SAVVY SENIOR
Driving safely with dementia and knowing when to quit

 

April 23, 2015

Jim Miller


Dear Savvy Senior,

Is it safe for seniors with dementia to drive, and if so, when should they stop? My dad has early Alzheimer’s disease but still drives himself around town just fine.

Looking Ahead

 

Dear Looking,

While most doctors agree that people with moderate to severe dementia should not take the wheel, in the early stages, the medical consensus is that driving performance should be the determining factor of when to stop driving, not the disease itself.

With that said, it’s also important to realize that as your dad’s driving skills deteriorate over time from the disease, he might not recognize it. So it’s very important that you work closely with him and his doctor to monitor his driving. Here are some tips that can help:

 

Warning signs

The best way to keep tabs on your dad’s driving is to take frequent rides with him watching out for key warning signs. For example: Does he have trouble remembering routes to familiar places? Does he drive at inappropriate speeds, tailgate or drift between lanes? Does he react slowly or make poor driving decisions? Also, has your dad had any fender benders or tickets lately, or have you noticed any dents or scrapes on his vehicle? These, too, are red flags.

If you need some assessment help, hire a driver rehabilitation specialist who’s trained to evaluate older drivers. To locate a specialist see driver-ed.org or aota.org/older-driver.

 

Transition tips

Through your assessments, if you believe it’s still safe for your dad to drive, you may want to start recommending some simple adjustments to ensure his safety, like driving only in daylight and on familiar routes, and avoiding busy roads and bad weather. Also, see if he will sign an Alzheimer’s “driving contract” (see alz.org/driving to print one) that designates someone to tell him when it’s no longer safe to drive.

In addition, you should also consider getting a GPS vehicle tracking system for his car (like motosafety.com or mobicopilot.com) to help you keep an eye on him. These devices will let you track exactly where he’s driving, and allow you to set up zones and speed limits that will notify you via email or text message when he exits an area or arrives at a designated location, and if he’s driving too fast.

 

Time to quit

When your dad’s driving gets to the point that he can no longer drive safely, you’ll need to talk to him. It’s actually best to start having these conversations in the early stages of the disease, before he needs to quit driving, so he can prepare himself.

You also need to have a plan for alternative transportation (including a list of family, friends and local transportation services) that will help your dad get around after he stops driving.

For tips on how to talk to your dad, the Hartford Financial Services Group and MIT AgeLab offers a variety of resources at safedrivingforalifetime.com - click on “Dementia and Driving.”

 

Refuses to quit

If your dad refuses to quit you have several options. First, suggest a visit to his doctor who can give them a medical evaluation, and “prescribe” that he stops driving. Older people will often listen to their doctor before they will listen to their own family.

If he still refuses, contact your local Department of Motor Vehicles to see if they can help. Some states require doctors to report new dementia cases to the DMV, who can revoke the person’s license.

If all these fail, consider hiding his keys or just take them away. You could also disable his vehicle, park it in another location so he can’t see it or have access to it, or sell it.

 

 


 

Social Security offers lump sum payouts to retirees      
April 14, 2015

Dear Savvy Senior,

I’ve heard that Social Security offers a lump-sum payment to retirees who need some extra cash. I have not yet started drawing my benefits and would like to investigate this option. What can you tell me?

-Almost Retired
 

Dear Almost,

There are actually two different kinds of Social Security claiming strategies that can provide retirees a big lump-sum benefit, but you need to be past full retirement age to be eligible, and there are financial drawbacks you need to be aware of too.

First, let’s review the basics. Remember that while workers can begin drawing their Social Security retirement benefits anytime between ages 62 and 70, full retirement age is currently 66 for those born between 1943 and 1954, but it rises in two-month increments to 67 for those born in 1960 and later. You can find your full retirement age at ssa.gov/pubs/ageincrease.htm.

At full retirement age, you are entitled to 100 percent of your benefits. If you claim earlier you’ll receive less, while if you delay you’ll get more - roughly 8 percent more for each year until age 70.
 

Lump Sum Options

If you are past full retirement age, and have not yet filed for your benefits, the Social Security Administration offers a retroactive lump-sum payment that’s worth six months of benefits.

Here’s how it works. Let’s say you were planning to delay taking your Social Security benefits past age 66, but you changed your mind at 66 and six months. You could then claim a lump-sum payment equal to those six months of benefits. So, for instance, if your full retirement age benefit were $2,000, you would be entitled to a $12,000 lump sum payment.

If you decided at age 66 and four months that you wanted to file retroactively, you’d get only four months’ worth of benefits in your lump sum, because SSA rules prohibit you from claiming benefits that pre-date your full retirement age.

Another option that provides even more cash is the “file and suspend” strategy. Again, this option is only available to people on (or after) full retirement age.

Here’s how this strategy works. Let’s say you’re 66, and you decide to delay your benefits. You could file for your benefit and then immediately suspend it. This gives you the ability to collect a lump sum going back to the date you filed. So if you need money at age 69 for example, and your full retirement age benefit was $2,000, you could get a three-year lump sum of $72,000.

 

Drawbacks

The big downside to these strategies is that once you accept a lump-sum payment, you’ll lose all the delayed retirement credits you’ve accrued, and your future monthly retirement benefit will be reduced to reflect the amount you already received.

Here’s an example of how this works. Let’s say that you are entitled to a $2,480 monthly benefit at age 69. By taking a three-year lump sum payment, your future benefits will shrink back to $2,000 per month, which is what you would have received at your full retirement age. This also affects your future survivor benefit to your spouse or other eligible family members after you die.

You also need to consider Uncle Sam. Depending on your income, Social Security benefits may be taxable, and a lump-sum payment could boost the amount of benefits that are taxed. To help you calculate this, see IRS Publication 915 “Social Security and Equivalent Railroad Retirement Benefits” at irs.gov/pub/irs-pdf/p915.pdf, or call 800-829-3676 and ask them to mail you a copy.

One other caveat: If you’re married and you “file and suspend” your Social Security benefit, you cannot file a “restricted application” too, which gives you the ability to collect spousal benefits while delaying your own retirement benefit past full retirement age.

 

 

Easier screening tests for colon cancer       
April 9, 2015

Dear Savvy Senior,

Are there any easier alternatives to a colonoscopy to check for colon cancer? I’m in my 60s and would like to be tested, but hate the idea of drinking all that laxative solution, and being sedated for the procedure.

Squeamish Jim

 

Dear Jim,

It’s a great question. While a colonoscopy is considered the gold standard screening test for detecting colon cancer and is widely recommended once adults reach age 50, only about half of Americans who’ve passed that milestone ever get tested.

Why? Because most people, like yourself, dread the all-day laxative prep and sedation, not to mention the procedure itself. Fortunately, there are some easier alternatives, but be aware that if these tests uncover any suspicious results, you’ll still need to undergo a colonoscopy.
 

* Take-home tests

There are two different types of tests on the market today that you can take in the privacy of your own home that requires no laxative-taking/bowel-cleansing preparation.

The best option is the new FDA approved Cologuard test (see cologuardtest.com), which has a 92 sensitivity rate for detecting colon cancers. With this test you simply take a sample of a bowel movement, and mail it in to the lab for analysis. The lab looks for both blood and cancer-related DNA cells in your stool.

The Cologuard test, which is recommended every three years, requires a prescription from your doctor, and costs $599 but is covered by Medicare and many private insurers.

If, however, you find that the Cologuard test is not covered by your insurer, and you can’t afford or don’t want to pay the $599 fee, the other option is the fecal occult blood test (FOBT) or the fecal immunochemical test (FIT), which detects 74 percent colon cancers.

These tests, which are also provided by your doctor, check for traces of blood in the stool that could indicate cancer or large polyps that can develop into cancer, but they don’t look at the DNA. You simply send a stool sample to the lab.

Recommended annually, both of these fecal tests cost only around $25 and are covered by Medicare and most insurers.
 

* Less invasive tests

Two other tests to consider that are less invasive then a colonoscopy but more entailed than the take-home tests are the virtual colonoscopy and the sigmoidoscopy (both tests are recommended every five years).

A virtual colonoscopy uses a CT scan to view your colon instead of a scope in the rectum, so it’s a less invasive procedure than a traditional colonoscopy and doesn’t require sedation. But, it still requires the same bowel-cleansing prep. It’s also more expensive, typically costing between $400 and $800 and is not covered by Medicare or most insurers.

A sigmoidoscopy exam, which is covered by Medicare and most insurers, uses a short, flexible scope inserted in the rectum like a colonoscopy to look at the lower colon only. This is a much faster and less involved procedure than a colonoscopy and one that doesn’t require sedation. You follow a clear liquid diet the day before the exam and take a laxative or enema the morning of.
 

Colon cancer numbers

Colon cancer, which develops slowly over several years without causing symptoms especially in the early stages of the disease, is the second largest cancer killer in the U.S., killing around 50,000 Americans a year.

The U.S. Preventive Services Task Force - an independent panel of medical experts that advises the government on health policies - recommends colon cancer screening to all adults, ages 50 to 75. Earlier screenings are recommended to people who have an increased risk due to family history or other factors.

Experts believe that as many as 20,000 lives could be saved each year, if the screening rate went up to 90 or 95 percent.

 


Handy Aids For Achy Hands   
  
April 2, 2015

Dear Savvy Senior,

What products can you recommend for seniors with hand arthritis? I really struggle with anything that requires gripping and turning, which makes most activities difficult.

-Gripless Joan
 

Dear Joan,

There are literally hundreds of different arthritis aids and other products on the market today that can help people with arthritic hands and carpal tunnel syndrome.

To find out which devices can best benefit you, a good place to start is to ask your doctor for a referral to an occupational therapist, who can test the strength and functionality of your hands and recommend appropriate aids. With that said, here’s a rundown of some helpful products for different needs.

Kitchen aids: Activities like gripping cooking utensils, cutting and chopping, opening jars and cans, and moving around heavy pots and pans can make preparing a meal much more difficult when you have hand arthritis.

Some products that can help are Oxo Good Grips, which makes dozens of soft, large-handle cooking, baking and cleaning utensils that are easier to grip. And for cutting and chopping the Dexter DuoGlide and Ergo Chef knives are excellent ergonomically designed options.

For opening jars, the wall-mounted or under-counter mounted Zim Jar Opener is a top manual opener. It has a V-shaped grip that holds the lid as you twist the jar with both hands. Some other good options are the Hamilton Beach Open Ease Automatic Jar Opener, and a nifty tool called the JarPop that pops the seal on jars so lids can be removed easier.

For opening cans, an electric can opener is the best option. West Bend and Hamilton Beach make some of the best.

And if you’re interested in arthritis-friendly pots and pans, look for lightweight cookware that has two handles. These are much easier to lift and move around.

Household helpers: Turning doorknobs, key locks, twist-handles on kitchen or bathroom faucets, and twist-on lamp switches can also be difficult. To help, there are doorknob lever adapters, key turners, lamp switch enlargers, and lever handles for faucets that provide leverage for easier turning.

Personal care: Squeezing a shampoo bottle or a tube of toothpaste, or gripping a bar of soap, a toothbrush handle or even a piece of dental floss can make grooming a challenge. Solutions include a wall-mounted soap, shampoo and toothpaste dispenser, which provides easy access to suds. And for brushing and flossing, there are wide-handled, electric toothbrushes and flossers that vibrate or spin to do the cleaning for you.

Easier dressing: Fastening buttons, pulling zippers and tying shoelaces can also present problems. To help with these chores there are buttonhooks and zipper pulls, and elastic shoelaces, which transform lace-ups into slip-ons.

Reading, writing and computing: Holding and turning the pages of a book, hand writing and using a computer mouse can also stress arthritic hands.

For readers, an eReader like a Kindle or Nook is recommended because they’re lightweight and easier to hold than regular books. For writing, there’s the soft rubber Pencil Grip that fits on pencils and pens, and ergonomic-shaped pens like the Pen Again that reduce hand fatigue. And for easier computing, the 3M Ergonomic Mouse and Contour Roller Mouse can eliminate hand and wrist stress.

Hobby helpers: There are dozens of arthritis aids for hobbies too. For example, there are automatic card shufflers and cardholders for card players. If you like to paint, knit or crochet, there are ergonomic paintbrushes, and oversized knitting needles and crochet hooks that are easier to hold. And for sewing, quilting or crafting, there are tools like Fiskars self-opening Easy Action Scissors that spring open for easier cutting.

For a rundown of additional products and where you can purchase them, visit my online article at www.AchyHandAids.org.






How divorce can affect your Social Security benefits    
  
March 26, 2015

Dear Savvy Senior: Am I entitled to my former husband’s Social Security benefits? I was married for 12 unpleasant years and would like to know what I may be eligible for.

- Ex-spouse

 

Dear Ex-spouse,

You’ll be happy to know that for the most part, Social Security provides divorced spouses benefits just like they do spouses, if you meet the government’s requirements. Here’s how it works.

A divorced spouse can collect a Social Security retirement benefit on the work record of their ex-husband (or ex-wife) if they are at least age 62, were married for at least 10 years, are unmarried now, and are not eligible for a higher benefit based on their own work record.

In order to collect, however, your former spouse must also be at least 62 and eligible for Social Security benefits. But, he doesn’t have to be receiving them in order for you to collect divorced spouse’s benefits.

Even if your ex is remarried, it won’t affect your right to divorcee benefits, nor will it affect your ex’s retirement benefits or his current spouse’s benefits.

 

Benefit amount

A divorced spouse can receive up to 50 percent of their ex’s full Social Security benefit, or less if they take benefits before their full-retirement age - which is 66 if you were born between 1943 and 1954. To find out your full-retirement age and see how much your benefits will be reduced by taking them early see ssa.gov/retire2/agereduction.htm.

Keep in mind though, that if you qualify for benefits based on your own work history, you’ll receive the larger of the two benefits. You cannot receive benefits on both your own record, and your ex’s work record too.

To find out your retirement benefits based on your own earnings history, see your Social Security statement at ssa.gov/myaccount. And to get an estimate of your divorced spouse benefit, call Social Security at 800-772-1213. You’ll need you’re ex’s Social Security number to get it.

 

Getting remarried

Since three-quarters of U.S. divorcees get married again, it’s also important to understand that remarrying makes you ineligible for divorced spouse’s benefits unless the later marriage ends. And, for those who have been married and divorced twice, with both marriages lasting more than 10 years, you can collect using the ex-spouse with the larger Social Security benefit.

 

Divorced survivor

You also need to know that if your ex-spouse dies, and you were married for 10 or more years, you become eligible for divorced "survivor benefits," which is worth up to 100 percent of what your ex-spouse was due.

Survivor’s benefits are available to divorced spouses as early as age 60 (50 if you’re disabled). But, if you remarry before 60 you become ineligible unless the marriage ends. Remarrying after age 60 will not affect your eligibility.

Also note that if you are receiving divorced spouses benefits when you ex-spouse dies, you will automatically be switched over to the higher paying survivor benefit.

 

Switching strategies

Being divorced also offers some switching strategies that can help boost your benefits. For divorced spouses that worked, there’s an option that lets you file a “restricted” application with Social Security (at full retirement age) to collect a divorced spousal benefit, which is half of what your ex gets. Then, once you reach 70, you stop receiving the ex-spousal benefit and switch to your own benefit, which will be 32 percent higher than it would have been at your full retirement age.

Divorced widows (and widowers) have even more options. If, for example, you are currently collecting Social Security retirement benefits on your own record, and your ex-spouse dies, you can switch to survivor’s benefits if the payment is larger. Or, if you’re collecting survivor’s benefits, you can switch to your own retirement benefits - between 62 and 70 - if it offers a larger payment.

 


How Medicare covers in-home care    
  
March 17, 2015


Dear Savvy Senior:

How does Medicare cover home health care? Because of my illness, my doctor suggested I get home health care, but I want to find out how it’s covered before I proceed.

- Need Some Help
 

Dear Need,

Medicare covers a wide variety of intermittent in-home health care services (usually up to 28 hours per week) to beneficiaries, if you meet their specific requirements. Here’s how it works.

In order for you to secure coverage for home health care, Medicare first requires that you be homebound. This means that it must be extremely difficult for you to leave your home, and you need help from a device (like a wheelchair or walker) or a person in doing so.

You will then need your doctor to approve a “plan of care” confirming that you need skilled nursing care or therapy services from a physical or speech therapist on a part-time basis. Your doctor can also request the services of an occupational therapist and a home health aide to assist with activities of daily living such as bathing, dressing and using the bathroom. Your doctor must renew the “plan of care” once every 60 days.

You will also need to use a home health agency that is certified by Medicare.

If you meet all of the requirements, Medicare should pay for your in-home care.

But, be aware that Medicare will not pay for home health aide services (such as bathing, dressing or using the bathroom) alone, if you do not need skilled-nursing or skilled-therapy services too. Homemaker services, such as shopping, meal preparation and cleaning are not covered either.

You also need to know that Medicare has recently changed its home health care policy regarding degenerative diseases. It will now pay for in-home physical therapy, nursing care and other services to beneficiaries with chronic conditions like multiple sclerosis, Parkinson’s or Alzheimer’s disease in order to maintain their condition and prevent deterioration. In the past, Medicare would only cover home health services if the patient were expected to make a full recovery. 

If you have original Medicare, you can locate a Medicare-certified home health agency by calling 800-633-4227 or by visiting medicare.gov/homehealthcompare. If you have a Medicare Advantage plan, you should contact your plan directly and ask which home health agencies work with the plan and are within the plan’s network of providers.

For more detailed information on how Medicare covers in-home health, see the “Medicare and Home Health Care” online booklet at medicare.gov/pubs/pdf/10969.pdf.

 

Other options

If you don’t qualify for Medicare coverage, there are other coverage options depending on your situation, including:

Insurance: If you happen to have long-term care insurance, check to see if it covers in-home care. Or if you have a life insurance policy, see if it can be utilized to pay for care. 

Medicaid: If your income is low enough, all states offer Medicaid programs that will pay for some forms of in-home care. To investigate this, contact your local Medicaid office.

Veterans assistance: If you’re a veteran, some communities have a Veteran-Directed Home and Community Based Service program, which give veterans a flexible budget to pay for in-home care.

Also available to wartime veterans and their spouses is a benefit called “Aid and Attendance” that helps pay for in-home care, as well as assisted living and nursing home care.

To be eligible, you must need assistance with daily living activities like bathing, dressing or going to the bathroom. And, your annual income must be under $21,466 - minus medical and long-term care expenses. If you’re a surviving spouse of a veteran, your income must be below $13,794 to be eligible. Your assets must also be less than $80,000 excluding your home and car.

To learn more, see va.gov/geriatrics or call 800-827-1000.





Simplified smartphone options for tech-shy seniors
March 4, 2014


Dear Savvy Senior,

I’m interested in getting my 72-year-old mother a smartphone, but want to get one that’s very easy for her to use. What can you recommend?

- Shopping Around
 

Dear Shopping,

There are several different ways you can go about getting your mom a simplified smartphone that’s easy for her to use. Depending on how much you’re willing to spend, here are some different options to consider.
 

Simplify a used phone

The cheapest way to set your mom up with an easy-to-use, uncomplicated smartphone is to get her a secondhand Android phone, and install a senior-friendly “launcher app” on it, which is a user interface software application.

This type of launcher will turn the appearance and performance of most android smartphone into a simplified phone with big understandable icons for commonly used features (phone, text messaging, camera, contacts, etc.) and no excess clutter. Most launchers can also be customized to fit your mom’s needs and preferences.

There are a variety of launcher apps available today that provide this type of technology and are completely free to use. Some popular options include Necta Launcher (launcher.necta.us), Wiser (wiser-me.com), Seniors Phone (seniorsphone.mobi), Fontrillo (fontrillo.com) and Big Launcher (biglauncher.com), which also offers an upgraded version for $9.

Or, if you have an old Apple iPhone that you’d like to convert, check out Silverline Mobile (silverline.mobi) that converts both Apple and androids for free.

 

Purchase a new phone

If you’re interested in purchasing your mom a new smartphone, you have options here, too. For starters, you could purchase her a smartphone that’s specifically designed for seniors, like GreatCall’s Touch3 that costs $150 (with no contract) at greatcall.com or 800-918-8543. This is an Android phone, made by Samsung, that has a 4-inch touchscreen and provides a simple menu list to often-used features like the phone, text messages, camera, pictures, email and Internet, along with your contacts and apps.

It also offers a variety of health and safety features like the “5Star app” that would let your mom speak to a certified agent 24/7 that could identify her location and get her the help she needs. “Urgent Care,” which provides access to registered nurses and doctors for advice and diagnoses. And “MedCoach,” which sends medication reminders.

Another way you could go is to purchase her a standard/mainstream smartphone that provides a built-in “Easy Mode” or “Simple” feature in the phone’s settings. This will let you convert the phone into a much simpler mode of operation, that provides larger, well-labeled icons, to only commonly used functions like the phone, camera, messaging, Internet, pictures, contacts and her favorite apps.

Smartphones that offer the “Easy Mode” or “Simple” feature include the Samsung Galaxy phones, which are available through most phone carriers at prices typically ranging between $400 and $850 without a contract. Or, for a more budget-friendly option, the Huawei Vision 2 and Huawei Ascend Mate 2, which you can buy as an unlocked phone or through Consumer Cellular (consumercellular.com, 888-345-5509) for $80 or $225 without a contract. Consumer Cellular is a top-rated no-contract service provider that also offers discounts to AARP members.

A nice advantage of getting your mom a mainstream phone is that if she masters the Easy/Simple mode (or gets bored with it), and is ready to expand her skills, you can always switch the phone back to the standard operation mode exposing her to more options. You can also add any number of health and safety features to her phone, like what the Touch3 offers, by downloading their apps at greatcall.com/medical-apps.

 



How to Protect Yourself from Osteoporosis Bone Fractures   
  
Feb. 24, 2015


Dear Savvy Senior,

Can a person in their early 50’s have osteoporosis? When I fell and broke my wrist last winter the doctor that treated me told me I might have osteoporosis. What can you tell me?

Worried Ronda
 

Dear Ronda,

While osteoporosis is much more common in older seniors, it can strike at any age. In fact, the National Osteoporosis Foundation estimates that half of women and up to 25 percent of men in the U.S. over the age of 50 will break a bone due to osteoporosis. Here’s what you should know.

 

Who’s at Risk?

Osteoporosis is a disease that causes the bones to become brittle and weak and more susceptible to fractures. Around 10 million Americans already have osteoporosis (80 percent are women) while another 43 million have “pre-osteoporosis,” or osteopenia. But the good news is this disease is both preventable and treatable. 

Most people, by the time they reach their late 30’s, gradually start losing some of their bone mass, but for women, menopause is the time when this process really accelerates. Bone loss for men occurs much more slowly. However, by age 75, osteoporosis is as common in men as it is in women. 

Some of the key risk factors of developing osteoporosis include: being over age 50; being female; menopause; having a family history of the disease; being small and thin; having an eating disorder; not getting enough calcium and vitamin D; getting too much protein, sodium and caffeine; having an inactive lifestyle; smoking; drinking too much alcohol; taking certain medications (see nof.org/articles/6 for a list); and having certain medical conditions (see nof.org/articles/5).

To help you determine your risk of osteoporosis, the National Institutes of Health has a quick, online quiz you can take at bonecheckup.org.

 

Prevention and Treatment

A good first step in preventing and treating osteoporosis is to get screened. For women, that should start around menopause, especially if you’re not taking estrogen, or anyone who has broken a bone after age 50 or who has other risk factors.

All women over 65 and men over 70 should be tested every two years - Medicare covers it. Screening for osteoporosis is a simple, painless, bone density test, which takes about five minutes.

 

Here’s what else you can do to protect your bones.

Boost your calcium: The best way to get bone-building calcium is through your diet.  Dairy products (low-fat milk, cheeses and yogurt), dark green leafy vegetables (broccoli, kale, collards), sardines and salmon, cooked dried beans, soy foods, almonds and fortified cereals and juices are all good sources of calcium. Vitamin D is also important to help you body absorb calcium.

The National Osteoporosis Foundation recommends 1,000 mg of calcium daily for women under age 50 and for men under 70, and 1,200 mg for women 51 and older and for men over 71. Note: Recent studies have found that excess calcium could increase the risk of heart disease.

They also recommend all adults under age 50 get 400 to 800 IU of vitamin D, or 800 to 1,000 IU if you’re over 50. If you’re not getting enough vitamin D through sunlight or food, consider taking a supplement. Most daily multivitamins contain at least 400 IU. 

Exercise: Weight-bearing exercises like walking, and strength training with weights or resistant bands three or four times a week can also significantly improve your bone health.

Control these vices: Avoid smoking, limit alcohol to no more than two or three drinks per day, and limit caffeine (coffee, tea or caffeinated soda) to three cups a day.

Consider medications: The most widely prescribed for osteoporosis are bisphosphonates, a class of drugs designed to slow or stop bone loss. Talk to your doctor about these and other medication options, as well as potential side effects.





 

Do You Need To File A Tax Return in 2015?     
Feb. 18, 2015


Dear Savvy Senior,

What are the IRS income tax filing requirements for retirees this tax season? I didn't have to file last year, but I picked up a little income from a part-time job in 2014, and I'm wondering I need to file this year.

Part-Time Retiree
 

Dear Retiree,

Whether or not you are required to file a federal income tax return this year will depend on how much you earned (gross income) - and the source of that income - as well as your filing status and your age. Your gross income includes all the income you receive that is not exempt from tax, not counting your Social Security benefits, unless you are married and filing separately

Here's a rundown of the IRS filing requirements for this tax season. If your 2014 gross income was below the threshold for your age and filing status, you probably won't have to file. But if it's over, you will.

* Single: $10,150 ($11,700 if you're 65 or older by Jan. 1, 2015).

* Married filing jointly: $20,300 ($21,500 if you or your spouse is 65 or older; or $22,700 if you're both over 65).

* Married filing separately: $3,950 at any age.

* Head of household: $13,050 ($14,600 if age 65 or older).

* Qualifying widow(er) with dependent child: $16,350 ($17,550 if age 65 or older).

To get a detailed breakdown on federal filing requirements, along with information on taxable and nontaxable income, call the IRS at 800-829-3676 and ask them to mail you a free copy of the “Tax Guide for Seniors” (publication 554), or see irs.gov/pub/irs-pdf/p554.pdf.

 

Special Requirements

There are, however, some other financial situations that will require you to file a tax return, even if your gross income falls below the IRS filing requirement. For example, if you had earnings from self-employment in 2014 of $400 or more, or if you owe any special taxes to the IRS such as alternative minimum tax or IRA tax penalties, you'll probably need to file.

To figure this out, the IRS offers a tool on their website that asks a series of questions that will help you determine if you're required to file, or if you should file because you're due a refund.

You can access this page at irs.gov/filing - click on “Do you need to file a return?” Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040. You can also get face-to-face help at a Taxpayer Assistance Center. See irs.gov/localcontacts or call 800-829-1040 to locate a center near you.

 

Check Your State

Even if you're not required to file a federal tax return this year, don't assume that you're also excused from filing state income taxes. The rules for your state might be very different. Check with your state tax agency before concluding that you're entirely in the clear. For links to state and local tax agencies see taxadmin.org - click on “State Agencies/Links” on the menu bar.

 

Tax Prep Assistance

If you find that you do need to file a tax return this year, you can get help through the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low-income taxpayers, age 60 and older. Call 800-906-9887 or visit irs.treasury.gov/freetaxprep to locate a service near you.

Also check with AARP, a participant in the TCE program that provides free tax preparation at more than 5,000 sites nationwide. To locate an AARP Tax-Aide site call 888-227-7669 or visit aarp.org/findtaxhelp. You don't have to be an AARP member to use this service.



 

 

Who should buy long-term care insurance?     
Feb. 10, 2015


Q: Is there a good rule of thumb on who should buy a long-term care insurance policy? My wife and I have a few assets we’d like to protect but we hate the idea of paying expensive monthly premiums for a policy we may never use.

A: There are two key factors - your financial situation and health history - you need to mull over that can help you decide if buying a long-term care (LTC) insurance policy is a wise decision for you and/or your wife. Currently, only around 8 million Americans own a policy. Here’s what you should know.

 

LTC Insurance?

As the cost of LTC (which includes nursing home, assisted living and in-home care) continues to skyrocket, it’s important to know that most people pay for LTC either from personal savings or Medicaid when their savings is depleted, or through a LTC insurance policy. National median average costs for nursing home care today is over $87,000 per year, while assisted living averages $42,000/year.

While national statistics show that about 70 percent of Americans 65 and older will need some kind of LTC, most people do not need to purchase a LTC insurance policy.

In fact, according to a recent study at the Boston College Center for Retirement Research only 19 percent of men and 31 percent of women should actually get one.

The reasons stem from a range of factors, including the fact that relatively few people have enough wealth to protect to make purchasing a policy worthwhile. Seniors with limited financial resources who need LTC turn to Medicaid to pick up the tab after they run out of money.

Another important factor is that most seniors who need LTC only need it for a short period of time - for example, when they’re recovering from surgery. For those people, Medicare covers in-home health care and nursing home stays of 100 days or less following a hospital stay of more than 3 consecutive days.

 

So who should consider buying a policy?

LTC insurance policies make the most sense for people who can afford the monthly premiums, and who have assets of at least $150,000 or more that they want to protect - not counting their home and vehicles.

Another factor to weigh is your personal health and family health history. The two most common reasons seniors need extended long-term care is because of dementia and/or disability. And, almost half of all people who live in nursing homes are 85 years or older. So, what’s your family history for Alzheimer’s, stroke or some other disabling health condition, and do you have a family history of longevity? The U.S. Surgeon General offers a free tool at familyhistory.hhs.gov to help you collect, organize and evaluate your genetic risks.

You also need to factor in gender too. Because women live and average of 5 years longer than men, they are at greater risk of needing extended LTC.

 

LTC policy shopping

After evaluating your situation, if you’re leaning towards buying a LTC policy, be sure to do your homework. The cost of premiums can vary greatly (ranging anywhere between $1,200 and $8,000 per year for a couple) depending on your age, the insurer, and the policy’s provisions. To help you find a policy, get a long-term care insurance specialist who works with a variety of companies. See aaltci.org to locate one. Also shop insurers like Northwestern Mutual and New York Life, who work only with their own agents.

If you want to save money, find out if your state offers a LTC partnership program (see aaltci.org/partnership). Under these programs, if you buy a long-term care policy approved by your state Medicaid agency, you can protect an amount of assets from Medicaid equal to the benefits that your policy pays out.






How to make your bathroom safer   
  
Feb. 3, 2014


Q: What tips do you recommend for making a bathroom safer and more functional for seniors. My 79-year-old mother slipped and fell getting out of the shower last month, and I’d like to modify her bathroom a bit with some safety features that can help protect her.
 

A: Because more accidents and injuries happen in the bathroom than any other room in the house, this is a very important room to modify for aging in place. Depending on your mom’s needs, here are some tips for each part of the bathroom that can make it safer and easier to use.

Flooring: To avoid slipping, a simple fix is to get non-skid bath rugs for the floors. Or if you want to put in a new floor get slip-resistant tiles, rubber or vinyl flooring, or install wall-to-wall carpeting.

Lighting: Good lighting is also very important, so install the highest wattage bulbs allowed for your mom’s bathroom fixtures, and get a plug-in nightlight that automatically turns on when the room gets dark.

Bathtub/shower: To make bathing safer, purchase a rubber suction-grip mat, or put down adhesive nonskid tape on the tub/shower floor. And have a carpenter install grab bars in and around the tub/shower for support.

If your mom uses a shower curtain, install a screw or bolt-mounted curtain rod, versus a tension-mounted rod, so that if she loses her balance and grabs the shower curtain the rod won’t spring loose.

If your mom has mobility issues or balance problems, get her a shower or bathtub seat so she can bathe from a seated position. In addition, you may also want to get a handheld, adjustable-height showerhead installed that will make washing while sitting down easier.

Another, pricier option is to install a walk-in-bathtub or a prefabricated curbless shower. Walk-in tubs have a door in front that provides a much lower threshold to step over than a standard tub. They also typically have a built-in seat, handrails and a slip resistant bottom, and some have therapeutic spa features with whirlpool water jets and/or bubble massage air jets.

Curbless showers have no threshold to step over, and typically come with a built-in seat, grab bars, slip resistant floors and an adjustable handheld showerhead. Prefabricated curbless showers and walk-in-tubs typically cost anywhere between $2,500 and $10,000 installed.

Toilet: Most toilets are about 14 to 16 inches high which can be an issue for many people with arthritis, back, hip or knee problems. To raise the toilet height, which can make sitting down and getting back up a little easier, you can purchase a raised toilet seat that clamps to the toilet bowl, and/or purchase toilet safety rails that sit on each side of the seat for support. Or, you can install an ADA compliant toilet that ranges between 17 and 19 inches high.

Faucets: If your mom has twist handles on the sink, bathtub or shower faucets, replace them with lever handle faucets. They’re easier to operate, especially for seniors with arthritis or limited hand strength. Also note that it only takes 130-degree water to scald someone, so turn her hot water heater down to 120 degrees.

Entrance: If your mom needs a wider bathroom entrance to accommodate a walker or wheelchair, install some “swing clear” offset hinges on the door which will widen the doorway an additional two inches.

Emergency assistance: As a safety precaution, purchase a waterproof phone for the bathroom or get a medical alert device (SOS emergency call button) that your mom could wear in case she falls and needs to call for help.

You can find all of the products suggested in this column at either medical supply stores, pharmacies, big-box stores, home improvement stores, hardware and plumbing supply stores as well as online.

 

 

How to take care of your kidneys   
  
Jan. 27, 2015


Q: What can you tell me about kidney disease? My mother died from kidney failure a few years ago at age 76, and I’m curious what my risks are and what I can do to protect myself.

A: Anyone who has a family history of kidney disease, or who has high blood pressure or diabetes is at risk and needs to have their kidneys tested. Here’s what you should know and some tips to help you take care of your kidneys.

 

Kidney disease

More than 26 million Americans currently have chronic kidney disease (when the kidneys can’t properly do their job of cleaning toxins and wastes from the blood), and millions more are at risk of developing it, yet most people don’t realize it. That’s because kidney disease develops very slowly over many years before any symptoms arise. But left untreated, the disease can eventually require people to spend hours hooked up to a dialysis machine or get a kidney transplant. Even mild kidney problems can double a person’s risk of heart attack and stroke, as well as cause anemia and bone disease.

The reason kidney disease has become so widespread today is because of the rise of obesity, type-2 diabetes and high blood pressure which all strain the kidneys.

Another factor is the increasing number of people who take multiple medications, which can overtax the organs. People over age 60 are especially vulnerable both because they tend to take more drugs, and because kidney function normally declines somewhat with age.

To help you rate your risk of kidney disease, the National Kidney Foundation has a quick, online quiz you can take at kidney.org.

 

Get tested

Because kidney disease has no early symptoms, the only way to catch it before it advances is to have a simple blood and urine test by your doctor. So, if you have diabetes, high blood pressure or heart disease, a family history of kidney disease, or are age 60 or older you need to get tested. African, Hispanic, Asian and Indian Americans along with Pacific Islanders are also at increased risk.

If you’re diagnosed with kidney disease you need to know that there’s no cure, but there are steps you can take to help contain the damage, including: 

Control your blood pressure: If you have high blood pressure, get it under 130/80. If you need medication to do it, ACE inhibitors and ARBs are good choices because of their proven ability to protect the kidneys.

Control your diabetes: If you have diabetes, keep your blood sugar as close to normal as possible.

Change your diet: This usually means reducing the amount of protein and phosphorus you eat, and cutting back on sodium and possibly potassium. Your doctor can help you determine an appropriate eating plan, or you may want to talk to a dietitian. Also see myfoodcoach.kidney.org where you’ll find lots of kidney friendly recipes and nutrition tips.

Watch your meds: Dozens of commonly used drugs can damage the kidneys, especially when taken in high doses over long periods - most notably NSAIDs like ibuprofen (Advil, Motrin and generic) and naproxen (Aleve, Naprosyn and generic). Herbal supplements can also be very dangerous. Talk to your doctor about all the prescription, over-the-counter and herbal products you take to identify potential problems and find alternatives.

Exercise and lose weight: If you’re overweight and inactive, start an aerobic fitness routine (walk, swim, cycle, etc.) that gets your heart pumping. This will help lower your blood pressure, control diabetes and help you lose excess weight all of which will help your kidneys.

Quit smoking: If you smoke, quit. Heart disease becomes a much greater risk to the kidneys if your smoke. Smoking also doubles the rate of progression to end-stage renal failure.

 

 

 

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