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Reasons to Have That End-of-Life Conversation
Tweet Share on Facebook March 11, 2013 CommentBOSTON—Ellen Goodman won the Pulitzer Prize for her thoughtful Boston Globe columns. Now retired from that job but busier than ever, Goodman publicly laments that she won no prizes for easing her mother through illness and very hard decisions about how to care for her during the final months of her life.
"The last thing my mom would have wanted was to force me into such bewildering, painful uncertainty about her life and death," Goodman writes on the website of The Conversation Project, an effort she co-founded in 2010. "I realized only after her death how much easier it would have all been if I heard her voice in my ear as these decisions had to be made. If only we had talked about it. And so I never want to leave the people I love that uneasy and bewildered about my own wishes. It's time for us to talk."
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13 Social Security Planning Questions
Tweet Share on Facebook March 8, 2013 CommentSocial Security is often in the news these days. Congress regularly threatens to change and possibly reduce benefits. The program's financial soundness is the source of constant speculation and concern. And the economic downturn shone a light on the fact that more than half of all retirees depend on Social Security benefits for more than 90 percent of their income—an alarmingly high percentage for a program designed to provide modest retirement support.
With all this attention, you'd think older Americans would be sharpening their plans to use this important benefit program. Yet according to a new poll of more than 800 consumers ages 50 to 65, fewer than 1 in 5 older Americans have even begun serious planning for how to use Social Security.
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How the ReServe Program Helps Older Workers
Tweet Share on Facebook March 6, 2013 CommentBOSTON—Alan Greenfield has leverage and he loves it. A serial community volunteer for many years, the Massachusetts Institute of Technology engineer is one of the Boston area's earliest participants in a new program called ReServe. It places older professionals who are often retired (Greenfield, 65, is not retired) in part-time jobs with nonprofit and government agencies.
The leverage Greenfield has stems from his work as a site coordinator for a volunteer income-tax preparation program aimed at helping low-income people with their taxes. Using his decades of business and entrepreneurial experience, he fills a spot the program would otherwise not be able to afford and certainly not be able to fill with someone nearly as experienced.
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Why Immigration Reform Is a Big Senior Issue
Tweet Share on Facebook March 5, 2013 CommentWith Social Security and Medicare programs facing deficit-cutting proposals in the new Congress, seniors and their advocacy groups already have big issues on their plates. Yet a good case can be made that immigration reform is another emerging issue for millions of seniors who need care. The shifting outlook has several components: rising demand for care due to a growing elderly population, a sustained effort to provide elder care in homes rather than institutions, a shrinking workforce of Americans, and an economic recovery that will eventually reduce the supply of family members available to provide unpaid care.
Historically, many paid caregiving jobs have been filled by immigrants. Immigrants who are physicians and other skilled medical workers are particularly important in rural and underserved U.S. markets. The demand for less skilled in-home care aides also has been filled in part by immigrants, although precise data could not be obtained. The U.S. Bureau of Labor Statistics does not ask immigration status in its research, and does not track caregivers as a separate job category.
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Why Social Security Benefits Require Careful Study
Tweet Share on Facebook March 4, 2013 CommentBOSTON—Social Security benefits are often explained in simple terms. Most people begin benefits near the earliest claiming age, which is 62 years old. A smaller percentage understands that benefits will rise by about 8 percent a year every year between age 62 and 70. A still smaller percentage knows it's possible to take spousal benefits and divorce benefits in certain situations without reducing one's own benefits at a later date. The percentages of informed people get smaller and smaller as the program's increasingly esoteric features present more rarified choices.
Finally, we reach the smallest possible sliver of Social Security wisdom. His is Larry Kotlikoff, an unconventional economist and thinker at Boston University. And it may be true that no one else covets this spot. But Kotlikoff has amassed an awesome amount of Social Security knowledge. He has been working for years to cram this information into a software product that will do all the heavy lifting to help people without such knowledge get the most possible money out of their Social Security benefits.
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Why Retirees Are a Threatened Species
Tweet Share on Facebook March 1, 2013 CommentBOSTON—With investment and real estate markets recovering, and cuts to Social Security and Medicare at bay for the time being, it would be comforting to paint a rosier picture of the retirement prospects for the surge of baby boomers continuing to reach retirement age every day.
Alicia Munnell, director of the Center for Retirement Research at Boston College, would like to don those rose-colored glasses as much as the next person. But she does not see a positive future for retirees. In fact, her outlook is, well, awful.
It's not that Munnell sees damaging cuts to Social Security or Medicare on the horizon, either. Her dour assessment includes some trims, but not necessarily deep cuts.
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Strong Links to a Healthy Life All Around Us
Tweet Share on Facebook February 27, 2013 CommentWhen you come to an intersection, you probably walk when the light is green or the signal icon tells you it's OK to cross. You do not need a multi-year research study to tell you how to proceed. Not so with science-based behaviors. Here, we would need to study years of people walking across the street, controlling for ambient light, traffic density and patterns, weather conditions, color patterns in pedestrian clothing, eyesight, and a number of other factors. If we had been waiting to cross that street we would, in all likelihood, have expired long ago.
So it is with the research findings called "startling" about the health benefits of Mediterranean diets, just published in the New England Journal of Medicine. Fresh fruits and vegetables, lots of fish, olive oil, and nuts, and healthy wine consumption were linked to big reductions in heart attacks, strokes, and deaths. These are not marginal benefits at the edge of healthy behaviors. They are the big ones.
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How to Develop Effective End-of-Life Plans
Tweet Share on Facebook February 26, 2013 CommentRetaining control over life decisions and maintaining dignity as the end of life approaches are top priorities for nearly everyone. These objectives can be achieved by good planning and the preparation of the proper directives under your state's laws. These safeguards have been greatly improved in many states in recent years. Still, experts say, few seniors have the right tools to make sure their end-of-life wishes are followed by family members and caregivers.
People often think of such matters only when they or a family member are seriously ill. But if a stroke, dementia, or another incapacitating event occurs, it may be too late. If people cannot make decisions for themselves and do not have directives or a power of attorney in place, decisions may be made for them that they would never have agreed with if they had been able to decide.
Michael A. Kirtland, an elder care attorney in Colorado Springs, Colo., says there are two ways to make sure your final wishes are followed: one is through legal documents, and the second is by communicating your wishes to anyone who might be involved in carrying out those wishes should you become incapacitated.
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How to Use Expanded Free Senior Health Services
Tweet Share on Facebook February 22, 2013 CommentSeniors are slowly taking advantage of the greatly expanded menu of free preventive health screenings and tests provided under Obamacare. Many of the procedures do not require a co-pay and are not subject to any insurance deductibles. Ideally, they should be part of an ongoing wellness plan that you and your physician develop.
Under the rules, for example, a free yearly wellness exam is available from doctors who participate in Medicare. This visit, in turn, can be used to build a year-long wellness plan with your primary physician. Most Medicare beneficiaries have some form of supplemental coverage beyond basic Medicare. They should check with their insurers for other wellness provisions provided under their policies.
The wellness exam supplements a one-time "welcome to Medicare" exam that is free to people who get it within their first 12 months of Medicare coverage. This welcome exam has no co-pay and is totally free.
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What You Need to Know About Long-Term Care Insurance
Tweet Share on Facebook February 20, 2013 CommentLong-term care insurance may or may not be the right choice for you. But it remains the only protection against potentially devastating later-life health expenses should you or a loved one be unable to perform common activities such as eating, dressing yourself, using the bathroom, and other so-called "activities of daily living" (ADLs).
Without insurance, you have two choices for financial planning: fund your own expenses out of your personal assets, which amounts to self-insuring, or spend down most, if not all, of your assets and then qualify for Medicaid. With no intended slight to Medicaid, an invaluable program that helps millions of Americans, its level of benefits does not exactly support a Club Med user experience. (And, no, Medicare does not pay long-term care expenses.)
There was voluntary long-term care insurance included in Obamacare, known as the CLASS program. Although enacted into law, CLASS never got off the drawing board. Its structure—voluntary participation and modest benefits—would not have attracted many users, and those it did attract would have overwhelmingly been sicker and very likely to have long-term care (LTC) expenses. The recent tax bill compromise included the creation of yet another long-term care commission but there is no insurance alternative to private policies on the horizon.
