sound, say it aloud or silently as you exhale. Second, don’t worry about how well you are meditating. Your mind will wander, especially when you are first learning to meditate. When you notice thoughts coming in, take a deep breath, repeat your calming focus, and pull your attention back to the focus.

Older adults may have more challenges getting to sleep and staying that way, but there are plenty of alternatives to prescription drugs that may help reduce or eliminate the problem. Whether you choose to change your sleep environment, add in meditation or embrace a technological sleep aid, a good night’s rest may not be far away.

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