Resources for Healthy Aging. You worked hard for decades, and now you get to retire. You have daydreamed about what you want to do during these hard-earned years. It would be tragic if you were too sick and frail to get to do those things, like play with the grandchildren, travel, enjoy your hobbies and other activities. We all want to be healthy, but it is easier to achieve that goal with a little help. The Department of Aging, a federal agency within Health and Human Services (HHS), provides information on resources for healthy aging.
The Eight Pillars of Health and Wellness for Older Adults
You do not have to tackle all eight of these factors on Day One. Getting stressed and overwhelmed will hurt your health, not help it. Work your way through this list at a comfortable pace. Make changes to your lifestyle that you can continue over the long haul. Resources for Healthy Aging. Consistent habits will give you the most significant benefit.
- Move around and exercise. It is a safe bet that the people who live into their nineties and triple digits did not spend their sixties and seventies as couch potatoes. Keep moving. Getting a little physical exercise every day is essential for long-term health. Choose low-impact activities, like walking and swimming, that have a low risk of injury. Be careful to avoid falls that can rob you of your mobility and independence.
- Stay involved. Loneliness is toxic to your physical and mental health. Find something in your community that brings you joy, whether it is a house of worship, animal shelter, or organized senior events at the local recreation department. Sign up and meet new people. Stay involved.
- Eat right. You know the adage, you are what you eat. You cannot have peak health, if you eat and drink highly processed foods and beverages with little nutritional value. Make sure that you include fresh fruits and vegetables into your routine every day. If you cannot get fresh, choose frozen over canned foods.
- Access benefits. Tap into all of the benefits and services you have earned over the years. Social Security, Medicare, and Medicaid can go a long way to keeping you and your wallet healthy. If you do not apply for and fight until you get all of the benefits for which you are eligible, you are leaving money on the table and draining money from your retirement savings. Too many people do not go after the income and services they qualify for, in the form of veteran benefits, state and county programs and non-profit agencies.
- Respect mental health issues. For too long, the topic of mental health carried a stigma. People did not talk about it. We now realize that mental health has a significant impact on your physical health and quality of life. Talk to your doctor about your mental health concerns.
- The little grey cells. Keep your brain healthy. Like everything else, you need to exercise your brain to keep it fit. Be a lifelong learner. Practice a healthy lifestyle. Read books and do word puzzles. Just do not let your brain be idle.
- Medical knowledge. If certain diseases run in your family, go to reputable websites like the Mayo Clinic and the National Institutes of Health to educate yourself on those conditions. You might be able to prevent a debilitating illness. If nothing else, you can learn how to manage a medical condition.
- Medication management. Have a frank talk with your doctor about all of your medications. If you have to take three drugs to handle the side effects from another prescription, your doctor should explore whether a different medication might be a better option. Make sure that your various prescriptions, supplements and natural remedies do not conflict with each other.
One additional piece of advice: be kind. Be kind to others and to yourself. Help people and they will reciprocate in kind. You will create a better community, that is worth living in during your golden years.
Health and Human Services. “Healthy Aging.” (accessed November 26, 2019) https://www.hhs.gov/aging/healthy-aging/index.html
Resources for Healthy Aging
Forbes’ recent article, “Two-Thirds Of All Americans Are Missing This Estate Planning Document,” explains that a health care directive is a legal document in which an individual writes down his decisions for caregivers in the event of illness or dementia and makes instructions about end of life decisions. It can also provide guidance on how caregivers should handle the body after death.
Health care directives are also called living wills, durable health care powers of attorney, or medical directives, but they all serve the same function, which is to provide guidance and direction on how a person’s medical and death decisions should be made.
Despite the importance of a health care directive, a 2017 study found that only 33% of all Americans have one.
A critical decision in a health care directive is selecting an agent. This is a proxy who acts on your behalf to make decisions that are consistent with your wishes. It’s important to pick an individual whose values are aligned with yours. This is your advocate on decisions, like if you want to have treatment continued or just be kept comfortable in palliative care.
Once you choose an agent, review your directive with her. This will give her guidance if and when the need for her to step in arises.
The agent’s role in the health care directive doesn’t end at death but continues to ensure that your post-mortem wishes are carried out. When the person dies, the agent takes control of the body. Prior to funeral plans, the agent must make certain that any organ donation wishes are carried out. This decision is usually shown on a person’s driver’s license, but it’s also re-stated in the health care directive.
After the donation wishes are carried out, the agent helps to make sure funeral wishes are handled properly. These instructions can be detailed in the health care directive.
Are You Forgetting this Estate Planning Document? With a health care directive put in place, you make things easier for your family and loved ones.
Reference: Forbes (December 13, 2019) “Two-Thirds Of All Americans Are Missing This Estate Planning Document”
Caring for Your Aging Parents – Top 5 Questions and Answers.
Caring for aging parents can be stressful. It’s a new experience, and one that you’re not always prepared for. The good news is that there are plenty of resources out there to help you navigate this new chapter in your life. To help get the process started, we’ve curated the top 5 questions that people have about caring for an aging loved one and have provided answers to those burning questions.
Question #1 – How do I ensure their legal affairs are in order?
No one likes to think about, much less talk, about the end of their lives. Unfortunately, burying your head in the sand can lead to costly and frustrating situations, once your loved one has passed. Of course, coming out and asking if your parents have an estate-plan in place may not be the most tactful approach. Consider these icebreakers to get a conversation started:
- “Bob and I just met with our estate planning attorney last week to update our will. Do you and dad have an estate plan in place?”
- “I was so troubled to hear that Uncle Harry passed and left Aunt Hilary with such a financial mess. Do you think you and mom have your affairs, so that doesn’t happen to one of you?”
- “We just sent Jenny off to college and our attorney recommended a HIPAA release and power of attorney, just in case something happens to her and we need to step in. Do you have a power of attorney?”
Question #2 – How can I gain access to their health information?
It’s not uncommon for parents to withhold healthcare information from their children. This is often because they don’t want to worry their adult children or grandchildren. It may also be because they don’t want to admit that they have a serious healthcare issue. Sometimes, this lack of disclosure can lead to lapses in care.
If you believe you need access to your parents’ medical records, you have a few options.
- Go to the doctor with your parents. Ask questions.
- Ask your parents to make you their personal representative for healthcare matters.
- Ask your parents to request in writing that medical records be sent to you.
If your parent is incapacitated and unable to give consent, the healthcare provider may share personal healthcare information, if they believe that disclosure is in your parent’s best interest.
Question #3 – Is it time to move them to a care home?
When the family home becomes unsafe for one or both of your aging parents, it may be time to consider some sort of alternative arrangement. Nursing homes are not the only alternatives, however. You might consider an incremental approach that includes things like:
- In-home Care
- Senior Daycare
- Assisted Living Communities
- Additional Dwelling Units
Discuss these options with your parents and other family members to determine what is best for the whole family.
Question #4 – Should they be driving?
Driving is one of the most important activities to one’s independence. Losing the ability to drive is naturally one of aging people’s top fears. Therefore, of course, you want to let them drive as long as it is safe for them to do so. Once reflexes begin to slow, flexibility declines, hearing levels decrease and peripheral vision narrows, it’s time to start assessing the safety of their driving.
How do you assess their abilities? Take a drive with them. See how they do with highways, traffic, driving at night and during inclement weather. It may not be that they need to give up driving all at once. Perhaps night driving becomes a problem at first. If that’s the case, ask them to agree to let you drive at night.
Question #5 – Am I partnering—or parenting my parents?
Often, when adult children are faced with caring for their parents, the go-to position is one of “parent.” It may be one you’re naturally disposed to, because you have children of your own. It could also be that you’re simply mirroring the role your parents played with you. While natural, this may not be the best approach, because your parents may perceive this new scenario as you taking their independence from them.
Instead of dictating terms and telling them how it’s going to be, reframe your roles from parent-child to partnership. Just because they may be lower on energy or losing memory function, doesn’t mean they can’t make decisions. Talk to them like the adults they are, making sure that each of you is maintaining boundaries and autonomy. You may find them more receptive to your help, which will make things much easier in the long run.
Caring for Your Aging Parents – Top 5 Questions and Answers
The Healthy. “8 Questions You Must Ask to Keep Your Aging Parents Safe and Healthy” (Accessed November 29, 2019) https://www.thehealthy.com/healthcare/caregiving/questions-to-ask-your-aging-parents/
HHS.gov. “Under HIPAA, when can a family member of an individual access the individual’s PHI from a health care provider or health plan?” (Accessed November 29, 2019) https://www.hhs.gov/hipaa/for-professionals/faq/2069/under-hipaa-when-can-a-family-member/index.html
What Happens If A Beneficiary Dies Before Receiving An Inheritance?
When the beneficiary of a deceased person’s probate estate or living trust dies during the course of administering the estate and before the full distribution of the inheritance has been made, things can get sticky.
Let’s say a mother dies and her estate is in the process of being probated when her son dies. The son’s estate can claim his inheritance, which it will in turn distribute to the beneficiaries of his estate, according to a recent article, “Beneficiary dies prior to receiving inheritance” from the Lake County Record-Bee.
This might require probating the deceased child’s estate. Whether or not probate is required, depends both on the value of the son’s own estate, which is increased by the amount of the unreceived inheritance. Another factor is whether all or some of the son’s estate passes to a surviving spouse or registered domestic partner.
In California, probate is required when the gross value of a deceased person’s estate exceeds $150,000 and passes to someone other than the decedent’s surviving spouse or registered domestic partner. Estate planning in California, as in other states, is important to lessen the impact of probate.
No probate is needed to transfer joint assets to a decedent’s surviving spouse or registered domestic partner. In some states they are entitled to use a spousal property court petition to transfer title to real property and other assets held in the name of the deceased spouse into their partner’s name, as relevant. In New York, a solely owned property or asset of the decedent must be probated.
In California, for an estate under $150,000, probate is not required and the estate can often be settled by affidavits, or, if the deceased owned real property worth more than $50,000, a small estate petition to confirm title to real and personal property. However, there are instances where probate of a small estate is necessary, because of the decedent’s debts or figuring out who is entitled to receive a portion of the estate.
This type of situation illustrates the benefits of holding assets in a living trust. This avoids probate, spousal property petitions and small estate petitions. Any time property is worth more than $50,000, it makes sense for the owner to hold title to the property in a trust.
Who will then, inherit the son’s estate? If he had a last will and testament, it is the governing document. If he had a revocable living trust, then he likely will also have a “pour-over will,” which “pours” everything over in the estate to the revocable living trust.
Either way, it’s likely the son’s heirs will need to be probated. With no will, the son’s heirs inherit according to the laws of intestate succession.
If the estate has been planned properly, even the complex situation described above will be more manageable. If neither the mother nor the son had an estate plan, it could take many years to unravel the estate. An estate planning attorney can create a plan that is designed with the laws of your state in mind and address many unexpected situations.
Reference: Lake County Record-Bee (December 7, 2019) “Beneficiary dies prior to receiving inheritance”
How to Spot Problems at Nursing Homes.
The best time to shop for a nursing home, is when you do not need one. If you wait until you can no longer safely or comfortably live on your own, you probably will not be in a position to do a lot of legwork to investigate facilities. Do your research well ahead of time, so you know the nursing homes in your area that provide high-quality care and, more importantly, the ones that have significant problems.
How to Spot Problems at Nursing Homes. As you evaluate and compare facilities, you need to know how to spot problems at nursing homes. The marketing brochure, website and lobby might be lovely, but you should base your decision about a long-term care facility on much more data than those things. Here are some tips on how to dig for possible problems at nursing homes:
- Online search. Check out the nursing home’s website to get an overview of the services it offers and the industry affiliations or certifications it has. Look at the daily menus to see if the meals are nutritious and have enough variety. Most people would not enjoy eating the same main course two or three times a week. Look at the activities calendar to see if you would be happy with the planned social events. On some websites, you can view the floor plans of the resident rooms.
- Ask your primary care doctor to name a few facilities he would recommend for his parents, and those where he would not want them to live.
- Local Office on Aging location. Every state has an Office on Aging. Contact them to get as much information as you can about safety records, injuries, deaths, regulation violations and complaints about local nursing homes.
- Your state’s Long-term Care Ombudsman (LCO). Every state also has an Ombudsman who investigates allegations against nursing homes and advocates for the residents. Your state LCO should have a wealth of information about the facilities in your area.
- State Online Database or Reporting System. Some states have online databases or collect reports about nursing homes.
- Medicare’s Nursing Home Compare website. Medicare maintains an online tool, Nursing Home Compare, that provides detailed information on nursing homes. Every nursing home that gets any funding from Medicare or Medicaid is in this database. You can enter the name of a specific nursing home or search for all the facilities in a city or zip code. The tool includes information about abuse at long-term care facilities. On the webpage, you can explore the Special Focus Facility section to find nursing homes with a history of problems.
- Word of mouth. Ask your friends, relatives and neighbors to recommend a quality nursing home. Personal experience can be extremely valuable.
- Make a short list of the top candidates. After you collect as much information as you reasonably can, narrow your options down to four or five facilities that best meet your needs and preferences.
- Visit your top choices. There is no substitute for going to a nursing home and checking it out in person. Pay attention to the cleanliness of the place throughout, not just in the lobby. Give the facility the “sniff” test. Determine whether they use products to mask unpleasant odors, instead of cleaning thoroughly. See whether the residents are well-groomed and wearing fresh, clean clothes. Observe the interaction of the staff with the residents. Notice whether people who need assistance at mealtime, get the help they need without having to wait.
- Take online reviews with a grain of salt. Fake reviews are all over the internet. If you see a nursing home with only a few reviews, and they are all five stars, be skeptical.
Once you gather this information, you will be ready in the event you need to stay in a nursing home for a short recuperation from surgery or longer term.
AARP. “Finding a Nursing Home: Don’t Wait Until You Need One to Do the Research.” (accessed December 5, 2019) https://www.aarp.org/caregiving/basics/info-2019/finding-a-nursing-home.html
CMS. “Find a nursing home.” (accessed December 5, 2019) https://www.medicare.gov/nursinghomecompare/search.html
What’s Everything I Need to Know About Wills?
Writing a will is a critical part of estate planning. A will contains your legally binding directions for the distribution of your property and responsibilities, when you pass away.
Like the title says, Money Check’s recent article, “Guide to Writing a Will: Everything You Need to Consider,” sets it all out—from soup to nuts.
Do it myself or hire an experienced estate planning attorney? It’s wiser to hire a qualified estate planning attorney to help you draft your will. There are many heartbreaking stories of people who decided to do it by themselves and missed important steps. If that’s the case, the probate judge will not recognize the will and will take control of the estate. Don’t let this happen to your family. Use a legal professional.
Name Your Heirs. List all of the people you want to include in your will. You can omit or include anyone you want. If you do want to leave out a certain family member, be sure you clearly indicate that in the will. You don’t have to explain why you decided to include or exclude family members from your will.
Name an Executor. Select your attorney or a close family member as the executor.
Select a Guardian for your Children. Name a responsible and willing guardian for your minor children. You should also be sure to discuss your decision with the potential guardian.
Be Clear on the Assets Beneficiaries are to Receive. Avoid vagueness or questions in your will. Clearly explain who gets what. This will help avoid confusion and disputes among family. A thoroughly crafted will prevents stressful and upsetting situations from happening to your family, after your passing.
Include Your Final Wishes with the Will. You can leave your will and a final letter to your family with your executor. This is also called a letter of last instruction.
Get Your Witnesses. When you’re ready to sign your will, be sure to get two witness (or only one depending on your state’s laws) of legal age, over 18-years old, to sign the documents.
Keep Your Will Somewhere Safe and Accessible. Store your will in a safe place, where your family can get to it when you die.
Reference: Money Check (October 23, 2019) “Guide to Writing a Will: Everything You Need to Consider”
Tailoring a Caregiving Plan to Your Family.
If you have a family member who needs ongoing assistance because of a disability, severe medical issue, or a chronic illness, you might need to create a schedule within the family for providing care to that loved one. Few of us can afford to hire a private nurse for a family member. Many people who need caregiving need someone available 24 hours a day, even if some of that time is watching over the person rather than providing medical attention.
Public assistance programs provide limited, if any services, so most families have to figure out who can pitch in and help care for the loved one. If you are like most people, you could use some suggestions on tailoring a caregiving plan to your family. Recent legislation could make that task easier.
The Inherent Problems of Caregiving
People who are already working full-time and raising their families, often end up taking shifts, along with other relatives. The situation can go on like this for years. The caregivers become exhausted, physically, emotionally and financially.
Resentment can build, if some of the family caregivers feel they are doing more than their share, while others are not doing their part. Years later, the primary caregivers can get accused of undue influence, if the person who received help gives a larger portion of the estate to the primary caregivers out of gratitude.
Why Congress is Paying Attention to the Challenges of Family Caregiving
Our population is aging. By 2026, the baby boomer generation will start to turn 80 years old. Many people in their eighties need long-term care, either in the home or a facility. The high numbers of baby boomers and the declining birthrates mean there will be more people needing family caregiving and fewer relatives available to provide those services.
Family caregiving takes a massive chunk out of our economy each year. Experts say 40 million people in the United States provide unpaid caregiving services to their adult loved ones, who have limitations in their daily activities. The experts on aging value these services at around $470 billion a year.
Another 3.7 million Americans take care of a disabled child under the age of 18. Some people have to provide caregiving for both an older adult and a child. People in the field estimate that about 6.5 million people in our country fall into this category.
The caregivers face immediate and long-term financial crises, because of the time they devote to the needs of their vulnerable loved ones. In the moment, the caregiver might have to cut back on work hours or leave a paying job to be there for the family member in need. Losing a paycheck and benefits, can put a caregiver into economic hardship. Many caregivers live in poverty in the future, because it was impossible to contribute to retirement savings or the Social Security system during the long years of caregiving.
Congress is working on measures to provide more public resources for family caregivers. The “Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act” contains strategies for state and communities to support caregiving families. Increased assessments and service planning dovetailed with education, supports and respite options can impact financial security and workplace issues of caregivers. The new law centers on both caregivers and people receiving the care.
AARP. “Building a Family Caregiving Strategy to Align with the Real Needs of Families.” (accessed October 31, 2019) https://blog.aarp.org/thinking-policy/building-a-family-caregiving-strategy-to-align-with-the-real-needs-of-families
Making Inheritance Talks Easier.
Conversations about money and finances can be problematic for many families. Those very same people you grew up with, aren’t always on the same page, especially when the inheritance is the topic, says The New York Times in a recent article “Tips to Ease Family Inheritance Tensions.”
Find a common interest. You may be very different, but you also have a lot in common. The sibling relationship is a long-running one, so focus on preserving or repairing that relationship.
Bring in help to facilitate discussions. If family history makes it too difficult to manage, bring in an estate planning attorney or financial advisor to mediate the conversation. Having an unbiased person to run the show can keep things on track, make sure all viewpoints are recognized and help the group get to a productive conclusion.
Listen to each other. The simplest task may also be the hardest. It’s so easy to fall into old behavior patterns (i.e., the bossy older sister, the brother who goes along to get along). Don’t interrupt each other and check in to make sure everyone is feeling okay about how the conversation is going.
Advice to parents. Even if you don’t have a mega-wealthy family, you may all benefit from having an outside person, like an estate planning attorney or corporate trustee, to be named as a trustee. The more financially competent sibling could be the trust advisor, who can give advice but does not make the final decision. This keeps everyone a little more arm’s length from the decision making.
Talk with your family about money. Inheritances are frequent sources of friction among siblings. Not knowing how they are going to share in the family assets, how it is going to be structured and what expectations are, can create considerable tension within the family. Many families do not talk with their children about money, but that’s a big mistake. Not comfortable with the idea of a conversation? Then write down your motivation for your decisions about how the family wealth is going to be distributed and ask your estate planning attorney to make it part of your documents. It won’t be legally binding, but it may provide your children with some further insights.
Reference: The New York Times (Nov. 6, 2019) “Tips to Ease Family Inheritance Tensions.”
Making Inheritance Talks Easier.