SAVVY SENIOR
How to protect your eyes from macular degeneration  

 

July 30, 2015

Jim Miller

 

Dear Savvy Senior,

Is macular degeneration hereditary? My mother lost her vision from it before she died a few years ago, and now at age 65, I’m worried I may get it. What can you tell me?

Nearsighted Susan
 

Dear Susan,

Having a parent or sibling with macular degeneration does indeed increase your risk three to four times. But the good news is there are things you can do to protect your eyesight, and a number of treatments that are available if you do happen to get it. Here’s what you should know.
 

What is AMD?

Macular degeneration, also known as age-related macular degeneration (or AMD) is the most common cause of vision loss in people over age 50, affecting about 10 million Americans.

AMD is a progressive eye disease that damages the macula, the part of the eye that allows us to see objects clearly, causing vision loss in the center of your vision. This affects the ability to read, drive, watch television and do routine daily tasks, but it does not cause total blindness.

There are two types of AMD - wet and dry. Dry AMD, which affects about 90 percent of all people that have it, progresses slowly and painlessly over a period of years. While wet AMD is much more aggressive and can cause severe vision loss in a matter of weeks or months.

Factors that can increase your risk of getting AMD include age (60 and older); smoking; excessive exposure to sunlight especially if you have light-colored eyes; certain genetic components; a family history of AMD; high blood pressure; obesity; and being Caucasian.

For anyone over the age of 60, it’s a smart idea to get your eyes examined by an ophthalmologist every year. They can spot early signs of AMD before vision loss occurs. Early signs, however, may include shadowy areas in your central vision or unusually fuzzy or distorted vision. The Amsler grid at amslergrid.org, is a good tool to check your eyes for AMD.

 

Preventing AMD

While there’s currently no cure for AMD there are some things you can do if you’re high risk. One option is to talk to your doctor about taking a daily dose of antioxidant vitamins and minerals known as AREDS - vitamins C and E, plus copper, lutein, zeaxanthin, and zinc. Studies by the National Eye Institute have shown that AREDS can reduce the risk by about 25 percent that dry AMD will progress.

Most drug stores sell these eye supplements in tablet or soft gel form over-the-counter for around $20 to $30, but be aware that not all eye supplements contain the proper formulation. Choose either the PreserVision Eye Vitamin AREDS Formula, PreserVision Eye Vitamin Lutein Formula, PreserVision AREDS2 Formula, or ICAPS AREDS. These four options contain the right formula mix.

Other lifestyle adjustments that may help prevent or delay AMD include eating antioxidant-rich foods such as dark green, leafy vegetables, and cold-water fish for their omega-3 fatty acids; protecting your eyes from the sun by wearing UV protective sunglasses; controlling high blood pressure; exercising regularly; and if you smoke, quit.

 

Wet AMD Treatments

For wet AMD, there are several effective medications (Lucentis, Avastin and Eylea) available that can stop vision loss and may even restore it. These medications are given by injection into the eye, and repeated every month or two, perhaps indefinitely.

Note that each of these three drugs works equally in treating wet AMD, but there’s a big cost difference. Avastin costs just $50 per month, compared with $2,000 for the other two. So experts recommend Avastin as the first choice for most people with wet AMD, especially if you don’t have supplemental Medicare coverage.



 

 

How to choose the best place to retire    
July 23, 2015


Dear Savvy Senior,

My wife and I will both be retiring in a year or two and are interested in moving to a smaller house in a better climate but could use some help. What resources can you recommend for locating and researching good places to retire in the U.S.?

Looking To Relocate

 

Dear Looking,

If you’re interested in relocating when you retire, like millions of other baby boomers, there are a wide variety of free Web-based resources that can help you find and research a new location that meet your wants, needs and budget. Here are several to help you get started.

 

Where to retire?

If you aren’t sure where you want to retire, a good place to begin is by taking a retirement test at sites like Sperling’s Best Places (bestplaces.net/fybp) or Find Your Spot (findyourspot.com). These are free quizzes that ask dozens of questions on your preferences such as climate, recreation, community size and more, and suggest possible destinations that best match your answers.

There are also various media sources and websites, like U.S. News and World Report, Kiplinger’s, Forbes, Money magazine, Reuters, Bankrate.com, TopRetirements.com, the Milken Institute and AARP that publish top retirement location lists you may find helpful too. To find them, go to any search engine and type in “best places to retire” along with the name of the media source.

You should also consider getting a subscription to “Where to Retire” magazine (wheretoretire.com, 713-974-6903), which is designed to help you find ideal retirement settings. A yearly subscription runs $18 for six issues.
 

Once you find a few areas that interest you, your next step is research them. Here are some important areas you need to investigate.

- Cost of living: Can you afford to live comfortably in the location you want to retire to? BestPlaces.net and Numbeo.com offer tools to compare the cost of living from your current location to where you would like to move. They compare housing costs, food, utilities, transportation and more.

- Taxes: Some states are more tax friendly to retirees than others. If you’re planning to move to another state, Kiplinger’s has a tax guide for retirees at Kiplinger.com/links/retireetaxmap that lets you find and compare taxes state-by-state. It covers income taxes, sales tax, taxes on retirement income, Social Security benefits taxes, property taxes, and inheritance and estate taxes.

- Crime rate: To evaluate how safe a community or area is, NeighborhoodScout.com is a top tool that provides property and violent crime rates, and crimes per square mile.

- Health care: Does the area you want to relocate to have easy access to good healthcare? To locate and research hospitals in a new area, use HospitalCompare.hhs.gov and QualityCheck.org. To search for new doctors that accept your insurance, contact your plan, or, if you’re 65 or older use Medicare.gov/physiciancompare. It’s also important to know that healthcare costs can vary by region, so you should contact your insurer to check out possible cost variables.

- Transportation: If you plan to travel much, or expect frequent visits from your kids or grandkids, convenient access to an airport or train station is a nice advantage. You should also investigate alternative transportation options, since most retirees give up driving in there eighties. To do this contact Rides in Sight (ridesinsight.org, 855-607-4337), a free transportation referral service, and the Area Aging Agency - call the Eldercare Locator at 800-677-1116 to get the local number.

 

Other resources            

To learn more about specific communities across the U.S., AARP’s new livability index (livabilityindex.aarp.org) along with Epodunk.com and GangsAway.com are three excellent resources, as well as the city’s chamber of commerce office. To locate it, go to any search engine and type in the name of the city and state followed by “chamber of commerce.”





 

When and how Social Security checks are delivered    
July 23, 2015


Dear Savvy Senior,

I plan to apply for my Social Security benefits in September. When can I expect my first check? And, is direct deposit my only option for receiving my monthly payment?

Almost Eligible

 

Dear Almost,

Generally, Social Security retirement benefits (as well as disability and survivor benefits) are paid in the month after the month they are due. So, if you apply for your Social Security benefits in September, you will receive your September benefits in October.

The day of the month you receive your benefit payment, however, will depend on either your birthdate, or the birthdate of the person whose work record you’re receiving benefits on.

If you’re applying for benefits as a retired worker, your benefit payment day will be determined by your own birthdate. But if you’re applying for spousal or survivors benefits based on your spouse’s or (if you were married at least 10 years) ex-spouse’s work record, your benefit payment date will be determined by his or her birthdate. Here’s the schedule of when you can expect to receive your monthly check:

*           Birthdate is 1st through 10th of month: Payment day is second Wednesday of each month.

*           Birthdate is 11th through 20th of month: Payment day is third Wednesday of each month.

*           Birthdate is after the 20th of the month: Payment day is fourth Wednesday of each month.

There are, however, a few exceptions to this schedule. For example, if the day your Social Security check is supposed to be deposited happens to be a holiday, your check will be deposited the previous day. And, if you are receiving both Social Security benefits and SSI payments, your Social Security check will be deposited on the third day of the month.

You should also know that Social Security beneficiaries who started receiving benefits before 1997, their Social Security checks are paid on the third day of the month.

To get a complete schedule of 2015 payment dates, visit ssa.gov/pubs/EN-05-10031-2015.pdf.

 

Direct deposit delivery

There are two ways you can receive your Social Security benefits today. Most beneficiaries choose direct deposit into their bank or credit union account because it’s simple, safe and secure. But, if you don’t like this option or if you don’t have a bank account that your payments can be deposited into, you can get a Direct Express Debit MasterCard and have your benefits deposited into your card’s account.

This card can then be used to get cash from ATMs, banks or credit union tellers, pay bills online and over the phone, make purchases at stores or locations that accept Debit MasterCard and get cash back when you make those purchases, and purchase money orders at the U.S. Post Office. The money you spend or withdraw is automatically deducted from your account. And you can check your balance any time by phone, online or at ATMs.

There’s also no cost to sign up for the card, no monthly fees and no overdraft charges. There are, however, a few small fees for optional services you need to be aware of, like multiple ATM withdrawals. Currently, cardholders get one free ATM withdrawal per month, but additional monthly withdrawals cost 85 cents each not including a surcharge if you use a non-network ATM. To learn more about the Direct Express Debit MasterCard, visit usdirectexpress.com or call 800-333-1795.






Choosing a Home Blood Pressure Monitor 
  
July 10, 2015


Dear Savvy Senior,

Can you recommend some basic simplified cellphones for seniors with hearing loss? My 82-year-old father needs to get a new cellphone for occasional calls or emergencies, but he needs something that’s easy to use and one that he can hear on.

Looking Around
 

Dear Looking,

There are several simplified cellphones on the market today that are specifically designed for seniors - including those with hearing loss. These are basic cellphones that come with big buttons, easy to navigate menus, SOS emergency buttons, enhanced sound and are hearing aid compatible too. Here are some top options.
 

Senior-friendly phones

If your dad isn’t locked into a cellphone contract, there are three senior-friendly options to consider, all from no-contract cellphone companies.

One of best is GreatCall’s Jitterbug5 (greatcall.com, 800-918-8543). This custom designed Samsung flip-phone offers a backlit keypad with big buttons, large text on a brightly colored screen, and “YES” and “NO” buttons to access the phone’s menu of options versus confusing icons.

It also offers voice dialing, a powerful speakerphone, a built-in camera, and a variety of optional health and safety features like the “5Star” medical alert button that would let your dad call for help and speak to a certified agent 24/7 that could identify his location and dispatch help as needed. “Urgent Care,” which provides access to registered nurses and doctors for advice and diagnoses. And “GreatCall Link,” which keeps family members informed through your dad’s phone activities.

The Jitterbug5 sells for $99 with a one-time $35 activation fee, no-contract, and calling plans that start at $15 per month.

If you’re looking for something a little less expensive, the Doro PhoneEasy 626 sold through Consumer Cellular (consumercellular.com, 888-345-5509) is an excellent option.

This flip phone offers a backlit, separated keypad that can speak the numbers as you push them, which is a nice feature for seniors with vision problems. It also has a big easy to read color display screen that offers large text with different color themes.

Other handy features include two speed dial buttons, shortcut buttons to texting and the camera, a powerful two-way speakerphone, and a ICE (in case of emergency) button on the back of the phone that will automatically dial one preprogramed number.

The Doro 626 sells for $50 with service plans starting at $10 per month, and no long-term contract. They even offer discounts to AARP members.

Another budget-friendly cellphone you should look into is the Snapfon ezTWO for seniors (snapfon.com, 800-937-1532), which costs under $20, with a $35 activation fee, no-contract, and monthly service plans that start at $10. If you don’t want the Snapfon service plan (you can go through AT&T or T-Mobile), the phone is $80.

This is a bar-style phone that provides big buttons, a color screen, enhanced volume with a speaker phone, a speaking keypad, and an SOS emergency alert button on the back of the phone that can sound an alert when pushed and held down for five seconds. It then sends a text message to as many as five emergency contacts and calls those contacts in order until the call is answered. Or, for an additional $15 per month you can subscribe to their SOS monitoring service that will dispatch help as needed.

 

Shared plan options

If you want to get your dad a simple cellphone through your cellphone provider, most carriers - like AT&T, Verizon, Sprint and T-Mobile - still offer a few basic cellphones that are inexpensive and hearing aid compatible.

If you’re an AT&T customer the option is the “LG A380.” For Verizon users, there’s the “Samsung Gusto 3” and “LG Revere 3.” If you’re a Sprint customer there’s the “Kyocera Kona” and “Alcatel OneTouch Retro.” And for T-Mobile users there’s the “LG 450.”





How seniors can tame pet care costs  
  
July 2, 2015

Dear Savvy Senior,

What tips can you recommend to help senior pet owners with their veterinary bills? I have two cats and a dog that are family to me, but their vet bills have become unaffordable.

Fix Income Frankie
 

Dear Frankie,

The high cost of veterinary care has become a problem for millions of pet owners today, but it can be especially difficult for seniors living on a fixed income. Routine medical care can cost hundreds of dollars, while urgent/specialized treatments and procedures can run into the thousands. But, it is possible to reduce your pet care costs without sacrificing their health. Here are some tips that can help you save.

Shop around: If you’re not attached to a particular veterinarian, call some different vet clinics in your area and compare costs. When you call, get price quotes on basic services like annual exams and vaccinations, as well as bigger-ticket items, like to repair a broken leg, so you can compare. Also, check to see if you live near a veterinary medical school (see aavmc.org for a listing). Many schools provide low-cost care provided by students who are overseen by their professors.

Ask your vet for help: To help make your vet bills more manageable, see if your vet’s office accepts monthly payments so you don’t have to pay the entire cost up front. Also, find out if your vet offers discounts to senior citizens or reduces fees for annual checkups if you bring in multiple pets.

Search for low-cost care: Many municipal and nonprofit animal shelters offer free or low-cost spaying and neutering programs and vaccinations, and some work with local vets who are willing to provide care at reduced prices for low-income and senior pet owners. Call your local shelter or humane society to find out what’s available in your area.

Look for financial assistance: There are a number of state and national organizations that provide financial assistance to pet owners in need. To locate these programs, the U.S. Humane Society provides a listing on their website that you can access at humanesociety.org/petfinancialaid.

Buy cheaper medicine: Medicine purchased at the vet’s office is usually much more expensive than you can get from a regular pharmacy or online. Instead, get a prescription from your vet (ask for generic is possible) so you can shop for the best price.

Most pharmacies such as Walgreens, CVS, Walmart, Kmart, Rite Aid and Target fill prescriptions for pets inexpensively, so long as that same drug is also prescribed to humans. And, many pharmacies offer pet discount savings programs too.

You can also save by shopping online at one of the Veterinary-Verified Internet Pharmacy Practice Sites accredited by the National Association of Boards of Pharmacy, like 1-800-PetMeds (1800petmeds.com), Drs. Foster & Smith (drsfostersmith.com), KV Supply (kvsupply.com), and PetCareRx (petcarerx.com).

Consider pet insurance: If you can afford it, pet insurance is another option worth looking into. You can get a basic policy for under $10 per month, and some insurers provide discounts for insuring multiple pets. See petinsurancereview.com to compare policies. Membership discount plans like Pet Assure (petassure.com) are another way to save, but you’ll need to use a vet in their network.

Look for other ways to save: In addition to cutting your veterinary bills, you can also save on pet food and other supplies depending on where you shop. Target, Walmart, Costco and the dollar stores typically offer much lower prices than supermarkets and specialty retailers like Petco and PetSmart. You can also save on treats and toys at sites like coupaw.com and doggyloot.com.

 

 

Helping seniors learn new technology     
June 24, 2015


Dear Savvy Senior,

What teaching resources can you recommend to help seniors learn how to use computers, tablets and smartphone devices? At age 72, I am interested in joining the technology revolution so I can keep up with my kids and grandkids a little better, but I need help.

Technology Novice

 

Dear Novice,

There are lots of different technology teaching tools available to boomers and seniors today, but what’s available to you will depend on where you live. Here are some different places and to look for help.

 

Local Classes and Workshops

There are many communities that offer beginning computer and personal technology classes for older adults that are new to technology. To find out what’s available in your area, contact your local public library, senior center, college or university, or local stores that sell computers. Your Area Agency on Aging may also be able to help you - call the Eldercare Locator at 800-677-1116 to get your local number. If you can’t find any local programs that meet your needs, here are some national resources that offer technology training in select locations.

SeniorNet: This organization offers a variety of basic online computer courses as well as instructor-led workshops at 36 learning centers throughout the United States. A first year membership fee of $43 is required. See SeniorNet.org or call 239-275-2202 for more information.

Oasis Connections: Provides primarily free computer, Internet and mobile technology classes in 30 U.S. cities. They partner with local libraries, job help centers, senior centers and faith-based organizations where these classes are offered. OasisNet.org/connections, 314-862-2933 ext. 272.

Lifelong Learning Institutes (LLIs): Usually affiliated with colleges and universities, LLIs offer a wide array of noncredit courses to retirees, and some may offer technology courses. To find an LLI that offers computer/technology classes, contact your closest colleges or search the websites of the two organizations that support and facilitate them - Osher (osher.net) and Elderhostel (roadscholar.org/ein/intro.asp). Together they support around 500 LLI programs nationwide.

AARP TEK Workshops: Available to everyone, TEK workshops are free technology learning events on tablets or smartphones and are offered in various cities throughout the U.S. AARPTEK.org, 202-434-3021.

Older Adults Technology Services (OATS): If you live in New York City, OATS provides free tech training to seniors in 70 locations throughout the city. OATS.org, 718-360-1707.

 

How-To Books

There are also a wide variety of books you can purchase that can help you learn how to use different types of technologies. Visual Steps (visualsteps.com), for example, offers a number of practical and accessible computer handbooks, software user guides and other instructional materials that are tailored specifically for seniors, as does the “For Dummies” books (dummies.com), which you can buy in book stores nationwide or online at sites like Amazon.com and BarnesandNoble.com.

 

Online Instructional Services

If you already have a computer and some computer and/or Internet skills, but would like to expand your knowledge, there are a number of online services you can turn to that offer a wide variety of self-paced technology lessons and instructional videos.

Some good ones to checkout include GCFLearnFree.org, which is supported by the Goodwill Community Foundation and is completely free to use. And MyPCSchool.com, which is privately owned and offers nearly 700 lessons for $39 for three months or $79 for one year.

Also check out TechBoomers.com, a free educational website that teaches seniors with basic computer skills about frequently used websites, and Geekatoo.com, which offers tech support house calls in all 50 states, and offers two-hour tutorial instruction for $79.

 

 

Choosing a Home Blood Pressure Monitor    
June 18, 2015


Dear Savvy Senior,

Can you offer me any tips on choosing a home blood pressure monitor? I just found out I have high blood pressure, and my doctor told me I need a monitor for the house so I can keep an eye on it.

Shopping Around
 

Dear Shopping,

Almost everyone with high blood pressure or prehypertension should have a home blood pressure monitor. Home monitoring can help you keep tabs on your blood pressure in a comfortable setting. Plus, if you’re taking medication it will make certain it’s working, and alert you to a health problem if it arises. Here are some tips to help you choose a good monitor.
 

Types of Monitors

The two most popular types of home blood pressure monitors on the market today are (electric and/or battery powered) automatic arm monitors, and automatic wrist monitors.

With an automatic arm monitor, you simply wrap the cuff around your bicep and with the push of one button the cuff inflates and deflates automatically giving you your blood pressure reading on the display window in a matter of seconds.

Wrist monitors work similarly, except they attach to the wrist. Wrist monitors are also smaller in size and a bit more comfortable to use than the arm monitors, but they tend to be a little less accurate.

To help you choose the best monitor for you, here are several things you need to check into:

*           Fit: Using a cuff that’s the wrong size can result in a bad reading. Most arm models have two sizes or an adjustable cuff that fits most people. Make sure your choice fits the circumference of your upper arm.

*           Accuracy: Check the packaging to make sure the monitor has been independently tested and validated for accuracy and reliability. You can see a list of validated monitors at dableducational.org.

*           Ease of use: Be sure the display on the monitor is easy to read and understand, and that the buttons are big enough. The directions for applying the cuff and operating the monitor should be clear.

*           Extra features: Many monitors come with additional features such as irregular heartbeat detection that checks for arrhythmias and other abnormalities; a risk category indicator that tells you whether your blood pressure is in the high range; a data-averaging function that allows you to take multiple readings and get an overall average; multiple user memory that allows two or more users to save previous readings; and computer connections so you can download the data to your computer. 

*           Portability: If you plan to take your monitor with you while traveling, look for one with a carrying case.

 

Where to Shop

You can find blood pressure monitors at pharmacies, medical supply stores or online, and you don’t need a prescription to buy one.

The price will typically range anywhere from $30 to $120 or more. Unfortunately, original Medicare does not pay for home blood pressure monitors unless you’re receiving dialysis at home. But if you have a Medicare Advantage plan or a private health insurance policy it’s worth checking into, because some plans may provide coverage.

Some of the best arm monitors as recently recommended by Consumer Reports include the Rite Aid Deluxe Automatic BP3AR1-4DRITE; iHealth Dock BP3 (requires an Apple iOS device); Omron 10 Series BP786; A&D Medical UA767F; and the ReliOn BP200. And the top recommended wrist monitor is the Omron 7 Series BP652.

After you buy a monitor, it’s a good idea to take it to your doctor’s office so they can check its accuracy and teach you the proper techniques of how and when to use it.

For more information on how to measure your blood pressure accurately at home, see the American Heart Association Blood Pressure Monitoring tutorial page at homeBPmonitoring.org.

 

 

How to compare and locate senior housing options  
  
June 11, 2015


Dear Savvy Senior,

Can you go over the different types of housing options available to seniors, and recommend some good resources for locating and choosing one? I need to find a place for my elderly mother, and could use some help.

Searching Daughter
 

Dear Searching,

There’s a wide array of housing options available to seniors, but what’s appropriate for your mom will depend on her needs and financial situation. Here’s a rundown of the different levels of senior housing and some resources to help you search.

Independent living: If your mom is in relatively good health and is self-sufficient, “independent living communities” are a good place to start. Typically available to people over age 55, this type of senior housing is usually apartments or town homes that are fully functional. In addition, many of these communities also offer amenities such as meals served in a common dining area, housekeeping, transportation and a variety of social activities.

To locate this type of housing, contact your Area Agency on Aging (call 800-677-1116 to get your local number), or use online services like newlifestyles.com and caring.com. Most of these communities are private-pay only, and run anywhere from $1,000 to over $4,000 per month. 

If that’s too expensive, another option is “senior apartments,” which are often subsidized by HUD for lower income seniors. You can locate these through your local housing authority or online at hud.gov - click on “Find Rental Assistance.”

Assisted living: If your mom needs some help with daily living activities, an “assisted living facility” is another option. These facilities provide personal care (like bathing, dressing, eating, going to the bathroom) as needed, as well as meals, housekeeping, transportation, social activities and medication management. Many facilities also offer special care units for residents with dementia. Costs typically run between $2,000 to $5,000 or more per month. Most resident’s pay for assisted living from personal funds, and some have long-term care insurance policies. But, some states now have voucher plans that let you use Medicaid money.

Another similar, but less expensive option to look into is “board and care homes.” These offer many of the same services as assisted living facilities but in a much smaller home setting. 

Your Area Aging Agency is again a good resource for finding these facilities, as are the previously listed senior housing locater websites. And for help choosing a facility, the Assisted Living Federation of America offers an excellent guide at alfa.org/checklist.

Nursing homes: If your mom needs ongoing medical and personal care, a “nursing home,” which provides 24-hour skilled nursing care, is the next option. To find a good one, use Medicare’s nursing home compare tool at medicare.gov/nursinghomecompare. But be aware that nursing home care is very expensive, costing anywhere between $4,500 and $11,000 per month depending on location. Most residents pay from either personal funds, a long-term care insurance policy, or through Medicaid after their savings are depleted.

Continuing-care retirement communities (CCRC’s): If your mom has the financial resources, a “CCRC” is another excellent option that provides all levels of housing (independent living, assisted living and skilled nursing home care) in one convenient location. But, these communities typically require a hefty entrance fee that can range from $20,000 to $500,000 or more, plus ongoing monthly service fees that vary from around $1,000 to over $5,000. For more information see carf.org/aging.

 

Need Help?

Consider hiring an aging life care expert (aginglifecare.org) who can evaluate your mom’s situation, and find appropriate housing for a fee - usually between $300 and $800. Or, you can use a senior-care advising service like A Place for Mom (aplaceformom.com, 866-344-8005) for free. (They get paid from the senior living facilities in their network.)

Some other helpful resources include the National Clearinghouse for Long-Term Care Information (longtermcare.gov), and your State Health Insurance Assistance Program (shiptalk.org), which provides free counseling.

 



 

Home Improvement Assistance Programs for Seniors      
June 4, 2015


Dear Savvy Senior,

Do you know of any financial assistance programs or other resources that can help seniors with home improvement projects? I would like to help my 86-year-old father make a few modifications to his house so he can live there as long as possible, but money is very tight.

Inquiring Daughter

Dear Inquiring,

There are actually a number of programs available that can help seniors with home repairs and improvement projects for aging-in-place, but what’s available to your dad will depend on his financial situation and where he lives. Here are some different options to explore:

Medicaid waivers: If your dad is low-income and eligible for Medicaid, most states have Medicaid Home and Community Based Services waivers that provide financial assistance to help seniors avoid nursing homes and remain living at home. Many of the waivers pay for home modifications to increase a person’s ability to live independently. Each state has different waivers with different eligibility requirements and benefits. Contact your Medicaid office (see medicaid.gov) for more information.

State and local programs: Some states and local governments have financial assistance programs, often called “nursing home diversion programs” or “deferred payment loans” that are not funded by Medicaid. These programs, which may include grants or loans or a combination, helps pay for modifications that enable low to moderate income elderly and disabled to remain living at home. Modifications covered typically include accessibility improvements like wheelchair ramps, handrails and grab bars. And some may be used for home improvements like roofing, heating and cooling, insulation, weather-stripping and storm windows.

To find out if there’s a program in your dad’s area, contact the city or county housing authority, the local Area Aging Agency (call 800-677-1116 for contact information) or the state housing finance agency - see ncsha.org/housing-help.

Federal programs: The Department of Housing and Urban Development offers HUD Home Improvement Loans, which are HUD insured loans made by private lenders for home improvement and building projects. Contact a HUD approved counseling agency in your area (call 800-569-4287) to learn more.

And the U.S. Department of Agriculture has a Rural Development program that provides grants and loans to low-income, elderly or disabled, rural homeowners for home repairs and improvements. Your local USDA service center (see offices.sc.egov.usda.gov) can give you more for information.

Veteran benefits: If your dad is a veteran with a disability, the VA provides grants like the SAH, SHA and HISA grants that will pay for home modifications. See benefits.va.gov/benefits/factsheets/homeloans/sahfactsheet.pdf for details and eligibility requirements.

Another possibility that’s available to veterans enrolled in the Medical Benefits Package is Veterans-Directed Home and Community Based Services. This program provides veterans who need help with daily living activities with financial assistance to help them remain living in their homes, and provides them with a certain amount of discretion to use those funds. To learn more see va.gov/geriatrics, or call 800-827-1000.

Nonprofit organizations: Depending on where your dad lives, he may also be able to get home repair and modification services through the national, non-profit organization Rebuilding Together (rebuildingtogether.org, 800-473-4229). They provide services to low-income seniors, veterans and military families, families with children, people living with disabilities and victims of disaster.

You should also check with the Area Aging Agency to see if any other local organizations that offer volunteer home modification help to low-income seniors.

Reverse mortgages: Available to seniors 62 and older who own their own home, or owe only a small balance, and are currently living there, a reverse mortgage (see reversemortgage.org) will let your dad convert part of the equity in his home into cash - which can be used for home improvements - that doesn’t have to be paid back as long as he lives there. But, reverse mortgages are expensive loans, so this should be a last resort.




How to find and choose a new doctor  
  
May 28, 2015


Dear Savvy Senior,

What resources can you recommend to help me find and research some doctors in my area? I’m looking for a good primary care doctor or internist for my elderly parents, and need to locate a good orthopedic doctor for me.  

Shopping for Doctors

 

Dear Shopping,

Thanks to the Internet, finding and researching doctors is a lot easier than it use to be. Today, there’s a wide variety of websites you can turn to that provide databases of U.S. doctors, their professional medical histories, and ratings and reviews from past patients on a number of criteria. Here are some of the best sites available, along with a few additional tips that can help you find the right doctors:
 

- Locating Tips

To help you locate some doctors in your area, a good first step, and one that doesn’t require a computer, is to ask for a referral. Contact some other doctors, nurses, or health care professionals that you know, for some names of doctors or practices that they like and trust.

You should also call your insurance provider, or visit their website directory to get a list of potential candidates. If you or your parents are Medicare beneficiaries, you can use the Physician Compare tool at medicare.gov/physiciancompare. This will let you find doctors by name, medical specialty or by geographic location that accept original Medicare. You can also get this information by calling Medicare at 800-633-4227.

Once you find a few doctors, you need to call their office to verify that they still accept your insurance, and if they are accepting new patients.

 

- Research Tools

After you find a few doctors you’re interested in, there are lots of online resources you can turn to, to help you check up on them.

For example, you can find out if a doctor is board certified at the American Board of Medical Specialties at certificationmatters.org or call 866-275-2267. And to learn about malpractice claims and disciplinary actions taken against doctors, you can use your state medical board - see fsmb.org/state-medical-boards/contacts to search your state.
 

Here are some other good websites that can help you find and/or research doctors in your area for free:

*           Healthgrades.com: This comprehensive easy-to-use site provides doctor’s information on education and training, hospital affiliations, board certification, awards and recognitions, professional misconduct, disciplinary action and malpractice records, office locations and insurance plans. It also offers a 5-star ratings scale from past patients on a number of issues like communication and listening skills, wait time, time spent with the patient, office friendliness and more.

*           Vitals.com: Provides background information on doctor’s awards, expertise, hospital affiliations, and insurance as well as patient ratings on measures such as bedside manner, follow-up, promptness, accuracy of diagnosis, and average wait time. There’s also a patient comment section.

*           RateMDs.com: Provides information on training as well as patient ratings on staff, punctuality, helpfulness and knowledge. Patients can also post questions and answers about doctors, and get doctor’s ratings based on patient reviews.

*           Look Up Tool: If you want to find out how many times a doctor did a particular service and what they charge for it, go to data.cms.gov and click on “Medicare Physician and Other Supplier Look-up Tool” at the top of the page.

*           AngiesList.com: If you don’t mind spending a little money ($20/per year), Angie’s List is a membership service that provides doctor reviews using an A through F scale.

When reaching a doctor, it’s wise to check out several of these sites so you can get a bigger sampling and a better feel of how previous patients are rating a particular doctor.

 


 

How to recognize stroke symptoms and what to do      
May 21, 2015


Dear Savvy Senior,

What are the symptoms of a stroke? My 66-year-old aunt had a stroke a few months ago and neither she nor my uncle had a clue it was happening.

Concerned Relative

 

Dear Concerned,

Unfortunately, most Americans don’t know the signs of a stroke, but they need to. Stroke is the fifth leading cause of death in the United States and the No. 1 cause of disability. Being able to recognize a stroke and getting to the hospital quickly can make a huge difference in reducing its potentially devastating effects. Here are some tips that help you recognize a stroke, and what you should do if it happens to you or your loved one. 
 

- Types of stroke

According to the Centers for Disease Control and Prevention, every year more than 795,000 people in the United States have a stroke - three-quarters of which are over the age of 65. A stroke occurs when a blood vessel that carries blood to the brain is suddenly blocked by a clot (ischemic stroke), or burst (hemorrhagic stroke), causing parts of the brain to become damaged or die. About 87 percent of all strokes are ischemic.

Depending on the severity of the brain damage, strokes can cause mild to severe disabilities including paralysis, loss of speech, vision and memory, along with other health and emotional issues, and death.

 

- Stroke signs

Because stroke injures the brain, the person having a stroke may not realize it. Stroke victims have the best chance if someone around them recognizes the symptoms and acts quickly. The five most common symptoms include:

 

*           Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body.

*           Sudden confusion, trouble speaking or understanding.

*           Sudden trouble seeing in one or both eyes.

*           Sudden trouble walking, dizziness, loss of balance or coordination.

*           Sudden, severe headache with no known cause.

 

The easiest way to identify a stroke is to use the F.A.S.T. test to identify the symptoms:

 

*           F (Face): Ask the person to smile. Does one side of the face droop?

*           A (Arm): Ask the person to raise both arms. Does one arm drift downward?

*           S (Speech): Ask the person to say a simple sentence. Is their speech slurred?

*           T (Time): If you observe any of these signs of stroke, call 911.

To help you remember the signs, the American Stroke Association has a free “Spot a Stroke FAST” app (see strokeassociation.org) that you can download on your smartphone or mobile device. Or, visit the National Stroke Association at stroke.org and print their “Act FAST” wallet card to keep as a reminder.
 

- Act quickly

Remember that stroke is a medical emergency and every minute counts. Even if you’re not sure a stroke is happening, call 911 anyway. The longer blood flow is cut off to the brain, the greater the damage. Immediate treatment can save a person’s life and improve their chances for a successful recovery.

Ischemic strokes are treated with a drug called t-PA that dissolves the blood clots that block the blood flow to the brain. The window of opportunity to start treating a stroke is three hours. But to be evaluated and receive treatment, patients need to get to the hospital within 60 minutes.

If you have a choice, wait for the paramedics rather than driving the patient yourself. Patients who are transported by EMS are evaluated and treated much quicker than people who are driven in. And, of course, don’t drive if you are the one having a stroke.

It’s also very important that you call 911 even if symptoms go away. When symptoms of stroke disappear on their own after a few minutes, a “mini-stroke” or transient ischemic attack (TIA) may have occurred which is a warning that a major stroke may be coming. That’s why mini-strokes need to be treated like emergences too.

 


How to search for lost pension money  
  
May 13, 2015


Dear Savvy Senior,

What tips can you offer for tracking down a lost pension from a previous employer?

-About to Retire

 

Dear About,

It’s not unusual for a worker to lose track of a pension benefit. Perhaps you left an employer long ago and forgot that you left behind a pension. Or maybe you worked for a company that changed owners or went belly up many years ago, and you figured the pension went with it.

Today, millions of dollars in benefits are sitting in pension plans across the U.S. or with the Pension Benefit Guaranty Corporation, a federal government agency, waiting to be claimed by their rightful owners. The average unclaimed benefit with PBGC is about $6,500.

To help you look for a pension, here are some steps to take and some free resources that can help you search if your previous employer has gone out of business, relocated, changed owners or merged with another firm.

 

-Contact employer

If you think you have a pension and the company you worked for still is in business, your first step is to call the human resources department and ask how to contact the pension plan administrator. Ask the administrator whether you have a pension, how much it is worth and how to claim it. Depending on how complete the administrator’s records are you may need to show proof that you once worked for the company and that you are pension eligible.

Your old income tax returns and W-2 forms from the years you worked at the company will help you here. If you haven’t saved your old tax returns from these years, you can get a copy of your earnings record from the Social Security Administration, which will show how much you were paid each calendar year by each employer.

Call 800-772-1213, and ask for Form SSA-7050, “Request for Social Security Earnings Information,” or you can download it at ssa.gov/online/ssa-7050.pdf. The SSA charges a $136 for this information.

Some other old forms that can help you prove pension eligibility are summary plan descriptions that you should have received from your employer when you worked there, and any individual benefit statements that you received during your employment.

 

-Search PBGC

If your former employer went out of business or if the company still is in business but terminated its pension plan, check with the PBGC, which guarantees pension payouts to private-sector workers if their pension plans fail, up to annual limits. Most people receive the full benefit they earned before the plan was terminated. The PBGC offers an online pension-search directory tool at search.pbgc.gov/mp/mp.aspx.

 

-Get help

If you need help tracking down your former company because it may have moved, changed owners or merged with another firm, contact the Pension Rights Center, a nonprofit consumer organization that offers seven free Pension Counseling and Information Projects around the U.S. that serve 30 states. For more information, visit pensionrights.org or call 888-420-6550.

If you, your company or your pension plan happens to be outside the 30-state area served by the projects, or if you’re trying to locate a federal or military pension, use Pension Help America at pensionhelp.org. This resource can connect you with government agencies and private organizations that provide free information and assistance to help your search.

For more pension searching tips, see the PBGC’s free online publication called “Finding a Lost Pension” at pbgc.gov/documents/finding-a-lost-pension.pdf.

 


Understanding Medicare’s enrollment rules  
  
May 7, 2015


Dear Savvy Senior,

Can you give me a rundown on Medicare’s enrollment choices and rules along with when and how to apply? I turn 65 next year and want to make sure I know what to do.

Almost Retired

 

Dear Almost,

The strict rules and timetables for Medicare enrollment can be confusing to many new retirees, so you’re wise to plan ahead. Here’s a simplified rundown of what to know.

First a quick review. Remember that original Medicare has two parts: Part A, which provides hospital coverage and is free for most people, and Part B which covers doctor’s visits and other medical services, and costs $104.90 per month for most enrollees in 2015.

 

When to enroll

Everyone is eligible for Medicare at age 65, even if your full Social Security retirement age is 66 or later.

You can enroll any time during the “initial enrollment period,” which is a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday. It’s best to enroll three months before your birth month to ensure your coverage starts when you turn 65.

If you happen to miss the seven-month sign-up window for Medicare Part B, you’ll have to wait until the next “general enrollment period” which runs from Jan. 1 to March 31 with benefits beginning the following July 1. You’ll also incur a 10 percent penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium. You can sign up for premium-free Part A, at any time with no penalty.

 

Working exceptions

Special rules apply if you’re eligible for Medicare and still on the job. If you have health insurance coverage through your employer or your spouse’s employer, and the company has 20 or more employees, you have a “special enrollment period” in which you can sign up. This means that you can delay enrolling in Medicare Part B, and are not subject to the 10 percent late-enrollment penalty as long as you sign up for within eight months of losing that coverage.

 

Drug coverage

Be aware that original Medicare does not cover prescription medications, so if you don’t have credible drug coverage from an employer or union, you’ll need to buy a Part D drug plan from a private insurance company (see medicare.gov/find-a-plan) during your initial enrollment if you want coverage. If you don’t, you’ll incur a premium penalty - 1 percent of the average national premium ($33.13 in 2015) for every month you don’t have coverage - if you enroll later.

 

Supplemental coverage

If you choose original Medicare, it’s also a good idea to get a Medigap (Medicare supplemental) policy within six months after enrolling in Part B to help pay for things that aren’t covered by Medicare like copayments, coinsurance and deductibles. See Medicare.gov and click on “Supplements & Other Insurance” to shop and compare policies.

 

All-in-one plans

Instead of getting original Medicare, plus a stand-alone Part D drug plan and a Medigap policy, you could sign up for a Medicare Advantage plan (see medicare.gov/find-a-plan) that covers everything in one plan. These plans, which are also sold by insurance companies, are generally available through HMOs and PPOs and often have cheaper premiums, but their deductibles and co-pays are usually higher which makes them better suited for healthier retirees. 
 

How to enroll

If you’re already receiving your Social Security benefits before 65, you will automatically be enrolled in Part A and Part B, and you’ll receive your Medicare card about three months before your 65th birthday. It will include instructions to return it if you have work coverage that qualifies you for late enrollment. If you’re not receiving Social Security, you’ll need to enroll either online at socialsecurity.gov/medicare, over the phone at 800-772-1213 or through your local Social Security office.

 

 

 

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