SAVVY SENIOR
How to recognize stroke symptoms and what to do

 

May 21, 2015

Jim Miller


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.

 

 
Medication management tools for organizing and remembering  
  
April 30, 2015


Dear Savvy Senior,

What products or solutions can you recommend to help seniors keep up with their medications? My mom is supposed to take several different medications at different times of the day but frequently forgets.

Reminding Son

 

Dear Reminding,

Anybody who juggles multiple medications can relate to the problem of forgetting to take a medication, or not remembering whether they already took it. This is especially true for people who take medications at varying times of the day. Here are some different product and service solutions that may help.

 

Medication helpers

Getting organized and being reminded are the two keys to staying on top of a medication schedule. To help your mom achieve this, there are a wide variety of affordable pillboxes, medication organizers, vibrating watches, beeping pill bottles and even dispensers that will talk to her that can make all the difference. To find these types of products go to Epill.com (800-549-0095), where you’ll find dozens to choose from.

Also check out Reminder Rosie (reminder-rosie.com, $130), a voice activated talking clock that tells you when to take your medicine, and can be used for other reminders, too.

And for a super comprehensive medication management device, there’s the MedMinder automatic pill dispenser. This is a computerized pillbox that will beep and flash when it’s time for your mom to take her medication, and will call her if she forgets. It will even alert her if she takes the wrong pills. This device can also be set up to call, email or text family members and caregivers letting you know if she misses a dose, takes the wrong medication or misses a refill. Available at MedMinder.com, or 888-633-6463, the MedMinder rents for $40 to $65 per month.

 

Medication packaging

Another possible way to help simplify your mom’s medication use is to get her prescriptions filled in single-dose packets that put all her medications (vitamins and over-the-counter drugs can be included too) together in neatly labeled packets organized by date and the time of day they should be taken. This does away with all the pill bottles and pill sorting. Some compounding pharmacies or independent drug stores offer single-dose packaging along with a number of online pharmacies like PillPack.com.

 

Reminding Services

Another simple solution that can help your mom stick to her medication schedule is to use a medication reminding service. These are services that will actually call, email or text your mother reminders of when it’s time to take her medicine and when it’s time to refill her prescriptions. Some even offer extra reminders like doctor and dentist appointments, wake-up calls and more.

Companies that offer such services are MyMedSchedule.com, which provides free medication reminders via text message or email. Their website can also help you make easy-to-read medication schedules that you can print out for your mom to follow. Or, if your mom uses a smartphone or tablet, there are free medication reminding apps that can help, like MediSafe (medisafeproject.com) or MedCoach (greatcall.com).

If, however, your mom doesn’t receive texts or use a smartphone, tablet or computer, OnTimeRx.com or Snoozester.com may be the answer. With starting prices ranging between $4 and $10 per month, these services will call your mom on her phone (they can send text messages and emails too) for all types of reminders including daily medications, monthly refills, doctor appointments, wake-up calls and other events.

Or, if you’re looking for extra help, Care Call Reassurance (call-reassurance.com, 602-265-5968 ext. 7) may be a better fit. In addition to the call reminders to your mom’s phone, this service can be set up to contact a family member or designated caregiver if she fails to answer or acknowledge the call. This service runs between $15 and $20 per month.

 


Driving safely with dementia and knowing when to quit      
April 23, 2015


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.

 

 

 

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