Wednesday, December 5, 2018

How to Pick a Nursing Home

Are you looking for a nursing home facility for your parents, your spouse or yourself?  You may feel overwhelmed.  There are approximately 16,000 nursing homes in the United States and they vary widely in quality.  When possible, it is a good idea to do advance research on the ones in your area so you have two or three in mind before you or someone you love needs to move into one.  Nothing is worse than hurriedly trying to find a skilled nursing facility during an emergency.  It can be too tempting to choose one simply because it is close to your home or seems convenient, rather than because of the quality of the care. Below are some of the things you need to consider while doing your nursing home research.

What Questions to Ask When Looking for a Nursing Home

1.  What is their Medicare rating?

Before you do anything else, you will want to know which facilities in your community are rated the highest by Medicare.  You will also want to know the specifics about their rating.  How did they score on issues such as staff attentiveness, health inspections and nurse-to-patient ratio?  One source of this information is the Medicare website at:

2.  What is the Shower Schedule?

In some states, such as California, the staff is required to help their patients shower at least twice a week.  You will want to confirm the schedule and find out if it possible for a patient to receive showers more frequently, if requested.  If so, is there an additional charge and how much would that be?

3.  What is a Typical Daily Schedule?

People stay in skilled nursing facilities because they are no longer able to care for themselves due to old age or because they are recovering from surgery, illness or an injury.  In most cases, the daily resident schedule will include some type of rehabilitation therapy.  However, if that is the only time the residents are engaged in an activity, they are likely to become very bored and feel lonely.  It is important that residents also have social activities, entertainment, exercise classes for those who can participate, and hair salon services for those who have an extended stay.  The photo above shows a group singing and enjoying a voluntary spiritual circle. Having activities and companionship is very important for the well-being of all of us, including the elderly.

4.  What is on the Menu and What Options Are Available?

Today, large numbers of people have a variety of dietary restrictions because of the nature of their illness, their religion, ethnic background or food preferences.  Consequently, it is important for the residents' health and emotional well-being to have input regarding their food choices.  Ask if special holiday meals are available and what options are available on normal days.  If possible, ask if you can go to the dining room and enjoy a meal with the residents.  This will give you the opportunity to try the food yourself and will enable you to observe how attentive the staff is when assisting people who need extra help.

5.  Are You Being Shown a Typical Room?

Most skilled nursing facilities are happy to give you a tour.  Make sure you take the tour and do not consider a facility if they will not show you around.  However, during your tour it is important to ask a lot of questions and be a little skeptical. Are they showing you a typical room, or is their model a little larger and fancier than the rooms of most residents?  Are the rooms private or semi-private?  Can the residents bring along a few pieces of their own furniture, especially if the move is likely to be permanent? Do the residents have access to Wi-Fi and computers?  Are there in-room televisions, or is TV viewing only available in the central lounge area?  Are there telephones in the rooms?  Are the facilities clean and attractive?  Are there outdoor areas where the residents can relax?  Does the facility smell pleasant? Is it reasonably quiet and cheerful?

6.  What Additional Costs Can You Expect?

Nursing homes often quote a price per month for basic care which includes room and board, as well as essential care.  However, you may be surprised to discover there are usually extra charges for things such as patient medications, having someone dispense the prescriptions at the appropriate times, and assistance with bathing, dressing or eating.  Ask if there an extra charge to drive residents to doctor's appointments.  Do they charge for other special services such as changing bandages or providing adult incontinence supplies?   These expenses add up quickly and can turn an affordable nursing home into an unaffordable one.  You will also want to ask how often the rates increase and how much they have historically risen.

7.  Can this Nursing Home Meet Residents' Future Needs?

While you or your loved one may initially move into a skilled nursing facility because of the need for physical care as you age, what happens if residents develop more complex problems, such as dementia?  Is this facility capable of handling all future needs, or do residents have to move somewhere else when their needs become more severe?  Moving can be very upsetting and disruptive to an elderly person with dementia.

8.  What Safety Measures are in Place?

Are the floors non-skid?  Are there handrails along hallways and stairways, as well as grab bars in the bathrooms?  Are the walkways and emergency exits clear?   Does the facility have an emergency preparedness plan?  Is there a back-up generator in case the electricity goes off?  What happens if the facility needs to be evacuated in the event of a natural disaster?  What contingency plans are there, especially for the weakest patients?  Are there emergency supplies in case the facility decides it is safer to shelter in place?

9.  How are the Caregivers Recruited, Trained and Screened?

Are the caregivers given continuing education classes?  Are they subject to background checks before being hired?  What is the employee turnover rate?

10.  Can You Chat with a Few Residents and Visitors?

Ask residents if they are happy in the facility.  Most of them will be extremely honest, but recognize that some people will complain no matter how good the facility is.  Try to observe if the staff seems to have a good relationship with the residents. Do people generally seem happy or disgruntled?  Does the staff greet the residents by their name?  If possible, ask the residents if they like the food, activities and staff.  If you run into family members who are visiting, ask what they think of the facility.  Ask everyone if there is anything else you might want to know ... such as unusual rules or expenses you might not expect.

Once you have visited several facilities and answered all the above questions, you will have a good idea which skilled nursing facility is most likely to meet your unique needs.

If you are interested in learning more about where to retire, financial planning for retirement, Social Security, Medicare, common medical problems and more, 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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Photo from public Facebook page of Serenades Assisted Living in Florida

Wednesday, November 28, 2018

Feel Younger at Any Age

How does your body feel at this very moment?  If you are like most Baby Boomers, you may be starting to feel your age and fear that things are only going to get worse as the years go by.  However, you do not have to just sit back in your recliner and assume that how you feel now is as good as it is going to get.  Instead, by applying the principles from the Younger Next Year books, you could slow down or even reverse the aging process and feel better than you have in years.

How to Feel Younger Within a Year

According to the authors of Younger Next Year, Chris Crowley and Henry Lodge, "how long you live is 80 percent genes and 20 percent you; but how well you live is 80 percent up to you and 20 percent genes."  They believe that people who follow their suggestions can avoid approximately 50 percent of all major diseases and accidents.  Of course, if this is true, it could make a tremendous difference in the quality of your life as you age.

AARP was so intrigued by the idea that the right lifestyle could help us all feel younger, they interviewed Henry Lodge, one of the authors of the Younger Next Year books (which I highly recommend) and summarized his findings in a special section of AARP Magazine in their October/November 2016 issue. So, what do you have to do in order to feel better and improve the quality of your life?

A Few Younger Next Year Recommendations

Exercise at least six days a week, as hard as you can, until the day you die!  Break it down into four days a week of aerobics and two days a week of strength training with weights.  Include some balance exercises.  Exercise regularly, even if you have arthritis.  It could actually reduce your pain.  Once you are in your 80s or older, continue with the exercise.  However, you can back off the high intensity workouts and rely more on longer, slower exercises.

Spend less money than you make.  This will help reduce the stress in your life.  You may even want to get a retirement job.  It will keep you active and involved in the world around you.  It will also make it easier to live within your means. 

Eat food which is alive, and stop eating dead, processed food.  Your diet should consist of 50 percent vegetables and fruit, 25 percent whole grains like brown rice, quinoa or whole wheat, and 25 percent meat, poultry and fish.  Replace butter and animal fat with olive oil. Limit alcohol to one or two glasses of wine a day, at most. Do not feel as if you have to eat everything on your plate.  The types of dead food we should minimize or eliminate from our diet include popular items such as bread, white rice, white pasta, sugar, chips, soft drinks, frozen meals, desserts, french fries, cheeseburgers, milk shakes, and anything which is fried. 

Care about others.  Connect with your friends and family, and commit to their well-being. Nurture yourself with friendships and, perhaps, a pet.

Enjoy your life. Explore your talents and follow your dreams.  Paint, write, or play an instrument.  Doing these things will make you happier, help you feel better, and you will enjoy your life more, too!

Of course, the entire book cannot be summarized in a short blog post.  As a result, I encourage anyone who wants to age well to read one of the Younger Next Year books.  You can use the Amazon link on the right side panel of this blog, near the top, to order the book.  The book makes a great gift, too! All ads on this blog are from quality, trustworthy sources such as Google, Amazon or Viglink.

If you are interested in learning more about dealing with common health problems as you age, financial planning, where to retire, Social Security, Medicare 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, November 20, 2018

Alzheimers Research - How to Join a Study

Alzheimer's Disease, the most common form of dementia in the United States, is expected to sky-rocket over the next few decades as Baby Boomers grow older.  Currently, about 5.5 million Americans are living with Alzheimer's Disease.  Over the next 30 years, that number is expected to triple to 16 million people, with approximately one-third of all Medicare dollars spent to treat this one disease alone.  If this concerns you, it is now possible to sign up to participate in a long-term research program, even if you currently have no signs of dementia.

There are thirty Alzheimer's Research Centers in the United States which are funded by the National Institute on Aging, part of the National Institutes of Health..  The map at the top of this post shows the cities where they are located. 

On a personal level, I recently registered with the Alzheimer's Research Center in my area, at the University of California in Irvine.  In order to participate, I registered on their MIND website at  Readers who live in Orange County, California may also want to register with this Research Center.  Unfortunately, each Research Center has its own separate studies and websites. You can find more information about how to register with other centers at the National Institutes of Health website at

To initiate my registration with UCI MIND, I completed an online questionnaire which took about 30 minutes to complete.  It asked about my family background (my mother died of Alzheimer's, but my father is alive at 90 with no signs of the dementia.)  It also asked about my health, medications I take, and my lifestyle habits, including my diet, amount of sleep I get, alcohol consumption, etc.   In addition, they wanted to know what diagnostic and treatment medications I potentially would agree to, if offered.  I was a bit uncertain about how to answer these questions, since they included whether or not I was willing to take experimental medications, get brain scans, or donate my brain to the researchers upon my death.  I did not agree to all of these things, and apparently it was not necessary to agree to them all.

The speaker who suggested that interested parties should register for the UCI MIND Alzheimer's Research Project told us that people would qualify for the early clinical trial if they met the following criteria:
  • Are 60 to 85 years old
  • Have generally normal memory function
  • Are not being treated for memory problems
  • Have a close friend or relative who can partner with you
  • Are willing to take an investigational medication
I met the above criteria.  As a result, I was contacted about six months after I registered on the UCI MIND website.  I went to the offices at UCI and had an interview with one of the researchers.  During the interview, I was also given a basic cognitive test to determine whether or not I was currently showing signs of dementia.  I was not.  The researcher told me that I would be contacted periodically in the future.  I would be asked to update my online questionnaire annually so I could report changes to my health, medications or medical record. 

I may also be invited back to their office occasionally to be interviewed again and given another cognitive test.  The researchers may decide at some point that I might be a good subject for more intensive study, perhaps receiving a brain scan or an experimental medication to prevent the progression of dementia.  That decision could be made at any time, or years from now.  However, it is reassuring to know that I am now part of their database and will be followed for the rest of my life. 

There is also a special, separate research study at UCI MIND which is called the 90+ Study. It is for people over the age of 90 and it has been featured on the television show "60 Minutes."  Some of the subjects of this study have been participating for over 30 years. You can find a video of the "60 Minutes" segment on YouTube, as well as other videos featuring Dr. Claudia Kawas, who is the lead investigator.

Whether you ever develop dementia or not, your participation in a research study could help someone else avoid Alzheimer's Disease and other forms of dementia in the future. That makes your participation well worth the time and an excellent way to help others and, possibly, yourself.

For more information about dementia and other common health problems as we age, financial planning, Social Security, Medicare, where to retire 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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Photo credit:  National Institutes of Health

Wednesday, November 14, 2018

Use the ACA for Pre-Retirement Medical Insurance - the Affordable Care Act

People between the ages of 50 and 65 often pay extremely high medical insurance premiums.  What they may not realize is that many of them may qualify for a discount on their medical insurance if they take advantage of the ACA or Affordable Care Act.  This is an income based discount and may only be available if you apply during the annual open enrollment period.  Currently, those who want to investigate whether or not they qualify for lower medical insurance premiums through the ACA need to apply between November 1 and December 15. 

Those who miss the deadline but have what is considered a special qualifying event, such as an adult child who recently lost coverage under their parents' plan, or someone who has lost their employer sponsored or COBRA insurance, can apply at any time of year.  However, they must apply within 60 days of the time the "qualifying event" occurred.    This program is available even if you only need the coverage for a few months until you get a new job or qualify for Medicare.

Apply Even if you did not Qualify in the Past

If you have not been eligible for a discount through the Affordable Care Act in the past, you may still want to try again this year.  Several states, including Idaho, Utah and Nebraska, have recently passed Medicaid expansions, which means hundreds of thousands of people who previously were not eligible to receive help from the Affordable Care Act are now eligible.  Other states have also expanded their programs.

How to Apply Online or in Person

The official national website for the Affordable Care Act is:  On the website you can either apply immediately for medical insurance or learn how to get personal help in the state where you live from a local agent or broker.  There is even a "Quick Start" guide on the website to make the application process easier.

If you live in California, the official site for receiving information about the Affordable Care Act is:  Covered California.  You can apply online or you can use the website to find the location of offices where you can get personal help with the application process.  You may also see small offices for Covered California in malls and shopping centers, manned by experts who can help you through the application process.

Pre-existing Conditions

According to the website, "Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts."

Preventive Care

The website also explains that the Affordable Care Act provides the following preventive care:

"You and your family may be eligible for some important preventive services at no additional cost to you.

If your plan is subject to the new requirements, you may not have to pay a copayment, co-insurance, or deductible to receive recommended preventive health services, such as screenings, vaccinations, and counseling.

For example, depending on your age, you may have access — at no cost — to preventive services such as:
  • Blood pressure, diabetes, and cholesterol tests
  • Many cancer screenings, including mammograms and colonoscopies
  • Counseling on such topics as quitting smoking, losing weight, eating healthfully, treating depression, and reducing alcohol use
  • Regular well-baby and well-child visits, from birth to age 21
  • Routine vaccinations against diseases such as measles, polio, or meningitis
  • Counseling, screening, and vaccines to ensure healthy pregnancies
  • Flu and pneumonia shots - Visit to learn more

Please Help Share this Information

It is important to pass this information to anyone you know who may benefit from the ACA, including your adult children who may no longer be eligible to be covered by your insurance.  Getting them insured under the Affordable Care Act could save you a great deal of money if they become injured or ill.

The advertising budget for the ACA has been drastically cut, so many people do not realize they are eligible and that we are currently in the open enrollment period.  There are virtually no television ads for the program. 

Feel free to email this information to friends you believe could benefit, or post a link to this article on Facebook, Twitter or other social media you use.  By sharing this information, you could make life much easier for someone who is not old enough to be eligible for Medicare, and may be feeling overwhelmed by the high cost of their medical insurance premiums.

If you are interested in learning more about Medicare, Social Security, common health problems as you age, where to retire in the US and abroad, financial planning and other retirement related issues, please 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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