Long Term Care Options for End of Life Care

Are you prepared for the last few years of your life?  Many people do not want to even think about what will happen if they become ill and can no longer take care of themselves. Others assume that their spouse or their adult children will be able to care for them.  However, are you sure your spouse or children are actually capable of lifting you if you fall, help you shower, keep you safe if you lose your memory, or deal with insulin injections or home dialysis?  Unless they are already in the healthcare business and know what they are doing, this may be more than they can handle.

Everyone should anticipate that they will need extra care during the last few months or years of their life.  While some people do die a sudden, unexpected death, it is far more common for people to spend the last few years of their life in a frail condition, dependent on others to care for them.  Who will be able to care for you?  How will you pay for it?

Before you make any decisions, you may find it helpful to read: "How to Care for Aging Parents: A One-Stop Resource for All Your Medical, Financial, Housing and Emotional Issues."   The more you know about your options, the easier it will be for you to make an informed decision for yourself and/or your parents.  

Below is a rundown of the most common options people have for paying for long-term care. 

Will Medicare Pay for My Care? 

If you assume that Medicare will pay the cost of your medical care during the last few years of your life, you will be disappointed.  If you spend at least three days in a hospital, Medicare will cover up to 100 days of needed care in a Medicare approved nursing facility.  After that, Medicare will no longer continue to pay and you will have to make alternative financial arrangements.  If Medicare determines that your illness does not require you to stay for the full 100 days, then you may not even be covered for that long. 

What about Medicaid?

Medicaid (called MediCal in California) is an option for low income people with few assets.  You have to apply for this coverage and meet their financial and medical qualifications.  Many experts suggest you apply for Medicaid the minute you or your loved one enters a nursing home, to see if you qualify financially.  If Medicaid will cover your expenses, it will remove a huge burden from you and your family. 

Should You Self-Insure for Your Long-Term Care?

If you have enough income and assets to cover assisted living or a lengthy nursing home stay for both you and your spouse, you probably do not need to worry about the cost of long-term care.  You can pay out-of-pocket when and if one or both of you need to go into a nursing home for the last few months or years of your life.  However, most people do not have sufficient assets to feel confident they could pay for all the care they need for an indeterminant length of time. 

What About Middle Income People?

The group which has the most significant problem covering the cost of long-term care are those in the middle class.  These are the people who have too much income and savings to qualify for their care to be paid for by Medicaid, but not enough savings to pay out-of-pocket for a lengthy stay in a nursing home.  What options do they have?  How can they prepare for the final years of their lives?

Purchase Long-Term Care Insurance as Early as Possible

One good option is to purchase a long-term care insurance policy, which will pay an inflation adjusted amount of money per day for your care for the length of time you believe you will need that care.  The younger you are when you purchase a long-term care insurance policy, the lower the premiums will be.  You can prepare for the future by purchasing a policy in your 50s, while you and your spouse are both in good health.  There are a variety of types of policies, including some which allow couples to share a policy.  You can also buy policies for varying lengths of time.  For example, you could get two or three years of coverage, or lifetime coverage. 

Your long-term insurance will begin paying for your care at the time you are no longer able to handle at least two of the following basic activities of daily life, which include dressing yourself, feeding yourself, toileting, safely bathing or showering, or transferring yourself out of a bed or chair.  A nurse may be sent to evaluate you before the insurance company will pay the claim. Depending on your policy, you may be able to have a caregiver come to your home, or you may be able to move into an assisted living facility or nursing home. The insurance carrier has to approve your plan. 

The advantage of these policies is that they bring you peace of mind and will help cover your expenses if you should become incapable of caring for yourself.  The disadvantage is that the premiums could rise, even if you start with a low premium.  One way to deal with rising premiums is to cut back on the amount the company may have to pay out by reducing your years of coverage, the daily rate they will pay, or the inflation factor they are using.   

Combination Life Insurance and Long-Term Care Insurance Policy

Another option is to purchase a life insurance policy which will allow you to draw on some of the value of your future death benefits to pay for long-term care.  If you never need long-term care, your heirs receive the full face value of the life insurance.  If you need some of the money for your long-term care, you can use some of the funds while you are still alive.

Move into a Continuing Care Retirement Community

Another option is to move into a CCRC or Continuing Care Retirement Community.  This usually requires you to sell your current residence and purchase a condo or cottage in the CCRC.  You pay the CCRC a monthly fee in addition to the "buy-in" you paid for your condo when you moved into the community.  In return, they guarantee they will take care of you for the rest of your life.  

Most of them require you to be in good enough health at the time you move in that you are "ambulatory" or able to walk on your own and do not need any immediate assistance caring for yourself.  As a result, do not wait until you are already seriously ill before deciding to move to a CCRC.  The CCRC provides you a place to live, meals, maid service, social activities and other amenities.  If you need future nursing home care or memory care, they will provide that, as well.  When you die, they will pay your heirs part of the remaining value of the condo, but it will be less than the price you paid when you purchased it.  How much your heirs receive is determined, in part, by how much the CCRC has spent on your lifetime care.

Plan Ahead and Plan Early

You may also find it helpful to read: "How to Care for Aging Parents: A One-Stop Resource for All Your Medical, Financial, Housing and Emotional Issues."   ABC News referred to this book as the Bible of eldercare and it also received high reviews from AARP and other sources. 

As you can see, you have a number of options which will help you prepare for the future without depending on your children or other family members to care for you.  What is important is that you start looking at your options while you are in your 50s or 60s, and then take the necessary steps to follow the plan which seems wisest for your situation.  For example, visit the Medicaid approved nursing facilities in your area and see if you are likely to qualify to live in one; if not, make arrangements to purchase a long-term care insurance policy.  You may also want to visit the CCRC's in your community and see which one appeals the most to you and how much it would cost to purchase a condo or rent an apartmnt in one.  Once you have a plan, you will worry much less about what the future has in store for you.

You can find gifts for retirees and others at my Etsy Store, DeborahDianGifts:  http://www.etsy.com/shop/DeborahDianGifts

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

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Reduce Junk Mail and Catalogs - Protect Yourself and Save Trees!

Does your weekly mail delivery include a pile of catalogs, junk mail and advertisements which go directly into your recycling bin?  My husband and I frequently receive catalogs which we never requested and which must have cost a fortune to publish.  It seems like such a waste for someone to print, mail, and deliver these items, only to have them end up unread, in the trash.  

We also receive unsolicited credit card offers, and promotions from hotels, investment companies, Medicare supplements and similar mailings.  While it may seem harmless to simply throw these things away, someone checking our trash could easily learn our name, address, that we are retired, and that we are considered good potential clients by investment companies.  If you want to make sure this type of information is kept private, your best solution is to purchase a home paper shredder (Ad) to destroy anything which comes to your home which could provide the wrong person with too much information about you.  In particular, you will want to destroy credit card offers. However, it may be too much work to shred larger items, such as catalogs.  In those cases, it might be better to stop them from coming in the first place.

Recently, I learned there are a few easy steps we can all take which may not totally eliminate these mailings, but could substantially reduce them.   Hopefully, after cutting down on our junk mail, it will be one less thing we have to deal with each day.  Below are some recommendations from experts:

Dealing with Catalogs and Junk Mail

DMAChoice.org - This is a site which will let you remove your name and address from many catalog lists.  You have to register an account and pay a $2 processing fee.  In return, they will unsubscribe you from entire categories of mail, which include catalogs and advertisements.  You can also unsubscribe only from the particular catalogs you do not want to receive.

Catalogchoice.org - This site is free and helps you unsubscribe from catalogs, but only one at a time.  In addition, it will not unsubscribe you from catalogs from businesses you have dealt with in the past as a customer.  They will only remove you from the prospect lists of companies you have not used in the past.  If you have been a customer of a company and want to unsubscribe from their catalog, you will have to visit their website to unsubscribe. 

Catalogchoice.org - In addition to reducing the number of catalogs you receive, this company will also offer a way to reduce your general junk mail.  You can use their free service, which will send opt-out requests to individual companies which are already marketing to you.  For a $20 "donation" they also have a premium unlisting service which will remove your name from data brokers who sell your contact information to marketers. 

It is unclear whether using the above services is a permanent solution, or if you will have to update your requests periodically.

Sweepstakes Lists

The two major companies which send out sweepstakes to virtually everyone in the country are Publishers Clearinghouse and Readers Digest.  You can remove yourself from these contests using the contact information below:

Publisher's Clearinghouse:  800-645-9242 or privacychoices@pchmail.com

Reader's Digest: 800-310-6261

If you still want to enter those contests, you can participate online, at your leisure, without the need to pour through thick packets of material and mail back an entry.  

Credit Card Offers

Credit card offers are a particularly dangerous type of junk mail.  Someone could potentially steal the applications from your mailbox and submit them, with an address change.  This could create a false identity which might ruin your credit and take you months or years to correct.  

Unfortunately, the major consumer credit reporting agencies, TransUnion, Experian, and Equifax, plus another company called Innovis, are the ones who maintain the mailing lists which are used by credit card and insurance companies to send you junk mail.  Fortunately, you can call one phone number to have your name and address removed from these mailing lists.  It is listed below 

Opt Out of credit card offers and insurance company mail at:

1-888-5-OPTOUT (1-888-567-8688)

Or, go online at:  optoutprescreen.com

Until you have successfully opted out of the credit card offers, make sure you use a home shredder (Ad) to destroy any offers which are sent to your home.  There are many choices and price ranges available. You do not want to simply toss credit card offers in the trash, without shredding them first. 

Stop Marketers from Sharing Your Name

Did you know that when you make a purchase, enter a contest, subscribe to a magazine, mail in a warranty card, or give your name and address to a company for any reason, you will be put on a mailing list which can be shared or sold to other companies?  

The best way to protect yourself is to be proactive anytime you mail in a warranty card (which is not usually necessary).  Whenever you give a business your name, write these words next to it:  "Do Not Rent or Sell my Name" or "No Mailing Lists."

Unsubscribe from Junk Emails

Another way to protect yourself from unwanted attention from companies is to go to the bottom of unwanted emails and click "unsubscribe."  It will reduce the number of junk emails you get, which could also reduce any unwanted attention from companies.  Another option is to just have anything from that company sent to the Spam file in your email.  

While taking these actions will not completely eliminate all junk mail, especially from local businesses and vendors, it could substantially reduce the amount of mail coming to your home. In addition, by eliminating unwanted catalogues and frequent mailings, you may also save a few trees!

You can find gifts for retirees and others at my Etsy Store, DeborahDianGifts:  http://www.etsy.com/shop/DeborahDianGifts

Enjoyed this post? Never miss out on future posts by following us.  You will receive one weekly email containing the most current post. 

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

Disclosure: This blog may contain affiliate links. If you decide to make a purchase from an Amazon ad, I'll make a small commission at no extra cost to you.

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

Photo credits:  Pixabay - cattu

Is Inflammation Killing You? Learn How to Tame It

 Many of us do not realize that inflammation is one of the causes of a wide variety of illnesses, including cancer, gout, arthritis, heart disease, asthma, dementia and diabetes.  Inflammation is complicated, because it is both the cause of many illnesses, as well as a result of them.  This creates a dangerous cycle.  As our body fights off illnesses, our level of inflammation increases.  When it increases, it can also trigger other illnesses. Consequently, it may feel as if our health is cascading downward.

The November, 2019 issue of the AARP Bulletin contained some helpful information about the ways we can protect ourselves from the damage that long-term chronic inflammation can cause.  First, however, we need to understand the causes.

What Causes Inflammation?

Inflammation is a natural response to a variety of assaults on our health.  It is the normal reaction to any threat to our body.  We are aware of it when we have a fever and our body temperature rises to fight a virus.  Inflammation is also present when we injure ourselves and the tissue around the injury swells.  These are examples of temporary, acute inflammation.  However, sometimes inflammation lingers and begins to damage the healthy, surrounding tissue or organs.  It can last a long time and become chronic.  That is when it can trigger other health issues.

Chronic inflammation can be caused by long-lasting infections such as hepatitis C or Lyme disease.  It can also be a response to air or water pollution, allergies, and similar environmental factors.  In addition, lifestyle issues such as obesity, smoking, stress, alcohol use, poor sleep, poor diets and lack of physical exercise can all contribute to chronic inflammation.

The more factors at work in your life, the more likely you are to be experiencing chronic inflammation.  For example, if you are recovering from a serious illness, and breathing polluted air, and overweight, sleeping poorly, and eating badly, you have created a situation where your immune system is constantly on high alert and continually inflamed. This makes you even more vulnerable to developing additional illnesses.  Of course, the cycle just escalates until it may feel as if every system in your body is breaking down.

One way you can reduce the inflammatory reaction in your body is to eat an anti-inflammatory diet, such as the one you can find in "The Complete Anti-Inflammatory Diet for Beginners: A No-Stress Meal Plan with Easy Recipes to Heal the Immune System." (Ad) If you suspect that inflammation has put your body into a downward spiral, following this diet is a good place to start turning things around. 

How Do You Know if You Have Chronic Inflammation?

The truth is that, as we age, virtually everyone has some degree of inflammation.  The AARP article described it as a "flickering ember" which you do not want to let "erupt into a forest fire."  Just carrying a little excess weight, especially belly fat, means you are carrying around "highly inflammatory tissue."  When you add in the fact that you may be eating too much sugar and/or unhealthy, fatty meats, you already have several factors causing inflammation in your body.

In addition, simply getting older causes our inflammation markers to rise. The older we are, the more opportunity we have had to be exposed over the years to chronic diseases, bad food choices, alcohol, and environmental toxins.  To make matters worse, aging makes it harder for our bodies to manage our immune system, shed weight and extract nutrients from food.  This means we need to work even harder to reduce our chronic inflammation.

Lifestyle Changes to Reduce Inflammation

If you want to reduce the amount of disease-causing inflammation in your body, the first step is to avoid foods and activities which tend to rev up the inflammation. 

Avoid white bread and other low-fiber foods.
Avoid processed foods and desserts which tend to be low in fiber and high in sugar.
Avoid fried foods.
Avoid bottled salad dressing.
Avoid saturated fats
Avoid drinking, smoking and places where there is second-hand smoke.
Work to get rid of any belly fat you are carrying.
Avoid situations and behaviors which lead to stress and a bad attitude.

How to Tame Your Chronic Inflammation

It is not enough that you simply avoid things which increase your inflammation.  It is also important to engage in positive activities and diets which will reduce it.

Focus on getting good, restful sleep every night.
Eat whole grains, including whole-grain bread.
Eat a variety of fruits, including grapes, apples, and berries
Include beans and tea in your diet
Eat yogurt which is low in sugar and contains live cultures
Consume plenty of colorful salads
Use healthy fats such as olive oil.
Eat food containing healthy fats such as avocados, nuts, fish and flax.
Get exercise.  Even a walk outdoors can make a difference.
Go to the dentist. Gum inflammation can lead to other diseases.
Use prayer and meditation to reduce your stress.  Yoga and religious practices can lower some markers of inflammation.

Why Should I Do These Things?

It may seem like it takes a lot of effort and major lifestyle changes in order to reduce your inflammation. However, would you rather do these things or spend years of your life dealing with heart disease, cancer, diabetes or, possibly, all three at once?

One more word of caution:  You cannot simply take a pill to reduce your inflammation.  While occasionally taking an over-the-counter anti-inflammatory like ibuprofen might help with acute inflammation, it is not a good solution for long-term chronic inflammation.  These drugs also have side effects such as stomach bleeding and increased blood pressure, and those problems will eventually increase your inflammation, not decrease it.

You can find gifts for retirees and others at my Etsy Store, DeborahDianGifts:  http://www.etsy.com/shop/DeborahDianGifts

Enjoyed this post? Never miss out on future posts by following us.  You will receive a weekly email with the most current post.
 

If you want to know more about dealing with common medical health issues as you age, Medicare, Social Security, financial planning, where to retire and more, use the tabs or pull down menu at the top of the page to find links to hundreds of additional articles.

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Photo credit:  Wikimedia

Dementia Risk Higher for Baby Boomers - Faster Mental Decline as We Age!

Have we Baby Boomers been careless about the way we are aging?  There seems to be some indication of this, based on what researchers are seeing with our mental decline. There are indications that our cognitive function is not as good as it was for our parents and grandparents at the same age! The good news is that it is not too late for most of us to make the necessary changes to protect our brains from declining too fast. 

As the attached graphic from the University of California in Irvine shows, dementia is an "umbrella term" which covers many types of cognitive decline,  with Alzheimer's Disease being the most common.  However, it also includes dementia which is caused by Parkinson's Disease, Lewy Bodies, Vascular problems, brain damage and many other pathologies. With everything we know today about dementia, how is it that Baby Boomers are seeing more cognitive decline at an earlier age than earlier generations?

What is it that researchers have discovered, and what can we do to avoid being one of the Baby Boomers who will prematurely develop dementia?

Baby Boomer Cognitive Decline

According to a study called "Health and Retirement" which appeared in the Journals of Gerontology, the University of Michigan followed a group of 30,191 people from 1996 to 2014.  This was a sizeable and lengthy study.  People born between 1942 and 1947 had better cognitive function than those born between 1890 and 1923. However, Baby Boomers, who were born after 1947, had significantly worse cognitive functioning than either of the preceding two generations.  

Some of the Baby Boomers they studied showed signs of cognitive decline as early as ages 50 to 54.  The participants were given standard cognitive tests which included memorizing lists of words and counting backwards from 100 by sevens.  Older senior citizens were able, as a group, to perform these tasks better than Baby Boomers, when their scores were compared at the same age.

Why are Baby Boomers Showing Faster Mental Decline?

The author of the study was Hui Zheng, an associate professor at Ohio State University. Although the study was not able to completely ascertain all the reasons for the rapid cognitive decline in Baby Boomers, they were able to get some indications from their research.  When compared with older generations, they found that Baby Boomers, as a group, had lower household wealth, were less likely to be married as they aged, were lonelier, and exhibited more depression and psychiatric problems.  

In addition, the physical health of many Baby Boomers was not as good as the overall health of their older relatives at the same age.  Baby Boomers were more likely to be obese, physically inactive, and suffer from diabetes or other chronic illnesses.

One cause of dementia is head trauma, and many Baby Boomers have engaged in more aggressive sports and other activities which exposed them to concussions and falls.  Baby Boomers should avoid risky activities that could lead to brain injury, as a way to reduce their risk of developing injury related dementia.

In addition to the research done at Ohio State University, and other study centers, researchers from the University of California - Irvine have also studied the causes of dementia and they have found that, although there are some factors which people cannot change, there are others which are well within our control.  Among those which are unavoidable are genetics, such as a family history of dementia. We cannot change our parents.  However, there are steps we can all take to reduce our dementia risk, even if we have a family history of Alzheimer's or similar diseases.

Are Baby Boomers Doomed to Early Dementia?

The good news is that many of the factors which contribute to early dementia are in our control.  We can make lifestyle changes which slow down the signs of cognitive decline and can improve our mental functioning.  Although not all dementia can be completely prevented, there are signs that people are able to slow it down, often by years, even when family members have a genetic predisposition.  Simply giving ourselves a few more years of clear thinking is something we should all strive to do.  

For example, in addition to avoiding brain injury, we can also lower our dementia risk by avoiding midlife obesity, midlife hypertension (high blood pressure), high cholesterol, and poor sleep. 

If you are serious about taking steps to protect your aging brain, a good place to start is by reading  "The End of Alzheimer's Program: The First Protocol to Enhance Cognition and Reverse Decline at Any Age." (Ad)

How to Slow Down Dementia

According to researchers at the University of California in Irvine, certain behaviors tend to speed up dementia, and other behaviors tend to slow it down. They have been studying the "Oldest of the Old" for over 50 years in the California retirement community where I live.  Some of their results have been presented on the television show "60 Minutes." The researchers have tested their participants, followed up with them annually for decades, and even dissected the brains of some of the participants after they died.  In their research, they have learned that the more lifestyle changes we make, the more likely it is that we will be able to postpone dementia. 

As you can see from the attached chart of Life Style Risk Factors from UCI, here are some of the actions which seem to slow down the development of dementia:

* Education: The more education we have, the lower our dementia risk.  It is never too late to continue to take classes and learn. Do not worry about whether or not you have an advanced degree.  Taking classes in anything which interests you or that improves your job skills is a good way to strengthen the connections in your brain.  You may also want to take foreign language classes, music lessons, or writing classes, even if you are already in your 70s or older.

*  Diet: Eat a healthy, balanced diet which includes adequate protein and a variety of fruits and vegetables, as well as healthy oils such as olive oil, avocados and nuts.  Often referred to as the Mind Diet, you can learn more details on how to follow it by reading "Mind Diet for Beginners: 85 Recipes and a 7-Day Kickstart Plan to Boost Your Brain Health."  (Ad)

*  Exercise: Get daily physical exercise.  At least 30 minutes a day of walking and/or weight training is recommended.  If arthritis or other problems make this difficult, try water aerobics.  It is important to move every day.  It will increase the blood flow to the brain.  

*  Brain activities: Stimulate your brain with a variety of cognitive activities, including playing games, working puzzles, etc.  Try to do different types of brain activities, especially ones which you find challenging. As you learn to do new things, your brain will also make new connections.

*  Social activity:  Many people, especially those who are isolated, do not realize how important it is to socialize with others on a regular basis.  Having a conversation is a complex process and people who engage with other people regularly are more likely to keep their brains sharp.  After the pandemic, when people were more isolated than normal, it became especially important for people to look for ways to socialize with family and friends as often as possible.  If you cannot get out of the house to see people, try having phone conversations or Zoom meetings as often as possible. What is most important is that you are actually engaged in these conversations, and not distracted.  You need to practice listening to what is said, and then responding appropriately in a way that invites them to respond.  This "conversational ping-pong" is one of the best ways to keep your brain sharp.

*  Get Necessary Medical Care:  It is much harder to stay engaged in conversation, take classes, get exercise, or do other brain stimulating activities if you are not taking care of your health and, most importantly, your hearing.  People who need hearing aides and do not get them are more likely to develop dementia.  Some researchers have also learned that people who have had Covid-19 may be more likely to develop dementia, which is one more reason to get vaccinated and take other precautions. You want to follow your doctor's recommendations regarding your cardiovascular health, as well.  A stroke, aneurysm, or serious heart attack can do significant damage to your brain. People who are sedentary because they do not feel well or experience pain are also more likely to develop dementia.  See your doctor and get medical treatment for any health problems you may be experiencing.  The better your overall health, the stronger your brain will be, too. 

You can learn more ways to maintain your brain health in "The End of Alzheimer's Program: The First Protocol to Enhance Cognition and Reverse Decline at Any Age." (Ad)

You can find gifts for retirees and others at my Etsy Store, DeborahDianGifts:  http://www.etsy.com/shop/DeborahDianGifts

Enjoyed this post? Never miss out on future posts by following us.  You will receive a weekly email with the most current post. 

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

Disclosure: This blog may contain affiliate links. If you decide to make a purchase from an Amazon ad, I'll make a small commission at no extra cost to you.

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

 Graphic credits: University of California - Irvine slides