Dangerous Medications, Vitamins and Herbal Remedies

Virtually everyone in the United States uses either prescription medications, vitamins, or herbal remedies.  In the right doses and combinations, most of them are safe.  However, your prescriptions and supplements can turn against you.  In extreme circumstances, they can cause you to develop new health problems or dangerous drug interactions.

According to an article in the August/September 2016 AARP Magazine, you should periodically have a "Checkup for Your Medicine Cabinet."  You should repeat it annually to make sure the pills you are taking are helping you, not making your health problems worse.

Examine Your Prescription Medications

Check Expiration Dates:  While you do not want to keep any drug after its expiration date, according to the article, you want to be particularly careful about insulin, inhalers, oral nitroglycerin, EpiPens, anti-convulsants, warfarin, digoxin and thyroid medication.  If the drug is in its original packaging, the expiration date should be stamped on the side or bottom.  Otherwise, you may have to ask your pharmacist or follow their recommended "discard by" date.

Avoid Allergy and Sleeping Pills:  There appears to be a link between the long-term use of allergy or sleeping medications and problems with decision-making and dementia, including Alzheimer's disease.  Even common over-the-counter products such as Benadryl and Nytol can cause problems. Find alternative, drug-free ways of dealing with your allergies or insomnia.

Do Not Overdo the Vitamins

Millions of Americans take vitamins.  However, excessive amounts of certain vitamins can cause health issues, rather than eliminate them.  Below are four vitamins that the article particularly recommended people limit:

Vitamin B6 - Over 100 mg. a day can cause temporary nerve damage.

Vitamin A - Over 10,000 IUs a day can cause vomiting, headaches, dizziness and blurry vision.

Vitamin D - Over 10,000 IUs a day can cause poor appetite, frequent urination and kidney problems.

Vitamin C - High doses (which were not specified in the article) can double a man's risk of kidney stones.

Watch for Interactions between Herbal Remedies and Certain Drugs

In an effort to avoid taking too many prescription drugs, Americans often resort to herbal remedies.  However, these preparations can be dangerous, especially when combined with medications that have been prescribed to you.  Make sure your doctor knows what herbal remedies you use.  Below are some that are particularly worrisome:

St. John's wort - It can interfere with your statins and high blood pressure medications.

Ginkgo and ginseng - These herbs can interact with blood-thinning medications, which could dangerously increase your bleeding risk.

Kava - Even when it is not combined with other medications, this herb can cause liver damage.

Bottom Line:  Any time you add a new medication or supplement to your usual routine, discuss it with your doctor to make sure it will not conflict with something else you are already taking.  Regardless of whether or not you have been taking the same drugs and supplements for a long time, check with your doctor if any new symptoms develop.  Sometimes it can take a long time for the toxicity to build up in your body.

If you are interested in learning more about retirement planning, common health problems as you age, 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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Dangerous Silent Heart Attacks

A study that tracked nearly 9,500 men and women from 1987 to 2013 discovered that approximately 45% of heart attacks are silent and the victims have no idea that they have experienced a heart event.  Men are more likely to experience silent heart attacks, but women are more likely to die from them.  In fact, anyone who has experienced a silent heart attack has triple the risk of dying from heart disease and is 34% more likely to die from all other causes.

How Do You Know if You Have Had a Silent Heart Attack?

Since these types of heart attacks do not exhibit the classic symptoms of chest pain and shortness of breath, how can someone find out whether or not they have had one?  A doctor can detect them with an EKG, which measures the heart's electrical activity.  In fact, most of the time people only learn that they have had one accidentally, during a routine physical.

What Symptoms Could Indicate You are Having a Silent Heart Attack?

The symptoms of a silent heart attack can be very subtle, but anyone should see their doctor for a physical if they are experiencing several of the following symptoms:

Unexplained fatigue
Muscle pain in the upper back, jaw or arms
Painful indigestion
Sudden sweatiness
Nausea
Flu-like symptoms

Often, people do not recognize that they have had a heart attack at the time.  They only recognize these symptoms when a test shows damage to their heart and they look back and remember a time when they experienced some of the above symptoms.

Are These as Dangerous as "Typical" Heart Attacks?

Yes!  In fact, silent heart attacks can be even more dangerous than a typical one, because the patient may not get the treatment they need in order to prevent another one.  This lack of treatment is even more common for women than it is for men.

"Just a Little Heart Attack" is a short movie about silent heart attacks you can watch using the link to this CNN article:  "Almost Half of All Heart Attacks are Silent."

How Can You Reduce Your Heart Attack Risk?

If you would like to reduce your risk of having a heart attack, either your first or a second one, there are some steps your doctor can help you take.  You should quit smoking, lose weight, get exercise and, if appropriate, make sure your cholesterol and blood pressure are both under control.

Treatments for Silent Heart Attacks

Hospitals and doctors should treat you in the same way they would if you had experienced more traditional symptoms.  There is no difference in the damage that could have been caused by the different types of heart attacks and, in fact, the damage could be more severe in a silent one because of a delay in seeking treatment, since any heart attack will stop or reduce the flow of blood to the heart for a period of time.

If you have been experiencing unusual fatigue, nausea or shortness of breath, especially during mild exercise, you should talk to your doctor about your symptoms.

Interested in learning more about medical issues, financial planning, where to retire, Social Security, Medicare, or other topics that pertain to Baby Boomers?  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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Will You Enjoy Retirement?

If you spent the last decade of your working years looking forward to the day when you could "take this job and shove it," have you given much thought to how you will spend your days once you walk out of your office or workplace for the last time?

According to research by the National Center for Health Statistics, the average person who reaches age 65 can expect to live another 19.3 years ... or until they are age 84.  What do you plan to do with those extra two decades of life?  Have you given that serious thought?

Will Retirement Be Fun?

Many people imagine spending long days on the golf course, in their fishing boat, or taking cruises and vacations to exotic locations.  However, is that really what you want to do every day for the last twenty years of your life?  Will you even be able to afford that daily round of golf, the fishing boat, or the travel?

According to U.S. News & World Report, the typical retiree between the ages of 65 and 74 spends four hours a day watching television ... and that is the age group of the youngest retirees, the ones who are most capable of being active.

Is it inevitable that your retirement will eventually leave you feeling isolated, bored, and lonely?  Not necessarily.

What Retirement Options Will Keep Your Life Interesting?

In addition to financial planning, people who are preparing to retire, or who are newly retired, should spend plenty of time thinking about the lifestyle choices they can make as they approach their mid-60's.  Below are some options they may want to keep on the table:

*  Keep working at their current career - What?  After all these years of planning to retire, why would you want to keep working?  Presumably, you have earned a nice income from your job in the past and now you will be able to supplement that income with your Social Security benefits ... which will give you extra money for travel and having fun.  You might also decide to postpone collecting your Social Security until you are age 70, thus substantially increasing your benefits.  Staying at your current job also enables you to maintain your work friendships and connections with other people.  It can give structure to your life and keep your brain alert ... without resorting to endless crossword puzzles.

*  Find an Encore Career - What if there is no way you want to keep working in your old career?  That doesn't mean you need to give up working altogether and just sit home every day.  There are so many possible career choices.  You could find a job with a local business or non-profit, work as a consultant in your former field, become a tutor, or give lessons.  Retirees are even eligible to sign up for the Peace Corps and share their valuable knowledge and experience around the world.  Yes, many people in the 60's (and sometimes a little older) join the Peace Corps.

*  Volunteer in your community - If you really don't need extra income, you still do not want to spend your days sitting around the house, watching television.  Why not contact your local hospital or charity and see if they need your help?  I know a woman who helps out one day a week in a local hospital. She particularly enjoys caring for premature babies that just need extra time being held.  The work is not physically demanding, but she feels it is very rewarding.

*  Find affordable, social hobbies - Everything you do in retirement does not need to be expensive.  Nor do you need to spend time alone when you are pursuing your hobbies.  Join a book club or other activity that you can enjoy with other people.  If you don't know how to find other people who enjoy your hobbies, try www.meetup.com.  This website helps you link up with people in your community who are looking for people with common interests ... whether that means hiking, traveling, tai chi, golf, playing games, learning bridge, dancing, tennis, photography, dog walking, writing, painting, yoga, attending movies, boating, playing music, cycling or eating out. Many places of worship also have special activities for their older members.  Go to your local senior center to find exercise classes, low-cost meals and a wide variety of activities.  There is no reason to pursue your favorite activities in solitude when it is so easy to connect with other people who enjoy doing the same things you do.

Plan Your Life After Retirement

Financial planning is a very important part of getting ready for retirement.  However, it is equally important to plan what you will do with that free time ... and hopefully that will not mean just sitting around for the last twenty years of your life.

Plan to have a satisfying and fulfilling life during this period of time.  Think about how you could enrich your life while sharing your gifts with others.

I know people who are as busy or even busier in retirement than they were when they had full-time jobs during their "working years."  What is most interesting is that those are the people who seem to be the happiest as they age!

Are you looking for more information about retirement planning, where to retire, common medical issues, Social Security, Medicare and changing family relationships?  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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Confusing Parts of Medicare

Are you confused about all the different parts of Medicare ... the so-called Medicare "alphabet?"  If so, you are not alone. Whether people are getting prepared to sign up for Medicare for the first time or are already using it, the different parts can seem like a foreign language.  Below is a brief summary of the different parts, as well as a little basic information that everyone needs to know. 

Medicare Parts A, B and D

Medicare is broken up into four different parts and each one has a different purpose and, in some cases, different requirements that determine whether or not you are eligible.

Medicare Part A:  This section will help pay for your stay in a hospital or skilled nursing facility. It might also pay for home health services and hospice care, if the patient meets certain criteria.  If you or your spouse paid into Medicare long enough during your working years, you do not pay monthly premiums for Part A.  If neither you nor your spouse paid into it while you worked, you can still buy Part A services by paying monthly premiums.  Everyone is entitled to Medicare Part A, either free or for a monthly fee.

Medicare Part B:  This section will help pay for doctors' services (whether in or out of the hospital) and outpatient care, including lab work, tests and health screenings.  It can also cover the cost of some types of medical equipment and supplies, under some circumstances, as well as most vaccines or drugs that the doctor gives you in his office.  You do pay monthly payments for Part B.  However, low-income people may quality for state assistance.  There is a seven month window to sign up for Part B ... three months before your 65th birthday month, during your birthday month, and three months after your birthday month.  If you wait too long to sign up, you can still obtain it, but you will pay extra premiums for the rest of your life.  Medicare Part B only covers about 80 percent of their approved costs and the patient pays the other 20 percent.  At the bottom of this article is more information on the two options you have for covering your portion of the bills.

Medicare Part D:  This section covers the cost of prescription drugs that you take at home.  There is an additional premium involved in getting a Part D drug plan, unless you purchase it as part of a Medicare Advantage Plan.

Medicare Supplements and Medicare Part C

Medicare parts A, B and D are frequently called "basic Medicare."  People often believe they are all you need.  However, sometimes they do not realize they need to sign up for Part D to cover their drugs.  In other cases, people do not realize that when they settle for basic Medicare alone, they are still obligated to pay 20 percent of their medical bills ... which can be substantial.

What do people do to solve these problems?  They have two choices.  First, they can get the three parts of basic Medicare (A, B and D) PLUS purchase a supplemental health insurance policy.  Second, they can simply get a Medicare Advantage plan, also known as Medicare Part C, PLUS a Part D plan if the Medicare Advantage plan they choose does not include drug coverage.  Confusing enough?  Below is a little more information.

Supplemental Insurance:  Many insurance carriers offer supplemental policies, sometimes called Medigap policies, including Anthem, Humana and United Healthcare.  There are different rates, depending on the size of the deductibles and co-pays you prefer. The government even has a website to help you compare Medigap policies.  If you decide to get a Medigap supplemental policy, do it as soon as you sign up for Medicare Part B.  If you buy one within six months of enrolling in Part B, the insurers cannot deny you coverage or charge higher premiums because of preexisting medical conditions.  With supplemental insurance, your doctor or hospital will send medical bills to Medicare first.  Once Medicare reimburses the doctor or hospital, next they bill the supplemental insurance carrier.  After that, they will bill you for any remaining costs.  This system sometimes confuses people, because they keep getting statements from the hospital, doctor and the insurance companies for the same procedure.  Sometimes they think they are being double-billed.

Medicare Advantage or Part C:  This is a completely alternative way to receive your Medicare services.  Everything is administered by one private managed care plan.  There are both HMO and PPO options.  These plans are required to cover everything that is offered in basic Medicare, but they may charge lower co-pays and/or offer additional benefits.  Some of the companies that offer these plans are Kaiser Permanente and Scan. The government also has a website to help you learn more about Advantage plans. The plan you buy may also include Part D drug coverage, or the company could offer you a choice of drug plans at a separate price.  Often they offer extra benefits such as dental, vision and hearing care.  In some cases, there are NO premiums, other than what you would pay for basic Medicare.  With other plans, you may have an additional premium.  They may restrict your choice of doctors to only ones who are in their network, or they may charge a higher copay if you go out of network.  Only one company is billed, the Medicare Advantage company, which is less confusing for some people, since they only receive one set of statements and bills for each procedure.

The Medicare Advantage choice is often the least expensive, since there is frequently no premium or only a small premium above the cost of basic Medicare.  However, it is always beneficial to shop around to make sure that you are getting the most for your money, from a reputable insurance company.  Make sure you are aware of all the major choices available in your state.

Summing Up Medicare

To bring it all together, it is important that everyone contact their local Social Security office as soon as possible when they get close to age 65.  In addition, most people will want to attend informational meetings and get more details about the insurance options for both Medicare Supplemental Plans and Medicare Advantage Plans in their state.  Don't make a decision until you have met with two or three different companies and learned about all your choices.

If you start with a company and realize that you wish you had chosen a different company or type of plan, you are not stuck with your first choice.  There is an open enrollment period every year between October 15 and December 7.  During that time, you are free to move to a different plan.

You May Also Want to Find Out About Common Medicare Mistakes

In addition to knowing the various parts of Medicare, you may also want to read the blog post linked below.  It explains the most common Medicare mistakes made by people approaching retirement:

COMMON MEDICARE MISTAKES  

Looking for more information about Medicare, retirement planning, where to retire, common health problems as we age or 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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Healthcare Advocates for the Seriously Ill

Life can get complicated at times and illnesses late in life can be especially difficult to handle.  Sometimes, a healthcare advocate can help patients get things sorted out and improve the quality of their lives.

An elderly couple we know have suddenly and unexpectedly gone through dual health problems at nearly the same time.  The wife injured her arm, making it difficult for her to lift or carry things.  Her husband developed multiple myeloma, causing cancerous tumors along his spine.  He cannot walk without a cane or other assistance.  She cannot help him.  They both are in physical therapy.  His chemotherapy includes numerous pills a day.  Their children do not live close enough to help with all the details of life ... handling doctor's visits, insurance forms, bills, etc.  Overwhelmed, their children hired a healthcare advocate to make certain the parents are getting the help they need.

The healthcare advocate will not carry the laundry for the wife; nor will the advocate help the man walk.  Her job is to help them hire a caregiver, go to doctor's appointments with them, get answers to their questions about treatment, make sure they are getting the attention and care they need and, at the same time, help them with insurance forms and other paperwork.

What Does a Healthcare Advocate Do?

Below is a list of the duties of a healthcare advocate. Most people will not need all of these services. However, it can be beneficial to have someone capable of handling these issues for you when you or a close family member is seriously ill:

•  Are you confused about choosing a new doctor or specialist? The healthcare advocate can provide you with a physician referral service.
•  Frustrated with your insurance company?  They will handle insurance disputes for you (fight for your payment, and handle insurance appeals & grievances).
•  Are your doctor and hospital bills too complicated to understand?  They will perform medical bill audits and dispute any questionable fees.
•  Are you paying a reasonable fee for your procedures?  Many of them will have a cost navigator that is designed to help you find lower cost procedures, when appropriate.
•  Are you getting the best deal for your prescriptions?  They will help you compare prices.
•  Are there alternative treatments or drug trials that may help you?  A healthcare advocate will assist you in finding treatments that could benefit you.
•  Do you have the best health insurance plan for your medical issues?  Your healthcare advocate will review your current insurance plan and help you decide if you would be better off with a different one.  Then, they will assist you in making the change, during the appropriate enrollment period.
•  Are you using the best prescription, dental and vision plans?  They will help you compare your choices and pick the appropriate one.
•  What if you need to go into a nursing home or assisted living facility, either for a short time while being treated, or permanently?  They will help you find one that will meet your needs both medically and financially.  They can help you apply for programs such as long-term care using Medicaid or VA benefits, if you qualify.
•  What if you are able to live at home during your treatment and recuperation, but only with the services of a home care aide?  Your healthcare advocate can help you hire one.  They can also coordinate visits with physical therapists, occupational therapists and other healthcare providers who may come to your home.
•  Do you feel as if you have a million forms to complete, and you feel too ill to deal with them?  The healthcare advocate can consolidate some of them and complete many parts of them for you ... especially the parts that are repetitive.
•  What if your physician tells you there is nothing more they can do to help you?  In this sad situation, you will be grateful for the assistance of the healthcare advocate in connecting you with caring hospice services to help you in your final days.

How Can I Find a Healthcare Advocate?

You can contact the National Association of Healthcare Advocacy Consultants
They have a member directory at:
http://nahac.memberlodge.com/

You can also learn more about the services provided by healthcare advocates at:


http://www.healthcareadvocates.com/services.html
(215) 735-7711
info @ healthcareadvocates.com 


What are the Advantages of Hiring a Healthcare Advocate?

Dealing with a serious illness can be overwhelming ... whether you are the one who is ill or it is your spouse, parents or another family member.  Whenever you are under stress or don't feel well, it can seem almost impossible to deal with insurance, hospital bills, medical specialists and all the other problems.

In addition, it can be extremely difficult to search for a skilled nursing facility or to hire a home care aid for yourself, should they be needed.

Using a healthcare advocate can be expensive, but they sometimes pay for themselves by saving you money in other ways.  They can also lower your stress ... important to help you heal both mentally and physically.

Interested in learning more about retirement planning, common medical problems, Medicare, where to retire, family relationships 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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Common Medicare Mistakes

Many people assume that when they sign up for Social Security they will sign up for Medicare at the same time.  They also expect the procedure to be fairly simple and uncomplicated.  While sometimes this is true, it isn't always.  Decisions about when to sign up for Medicare, which parts you should enroll in, and what supplemental policies to purchase can be very complex.

Many people make mistakes when they initially sign up for Medicare.  When they do, it can make a significant difference in what they will pay in premiums for the rest of their lives.  Below are the most common mistakes retirees make.  It is important to educate yourself BEFORE you sign up.  While you can make some changes later, for example in which supplement you want to use, other mistakes are irrevocable.

Common Medicare Mistakes

*  Do not assume that you do not qualify for Medicare if you have not worked long enough to qualify for Social Security (a total of about 10 years).  If you are age 65 or older, you qualify for Medicare Parts B and D as long as you are a U.S. citizen or a legal resident who has lived in the U.S. at least five years.  You might not qualify for Part A if you have not worked long enough, but you could qualify on a spouse's work record or you can pay premiums for Part A.  Go to your local Social Security office during the three months before you turn 65, or before another 3 months have passed afterwards, so you know your options ... even if you do not plan to start collecting your Social Security benefits for a few more years!

*  Do not postpone signing up for Medicare Part B, unless you have health coverage beyond age 65 through an employer or spouse's employer, and the employer has 20 or more employees.  Other than that exception, the seven month window for signing up is the month you turn 65, three months before and three months after.  If you fail to sign up on time, you will pay a penalty, in the form of a surcharge, for the remainder of your life.

*  Retirees covered by a COBRA or a retiree plan from an employer often still need Medicare Part B.  Many of these plans are set up to be a supplement to Medicare Part B.  If you fail to sign up on time, you'll have no coverage for doctors' services, outpatient care and medical equipment until you enroll.  You need to sign up either during your regular seven month window, or no later than eight months after you stop working (if you work past the age of 65).

*  Do NOT wait until your "full retirement age" or until you collect Social Security before you sign up for Medicare.  As mentioned above, the window for signing up for Medicare is NOT the same as your full retirement age.  They are not linked.  If your full retirement age is 66 or 67, you still need to sign up for Medicare around your 65th birthday, with the few exceptions mentioned above.

*  Do NOT postpone signing up for Part D drug coverage, just because you currently do not take any drugs.  You will end up paying extra penalties and have a delay in coverage when you need it.  One way to save money is to sign up for the Medicare approved Part D plan in your area with the lowest premiums. If you do use prescription drugs, you can research which plan is best for you by using the plan finder program on Medicare.gov or by calling Medicare at (800) 633-4227.

*  Do not get confused about the meaning of open enrollment.  The widely advertised open enrollment period of Oct. 15 to Dec. 7 each year only applies to people who are already on Medicare and wish to change their coverage.  If you are new to Medicare, you can sign up for a supplement or Medicare Advantage plan any time of year.

*  Do NOT wait too long to choose a Medicare Supplement or Medicare Advantage plan.  Since basic Medicare only covers about 80 percent of most medical bills, the majority of people will want to use either a Medicare Supplement or a Medicare Advantage plan.  You need to enroll in one within six months of enrolling in Part B.  If you do that, you cannot be denied coverage or charged higher premiums because of a preexisting medical condition ... no matter how sick you are.  This is a one-time opportunity.  If you are not happy with the plan you initially selected, in most cases you can change it each year during the open enrollment period. (Your choices may be limited if you have end-stage renal failure). If you sign up for Part B when you turn 65, but you do not get a supplemental policy within six months because you are still working and have employer provided insurance, you lose the federal protection against being charged higher premiums because of a preexisting medical condition.

*  Make sure you understand the difference between a Medicare Supplement and a Medicare Advantage Plan.  Both are available across the United States.  A Medicare Supplement is a policy you buy in addition to paying for your Medicare benefits.  You normally have a wider choice of doctors and hospitals; however, they are typically more expensive than a Medicare Advantage Plan and you are basically paying for and dealing with two insurance companies ... the basic government Medicare agency and the insurance carrier handling your Medicare Supplement.  A Medicare Advantage Plan limits you to their group of doctors and hospitals.  However, they are typically less expensive and sometimes cost no more than basic Medicare, yet offer better coverage.  In addition, you only need to file claims and deal with the Medicare Advantage insurance company.  They handle government claims for you.

*  Do not ignore the Annual Notice of Change.  It will be mailed to you every September if you are enrolled in a Medicare Advantage plan (either HMO or PPO) or a Part D prescription plan.  It will explain what changes in coverage and premiums will be made for the coming year.  After reading it, you can decide if you want to select a different plan during the fall open enrollment period.  This could help you avoid a nasty shock from rising premium prices or changes in coverage.

*  Do not forget that many retirees qualify for financial assistance.  This is not charity.  You are entitled to this assistance and extra benefits.  If money is tight, find out if you qualify for these programs:

Medicare Savings Program - Your state will pay the Part B premiums and possibly other expenses.

Federal Extra Help - You could qualify for low-cost Part D prescription drug coverage.

To find out if you qualify, contact your State Health Insurance Assistance Program (SHIP).  You can find the toll-free number at:   shiptacenter.org

Want to find more information about Medicare, Social Security, common health issues, financial planning or the best places to retire?  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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Protect Yourself from Investment Fraud

If you are like most people approaching retirement, you have worked hard all your life and put aside a nest-egg to help supplement your Social Security or pension.  Whether your nest-egg is small or large, the last thing you want is to lose it all to investment fraud.

The Securities and Exchange Commission has published a booklet titled "A Guide for Seniors - Protect Yourself Against Investment Fraud" (SEC Pub 144). The information is actually invaluable to investors of all ages, not only seniors.  While everyone may want to obtain a copy of this brochure, below are a few of the more important points made in this publication.

How to Avoid Investment Fraud

* Seniors tend to be especially vulnerable to scam artists who come across as being particularly "nice" or helpful.  Some seniors are too polite to turn down a friendly salesperson or they may feel they are indebted to someone who has provided them with investment advice.  Do not fall for the opposite tactic, either ... salespeople who prey on our financial fears and assure you that they have the best or, perhaps, the only solution.

* All investors need to ask questions and take the time to confirm the answers.  Do not rely on the references they give you ... do your own independent research on the company and the investment. One place to start is at the SEC's EDGAR database at www.sec.gov/edgar.shtml.  You can also contact your state's securities board.

*  Check out the salesperson and make sure they are licensed to sell securities in your state.  Find out if they have been disciplined by using the online databases of the SEC and the Financial Industry Regulatory Authority (FINRA).  Do not rely on someone simply because they say they are a "senior specialist" or "retirement advisor."  Check out the meaning of Investment Professional Designations at the FINRA website at www.finra.org/investors.

* Take your time before making an investment and be wary of those deals that are unsolicited or "too good to be true."

*  Do not trust a financial advisor who says, "leave everything to me."

Red Flags that Could Signal Possible Investment Fraud

*  Any promised returns that are significantly higher than normal are almost certainly risky ... if not completely fraudulent.  High returns typically means high risk; low returns should correspond to a lower risk ... although even that may not be true.

*  Be skeptical of guaranteed returns.

*  Ignore pressure to send money immediately.

*  Ignore and/or thoroughly investigate "once-in-a-lifetime" offers.

Common Types of Fraud

Every investor should be aware of the different types of fraud.  By educating yourself, you are less likely to be a victim of one.

*  Ponzi and Pyramid Schemes:  In these investments, the money manager basically robs one person to pay another.  The first people who get into the deal will initially get a high rate of return, and they happily promote the investment to others.  Unfortunately, eventually the money runs out and everyone loses both the high income and their principal ... since it was given to other people!

*  Oil and Gas Scams:  While there are legitimate deals, a large number of them are fraudulent deals promoted by telemarketers. If this is not your business, it is probably best to avoid these deals.

*  Promissory Notes:  These are widely promoted loans the investor supposedly makes to a company in return for a high interest return ... and they are commonly nothing more than a scam.

*  Prime Bank Fraud:  The salespeople convince you they are purchasing prime bank financial instruments overseas through secret deals only they can arrange.  The best that can be said about these deals is ... RUN!!

*  High Return or "Risk Free" Investment:  These are often actually unsuitable investment products, such as speculative or risky deals which are sold to the elderly, who are told that they are low-risk.  Confirm, confirm, confirm before taking on a new investment, especially if you have been promised a high rate of return.  Make sure you completely understand what you are buying.  If you can't understand it, don't buy it.

*  Internet Fraud:  The internet is just one more way these fraudulent salespeople try to contact potential investors.  Be as skeptical of something you receive over the internet as you would be of a phone call or letter from a stranger.

Where to Get More Information or File a Complaint

Sometimes, no matter how careful you are, you will need the information below to either file a complaint or check out an investment advisor.  I highly recommend that all investors use this information before dealing with any new investment advisor or purchasing a new investment product.  Print it out and keep it in your file with your brokerage statements.

Securities and Exchange Commission
Office of Investor Education and Advocacy
100 F Street, N.E.
Washington, D.C.  20549-0213

Telephone (800) 732-0330
Fax:  (202) 772-9295
Website for senior citizens:  www.sec.gov/investor/seniors.shtml

Complaints:  www.sec.gov/complaint.shtml
Email complaints:  help@sec.gov

FINRA Investor Complaint Center
1735 K Street N.W.
Washington, D.C. 20006

Fax: (866) 397-3290

File complaints online at: www.finra.org

Verify registration and disciplinary information about brokers and brokerage firms:

FINRA BrokerCheck at www.finra.org/brokercheck
Telephone:  (800) 289-9999

If you are interested in more helpful retirement information, including where to retire in the U.S. or overseas, helpful financial information, common medical problem, family issues 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:  morguefile.com

 

Self Help Tips for Heart Attacks

Like thousands of other people every year, my brother-in-law had a heart attack while he was alone in his car.  He drove himself eight miles to a hospital, where he collapsed as he entered the emergency room.  Although he survived, no one recommends that you try to drive yourself to the hospital if you suspect you are having a heart attack.  The chances are good that you will not reach the hospital and, to make things worse, you might kill someone else.

The truth is that nearly everyone spends at least some time alone.  As we get older, many people live alone and, in a health emergency, this can be dangerous.  Some people wear an emergency pendant which puts them in contact with emergency personnel, neighbors or relatives with the push of a button.  Other people keep their cell phone in their pocket at all times.  Those are both excellent ideas.

Every 60 seconds, someone in the U.S. dies of a heart attack.  What should you do if you are alone and suspect that you are having a heart attack? How can you tell?  These are important questions to ask, because 40 percent of heart attack victims never make it to the hospital. 

Symptoms of a Heart Attack

Heart attack symptoms can be wide-ranging and vague. Below you will find common and uncommon symptoms.  If you are in extreme discomfort or you are suffering from several of these symptoms, you should suspect a heart attack:

Chest pain (although 1/3 of patients do NOT have chest pain)
Pain or discomfort in one or both arms, the back, the shoulders, the neck, or the stomach (above the belly button)
Shortness of breath
Sweating
Nausea and vomiting

The older you are, the more likely you are not to have chest pain, but have atypical symptoms, instead.  Some of the atypical symptoms are:

Confusion
Labored breathing
Fainting
Vague chest pressure

You may feel unwell for days or even weeks before experiencing the heart attack. 


Self Help Tips for Heart Attack Victims

If you experience the above symptoms and you are alone, here are a list of the steps you should take to save yourself.

* Call 911 - It is important to get to the hospital within an hour.
* While you are waiting for an ambulance, chew and swallow a regular, uncoated 325 mg. aspirin.
*  Unlock your doors so emergency personnel can get inside, in case you cannot open the door later.
*  Sit down, but do not lie down; try to rest and relax while you wait.
*  Call a neighbor, friend or relative and stay on the phone with them until help arrives. If they are close, ask them to come over and wait with you.
*  Do NOT drive yourself to the hospital or have someone else drive you; ambulances have defibrillators and clot-busting medications.  They will also be able to get help for you more quickly, once you reach the hospital.
*  When the EMTs arrive, be ready to tell them what medications you are using and explain exactly what you are feeling.
*  Be assertive.  If you seem shy or reticent, studies show that you may wait longer to receive treatment.  Speak up.  Even if it turns out that you were not having a heart attack, but some other health problem instead, it is important to get checked out as soon as possible.

Want to learn more about common health issues as you age?  Use the tabs or pull-down menu at the top of the page to find links to hundreds of additional helpful articles.

You are reading from the blog:  http://www.baby-boomer-retirement.com

Photo of heart model courtesy of morguefile.com

Reata Glen and other CCRCs in Orange County, CA

A growing trend in housing for senior citizens is the CCRC - Continuing Care Retirement Community.  These are communities where people initially move in while they are still in good health and enjoy independent living in their own private residence.

Later, if the residents eventually need higher levels of care such as assisted living, skilled nursing or memory care, they can get whatever help they need while staying in the same community.  There are a wide variety of CCRCs with different types of amenities.  The costs vary accordingly.

Why People Move to a CCRC

CCRCs are located throughout the United States.  They have become a popular alternative for people who do not have long-term care insurance and want to make sure they will receive care for the rest of their lives, no matter what happens with their health.  However, not everyone who moves into a CCRC is someone who does not have long-term care insurance.  Some types of CCRCs do take this insurance.  Others will accept Medicaid payments to cover at least part of the cost of nursing home care.

Most CCRCs require a buy-in or entrance fee that, in many cases, will be partially refunded to your estate when you leave or die.  On the other hand, there are some that are entirely rental.  All of them have a monthly fee, including the ones that require you to buy it at the beginning.  In some cases, the fee is guaranteed to remain about the same as long as your live there.  In other cases, you pay different amounts based on the services your receive.

It is wise to thoroughly investigate all the choices in your area so you know the options that are available before deciding which one is right for you.

Financing a CCRC

There is a wide range in costs for a CCRC.  If you choose one with a buy-in, it can cost $300,000 or more at the time you move in.  If you rent your housing unit rather than buying it, you may still have an entrance fee of $20,000 or more ... but not always.  In either case, you will also have a monthly fee.  Some facilities that cater to middle-class and low-income senior citizens may allow you to apply for Medicaid and apply it to your expenses.  There are also CCRCs for people who have long-term care insurance.

If the CCRC you choose is a life-care community, you will typically pay a large up-front fee plus a monthly fee that will remain about the same no matter how much care you need in the future.  This is particularly popular with people who do not have long-term care insurance or family members who could care for them, and want the security of knowing that they will be cared for no matter what happens to them in the future.  If you choose this option, financial advisers recommend that you have a professional scrutinize the financial viability of a community before you trust it with your life's savings and care.

Popular CCRCs Located in Orange County, CA

Below is a list of popular CCRCs in Orange County, California.  In nearly every major populated area in the United States, you will find similar types of communities.  In some areas of the country, the costs may be less ... or more.

Regent's Point - Irvine, California - Entrance fee ranges from $47,500 (for UCI alumni and faculty) to $467,500, plus a monthly fee of $2,352 to $4,936 a month.  In addition, there is a tiered cost plan.  The more services you need, the more you pay.

Capriana - Brae, CA - $300,000 to $500,000+ entrance fee - minimum monthly fee of $4,195 plus additional charges for extra services.  They will help you sell your current home to help make it possible for you move in.

Covington - Aliso Viejo, CA - No specific buy-in price was publicly available.  However, like most of the others in Orange County, there is an entrance fee and reviewers indicated it is one of the more expensive options in Orange County.  However, 90% of your entrance fee is returned to you or your estate when you leave the community, once the unit where you lived is reoccupied. The Covington does not accept Medicaid, Veteran's benefits or long-term care insurance.  Basic daily cost for a private room in their care center is $309 a day.

Fountains at Sea Bluffs - Dana Point, CA - No pricing information listed.  While not confirmed, one reviewer said that she was paying nearly $9000 a month for her father to live there in the memory care facility.

Town and Country Manor - Santa Ana, CA - Independent living ranges from $2,750 to $4,090 a month, plus $1,250 a month for a second person in your apartment.  There is a $1,000 application fee.  Assisted living ranges from about $4,000 to $4,550 a month, plus $1,250 for a second person.  Skilled nursing is based on the level of care needed.  There does not appear to be memory care at this facility.  Residents do not have a buy-in.  This is a rental CCRC.

Walnut Village - Anaheim, CA - According to reviews, this CCRC has entrance fees that range from $209,000 to $700,000+ and 90% is refundable. There is also a monthly fee that can range from $2800 to $6200.  There are cottages as well as apartments.

Morningside - Fullerton, CA - The reviews indicated there was a large entrance fee, but it was not published on their website. It is operated by the same company as Reata Glen, described in detail below, so fees and the way it is operated will probably be similar.  

Brookdale - San Juan Capistrano, CA -  There is an entry fee, plus a tiered level of monthly costs, based on the care you require.  You only pay for the services you need.  There are a variety of plans available.  For example, you have the option of paying a lower entry fee if you have long-term care insurance.  In addition, you can choose from a variety of refund percentages and this can alter the size of your initial buy-in costs.

Reata Glen - A New CCRC in Orange County

A new CCRC is under construction in San Juan Capistrano, CA.  They have 19 designs in both apartments and villas.  Sizes range from a one-bedroom with 646 square feet to three bedrooms with 2,827 square feet.   Depending on the size of the home you choose, the buy-in entrance fee can range from $400,000 to $2,499,000.    A typical two bedroom, two bath 1,268 square foot Garden Terrace with covered parking can have a buy-in of $949,000 to $993,000.  For those who do not have covered parking with their apartment, there is an optional additional entrance fee of $10,000 for a carport and $25,000 for a garage.  There is also a monthly fee which should remain stable during the remainder of your life.

Like most other CCRC's, there will be a variety of amenities.  When complete, this community will have tennis courts, a wood shop, gardens, a putting green, a swimming pool, a fitness center, and a performing arts center.

You can get a brochure and learn more about this newest CCRC in Orange County at http://www.reataglen.com/


If you are interested in learning more about where to retire in the United States or overseas, common health concerns, 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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Photo credit:  Photo of Reata Glen from their website

Death from Falls Can Be Prevented

https://twitter.com/BobbyMalevski/status/673535222554738688

In 2013, an estimated 25,464 senior citizens died from a fall.  Approximately 2.5 million more were injured.  Of those, 734,000 people required hospitalization.  Shockingly, one in three adults over the age of 65 will experience a fall every year and a significant of them will suffer serious injuries, including broken hips or head trauma.  Medical costs for falling amount to over $30 billion a year.  The Centers for Disease Control and Prevention estimate that these numbers may double in the next five years as our population ages.  In addition, falls are also a major reason for emergency room visits for people in the 45 to 64 age group, so problems are not limited only to those in the 65 and over age group.

Researchers have studied this problem extensively and they have discovered that certain programs are effective in preventing falls.  However, there is virtually no government support for these programs, which means they are not always available in the communities where they are needed.  When they are available, the programs are usually sponsored by local hospitals, community groups and agencies.

Even if you do not believe you are at risk of falling, accidents can happen to anyone.  In addition, you may have a spouse or other family member who could be injured from a fall.  Everyone should be aware of the causes and how to reduce the risk.

Why Senior Citizens Fall

There are a number of reasons why people fall, regardless of their age ... although the problems associated with falling are more serious in senior citizens.  Some of the more common causes are:

Arthritis
Inner-ear Problems
Diabetes - Particularly for those who suffer from Neuropathy
Illnesses that cause patients to feel weak, dizzy or shaky
Medications - People should be especially concerned about sleeping medications or those that lower blood pressure or cause dizziness

How to Prevent Falls

Fortunately, there are steps everyone can take to dramatically lower their risk of falling.  Below are some suggestions you can implement yourself.

Attend the CDC program called "Stopping Elderly Accidents, Deaths & Injuries" (STEADI).  Contact your local hospital or senior center to see when a class will be held in your community.

Attend a Balance Training Program.  Many senior centers and communities offer separate balance classes or include balance training in their yoga, Tai Chi, Pilates, dance and other exercise classes for seniors.

Practice balance exercises at home including:

* Standing on one leg for 30 seconds at a time
* Walk heel to toe along a straight line on the floor
* Practice sitting and standing from a chair to build leg and core muscle strength

Eliminate or avoid danger zones in your home, especially:

* Potentially icy areas outside your home in cold weather
* Anything in your home or yard that could trip you -- wires, plants, furniture legs, etc.
* Loose rugs or carpeting
* Slippery floors like polished hardwood or wet floors in the bathroom and kitchen

Other ways to reduce falls include:

*  Installing grab bars in your shower or around your bathtub.
*  Giving up your high heels.
*  Having someone move items from high shelves and placing them where they are within easy reach.
*  Avoiding risky behaviors such as climbing on ladders or standing on chairs to reach high items.

Finally, watch your medications and read the package inserts.  Pay close attention to the possibility of falling because of the prescription drugs you are taking.  Many medications can lower your blood pressure and make you dizzy, especially when you first get out of bed in the morning or get up from a chair.  Take things slowly and make sure you feel OK before making any sudden moves.  Talk to your doctor about your dosage levels or ask about alternative medications if one you are taking seems to make you especially dizzy.



If you are interested in learning more about how to take care of your health as you age, where to retire, financial planning or family relationships, 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:   https://twitter.com/BobbyMalevski/status/673535222554738688

Social Security Plans of Clinton and Trump

Although it has not been discussed in detail by the media, one of the major issues for senior citizens in the November, 2016 election is the future of Social Security.  Because we have repeatedly been warned that the trust funds for both Social Security and Medicare will run out of money in the coming decades, this issue is on the minds of both current retirees and those who are approaching retirement.  As a result, AARP recently requested written statements from the presumptive candidates of both major political parties to ask their plans for the future of Social Security.  The results of those statements were in the July-August 2016 issue of the AARP Bulletin.

The statements expressed in the sections below are based on direct quotes that were provided in writing to AARP by the candidates.

The intent of this article is not to sway your vote either way, but to help you make your own informed decision, based on the candidates' expressed views.  Of course, any action by the next president will need the support of Congress in order to become law.

Hillary Clinton's Plan for the Future of Social Security

*  Raise the current income cap on Social Security contributions. Currently, only the first $118,000 in income is taxed for Social Security. This means that higher income Americans will pay more than they have in the past.  Some types of income which are not currently taxed may also be included.

*  Avoid risks to Social Security by resisting efforts to privatize it.

*  Maintain on-going annual cost-of-living adjustments for retirees receiving Social Security benefits.

*  Resist efforts to further raise the retirement age.

*  Avoid adding to the burden on the middle class by resisting efforts to cut benefits or increase the percentage of taxes withheld.

*  Expand Social Security benefits to widows and people who took time out of the workforce to be caregivers for their children, elderly parents or other sick relatives.

*  Reduce the amount that Social Security decreases when a spouse dies.  This is a particularly serious issue for two successful wage-earner couples after they retire.  When one dies, the remaining household Social Security benefits for the surviving spouse can be cut in half.

Donald Trump's Plans for the Future of Social Security

*  Have an economy that is "robust and growing."

*  Lower corporate tax rate to 15 percent and make other business tax changes.

*  Renegotiate trade deals and impose budget discipline to stop increasing our national debt.

*  Repeal both the Dodd-Frank Wall Street Reform and Consumer Protection Act and the Affordable Care Act to increase competition and lower costs to consumers.

*  Reduce fraud, waste and abuse in the government, including reducing the size of the federal government.

*  Immigration reform will enable the government to save money on education, health care and public safety.  It will also increase security and lower the incidence of drug use.

*  In summary, "If we are able to sustain growth rates in GDP ..., we will be able to secure Social Security for the future."

*  After the above have been accomplished, the administration would "examine what changes might be necessary for future generations."  Mr. Trump did not specify what future changes that could include in order to secure Social Security.

Summary of Social Security Plans of Clinton and Trump

This blog has long mentioned that many experts believe minor tweaks to Social Security could make it more secure in future decades and, possibly, indefinitely.  One of these tweaks would be to increase the amount of income that is taxed by lifting the current ceiling on taxable income.  Another possibility is to raise the full retirement age by a year or two.  A final choice would be to slightly increase the Social Security tax on income.  Analysts have suggested that any one of those tweaks, or a wide variety of combinations of them, would be sufficient to secure the Social Security Trust for future generations.

Of the above possibilities, Hillary Clinton is only recommending the first one ... increasing the cap on taxable income so that more income is taxed ... but not at a higher rate.  She also is against raising the full retirement age.  

Donald Trump is recommending an entirely different approach.  He believes that a strong economy will solve the problem, although he does not specify what mechanism he would use to get the additional GDP into the Social Security Trust ... through the use of a higher tax cap or an increase in the Social Security tax rate.  He only wrote that he would, "examine what changes might be necessary for future generations." 

This could be a good choice for a debate question for the candidates, so voters will have more specifics about exactly how the future of Social Security will be secured.


Resource:

"Trump & Clinton - Where They Stand On Social Security" AARP Bulletin/Real Possibilities July-August 2016 (written responses submitted to AARP by the candidates for president.)


If you are interested in learning more about how Social Security and Medicare work, or want to know about where to retire, common medical problems, 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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Photo credit:  Photos from candidates' Twitter accounts.

Which Senior Housing Option is Best for You?

As Baby Boomers begin to reach retirement age, one thing on their mind is where they should live as they age.  Some Boomers want to make one decision and be done.  They hope to find a single choice that will meet their needs for the rest of their lives.  Other people want to live an active, independent life first and later move to assisted living or a similar facility.

There is no option that is perfect for everyone.  Your financial situation and health will almost certainly affect your decision.  You may also be influenced by where you currently live, as well as where other members of your family live ... aging parents, adult children, grandchildren and, in some cases, your siblings.

To help readers know their range of options, below is an overview of the types of housing that are available.  Most of these choices are available in every region of the United States.  Some of these may be senior housing options that you might not have previously considered.  However, before making a final decision about where to retire, it is important that we know what choices are available. You can find links to more articles about most of these options by clicking on the tab above labeled: "Retire in the U.S."  There are dozens of helpful articles that will give you more detailed information.

Senior Housing Options

Age in Place:  One of the most popular choices is to remain exactly where you are.  The Age in Place movement has become more popular and there are now a wide variety of resources to make it easier for people to continue to live in their own homes as they get older.  Contact senior centers and home heath care facilities in your area to see what types of assistance are available.  Many communities can help with low cost meals at near-by senior centers or Meals on Wheels delivered to your home; free or low-cost transportation; exercise programs; social programs and other activities that can make it easier for you to remain in your home.  Many communities also offer a PACE program.  This is short for Program for All Inclusive Care for the Elderly and offers the equivalent of high quality nursing home care in your own home.

Over-55 Communities:  Del Webb, Lenair, Trilogy and several other builders have created over-55 communities in a wide variety of locations across the United States ... especially across the Sunbelt, although there are also options in northern states.  These communities are more than subdivisions for senior citizens.  They often pride themselves in the resort-style facilities they provide their residents ... golf courses, swimming pools, tennis courts, clubhouses, exercise facilities, theaters and more.  They are sometimes also called Active Adult Communities.  My husband and I currently live in an over-55 community near Laguna Beach, California.  It has been a very relaxing and pleasant option, since so much is done for us ... including lawn care and building maintenance.

Senior Apartments:  Many seniors choose to move into senior apartments, especially if they wish to get away from maintaining a home.  There are luxury apartments for middle class and affluent retirees, as well as subsidized apartments for moderate and low-income retirees.  In subsidized apartments, the rent is usually based on a percentage of your income (on a sliding scale).  Whether luxury or subsidized, most of these senior apartments provide special services for seniors ... social events, transportation, assistance with housekeeping, exercise facilities, swimming pools, etc.  Sometimes the services are provided by outside agencies in the communities ... such as transportation to medical visits.

Accessory Dwelling Units or Granny Pods:  Another option some Baby Boomers are choosing is to move in with their children.  Instead of boomerang kids, many Baby Boomers are becoming boomerang parents.  There are several valid reasons for this choice:  you may be in poor health and need assistance with meals or dressing; your children may want you there to provide care for your grandchildren; it could be the best choice financially for either you or your children.  One way to facilitate this when the parents have their own, separate living space. An accessory dwelling unit is the term used to describe a second living space in the home or on the property that will allow you some privacy while living with your children.  This second living space can be an addition to the home, a remodeled basement or a separate apartment.  Granny Pods, another possibility, are pre-fab senior homes that are set up on the property.

Board and Care Homes:  These are group homes for people who don't need a nursing home, but cannot live independently, either.  Many people like them because of their comfortable, homey atmosphere.  Residents usually have a private room and bathroom, but share meals and common areas. I have known a variety of people who have chosen this option ... for reasons such as severe arthritis or mild mental impairment which make independent living difficult.

Continuing Care Retirement Communities (CCRCs):  One new wave in senior housing is the CCRC.  These are communities which you usually buy into by paying a large upfront fee, as well as a monthly fee.  When you first move into the community, you live independently in your own home or apartment.  The community guarantees that they will then take care of your needs for the rest of your life, whether that means you need some assistance in your own home or you need to move into an assisted living facility, a skilled nursing facility or a memory care home ... facilities which are usually located within the community.  This is an especially popular option for couples who believe that one of them might have to move into a nursing facility, but not the other.  In this way, they can still be close to each other.  CCRCs have also become a popular option for healthy people who know they will not qualify for affordable long-term care insurance.  Once they move into a CCRC, residents do not have to worry about their future care, regardless of what health problems they or their spouse may develop.

Assisted Living, Skilled Nursing and Memory Care Facilities:  Many people who start out living in their own home or senior apartment will eventually need more care than they can easily receive in their personal residence.  Those people may eventually move into one of the other types of senior housing mentioned above, or they may move directly into the type of assisted living, skilled nursing or memory care facility that is appropriate for their needs.  These are usually paid for in one of three ways:  Medicaid, long-term care insurance, or out-of-pocket payments made by the senior citizen or their family members.  Of those, Medicaid (called MediCal in California) is the most common provider of funds for these programs, although there are financial asset and income restrictions on who can qualify for Medicaid.  These facilities can be expensive ... ranging from $6,000 to $12,000 a month, depending on the region of the country and the amount of care the resident needs.  That is why long-term care insurance is a good investment, especially if you believe there is even a possibility that you or your spouse could someday need to move into one of these facilities.

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

You are reading from the blog:  http://www.baby-boomer-retirement.com

Photo credit:  Photo of clubhouse at the Laguna Woods Village over-55 community was taken by author, Deborah Dian; all rights reserved.