Hospice Care - What You Should Know

Baby Boomers are beginning to reach the age when they, their spouse, or their elderly parents may be nearing the end of their lives.  This new challenge brings with it a great deal of anxiety and uncertainty, as well as the possibility of pain and discomfort.  Although we would all prefer the end of our lives to be as easy and peaceful as possible, we are not sure how to bring this about.  One way to get the help you need is to call on hospice to provide assistance during the final months of life.

This week we have a special guest post by Lucille Rosetti from TheBereaved.org.  She has written a book called "Life After Death - A Wellness Guide for the Bereaved."  You can use the above link to her website to contact her for more information about her book.  In the thoughtful post below, she discusses common questions people have about hospice.

Three Questions to Ask When Considering Hospice Care

by:  Lucille Rosetti

When people run out of options for curing or treating an illness, they and their families often have to make some difficult decisions. No one wants to see a family member in pain or discomfort, so hospice care is frequently one of the options on the table.

For most of our lives, medical decisions are fairly simple and easy — take this antibiotic, or eat more vegetables. However, for people facing the end of their lives, the decisions are rarely simple and never easy. You have a lot of questions, so here are a few basic answers to help make you and your loved one feel more comfortable about hospice care.

What can I expect from hospice care?  Comfort.

Hospice care is relatively diverse, so the nuances of what to expect vary greatly depending on your needs. In general, the goal of hospice care is to give someone the best possible life they can have in whatever time remains. Some people mistakenly think hospice care is only for those who are about to die. In reality, hospice care is about providing physical comfort to those whose terminal illness is no longer responding to treatment. There is a misconception that hospice care is a last resort, or that it only occurs shortly before death. While that is true in some cases, there are many people who live for several months or even longer in hospice care.

Who will be caring for my loved one?  Professionals.

Depending on your situation, you may have a variety of caregivers in your hospice team, from nurses to dieticians to personal care assistants to social workers. Taking the time to get to know the individuals on your hospice care team will reduce negative emotions, such as anxiety or awkwardness, and help everyone work together with more compassion and empathy. Building rapport with the team will help both you and your loved one have an easier time trusting the professionals and understanding medical decisions.

This is especially true for the hospice care social worker. Their job is to provide support and comfort to your loved one, making sure their wishes are understood. These are highly trained professionals, and they must have a master’s degree in social work, which often includes around 1,000 hours of hands-on practical experience. 

Some people may wish for their loved one to receive care from a licensed osteopath, who can provide a more holistic approach. However, while Medicare doesn’t offer coverage for holistic medicine, they do offer coverage from physicians who are licensed as osteopaths. If you would like expanded coverage for your loved one, consider looking into a Medicare Advantage plan, which offers a number of different options for you and your family to explore.  (Some Medicare Supplements may also offer you choices which will fit your needs.  You should always explore the best Medicare plan for your situation well in advance of needing hospice care or any other specialized treatments.)

How will I manage things when my loved one passes away? Day by Day.

There are a great many things to do and consider after a loved one passes away. Making sure you have a clear understanding of their end-of-life wishes can make this process exponentially easier. Hospice care workers help ease the burden of end-of-life care for family members and caregivers, but they won’t be involved in how to manage the burden after death.

To keep things running smoothly, be sure your loved one shares their important documents with you, such as their will, insurance information, living will, asset information, and financial records. Your hospice care team can help you know which documents you need and help you start difficult conversations with your loved one about end-of-life arrangements. Talk to them about how they want to be remembered: funeral or memorial, burial or cremation, flowers or donations. 

Moving into hospice care can be scary. To many, it signifies that your loved one has entered the final stages of life. The emotional turmoil can be draining for you and your family member entering hospice. You can find comfort in remembering that hospice care isn’t about dying. It is about prioritizing comfort, living life to the fullest, and celebrating a person surrounded by love.

Our thanks to guest poster:  Lucille Rosetti

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

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

Photo credit:  provided by Lucille Rosetti - photo from Pexels

Best States for Retirement per Moneywise

Many Americans prefer to remain in their home state after they retire.  However, do you know how your state ranks compared to other states as a retirement destination?  Is it affordable and safe, with a comfortable climate and good healthcare?  Moneywise did the research for you and put together a list of the best states for retirement.  If your current state is on this list, you may be best off remaining where you are, or at least in a retirement community in your home state.  If your current state is not on this list, you may want to do a little research and decide if there is a nearby state where you may be able to live more affordably, comfortably, and safely.

Below is the list of states which Moneywise believes are the best places to retire, with the best states at the top of the list and the rating dropping from there.  All of these states are in the top twenty of those in the United States, according to the Moneywise research.

If your home state is not listed below, you may want to check the article "Worst States for Retirement" to see if it is listed there.  If it is not on either list, consider it a neutral state for retirement.  

Top Ten States for Retirement

New Hampshire - According to both Moneywise and U.S. News, this is the best state for retirement, although you will still have to deal with cold weather in the winter.  However, it has low taxes, including no sales tax or state income tax, beautiful scenery, and high quality healthcare.  In addition, housing prices are lower than that in other nearby states in the Northeastern U.S.   You should know that there is a 5 percent tax on dividends and interest.

South Dakota - If you are looking forward to spending time in the wild outdoors, hunting, fishing, camping and hiking, this could be the ideal state for you.  There is an abundance of affordable housing in both the small towns as well as the cities of Sioux Falls and Rapid City. The state does not tax Social Security or pensions, there is no inheritance tax, and the state sales tax is only 4 percent.

Colorado - Do you love the mountains?  Enjoy skiing or other winter sports? This state has a high quality of life, good healthcare, and high senior tax deductions.  Many of the small towns are quite affordable, although the major cities can be expensive.

Iowa - You may be starting to see a theme in this list of the best retirement states.  It seems that many of the states with plenty of outdoor activities are also great places to retire.  Housing in Iowa is affordable.  In fact, the cost-of-living in Iowa is approximately 12 percent below the national average.  Healthcare is also less expensive than in many other states.

Florida - Florida has long been considered a mecca for retirement, especially for people who lived along the East Coast during their working years.  On the Moneywise list, it is ranked as the 5th best state for retirement. There are miles of beaches and plenty of delicious seafood.  The photo of the sunset at the top of this article was taken in Florida.  Grandchildren will want to visit on their way to Disney World and the other theme parks in Orlando.  Homes are very affordable, whether you buy or lease.  There is no state income tax, estate tax or inheritance tax.  There is also no tax on Social Security or other retirement income. My parents retired to Florida and lived there for three decades until the last few years of their lives, when they returned to their home state to live with family.  They loved Florida and hated to leave.  Of course, if you retire there, you will need to deal with some of the less pleasant wildlife there, including mosquitoes and alligators!

Utah - This state has one of the fastest growing populations for people of all ages.  There are many reasons why people find this state appealing, including beautiful scenery, national parks, and other amenities.  The state is rated high for its healthcare system, Salt Lake City is affordable, and the city also has excellent public transportation.  Social Security and other types of income are taxable, but seniors get a tax credit of $450 per person and other taxes are low.

Virginia - This state has both mountains and beaches, with numerous small towns, yet parts of it are in close proximity to Washington, DC and other large cities.  Blacksburg, which is home to Virginia Tech University, was ranked by Forbes in 2014 as the best place in the nation to retire. My college roommate, who is now a retired English professor, lives there and loves it. Housing throughout most of the state, except for the area close to Washington DC, is quite affordable.  There are also special tax benefits for retirees.

Idaho - Another great state for those who love the outdoors is Idaho.  It is rated the 4th safest state in the nation and the overall cost-of-living is 5 percent lower than the average in the United States.  Social Security is not taxed and healthcare is also less expensive than in other states.

Arizona - This state has become popular for some people moving out of California but who want to stay close enough to easily visit friends and family in their home state.  There are a wide variety of activities in Arizona, including trips to the Grand Canyon.  Golf courses are plentiful and can be enjoyed the year around (although you will want to play early in the morning during the summer).  The state gets 250 days of sunshine every year.  You can choose from the desert areas around Phoenix or the mountain communities surrounding Flagstaff.  My sister-in-law and her husband moved from California to Flagstaff and love it there.  Housing is generally affordable and Social Security is not taxed.

Minnesota - Minnesota is well-named as the state of 10,000 lakes.  There are actually more lakes than that!  On the other hand, the winters can get extremely cold.  The state has a high quality of life, including its healthcare system.

Other States in the Top Twenty Best States for Retirement

The states listed below are also ranked in the top 20 for retirement.  You may want to explore a few of these, as well, before making your final decision about where to retire.

Washington State
North Carolina
Montana
North Dakota
Pennsylvania
Missouri
Massachusetts
Nebraska
Wisconsin
Nevada

If the state where you are currently living is one of those mentioned in this article, you may be best off staying right where you are.  If not, you may want to consider moving to one of the states on this list, especially if you are struggling financially or you do not feel safe or happy with the healthcare in your current location.  Do your research before making a major move, so you feel confident you will be happy with the change.

If your state is not on the list above, check out this article to see where it ranks on "The Worst Places for Retirement."

For more information on where to retire in the U.S. or overseas, financial planning, Social Security, Medicare, or common medical issues, 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

Worst States for Retirement per Moneywise

The vast majority of Americans retire in the same state and home where they lived in the years prior to retirement. Usually, they are happy there and wish to remain. However, some retirees yearn to live somewhere fresh and new during the last few decades of their life.  Before they do something rash, they need to carefully research that decision.  They will almost certainly want to avoid ending up in one of the worst states for retirement. Fortunately, Moneywise looked at the cost of living, taxes, climate and crime rates in all fifty states and came up with their list of the 25 worst states for retirement.

What if you already live in one of the states listed below?  If you are comfortable where you are, can afford the cost-of-living, enjoy the weather and you are not affected by a high crime rate in your specific community, you may decide to stay where you are.  After all, you have managed to survive there for most of your life, and enjoyed it.  There is no reason to leave. However, if you are struggling to survive financially or you are fearful because of the crime, you may want to leave your current state in favor of one with a lower cost-of-living and less crime.  

Below, you will find the states which Moneywise listed as the worst places for retirement. The summaries below give details about the twelve worst states based on the Moneywise research, followed by a list of thirteen more which are not as bad, but still fall in the bottom half of the states for retirement locations.

You may also be interested in reading about the "Best States for Retirement per Moneywise."


Twelve Worst States for Retirement

Louisiana - This state was rated as the very worst one for retirement.  It is a pretty state and the people are friendly, but it has high heat and humidity, and you are very likely to have to deal with an occasional Category 4 or 5 hurricane if you live there very long.  You may even meet an unwelcome alligator if you live near a lake or river. The sales tax rate is 9.88%, the nation's highest.  The state also has the second-highest crime rate in the country, although there are some communities like Inniswold and Belle Chase with lower than average crime rates for the state.  In addition to the other problems, the healthcare system is rated low in quality

New Jersey - Although this state has wonderful beaches and multiple golf courses, it also has high taxes and an extremely high cost for housing, whether you are purchasing a home or renting.  As a result, it was rated the second worst state for retirees.  The combined state and local taxes are also the second highest in the United States.  The state sales tax is almost 7% and is charged on restaurant meals, furniture, and car repairs in addition to most consumer goods. The state cost of living is 22 percent above the national average!

West Virginia - This state is beautiful and the cost of living is approximately 3 percent below the national average.  However, the residents of this state are also the most obese and healthcare is expensive compared to other places. Because of the demise of the coal industry, many small towns are in decline and the rate of property crimes is high.

Hawaii - This state sounds like a dream come true for many retirees.  However, the high cost of living is too much for the majority of retirees.  Both the cost of purchasing a home and the rents are exceptionally high.  Many people end up living in expensive high-rises in busy cities on the islands.  Basic items can be expensive and gasoline prices are the highest in the US.  In addition, if you want to visit family and friends on the mainland, the travel can be very costly.

New York State - Outside of New York City, this state has many charming small towns and wineries.  We know, because one of our daughters lives in an adorable town a few miles outside of New York City. Unfortunately, the cost of living is about 29 percent higher than the national average, no matter where you settle in the state.  Healthcare costs are also quite high.  It can be a difficult place to live for retirees on a fixed income.

Arkansas - This state has spectacular scenery and could be a nature lovers paradise.  Sadly, the state also has one of the highest crime rates in the U.S., as well as one of the lowest scores for healthcare.  According it WalletHub, it is ranked last for quality of life.  It gets very hot in summer, with high humidity and lots of mosquitoes. On the other hand, if you don't mind those problems, it is a very affordable place to live.

Kentucky - Hunting and watching football are popular activities in this state.  Sadly, 11 percent of senior citizens in Kentucky live in poverty, and healthcare costs are unusually high. The typical senior is in poor health compared to comparable seniors in other states, often because the number of people who smoke is quite high and the people tend to be more sedentary than average. On the bright side, the cost of living is also very low. 

Rhode Island - It gets extremely cold in this little state.  Although healthcare is good, the state has high taxes, a high cost-of-living and the worst transportation infrastructure in the U.S.  Unless you grew up there and feel connected to the state, it may not be a good choice for most retirees.

New Mexico - This state was on the list because the cost of housing is above average in desirable cities such as Albuquerque and Santa Fe, and the crime rate is very high in other cities, such as Las Cruces. In addition, there are severe weather extremes, ranging from high summer temperatures in the lower elevations, to snow and ice during the winter in the more mountainous areas.

Alaska - Many people who decide to "get away from it all" think of moving to Alaska.  However, the lifestyle can be harsh for someone who is not accustomed to living in a state which is subject to earthquakes, volcanoes, harsh temperatures, and other potential natural hazards, in addition to going months at a time in almost total darkness.  Although state, city and real estate taxes are low, the overall cost-of-living is high because so many products must be flown in from outside Alaska.  The cost of healthcare is the highest in the U.S.  Some people even go to hospitals in the lower 48 states for some of the more expensive procedures.

California - My husband and I have retired to California, and we appreciate our ability to live near some of our children and grandchildren, but we recognize that it can be a difficult state for retirement, despite the generally mild climate and beautiful coastal views, including the one in the photo at the top of this article.  Unfortunately, it also has the second highest cost-of-living, the fifth worst tax burdens, and the seventh-worst healthcare in the U.S.  The state's sales tax is 7.25 percent, plus there are often local taxes.  Roads in some areas are in disrepair. About 15 percent of California retirees end up moving to the neighboring states of Arizona, Nevada or Oregon, where their retirement dollars stretch much further.  My husband and I have benefited by living in one of the more affordable retirement communities in the state, Laguna Woods Village, and we have been pleased by the care we have received from our Medicare Advantage HMO, Kaiser Permanente. However, not everyone can take advantage of these resources, so we understand why this is definitely not the right retirement state for everyone.

Oklahoma - This state is popular for those who love country music and are seeking an enthusiastic group of sports and rodeo fans. However, it is also in the middle of "tornado alley" and residents can expect to be exposed to frequent violent storms on an annual basis.  As a result, many of the roads and bridges are in need of major repairs.  There is a lower than average number of doctors per capita, and a higher than average rate of crime in the cities, as well.

Other States with Below Average Retirement Appeal

The states below were also ranked by Moneywise to be in the bottom half for retirement, either because of their climate, taxes, cost-of-living or crime rates.  However, these states are at least closer to average than the states listed above.  Any state which is not mentioned in this article are considered more desirable for retirees:

Mississippi
Maryland
Indiana
Connecticut
Alabama
Georgia
Illinois
Tennessee
Michigan
South Carolina
Oregon
Texas
Delaware

If your state was not mentioned in this article, you have probably retired in a great place.  If you are considering a move from a state not on this list to one which is, you may want to do more research before making a final decision.  Just make sure you can afford to live comfortably and safely in your new state, pay the taxes, and get the quality of healthcare you need.  If you are happy, that is more important than any list of best or worst places to live!

If you still have not decided where yo wish to live after retirement, you may want to check out the article "Best States for Retirement."

If you are interested in more information about where to retire in the U.S. or overseas, Medicare, Social Security, financial planning, 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.

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

Photo credit:  Photo of the Laguna Beach coast courtesy of the author.

Dental Hygiene and Your Health - Take Care of Your Teeth to Extend Your Life

Many people who are currently retired or near retirement grew up in a time when dental hygiene consisted of brushing your teeth before bed and visiting the dentist only when you were in pain.  Using dental floss and going to the dentist for regular check-ups was not a priority for many middle class and low-income families in the 1940s and 1950s.  Today, after decades of neglecting their teeth and gums, millions of seniors now suffer from dental problems, including inflammation and gum or periodontal disease. What many do not realize is that neglecting your teeth can also contribute to a wide variety of illnesses which affect your entire body and could even shorten your life.

The good news is that taking a more aggressive approach toward dental care, even in your later years, can reverse or slow down the damage the inflammation may have caused to other organs in your body.

Does Medicare Cover Dental Care?

The bad news is that Medicare does not cover most dental care, dental procedures, or supplies, including fillings, cleanings, tooth extractions, dentures, dental plates, or other dental devices.  Patients pay 100 percent for these non-covered services, which means the patients carry the burden of most dental care.  As a result, it is smart for Medicare recipients to buy a dental supplement or choose a Medicare Advantage plan which includes dental coverage.  Both choices are available and are a good idea for retirees.  You should discuss your options with your insurance agent.

In addition, you may want to find a dental school in your area which might provide some types of dental care at a discount.

Taking care of your teeth as you age can be life saving, so it is important to make sure you find a way to access the care you need.

Medical Advantages of Better Dental Care

Fewer Lost Teeth - The most obvious advantage to caring for your teeth and gums is that you are less likely to lose your teeth as you age.  According to AARP, the current average amount an American over the age of 65 spends on dental care is $15,340 over a 20-year period.  People who spend the last decades of life getting dentures, implants or undergoing multiple root canals may actually spend significantly more than that amount.  Learning to take proper care of your teeth could reduce this expense substantially.

Healthier Heart - People who have poor dental hygiene may develop endocarditis, which is an infection or inflammation of the inner lining of the heart chambers and valves.  This can be a fatal heart problem.  In other words, ignoring your teeth could kill you.

Healthier Kidneys and other organs - Research has shown a correlation between poor periodontal health and atherosclerosis, which is the hardening and narrowing of the arteries.  They now know that atherosclerosis is suspected to contribute to a variety of health problems, including chronic kidney disease. 

Lower Cancer Risk - According to a study done in 2017, postmenopausal women who have a history of periodontal (gum) disease are also a a heightened risk of developing breast, esophageal, gallbladder, skin and lung cancer.  

Clearer Lungs - Another study showed that patients who practice good oral care during a hospital stay are able to decrease their risk of hospital-related pneumonia by 39 percent. Even if you are so ill you do not feel like taking care of your teeth, forcing yourself to do so could save your life. Brushing your teeth and using floss regularly at home may also help protect your lungs from unnecessary infections.

Reduced Blood Sugar Levels - People who have periodontal disease and diabetes at the same time may have a more difficult time controlling their blood glucose levels.  Doing everything possible to deal with both these medical issues in appropriate ways will help minimize your risk.  

Less Erectile Dysfunction - Most men have never considered that there may be a link between caring for their teeth and their sexual function.  The reason for the connection is because chronic inflammation in any part of the body, including the gums, can eventually damage the lining of blood vessels in all parts of the body, including the sexual organs.  This one reason alone may make men more willing to care for their teeth and gums!

How to Properly Care for Your Teeth and Gums

See a Dentist at Least Every Six Months - Your dental hygienist and dentist will check your mouth, looking for signs of oral cancer, decay and periodontal pockets in your gums.  If they notice a problem, they will recommend a course of treatment.  It is smart to follow their advice, whether that means flossing your teeth more often, having cavities filled, getting a root canal, or undergoing gum surgery.  While some of these treatments may seem expensive at the time, in the long run they can be less expensive than allowing dental problems to go untreated.  If your dentist suggests that you see him more often than every six months, it is a good idea to follow their instructions.  It could save you money on more expensive treatments in the future.

Follow Your Dentist's Instruction for Oral Care - Between visits to the dentist, it is important you follow your dentist's instructions regarding flossing, the type of toothbrush you should be using, and the type of mouthwash, toothpaste and other products which will work best for your particular dental hygiene issues.  For example, they may recommend products specifically designed to treat dry mouth or tooth sensitivity. If you have any questions about which products are best for you, you should ask them directly.

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

Source of facts used in this article:  AARP Bulletin, October 2018

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

Photo Credit: Dental School at the University of New England