Wednesday, May 16, 2018

Americans Retiring in Vietnam

During the 1960s and 1970s, when many Baby Boomers were engaged in fighting a war in Vietnam, it is unlikely that most of them ever considered the possibility they would be returning in 50 or 60 years to retire to a tropical, beachside community in that country.  However, that is exactly what has been quietly happening over the past few years.  Where do they live in the country, and what is the appeal?

The Beautiful Bay at Nha Trang

While some people have moved to modern cities such as Da Nang and Ho Chi Minh City, one of the more popular locations for American ex-patriots is Nha Trang.  Today it is a gorgeous seaside resort town along the edge of one of the most beautiful bays in the world.  The beach is 5.6 miles long and features jogging trails, paved footpaths, sculpture parks and lovely landscaping.

Modern Facilities

If you are remembering the Vietnam of the 1960s and early 1970s, then you will be stunned by how much has changed over the past five decades.  For example, the beach at Nha Trang is lined with modern high-rise hotels and resorts, spas, seafood restaurants and casual bars and cafes.  The photo below shows a modern Sheraton Hotel and Spa in Nha Trang.

There are major supermarkets where you can shop for a variety of food items, including some which are imported, as well as traditional neighborhood markets for local food.

Speaking of food, French-style baguettes are baked fresh daily in virtually every village in Vietnam. Street vendors sell them stuffed with omelettes or pate for less than one American dollar.  In addition, you can find Italian restaurants, pizza, Texas BBQ, neighborhood bars and other American favorites in Nha Trang.  There is no reason to change your lifestyle dramatically, even while living thousands of miles away.

Americans have vacationed there for so many years, that most of the locals speak English well, and they are friendly towards Americans.

Moderate Climate

Another pleasing feature in this part of Vietnam is the climate.  The average year-around temperature is 79 F.  It is rare for the highs to fall below 68 F or the highs to be above 90 F.  It is a little cooler in the winter (November through February) and warmer in the summer, although the sea breezes keep you comfortable.

Modern Hospitals and Health Facilities are Available

The top hospitals in Vietnam are in Ho Chi Minh City, about an hour flight from Nha Trang, but new facilities have also recently opened in this beachside community.  The staff at the local hospital even speaks English.

Affordable Cost of Living

According to "International Living Magazine," a couple can live in a nice, Western-style house or apartment near the beach, have a housekeeper once or twice a week, eat out every day, and go to a spa once in a while for about $850 a month.  That is well within the means of millions of Americans on Social Security!

What You Should Know Before Moving Overseas

Readers will find other helpful articles in this blog about moving abroad.  There are a few things you should know.  You can have your Social Security deposited directly into bank accounts in most countries around the world, and as many as 600,000 American retirees are living abroad.

You cannot use your Medicare in foreign countries.  Some countries allow you to buy into their national health insurance plan.  Others have such affordable healthcare that retirees find they can pay out-of-pocket.  Some retirees continue to subscribe to Medicare, which they can use when they return to the U.S. to visit family and friends.  You may wish to speak with your insurance agent to explore a variety of choices.

We strongly suggest that whenever you are overseas, you should follow the State Department website and watch for warnings and alerts which could affect you.  Things can change, even after you move abroad, so you want to stay informed.

Before moving to a foreign country, we always recommend you visit the area on vacation and speak to a local attorney, real estate agent, and CPA, so you know if you will be allowed to purchase property, work in your new country, and any other tax or legal issues which could affect you.

If you are interested in learning more about where you should retire in the US and abroad, financial planning, common medical problems as you age, Social Security and Medicare, use the tabs or pull down menu at the top of the page to find links to hundreds of additional helpful articles.

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Tuesday, May 8, 2018

Stay Safe and Enjoy Facebook

Many older Americans enjoy Facebook as an easy way to stay in touch with rarely seen friends and family members.  For some shut-ins or people who are ill, it may the only way they can easily stay in touch with the outside world. However, the well-publicized scandals regarding fake news and the misuse of personal information have caused many people to wonder if they should avoid the site.  According to AARP, recent upgrades made by Facebook have reduced some of the problems.  By taking a few actions on your own, you can protect yourself on Facebook and continue to enjoy staying in touch with family and friends at the same time.

Upgrades Made by Facebook

If you are a regular user of Facebook, you may have noticed a decrease in the number of questionable news stories on the site.  They have made a concerted effort to eliminate so-called "news sites" which were known to share fake news stories in the past.  They have also supplemented their computer screening systems with more real human beings who review items shared on the site, and the company has made it easier for users to report phony stories.

In addition, Facebook recently announced they will be rolling out one centralized page which will allow users to control their privacy and security settings.  Until they do, the information below will help you protect your privacy yourself. 

How To Protect Yourself on Facebook

In addition to the increased security measures taken by Facebook administrators, most users will find it helpful to take a few simple steps to protect their private information, minimize conflict with others on the site, and make it easier to focus on the Facebook posts which interest them the most.  Below are a some of the actions you should consider:

1.  At the top of your Facebook page you will see a question mark in a dark circle.  Click on it.  About halfway down the pop-up menu you will see "Privacy Checkup."  Click on it and a new box will open up.  Make sure you choose "only me" or "friends" for everything.  You should not choose "public" for any of your settings.  While you are there, remove any unfamiliar apps which you do not want accessing your information.

2.  Avoid Facebook games and apps.  Yes, many of these games are fun.  However, you are safer if you download games separately to your tablet, phone or other device and play only games which are not connected to Facebook.  You especially want to avoid any games which ask for access to your name, email address and the names of your friends.  In the Privacy Checkup, you can click the X next to any apps you want to remove.

3.  Next, click on the down arrow to the right of the question mark.  On the left hand side of the page which opens up, you will see a column of choices including privacy, apps and websites, and ads.  Click on each of those items and see if you want to make changes in this area.  For example, under ads you can decide whether or not to allow Facebook to show you ads based on your computer activities when you are NOT on Facebook.  Go through all your choices in this section and make sure you are protecting your privacy as much as possible.

4.  Avoid questionnaires on Facebook.  They may seem like harmless fun, but they are often attempts to get your personal information, potential passwords, or the answers to security questions by asking you when and where you were born, your middle name, the names of your pets, the names of schools you attended, your favorite flavor of ice cream, etc.  You should avoid answering these questions unnecessarily on any site.

How to Control Who Sees Your Facebook Posts

You can also control which of your friends see what you post.  If you are simply wishing everyone Happy New Year, you may want all your Facebook friends to see your post.  However, if you are making a comment about a politician or other controversial subject, there may be some Facebook friends who you would prefer NOT to see your posts.

In this case, when you write the post, make sure you choose who can see your post.  You can choose that it can only be seen by you, by the public, by your friends, by friends of friends or you can choose "Facebook friends except for ...."  When you make this last choice (my personal favorite), you can choose which friends cannot see each post.  You remain Facebook friends with the people who are not seeing all your posts, but they cannot see your posts when you choose this option.

I have also sent messages to the Facebook staff requesting that they make this an option when you leave a comment on a controversial news item.  I hope they will make this additional option available to us in the future, so we can control which of our friends can see our comments.

When you control who can see your posts, you are much less likely to get into conflict with friends who may disagree with some of the things you post.

What If You See Posts You Dislike?

Are you seeing news stories or other posts which you find upsetting?  You can also put a stop to those.  Whenever you see a post you do not like, you can click on the three dots in the top right-hand corner of the post and choose what action you would like to take. For example, you can choose to unfollow that person or site. This is a good choice if it is a news site, for example, which posts controversial stories which upset you. However, if you do not want to do anything that drastic, you can also choose to hide the post, snooze the source of the post for 30 days, or give feedback on the post and report it. The last one is an especially good choice if you believe the source of the post is spreading fake news or posts which are inappropriate in some way.  Facebook administrators will then investigate the organization which created the post and determine if they are breaking any Facebook rules. 

How to Find Interesting Posts

One beneficial way to use Facebook is to follow organizations which interest you.  These organizations will post articles which you may find helpful.  You can search for these organizations by using the search bar at the top of your Facebook page.  When you find sites you want to follow, click on the Follow button in their page. For example, I follow the Facebook pages for the city where I live, neighboring cities, politicians whom I support, my county commissioner, several major local and national news organizations and several health organizations.  Because of this, Facebook has become an easy place for me to stay informed about topics of interest to me.  Depending on your interests, you can find sites which provide recipes, gardening tips, art, and information about any chronic illnesses you may have, as well as thousands of other topics.

If you follow the above suggestions, you will soon find that Facebook is enjoyable once again and, at the same time, you will keep your personal information safe.  In addition, you will also discover that you are having fewer disagreements with your friends on Facebook.  Now that is a win-win way to use Facebook!

If you are looking for more helpful articles about how to protect your health and safety, where to retire, Medicare, Social Security, financial planning and more, use the tabs or pull-down menu at the top of the page to find links to hundreds of additional articles.

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Wednesday, May 2, 2018

Hearing Loss Increases Dementia Risk Dramatically

As we age, many of us find it a bit more difficult to hear.  We may turn our televisions up, set the radio in our car a little louder and smile politely when someone says something which we cannot quite hear.  Unfortunately, ignoring our hearing loss can dramatically increase the likelihood that we will develop dementia.

Causes of Hearing Loss

There are a number of reasons why your hearing may decline as you age.  It could be hereditary.  You may have spent years in an occupation where you were exposed to loud noise.  It is possible you damaged your hearing by occasionally attending loud concerts or clubs where the music was quite loud.

Whatever the reason, at first you may only lose the ability to hear high pitched sounds.  Then, you may notice it is more difficult for you to participate in a conversation at a noisy restaurant.  When you first notice it, you may tell yourself that what you are experiencing is normal.  If you also develop tinnitus, or ringing in the ear, you may feel compelled to see a doctor.  Otherwise, you may suffer in silence for years.

Dangerous Consequences of Hearing Loss

Many people are surprised to discover that hearing loss can actually cause more problems than we realize.  Johns Hopkins followed 639 adults for almost 12 years and discovered that people with mild hearing loss had double the dementia risk; those with moderate hearing loss had triple the risk; and those with severe hearing impairment were "five times more likely to develop dementia."

You may want to go back and re-read that last paragraph.  Even those with MILD hearing loss have double the risk of developing dementia.  The worse your hearing loss, the higher your risk of dementia.  This should be a wake-up call to anyone who chooses to ignore their hearing problems.

In addition, they discovered that people with hearing loss were more likely to experience problems with walking and they fell more often.  This can contribute to other serious health issues

Why Does Hearing Loss Contribute to Dementia?

According to the research from Johns Hopkins, there seems to be two factors which contribute to the increased dementia and other problems.  The first reason, according to their site, is that "brain scans show us that hearing loss may contribute to a faster rate of atrophy in the brain."  The other reason is that it can cause social isolation.  As we have reported in the past in this blog, social interaction is a very important tool in preventing or slowing down the development of dementia.  If your hearing loss causes you to avoid social situations, the lack of interaction could gradually cause you to develop dementia.

Can Hearing Aids Make a Difference?

The researchers at Johns Hopkins are in the process of studying whether the use of hearing aids can reduce the risk of dementia.  However, they said "there is no downside to using hearing aids."  They benefit the majority of people who use them and they make it easier for you to stay engaged with your friends and family.

Researchers in France also studied a group of 94 people between the ages of 65 and 85 who had profound deafness in at least one ear.  They gave them cochlear implants along with auditory rehabilitation twice a week.  Impressively, over 80 percent of the people with the lowest cognitive scores showed marked improvement after one year.  In fact, the improvement was almost twice that seen with any of the current medications which have been approved by the FDA for treating Alzheimers. 

It appears that improving your hearing can significantly reduce your risk of dementia, even after you have already begun to develop it!

Hearing Loss is Very Common

Approximately 27 million Americans over the age of 50 have some hearing loss, yet only about one in seven uses a hearing aid.  There is no reason why people should not give them a try.  Today's hearing aids are small (as you can see in the above photo) and are often unnoticeable; they can improve your relationships with the people you love; and most people adjust well to them after the breaking-in period.  It takes a little time for your central auditory system and brain to adjust to one, so it is important that you not give up too soon.  After that, they can be life-changing.

Hearing Aids Can be Expensive

Health insurance usually does not cover the cost of hearing aids and the average price is about $1,675 per ear.   The expense is a major reason why many people do not get them.  However, prices for hearing aids are expected to drop over the next few years, which could mean that more people will try them.  If more people begin to use them, it could be one way we might reduce the number of people who develop dementia in the future, and reduce the extremely high cost of treating dementia patients in coming decades.  Hopefully, if insurance companies see that providing hearing aids to their subscribers will save them money in the long run, the insurance companies will begin to cover more of the cost.

If you are interested in learning more about common health issues in retirement, Social Security, Medicare, where to retire, financial planning and more, use the tabs or pull-down menu at the top of the page to find links to hundreds of additional articles.

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Tuesday, April 24, 2018

'Being Mortal' and End of Life Planning

We are all going to die.  Most of us do not want to think about this.  We admire people who fight bravely against the ravages of disease, even if it only means they have extended their lives a few weeks or months.  At the same time, we rarely envision that we may be tethered to machines at the end of our life.  When we do think about the end of our life, we have a pretty image of ourselves living until an extremely old age, then dying at home in our bed, surrounded by our loved ones, saying our gentle good-byes.  Most of the time, however, we prefer not to think at all about the end our life.

However, we need to remember that we are all going to die and DEATH IS NOT A FAILURE.  It is a perfectly natural part of life and something for which we need to prepare, for our own sake as well as the sake of our loved ones.

Review of "Being Mortal" by Dr. Atul Gawande

Only rarely have I recommended a book in this blog.  However, I believe it would be helpful for anyone who is over the age of 60, or who has a loved one over the age of 60, to read "Being Mortal" by Dr. Atul Gawande. I believe they would find it very helpful and eye-opening.  It will help you make smarter decisions for yourself and your loved ones concerning the best types of assisted living and medical treatments for the very elderly or sick.

This book is easy to read and contains a large number of case studies which illustrate the various points made by the author, Dr. Atul Gawande, an American surgeon at Brigham and Women's Hospital in Boston. He is also a professor at Harvard Medical School.

Early in the book, he talks about the normal aging process and the types of illnesses and disabilities which are common.  Dr. Gawande notes that the normal decline in our health due to aging often results in losing our independence and being placed in traditional American nursing homes.

In the opening sections of "Being Mortal: Medicine and What Matters in the End," Dr. Gawande discusses the problems with normal nursing homes and their desire to put our medical care and safety above any other consideration.  However, he then shares information about a variety of developers of assisted living facilities who also take into consideration our very human desire to have privacy, independence, pets and a variety of activities available to us as we age, even if this means we are not always bubble-wrapped in the name of "safety."

Later in the book, Dr. Gawande discusses the value of hospice and palliative care, whether or not a terminal patient decides to continue to try various treatments for their illness.  He explains that it is important for the family and care providers to take the time to learn how the patient wants to spend their final days or weeks.  Often, in an attempt to avoid telling the patient they are dying, doctors subject their patients to a series of worthless treatments which may make them miserable or even shorten their lives!

This book covers a great deal of helpful information which will make it much easier for you and your loved ones to make more informed decisions about where they want to live during the final years of their lives and the types of treatments they wish to try.  In many cases, it will enable families to improve the quality of the time they spend with a loved one who is dying.  This is a book which every family will be able to use as a helpful guide when they have aging family members.

The book, "Being Mortal: Medicine and What Matters in the End" is available in hardback, paperback, audio, Kindle, and large print editions in bookstores and from Amazon.

To learn more about common medical issues which affect us as we age, suggestions on where to retire, Social Security, Medicare, changing family relations, financial planning and more, use the tabs or pull-down menu to find links to hundreds of additional helpful articles.

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