Voice Therapy for Senior Citizens

A woman I know enjoys having lunch with me at noisy, popular restaurants. We also attend many of the same gatherings of our friends. However, whenever she speaks, a number of people will later tell me that they could not hear anything she said. Her voice, which was always quiet, has diminished to the point that it is almost impossible to hear what she says unless you are sitting right next to her in a quiet room.

Recently, I read an article titled “Take Care of Your Voice: Why You Sound Hoarse (or Old) and What to do About It” in the September, 2015 issue of Reader’s Digest Magazine.  The article is about common vocal problems in senior citizens.  Many people experience these voice issues, but may not realize that there are therapies that can improve the quality of their speaking voice.

Therapy for a Hoarse Voice

One common problem is having a voice that constantly sounds hoarse.  This often occurs in people who have careers that involve a lot of speaking … lawyers, teachers and people who spend hours on the phone.  It can also be an issue for people who have smoked, experienced chronic allergies or were exposed to chemical fumes.

A hoarse voice can be caused by nerve damage or a polyp or similar growth on the vocal folds.  If the hoarseness is caused by a polyp or growth, it can be surgically removed.  In addition, the patient should see a vocal therapist who can recommend appropriate exercises to enhance their voice quality and prevent a re-occurrence.

Treatments for a Soft Voice

If people have a hard time hearing you and it is difficult for you to project your voice, you may have developed vocal fold atrophy or presbyphonia.  Our vocal folds can become weaker as we age.  This is especially true for women after menopause or for anyone who is not using their vocal cords enough … for example, someone who has retired and lives alone.  This can be a particularly frustrating problem, because it often happens at the same age when our friends are also developing hearing loss.  You cannot speak louder and they cannot hear.

Having too soft a voice is another situation for which you will want to see a vocal therapist.  An Ears, Nose and Throat doctor should be able to refer you to one. The therapist will use vocal strength training exercises, called PhoRTE (pronounced “forte”), that are designed to help you develop better control of your voice volume.

 

If the voice therapy does not resolve the problem, doctors can also inject a filler into the vocal cords, similar to the fillers used to eliminate face wrinkles. 

 

Medical Conditions That Change Your Voice

As we all know if we have ever screamed too loudly at an exciting sporting event, there are many situations that can temporarily affect our voices.  For example, when you catch a cold, one symptom is often the nasal quality your voice develops.  However, if you experience a voice change that lasts more than three weeks, it could indicate a more serious condition including allergies, sinus problems, GERD (gastroesophageal reflux disease), vocal cord cancer or Parkinson’s.

 

While it is more likely that your vocal problem is caused by an issue that can easily be resolved with therapy, it is important to get a diagnosis and not ignore long-lasting changes to your voice.

How to Care for Your Voice

If you wish to avoid some of the problems mentioned above, here are a few tips for taking care of your voice:

Drink plenty of water, especially if you take medications

Avoid large quantities of coffee, caffeinated soda and alcohol

Do NOT yell or scream

Sing or read aloud daily to work your vocal muscles

Do NOT smoke

Do not purposely try to speak in a deep, low voice that is not natural to you

See your doctor if you are experiencing voice problems; do not accept it as a "normal" part of aging.

If you follow these steps, most people will be able to maintain a pleasant, resonant speaking voice throughout their life.

Additional information available at:  The Speech-Language-Hearing Association

If you are interested in learning more about health issues that can affect you as you age, retirement planning, financial concerns, where to retire or changing 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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National Prescription Drug Take Back Day

Public Service Announcement:  It is not uncommon for many people to have unwanted, unused and expired prescription medications in their homes.  In order to avoid having people either throw these drugs in the trash, flush them down the toilet (and into our water supply), or risk having them stolen and sold on the street, communities across the country participate in National Prescription Drug Take Back Day.

In 2016, the time for returning drugs is April 30 from 10:00 to 2:00.

In following years, the date will normally be the last Saturday in April, although you will want to check annually to confirm the correct date and nearest location.

This event is sponsored by the Department of Justice Drug Enforcement Administration.  Drugs can be turned in anonymously, no questions asked, in a variety of locations.  In our county in California, the drugs can be returned to virtually any city hall, as well as some hospitals and other public facilities.

Call your local city hall or police department to see where you can turn in unused, unwanted and expired prescription medication or go online to find a location near you.

Below is the link to the DEA website where you can find the collection center that is nearest to you:

DEA Prescription Drug Collection Center Locator

If you missed out on the National Prescription Drug Take Back Day this year, you may still want to contact your city hall or police department and see if there is a place where you can turn them in at other times.  If no location is available in your area, lock your unwanted prescriptions up and turn them in next year. Most important, make sure you do everything you can to keep them out of the hands of children and other visitors to your home.  They could be dangerous!

Over-the-Counter Painkiller Dangers

If you are one of the millions of Americans who use over-the-counter painkillers to cope with chronic pain from arthritis, injuries, headaches or minor aches and pains, it is important that you know the risks and which painkillers are less dangerous than others.  While many people believe there is no harm in taking these medications on a daily basis, they may be shocked to discover just how dangerous they are.

Dangers of Taking Advil, Motrin and Aleve

The over-the-counter NSAIDs, or nonsteroidal anti-inflammatory drugs, known as Advil, Motrin and Aleve, appear to be particularly dangerous for large numbers of people.  This is also true for generic or store brand versions of these drugs.  Here are some of the risks people take when they use these drugs on a regular basis:

*  Increased risk of a heart attack
*  Increased risk of a stroke
*  Increased risk of heart failure
*  Increased risk of death during the first year after a heart attack, if you are treated with an NSAID during that time.

These risks even affect people who do NOT have heart disease!  In addition, the increased risk can occur as early as the first few weeks after you begin taking one of these drugs and goes up the longer you take it and the higher doses you use.

How Much Do NSAIDs Increase Your Risk of a Heart Attack?

Simply using over-the-counter, moderate dosage levels of these drugs will increase your risk of a heart attack or stroke by 10%.  If you take the prescription strength versions, your risk could be increased by 30% to 50%.   Dangerous levels of these drugs, which could increase your risk of a heart attack or stroke the most, are:

Motrin (ibuprofen) - 2,400 mg. a day
Aleve (naproxen) - 1,000 mg. a day
Voltaren (diclofenac) - 150 mg. a day
Celebrex (celecoxib) - 400 mg. a day

It is important to remember, however, that even a 10% increased risk from the over-the-counter dosages is significant for someone who already has heart disease.  If you do take one of these medications, it is important to take the lowest dosage for the shortest time possible. 

Which NSAID is the Least Risky?

The FDA statement on the NSAIDs indicated that Aleve (naproxen) appears to be the "least likely to increase the risk of stroke and heart problems."  However, Aleve is also the NSAID that is the most likely to cause stomach bleeding, so that is something for consumers to consider, as well.

What are the Best Alternatives to NSAIDs?

Instead of using Motrin, Advil, Aleve, Celebrex or Voltaren, most people can receive the relief they need by switching to aspirin or Tylenol (acetaminophen), or using alternative methods of pain relief, such as yoga, acupuncture, massage or physical therapy.   If using aspirin or acetaminophen, you still need to be cautious about the quantities used in order to minimize the risk of stomach bleeding.

Sources:

"New Warnings on OTC Painkillers," AARP Bulletin, September, 2015, pg. 10

http://www.fda.gov/Drugs/DrugSafety/ucm451800.htm

If you are interested in getting additional information on medical issues affecting Baby Boomers, where to retire, financial planning, family relationships and more, use the tabs or pull down menu at the top of the page to find links to hundreds of helpful articles.

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New Investment Rules for Retirement Savings

Do you believe that your broker or financial adviser puts your best interests ahead of his own?  Are you sure that your broker suggests the best investment products for your retirement accounts, including those with the lowest fees and commissions?

You might be surprised to know that, until now, your broker has not been required to put your needs above his own! The U.S. Labor Department announced new rules in April of 2016 which are designed to fix this problem. Although the new "customer first" fiduciary rules will not actually go into effect until the spring of 2017 and there will probably be court challenges, most of the larger brokerage firms have already begun to change their practices.

What are the New Rules Affecting Retirement Accounts?

The "bottom line" is that brokers and financial advisors now have to recommend suitable investments which are moderate or low in risk and have reasonable fees and commissions.  They have to offer their clients investment products with lower commissions and fees, when two products are otherwise similar.

In addition, brokerage and investment advisory firms are required to direct clients to websites which explain exactly how they will be paid ... and those fees and commissions must be "reasonable."  The brokers can still engage in revenue sharing with mutual fund companies, but that fact must be spelled out in detail on the website.

Brokers will also be required to act in the best interest of the clients when they roll over retirement funds from a 401(k) into an IRA.

Brokers will be discouraged from putting retirement savings accounts into investment products which are generally considered unsuitable, such as non-traded REITs or variable annuities.  Brokers will also be discouraged from "churning" or actively trading stocks and options in their clients' retirement accounts.

There Are Exceptions to the New Fiduciary Rules

Although the new rules only apply to tax advantaged retirement savings accounts, such as a 401(k) or IRA, it is expected that the rules will also affect the way brokers deal with clients, in general.  However, there are times when a broker or financial adviser may recommend an investment product to someone that will not necessarily follow the "lowest commission" philosophy.

For example, in some situations a variable annuity might be the right product for a person, even though the commissions tend to be higher than other products.

In addition, brokers and financial advisers who assist companies with a small 401(k) plan or assets that are less than $50 million, are exempt from some of the strictest rules.  However, they still need to be careful to put the needs of the clients above their own!

Why Will There Be Court Challenges to the New "Customer First" Rules?

The Labor Department expects some firms to challenge the new rules.  Some of those who object fear that these new rules will make it harder for people to build their savings, because they will be steered towards low-risk, slow-growth, low-commission "standard" investment products, with little creativity.

Other firms are worried that the new rules will result in constant lawsuits, whenever any retirement savings account loses money.  They feel that compliance with the rules will become burdensome.

What Should Consumers Do?

If you have any questions about whether or not you are being offered the best low-risk investments for your retirement accounts, with the most reasonable commissions or fee-sharing arrangements, you should interview more than one investment adviser.  

If you have any questions, make sure you read anything you sign thoroughly, and check the disclosures on the company website.  While most firms will comply with the new rules, there will always be some unscrupulous advisors who will still try to take advantage of consumers.  Ultimately, it is up to you to shop around, compare products and investigate every investment thoroughly.

The Bottom Line on the "Customer First" Labor Department Rules

In general, large investment firms seem to support the new rules; smaller firms are more nervous about them.  The following statement was released by Merrill Lynch:

"We support a consistent, higher standard for all professionals who advise American people on their investments." -John Thiel, Merrill Lynch

The goal of the new rule changes is to protect the "little guy" from having their retirement assets eaten up by large commissions or losses caused by inappropriately risky investments.  Because of this, many consumer advocates applaud the decision of the U.S. government to establish these regulations for brokers and investment advisers.

Suze Orman said the following about the new regulations on her Twitter account:  "Congrats to the Labor Department for its regulations requiring financial advisers to act in the best interests of their clients retirement $"


Are you looking for more information on financial planning, where to retire, common medical 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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Best Senior Housing Choices for Aging Boomers

While most of us do not like to think about it, the Baby Boomer generation is getting older.  Currently, over 10,000 Baby Boomers a day are turning 65.  The oldest Baby Boomers are now turning 70.  This trend has been going on for several years and will continue over the next decade.  Many of us are in good health, active and involved with our families and communities. 

The vast majority of Baby Boomers currently live independent lives in our own homes.  Most of us are still able to take care of housework, yard work, shopping and meal preparation.  It may be hard to believe, but this will not always be true.  What does the future have in store?

Our Future Housing Needs

Over the next ten to twenty years, the housing needs of Baby Boomers are going to change.  Based on what typically happens as people reach their late seventies and early eighties, it is likely that most of us will find it increasingly difficult to live independently.

Statistically, about two-thirds of us will need long-term care.  About one-fifth of us will need long-term care for more than five years.

If you want to have a choice in the type of care you receive when the time comes, you need to educate yourself about your choices while you are still in your late sixties or early seventies.  Even if you never need this information yourself, it is likely that one of your near relatives will need it, and you will be equipped to assist them.  With this thought in mind, I would like to highly recommend this book:

"Your Senior Housing Options" (available using this link from Amazon)

I did not write this book, nor do I know the author.  However, it is an excellent resource for anyone who wants to have a voice in their future housing choices as they age, rather than being dependent on their children to make decisions for them.

Even if you do not purchase the book, there are certain things everyone needs to consider when thinking about where to live as you age.

The Seven Deadly Sins in Finding Senior Housing

Among the information you will learn in this book are the things you do NOT want to do as you age.  Below is a brief summary of them.

You do NOT want to:

*  Wait until you are desperate and need housing immediately;
*  Base your choice solely on the cheapest place you can find;
*  Not have a plan for your long-term care costs;
*  Judge your senior housing solely on its outward appearance, apartment size and location;
*  Not know which questions to ask;
*  Believe whatever the sales person says, without making sure their promises are written in the contract (or not realize that you are dealing with a sales person and not a helpful consultant);
*  Fail to get the opinions of your friends and relatives when you evaluate your choices.

What Should You Be Doing Now?

In addition to reading the above book, it would be advisable to start planning for your later years.  Those who are planning ahead are more likely to have long-term care insurance.  They are also more likely to visit the various assisted living and long-term care communities in their area.  Most of these facilities have luncheons and tours which will give you the opportunity to see their model apartments and learn more about the costs associated with living in them.  You can also find out what amenities they offer.

In addition, visit your friends who have moved to one of the senior apartments, assisted living or nursing care facilities in your area.  Your friends will appreciate the visit and you will be able to decide which communities you like the best.

Personally, I have had friends who have moved into a wide variety of facilities in our area.  It is amazing to me how different they are.  To be honest, some of them look and smell like hospitals, especially the skilled nursing facilities.  Others are more like upscale senior apartment complexes with meals that are served restaurant-style in elegant dining rooms.  Some even have the option of requesting "room service" when you are ill or don't feel as if you can get down to the dining room.

Nearly all of these communities have planned activities and special events, but you need to make sure that they have the types of events that interest you.  Some of them, for example, are sponsored by religious groups.  In this case, make sure you are comfortable with the religious affiliation that supports that particular assisted living facility.

Aren't All Assisted Living Communities Pretty Much the Same?

NO!  There are enormous differences in the types of communities that are available. Here are just a few of the major differences you should know about:

*  Some of them require that you buy into the community at a cost of hundreds of thousands of dollars ... which frequently comes from the equity in your current home (assuming you have not taken out a large reverse mortgage).  However, these communities will usually guarantee that they will take care of you for the rest of your life, even if you need skilled nursing or a memory care facility.  They are also called a CCRC, or Continuing Care Retirement Community and can be an excellent choice for people who do not have long-term care insurance.  They provide peace-of-mind to the person who wants to be sure that will be cared for, no matter what happens in the future.

*  Other senior housing communities have no down-payment or buy-in requirement.  You pay for them month-to-month on a rental basis.  Often, these communities contain both people who need assistance as well as residents who moved there long before they developed a medical issue that forced them into assisted living.  Sometimes people move into a senior community simply because they do not want to cook any longer.  In other situations, one spouse is still healthy but the other needs care.  These senior housing communities may or may not have skilled nursing and memory care facilities, so make sure you choose one that meets your specific needs.  Most of these rental communities will accept your long-term care insurance when you need extra assistance (assuming you have purchased it).  This is usually not an option in the communities which require a large down payment, although there may be exceptions. 

This is an important consideration:  If you purchased long-term care insurance, a rental assisted living community will probably be your best future option.  If you did not purchase long-term care insurance, buying into a CCRC community that promises to care for you for the rest of your life is an excellent option.  Just make sure you fully understand the services that are offered by the community your choose.

*  Some assisted living communities and nursing homes accept Medicaid and these are ideal choices for those people who have a low retirement income and few assets.  Like the other types of facilities, they may or may not have the specific amenities and services that appeal to you.  Even low-income patients have options, so it is wise to explore them in advance.  I have known people who loved their Medicaid-covered assisted living facilities, so keep an open mind.

The quality of all these facilities varies widely.  As a result, you want to have plenty of time to visit them, talk to current residents and discuss the costs, amenities and care you would receive in each one.  This is why you do NOT want to wait until the need arises before you start investigating your choices.

What Happens to People Who Do Not Plan Ahead?

Most of us don't like to believe that we will ever need to move into an assisted living facility and, if you are lucky, you may be one of the one-third of Baby Boomers who never needs this extra care, even on a short-term basis.  However, it is smart to have a plan, just in case.

Everyone should have the name of a place they can afford and that they believe they would like.  Perhaps it is one where some of your friends already live.

If you do not plan ahead, you could find yourself in the unfortunate position where your adult children or other relatives make the decision for you, and they are unlikely to have any idea where your friends already live.  In addition, they may not know which community is the most appealing to you.  Finally, they may have no idea which items from your home you would like to take with you.  Take the time to plan ahead and you are much more likely to be happy with your living situation, when the time comes.

If you are interested in additional information on where to retire, long-term care, financial planning, medical issues that can arise in retirement, 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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Photo of Clubhouse at Laguna Woods Village, an independent living senior community in Southern California, is property of author, Deborah-Diane; all rights reserved.

Dangerous Prescription Painkiller Addictions - Opioids

The United States has an addiction problem.  No, it is not just teens and young adults who are affected; it also affects Baby Boomers and the growing epidemic of addiction and overdoses related to opioid prescription pain medications like morphine, oxycodone and hydrocodone.

Risks of Prescription Painkiller Addictions

There are a number of risks associated with these opioid prescription pain medications.  To make matters worse, many doctors are unaware of the dangers and, consequently, the patients are not well-informed, either.  By the time people are addicted, it is difficult for them to get off the drugs.  Here are some of the facts that people should know ... especially if a doctor suggested an opioid medication for them or someone they love:

*  Between 1993 and 2012, there was a 500% increase in the rate of hospitalizations for overdoses from prescription pain pills among people between the ages of 45 and 85.

*  At the same time, the number of overdose deaths rose 700% for adults between the ages of 55 and 64.

*  The highest number of deaths was in people between the ages of 45 and 54.  Their rate was actually four times the overdose death rate for teens and young adults!  This statistic alone should terrify any adult who believes these drugs will be safe for them to take, because they were prescribed by a physician.

*  The death rate may be even higher than we realize because so many deaths in the elderly are attributed to natural causes, especially when the person has multiple health issues.  However, the real cause may have been an accidental overdose or the inability of the liver and kidneys to clear multiple medications from the body.

*  In 2012, 8% of adults ages 40 or older reported that they had taken an opioid painkiller in the past 30 days.  (That is correct.  According to AARP, during a single month, approximately one out of twelve people over the age of 40 had taken an opioid painkiller.)

Side Effects of Prescription Opioid Painkillers

What many people do not realize when they begin taking these drugs is that there are a number of dangerous side effects, in addition to the risk of becoming addicted and/or dying of an overdose (as though that was not bad enough)!

Opioid drugs also result in:

*  Increased rate of heart attacks
*  Increase in number of falls and related fractures
*  Grogginess or foggy thinking
*  Constipation
*  Sexual dysfunction
*  The drugs become less effective at controlling chronic pain over time
*  The drugs may actually make people more sensitive to pain
*  It can be very difficult to stop using the drugs.  (ABC News reported in a news special in March, 2016 that 80% of new heroin users start out on opioid painkillers and, when the opioids are removed, the patients seek out an affordable substitute ... heroin.)

How to Use Opioid Pain Medications Safely

If you are suffering from acute pain after surgery or at the end of your life, it is possible that your doctor may prescribe one of these medications for you.  If this happens and you decide to use these medications, here is how to make sure you are using them safely:

*  Try taking only one-quarter to one-half of the normal dose.

*  Let your doctor know about other medications you are taking, especially benzodiazepines which may be prescribed for anxiety or insomnia.

*  Do not mix opioids with alcohol or other medications, which could trigger an overdose.

*  Make sure your doctor is monitoring you frequently, up to once a month.  They need to order frequent urine tests to measure the opiate levels in your system.

*  Be realistic about your pain.  Painkillers, including opioids, cannot eliminate all pain completely.  In fact, studies show that painkillers can only reduce chronic pain by 30%, at the most.  Patients should try less risky alternative treatments such as physical therapy, stress management, yoga, acupuncture, massage, etc.

*  Protect your loved ones by keeping all prescription painkillers locked up in a special cabinet or lockbox.  Thieves and even teenage relatives could be tempted to steal them and either use or sell them.

If you would like additional information on medical issues affecting Baby Boomers, where to retire, financial planning, family relationships, travel and more, use the tabs or pull down menu at the top of the page for links to hundreds of additional articles.

Sources:

"46 Americans Die Each Day from Painkiller ODs," AARP Bulletin, September, 2015, pg. 6.

http://www.medpagetoday.com/Geriatrics/PainManagement/32967

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Laws Regarding Caregivers for Senior Citizens

Are you thinking about getting a caregiver, either for your aging parents, an ill spouse or yourself?  There are definite advantages to having a caregiver.  Since an estimated 90% of people over the age of 65 would like to stay in their own homes as long as possible as they age, a caregiver is often necessary in order to make this possible.

Caregivers can help with shopping, meal preparation, light housekeeping, dispensing medication, bathing, dressing and transportation.  Without this help, many individuals would need to move into assisted living in order to get the care they need.  Those who want to stay in their own homes benefit by having caregivers who come to their home and provide whatever services they need.

However, if you are going to have a caregiver in your home or the home of a relative, it is important that you know the law.

A Caregiver is an Employee, Not an Independent Contractor

According to the IRS, there is no such thing as a 1099 Independent Contractor Caregiver.  This means that a caregiver must either be hired by an agency or by the consumer, and become that consumer's employee.

If an agency employs the caregiver, they are responsible for meeting all the requirements and making sure that payroll taxes, worker's compensations, etc., are handled correctly.

If an individual hires someone to be a caregiver, they automatically become that person's employer.  They must make sure they are paying them the minimum wage for the first 40 hours a week or 9 hours a day that they work.  If they exceed either the daily or weekly maximum, they must pay their employee wages that are at least 1 1/2 times their normal hourly rate.  This is according to Federal Law.

In addition, a consumer who is hiring a caregiver as an employee immediately becomes responsible for handling workers' compensation insurance, income tax withholding, and all other payroll taxes.

Most health care providers believe that the cost is approximately the same whether you use an agency or employ the caregiver privately.  Using an agency requires far less paperwork, which could be an advantage as you get older.

Other Laws Affecting Caregivers

In addition, most states require that caregivers go through a certain amount of education and training.  While some of the programs may only take a few weeks, it is still important that you are certain the caregiver you use has received this training.

Most states also require that caregivers are licensed and registered with the appropriate state agency.

Be Sure You Comply with All Laws and Check References

It is extremely important that, whether you find a caregiver through an agency or on your own, you are complying with all the necessary laws.  The laws are there to protect both the employee and the person receiving the care.

In addition, take the time to check references and do background checks.  While there have been very few instances of a hired caregiver taking advantage of a patient, it has happened occasionally. This person will have complete access to the home and belongings of the person under their care.  You want to be sure they are someone you can trust.

If you are interested in more helpful retirement information, use the tabs or pull down menu at the top of this article to find links to hundreds of additional articles on medical issues that can arise, financial planning, where to retire, family relationships and more.

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Stanford Research on Alzheimers

Many experts believe that if someone lives long enough, it is virtually inevitable they will develop some type of dementia, most likely Alzheimer's.  While many of us express the desire to live a long, healthy, active life, very few of us like the idea that Alzheimer's will be a part of that scenario.

The University of California - Irvine has been studying people who are 90+ or the "oldest of the old" for over 30 years, and the results of their research has been included in this blog.  Meanwhile, Stanford University and several other well-known research universities have been doing their own research on Alzheimer's and dementia.

Dr. Frank Longo, chairman of the Department of Neurology and Neurological Sciences at Stanford University, heads up their research into treatments for Alzheimer's.  So far, although over 200 Alzheimer's drugs have been developed and tested in the U.S. since 2000, none of them have proven successful at stopping or reversing this disease. In a few cases, some of the drugs have shown a little promise in relieving the worst problems related to memory loss and confusion.  However, much more needs to be done.

Dr. Longo is frustrated by their limited success.  He reports, "My biggest frustration is that we've cured Alzheimer's in mice many times.  Why can't we move that success to people?"

Longo is now studying a drug known as LM11A-31 (or C31) that shows promise.  Rather than trying to erase the plaques of amyloid that seems to be present in most cases of Alzheimer's, this drug attempts to keep brain cells strong enough that, hopefully, they will be protected against neurological onslaughts, whether they are caused by amyloids or other factors.  This is a new, but important approach, because about 30 percent of people over 70 have amyloid in their brains but no signs of dementia.  In addition to amyloids, another Alzheimer's related protein is called tau.  Tau usually appears in the late stages when memory, organized thinking, and language have already begun to decline.

Approximately 1/3 of Americans over the age of 85 already are afflicted with Alzheimer's.  Around the world, 50 million people are living with some form of dementia.  Within 20 years, that number is expected to double.  Within three years, the global cost of caring for people with dementia could reach over $1 trillion.

Doctors are now able to do brain scans that can identify whether or not someone has amyloid deposits or tau in the brain.  However, they do not have a way to remove either problem, even if they see it in the scan.  That is why Longo's drug, C31, could be game changing.  If this drug is able to successfully slow down or stop the deterioration of nerve cells, it could enable doctors to prevent some of the damage caused by the amyloid in the brain. In mice, this drug has even been able to reverse some of the damage that has already been done ... although researchers are not sure if it can restore lost memory.

Other avenues of research are also being pursued.  For example, researchers at the Rush Alzheimer's Disease Center have discovered that people who have higher levels of a nerve-growth factor called BDNF tend to retain their cognitive functions longer, even when amyloid builds up.  Those who have the most BDNF saw a 50 percent slower rate of cognitive decline.  So far, there are no drugs that will boost a person's BDNF levels, although that is another avenue of exploration.

While more research needs to be done, these studies at Stanford and other locations are encouraging.

You may also want to read more about the University of California at Irvine's 90+ Study on the Oldest of the Old.

Source:

"Alzheimer's From a New Angle," Time Magazine, Feb. 29, 2016.

Interested in more information about aging, health, where to retire or financial planning?  Use the tabs or pull down menu at the top of this article to find links to hundreds of additional helpful articles related to retirement and aging.

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Longevity Tips from Time Magazine

In the Feb. 22, 2016 issue of Time Magazine, the editors devoted an entire section to longevity and and how to age well.  While I recommend that people read the entire issue, I also wanted to summarize their major findings in this article.

In the past, this blog has covered a number of longevity discoveries, including the findings of the University of California - Irvine 90+ Study ... which has been going on for more than three decades.

Researchers continue to learn new things about why some people are able to live decades longer than their counterparts, as well as why some of the elderly seem to escape many of the physical and mental health issues related to aging.  Below is a summary of recent findings from the Stanford Center on Longevity and the Sightlines Project, both of which were cited in the Time Magazine article.

Longevity Tips from Time Magazine

*  As most of us have always suspected, having good genes is the reason why at least some people manage to live long lives despite bad behavior.  Dr. Nir Barzilai, the director of the Institute for Aging Research at the Albert Einstein College of Medicine, studied a group of 500 long-lived Jews who had a mean age of 97.3.  Over 50 percent of the group was either overweight or obese;  60 percent of the men and 30 percent of the women had been heavy smokers at some time in their life; only half said they did even moderate exercise.  What Dr. Barzilai's group discovered was that these subjects had two gene sequences that reduced their bad cholesterol and raised their good cholesterol. They also seemed to obtain other health and longevity benefits from these special gene sequences. 

Fortunately, for those of us who do not have these powerful gene sequences, there are still actions we can take that will significantly increase the odds that we, too, can live a long life.

*  Our diets are extremely important.  One approach to a long life is to cut the number of calories you eat by 25 percent.  That action alone will lower your blood pressure and cholesterol a small amount.  However, it will also cut you C-reactive protein, an inflammatory marker linked to heart disease, by 47 percent.  For those who have read the University of California-Irvine 90+ Study, this may seem to fly in the face of their research that shows that people tend to live longer when they weigh up to 10 percent over their "ideal" weight when they are in their 70s.  Some of this could be attributed to the fact that many of the people who live to be in their 90s are the ones who have those special gene sequences. 

*  Occasional fasting also lowers the risk factors for age-related diseases, according to the Time Magazine article.  In a study performed on mice, a low-calorie and low-protein fasting diet improved their metabolism, slowed down bone loss, and improved cognitive function.  The mice also developed cancer at a lower rate and lived longer lives.  When people were put on a similar fasting plan for five days a week, they got similar results including lower rates of diabetes, heart disease and cancer.  The periodic fasting diet also lowered their blood sugar levels, as well as levels of the growth hormone IGF-1, which is believed to accelerate aging.

*  Reduce your protein consumption so that only 10 percent of your calories come from protein.  People who get 20 percent or more of their calories from protein have a 400 percent increase in cancer risk compared to people who only get 10 percent of their calories from protein.

*  Another advantage of fasting is that it appears to flush bad cells from the body and spurs the generation of new stem cells.  The new cells replace the lost cells and rejuvenate the body.

*  Lower your inflammation levels by eating a diet rich in plants and omega-3 fatty acids.  Inflammation is believed to be the culprit in comorbidity, which means having more than one disease.  Meditation and regular exercise can also reduce inflammation and your risk of comorbidity.

*  Move a little more.  Researchers have discovered that just moving around a little bit during the day is enough to lower your risk of a heart event.  In addition, moving more also helps older people keep their mobility.  Sitting all day is a risk factor for an earlier death.  It can contribute to Type 2 diabetes and nonalcoholic fatty liver disease ... even for those people who get regular exercise.  It is actually more important that the elderly get out of their chairs and fidget, do chores around the house, take a walk and engage in other easy activities than it is to take an exercise class, if all they do is sit in a chair the remainder of the day.

*  Manage your stress, cultivate a positive outlook about aging, and reduce feelings of anger and resentment.  All of these actions contribute to a longer, healthier life.  The elderly see positive improvements in their health, resilience and mental acuity when they practice mindful meditation.  It is believed that it actually slows biological aging by stabilizing telomeres.  What are telomeres?  They are defined as "The disposable buffers at the ends of chromosomes which are truncated during cell division; their presence protects the genes before them on the chromosome from being truncated instead. Over time, due to each cell division, the telomere ends become shorter." (Wikipedia)  The bottom line is that the shorter your telomeres, the less time you have left to live.  Anything that slows down their deterioration or stabilizes them, such as meditation, will extend your life.

As you can see from the list above, most of the above behavioral changes involve being aware of what you eat.  The other two were simply taking the time to move around your house as much as possible, and spending a little time each day in meditation.  While not everyone can have the magic gene sequence mentioned at the top of the article, nearly anyone can learn how to manage their own lives.

Source:

Time Magazine, Feb. 22, 2016:  http://time.com/4217189/in-the-latest-issue-59/

Looking for more information about aging, health, retirement planning, where to retire and more?  Use the tabs or pull-down menu at the top of this article to find links to hundreds of additional articles.

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Photo courtesy of morguefile.com

Statistics About Senior Citizens

Sitting too much can lead to an early death.

The February 29, 2016 issue of Time Magazine contained a large section that was dedicated to aging ... far more information than can be relayed in one blog post.  As a result, additional information will be shared over the next couple of weeks.

This week's post contains some of the fascinating statistics Time provided about people in the U.S. over the age of 45.

Time Magazine's Statistics about Senior Citizens

*  Since 2003, there has been an 11 percent increase in the number of people over age 75 who are married.

*  57 percent of Americans between the ages of 65 and 74 admit they spend 7 hours or more a day being sedentary.

*  Sedentary behavior, specifically sitting all day, is a risk factor for earlier death.

*  45 percent of Americans between the ages of 45 and 64 exercise three or more times a week (which means that 55 percent do not get exercise at least three times a week.)

*  47 percent of Americans over the age of 75 take five or more prescription drugs every day.

*  29 percent of Americans ages 65 to 69 still work for pay.

*  Since 2000, only one Alzheimer's drug has been approved, out of 244 that have been tested.

*  "Diet is by far the most powerful intervention in delaying aging and age-related diseases," according to Valter Longo, director of the University of Southern California's Longevity Institute.  Their research shows that when people periodically fast, they lower their risk factors for age-related diseases.

*  When people were put on a low-calorie, low-protein diet for five days a week, with approximately 34% to 54% fewer calories than was normal for them, after three months they had lower rates of aging, diabetes, heart disease, blood sugar, and cancer.    

*  Cancer risk increases about 400% for Americans who get 20% or more of their calories from protein, compared to people who get only about 10% of their calories from protein.

*  Mindfulness meditation reduces stress and appears to slow biological aging by stabilizing your telomeres.

*  A 2011 study published in "Proceedings of the National Academy of Sciences" revealed that older people who reported they were the least happy died at almost twice the rate in the next five years as people who reported they were the most happy.  Happier people also retained their physical functions, such as walking speed, longer.

*  Social Security is the sole source of income for one in four recipients.  By 2033, payroll taxes at the current rate will only be enough to pay 77 percent of promised benefits.  One possible solution is raising or removing the cap on annual earnings that are subject to the Social Security tax.  The limit is currently $118,500.  (Some smaller actions have already been taken to save Social Security, such as eliminating the file and suspend option.)

Summary of the Time Magazine Findings

If you wanted to sum up the statistics about senior citizens in America today, it would boil down to the fact that each of us needs to eat less food, particularly less protein, exercise more, meditate more and cultivate a more positive outlook on life.  Saving additional money towards retirement would be a good idea, too.

Want to know more about aging and retirement?  Use the tabs or pull down menu at the top of the page to find links to hundreds of additional articles on retirement, where to retire, common medical issues, financial planning and more.

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

Photo credit:  morguefile.com

Dental Care, Oral Health and Retirement

One problem that most retirees will face is the expense of dental care after retirement.  Unfortunately, although oral health is absolutely essential to our overall health, Medicare does not cover dental care.  In addition, taking care of our teeth can become increasingly expensive as we become older, especially if we begin to lose teeth and need dentures or implants. This can put a financial strain on many of the elderly.

Dental Care After Retirement is Expensive

The issue is serious enough that my husband recently set up a GoFundMe account for a friend and retired veteran who needed to have a number of his teeth replaced with implants.  Neither Medicare nor the Veteran's Administration offered a program to help him.

Fortunately, the money was raised and friends of the man were able to work out a system to take turns driving him to a dental school about 60 miles away, so that he could get his implants at a discount.  However, GoFundMe accounts are unlikely to be the solution for every retiree in America.

Sadly, it is quite possible that the man would not have let his teeth decline to the point where his teeth needed to be pulled and replaced with implants, if he had been able to afford to get consistent dental care sooner.

Other Health Conditions are Affected by Poor Dental Health

One reason that we need to take care of our teeth is because poor oral health does not just affect your mouth.  The resulting decay and infections can complicate the treatment of other medical conditions, including:

Diabetes
Heart Disease
Alzheimer's Disease
Other forms of dementia

Symptoms of Poor Dental Health

There are a number of both obvious and vague symptoms that can indicate that a person needs to see a dentist.  These include:

Pain or discomfort
Bleeding gums
Bad breath
Difficulty swallowing or chewing food
Difficulty speaking
A decrease in socialization, often because of discomfort when eating or embarrassment over bad breath or the appearance of the teeth.

How to Make Sure You Will Have Adequate Dental Care after Retirement

Dental care is not part of Medicare.  As a result, most experts highly recommend that everyone get a dental insurance supplement when they sign up for Medicare.  It is available with both Medicare Advantage and Medicare Supplement plans and is offered by most insurance carriers.  This is one reason why most retirees will not want to rely on basic Medicare without some type of supplemental plan.  In fact, the lack of dental coverage is one of several disadvantages of relying on basic Medicare alone; most people will be better off with either a Medicare Advantage or Medicare Supplement plan, with an additional dental plan.

Many of the dental supplement insurance plans are offered in combination with a vision plan ... another healthcare issue that is not covered under basic Medicare.

Retirees need to know, however, that while dental plans are helpful in reducing costs, they will not completely cover dental expenses.  In addition, it is important for senior citizens to have extra savings in order to cover unexpected dental expenses, especially for major dental problems such as root canals, crowns, dentures or implants.

For example, with my Kaiser Permanente Medicare Advantage Plan, I pay an additional $20 a month for a dental and vision plan.  Under this plan, I pay $80 out-of-pocket every four months for teeth cleaning and approximately $1000 if I need a crown ... and that is only if I use one of their in-network providers.  Out-of-network providers can cost me double that.  However, despite the hefty cost of dental care, the co-pays are substantially cheaper with the insurance than they would be if I did not have dental insurance.

Advocating for Better Dental Care Insurance Plans

Considering that oral health is closely associated with cardiovascular health and other medical issues, it would benefit millions of people if better dental care programs were available to all senior citizens.  In particular, it would be helpful if plans with low co-pays were available to low-income and moderate-income retirees.

Hopefully, as Baby Boomers retire, they will put pressure on Medicare insurance providers to make sure that comprehensive dental care is included at a reasonable price.

Learn more about oral health at the website of the American Dental Association.

If you are looking for additional information for retirees about health issues that can arise as you age, or other retirement information, use the tabs or the pull down menu at the top of the page to find links to hundreds of additional articles.

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

Photo credit:  morguefile.com

The Wellington - Vintage Senior Living in California

The Wellington is just 5 miles from Laguna Beach!

Once most seniors reach their 80's, depending on their health, many of them will make the decision to move to a Senior Living Community, Assisted Living, or to a Continuing Care Retirement Community. 

CCRCs are multi-level retirement communities that contain both independent living apartments or cottages, as well as at least one additional level of care such as assisted living.  A CCRC also has skilled nursing and/or memory care facilities.

Although I have researched a variety of assisted living and continuing care communities, I have only occasionally spent any length of time touring or visiting one.  When a friend of mine moved into The Wellington, a senior living community near my home, and invited a few friends over for the weekly cocktail hour, I thought it was time to check it out.

Although The Wellington in Laguna Hills, California is just one out of thousands of these communities around the United States, it is fairly typical of the way they are run.  I must admit I was pleasantly surprised when I visited.  Below are some of my observations.

What are Assisted Living or Continuing Care Retirement Communities?

*  First of all, these places are nothing like the old nursing homes where some of us may remember our grandparents living.  The Wellington is part of the Vintage chain of senior living communities, which has multiple locations on the West Coast.  Rather than living in a small room in a nursing home, residents in these communities have their own spacious, comfortable, private apartments. 

*  There are different ways to pay for a CCRC.  At many CCRCs, they require you to "buy in" and this can cost $200,000 to $400,000 or more (which can be partially refunded when you move out or die).  At the Wellington, and many other senior living communities, you rent your apartment and it is on a month-to-month basis.  This allows residents more flexibility, should they decide to leave and move somewhere else.  This is especially important because the Wellington offers independent living and assisted living, but it does not offer skilled nursing or memory care. In those situations where you need more intensive care, you may need to move somewhere else at some point in your life.

My Impressions of The Wellington

*  Upon entering The Wellington, the lobby area has the feeling of an upscale hotel.  On the far-side of the lobby is an elegant dining room with tables covered by white table cloths. I checked out the menu, which offers the residents a nice variety of choices in their meals, including daily specials. Residents order from the menu or off the list of specials and the meals are served restaurant style.

*  Our hostess showed us around the community and we saw a number of pleasing amenities including a large pool and spa, a putting green, a fitness center, a barbecue area and several park like sitting areas, shaded by large eucalyptus trees that are scattered between the buildings.

*  The individual apartments are large, comfortable and personally decorated by the individual residents, using their own furniture and artwork.  Each apartment also has a covered balcony where residents can relax in privacy and enjoy the outdoors.  Residents are even allowed to keep their pets with them.  There is no need to give up your beloved animal companion.

*  Most of the apartments at The Wellington also have large kitchens with full-size appliances, despite the fact that the residents are provided all their meals, as well as snacks throughout the day.  However, it is my understanding that many of the apartments in other, similar communities do not have kitchens or have very small kitchenettes.

*  Many of the apartments at the Wellington have stunning mountain and city lights views; others have a view of the tree lined paths in the inner courtyards.

*  According to our hostess and the calendar we were given, there is a full schedule of activities for the residents.  In addition to the weekly cocktail party, there are daily exercise classes, shopping trips to a variety of stores in the area, art classes, brain games, book club meetings, religious services, Bingo, movies, bridge and classes.  There is no reason for anyone to sit alone in their own apartment.

*  Transportation is available for field trips, shopping, doctor's visits, the airport, and special events or outings.  There is no need to use your own car, although you can keep one at The Wellington if you choose, especially if you wish to plan your own outings to places like nearby Laguna Beach (pictured above).

*  In addition to the independent living arrangement, additional services are available through their assisted living program.  These are offered for additional fees above the cost of the apartment rental.  These extra services can include keeping track of your medications, assistance getting to and from the meals and other activities, feeding assistance, housekeeping services, incontinence assistance, and help with bathing, grooming or dressing.  They will even bring your meals to you in your room, if you prefer.  If you have long-term care insurance, your rent and many of the xtra fees may be covered by your insurance.

What Else Should You Know?

*  While The Wellington has many wonderful attributes, there are limits to the care that is available there.  There are no skilled nursing services, physical therapy facilities, or a memory care unit.  Should you need any of those services, you would have to move to another community, at least temporarily.

Is Living in a Senior Living Community or CCRC Right for You?

Only you can decide when or if you should move into a senior living community, assisted living facility or a CCRC.  The average resident who moves into one of these living situations is usually in their 80's.  Some people move in earlier, especially if a husband or wife has a serious illness and their spouse cannot care for them alone.  For example, at the cocktail party I attended, my hostess introduced me to a very healthy, active man who had moved into The Wellington because his wife was dying and he needed help caring for her.

You need to be comfortable living and socializing with a wide variety of people, some of whom are feeble, ill or using walkers.  On the other hand, not everyone living in these communities is in declining health.  Among the outings that were shown on the monthly calendar was a men's lunch at Hooters and regular beach walks.  Activities are planned that will appeal to a wide variety of senior citizens, including aging Baby Boomers.

If you are looking for more information about retirement, use the tabs or drop down menu at the top of this page to find links to hundreds of additional articles about where to retire, common medical issues, financial planning, changing family relationships and much more.

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

Photo credit:  Photo of Laguna Beach taken by author, Deborah-Diane

Websites to Help Protect Your Identity

If you are like most people, you probably feel as though your identity has been sold so many times that everyone in the world must have your name, address, Social Security number and other private information by now.  Identity theft is an ongoing problem and it seems to get worse every day.

However, there are still a few things you can do to protect yourself.  While no system is perfect, with the help of a few websites you can at least reduce the amount of information that can be used against you.

The first step you need to take is to limit the amount and kinds of information about yourself that is available.  Next, you need to know how to check your credit information to make sure it is correct and has not been contaminated by a company's carelessness or by someone who has been using your identity for their own purposes.  Then, learn how to keep your personal information private whenever you use social media.  Finally, consider using a credit tracking company to protect your identity in the future.  Below is the information you will need to do these things.

How to Get Yourself Off Phone and Mailing Lists

Everyone should contact the services below and have their name removed from as many lists as possible.  Start with these free services:

To Remove Your Name from Direct Mailing Lists:
www.dmachoice.org

or write:
DMA Mail Preference Service
P.O. Box 643
Carmel, NY  10512

For Telemarketing Lists - Use the Government Do Not Call List:
www.donotcall.gov
1-888-382-1222

Remove the name of deceased individuals, whose identity is frequently stolen:
www.ims-dm.com/cgi/ddnc.php

Opt out of pre-approved credit offers:
www.optoutprescreen.com
1-888-5 OPT OUT

Remove your email address from internet or email ads:
www.dmachoice.org

How to Check Your Credit Reports

Everyone is entitled to free copies of their credit reports.  It is important that you check yours several times a year to make sure no one is taking out credit cards or opening accounts in your name.  You can contact the credit bureaus directly or you can contact them all at once by using the single service listed below.  Do NOT pay to get your credit reports.  If anyone asks for your credit card information, you are on the wrong site.

www.annualcreditreport.com
1-877-322-8228

Another site that provides free credit reports and will help monitor credit applications in your name is CreditKarma.com. 

https://www.creditkarma.com/

A third site that allows you to check your credit scores is WalletHub.com.  They will also monitor your accounts and you can join for free.  They also update credit scores and credit reports every day, so your information is always as current as possible.

https://wallethub.com

Learn How to Keep Your Information Private on Social Media

Both the police and criminals have become adept at using social media.  The police use it to catch criminals; the criminals use it to find victims.  You do not want to make yourself an easy victim.

Read the privacy information on sites like Facebook.  Make sure you use the tightest privacy settings possible.

Do not become Facebook friends with people that you do not know very well.  Unfriend people who you suspect are sharing your posts with strangers.

Just to be extra careful, do not post detailed personal information on social media, especially your travel plans.  Wait to post photos of your trips until after you get back home.  You do not want strangers to know that you are out-of-town.

In addition, reset your passwords periodically, especially if you think your account has been hacked.

Services that Protect Your Credit

In addition, if you are still concerned that your private information might be stolen, use a service like LifeLock.  For a monthly fee, they will give you your credit rating or report to you any attempt to open an account or credit card in your name.  If you are the person who opened the account, then there is no problem.  If you weren't the person, then you will be alerted and take immediate action.

www.lifelock.com

A free service which will also give you free credit reports and monitor credit applications that are made in your name is Credit Karma.

https://www.creditkarma.com/ 

Take Action to Protect Your Identity

With so many hackers and other criminals, it is important for all of us to do everything we can to protect our identity.  While we would like to think that the government and corporations are doing it for us, the truth is that they are not doing a good job of protecting us.  We have to make sure we do everything we can on our own.

Another step you can take is to ask your bank and credit card companies to send you new cards that contain chip technology rather than the "old-fashioned" strips.  The chips are much harder to hack.

If you are looking for more information to help with your financial planning or other information of use to retirees, use the tabs or pull down menu at the top of the page to find links to hundreds of additional articles.

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

Photo credit:  morguefile.com