Financial Planning Tips for Working Caregivers

The millions of employed family caregivers in the United States lose a considerable amount of money when they take time from their jobs to care for their aging parents, and spend a good deal of their own funds to do so.

The MetLife Mature Market Institute released a study, “The MetLife Study of Caregiving Costs to Working Caregivers: Double Jeopardy for Baby Boomers Caring for Their Parents,” which found that as of 2011, employed caregivers in the U.S. lost an estimated $3 trillion in wages, pensions and Social Security benefits over a lifetime if they left the workforce prematurely. The average losses were $304,000 per person. That does not include additional out-of-pocket expenses related to caregiving, such as travel costs, contributing to the parents’ household upkeep and purchasing items needed by the care recipient.

The study offered 10 financial planning tips for family caregivers:

1. Think twice about leaving your job to provide care, as it will impact your lifetime wealth and future employment prospects. In addition to losing a paycheck, you also could be missing out on years of service required to become vested in a defined benefits pension plan, to receive matching 401(k) funds or to build Social Security benefits.
2. Check with your employer to determine what benefits are offered and how you would replace them, should you curtail your employment. Your employer may be able to provide workplace accommodations, such as flex time or family and medical leave, so you can stay in the workplace while caring for your relative.
3. Take stock of what you have and your expenses for caregiving. Consider your current costs for travel, home care and any other items you cover. Add up all your current out-of-pocket costs for caregiving and create a budget for these expenses.
4. Look into public benefits. Community services may be available for free or at a low cost and can offset out-of-pocket expenses. The Benefits Checkup website (www.benefitscheckup.org) from the National Council on Aging offers a free, confidential service that can help older adults find programs to help pay for some of the costs associated with prescription drugs, healthcare, utilities and other essentials.
5. Become knowledgeable about Medicare and Medicaid. Medicare is not all-inclusive and you will want to be aware of costs for premiums and deductibles. Some enrolled in Medicare also may qualify for Medicaid, which covers a range of health and long-term care services.
6. Calculate what it would cost to keep your loved one at home. There are many resources to enable an older person to age in place, such as meals-on-wheels, adult day care services, home care and home modification.
7. Consider enlisting a geriatric care manager. Geriatric care managers are usually social workers or nurses who assist with evaluation, referral and monitoring a plan of care for older persons. (Note: today, geriatric care managers are often referred to as “aging life care specialists.”)
8. Be aware of possible elder financial abuse. Older individuals, especially those with physical or cognitive impairments, can be vulnerable to exploitation, which may deplete their savings.
9. Discuss your loved one’s legal, financial and medical wishes. Investigate legal tools such as power of attorney, durable power of attorney and a living will.
10. Create a budget for your own future retirement expenses. Consider what portion of your income you’ll need to maintain your current lifestyle after retirement; experts typically place it at about 80 percent of current income.

“Legions of dedicated caregivers are making not only emotional and physical sacrifices, but also financial sacrifices for their parents,” said Sandra Timmermann, Ed.D., who served as director of the MetLife Mature Market Institute. “There are steps people can take to mitigate the hidden costs of caregiving, and there are programs employers can put into place to help support their employees.”

Source: The MetLife Mature Market Institute. Read more about the “The MetLife Study of Caregiving Costs to Working Caregivers” (https://www.metlife.com/mmi/research/caregiving-cost-working-caregivers.html) on the MetLife Mature Market Institute website (www.metlife.com/mmi/index.html), where you will find other studies that were created by MetLife to educate consumers on aging, longevity and the generations.

Pain Often Untreated in Seniors With Dementia

Older adults are apt to suffer from a variety of painful health conditions, including arthritis, osteoporosis, urinary tract infections, diabetic neuropathy, tooth problems, constipation and many others. It’s important to address this discomfort and work with the person’s healthcare provider to arrive at the most effective treatment for pain. Treatments might include medication, exercise and managing conditions that cause the pain.

But when a person also has Alzheimer’s disease or other dementia, it can be very challenging to realize that the person is in pain, and what is causing the pain. As Alzheimer’s and other dementias progress, patients lose the ability to communicate what they are feeling. Consequently, they may express pain in ways that aren’t readily understood by family or even by medical personnel—and their pain may go untreated.

People with dementia may express pain in nonverbal ways, such as wincing, shouting, rocking, eating or sleep problems, or aggression. According to experts from the University of Alberta, family often assume that these behaviors are just a part of their loved one’s dementia. Said the researchers, “It is important for those who live or work with persons with dementia to know how to identify when an elderly person is experiencing pain.” The University of Alberta team offers an excellent online tutorial for families; it can be accessed here; a simple registration is required.

Dr. Alexia Torke of the Indiana University School of Medicine calls for increased access to hospice and palliative care for people with dementia. Said Torke, “Although the general public and many physicians do not associate palliative or hospice care with dementia, dementia is a terminal disease and should be respected as such. Palliative care is needed throughout the illness and can provide those who are unable to communicate their needs with a better quality of life as well as lowering the stress the illness places on caregivers and the entire family.”

A recent study by University of California, San Francisco School of Nursing researchers sought to better understand the issue of pain in people with dementia. The team found that while pain in nursing home residents had been studied, little was known about pain treatment for people with dementia who live at home. Said lead author Lauren Hunt, RN, MSN, “As a hospice nurse caring for people in their homes, I have seen many patients with dementia who suffer from distressing pain. I was motivated to conduct this research study to understand the issue from the broader national prospective. It turns out that pain is very common in this population and is frequently severe enough to limit activities.”

The researchers reported that people with dementia actually are at higher risk of pain, with 63 percent experiencing “bothersome pain” and 43 percent having “pain that limited activities.” The team reported that access to treatment was a big hurdle; many of the patients found it difficult or impossible to get to healthcare appointments, and had little access to care at home.

The study, which appeared in the Journal of the American Geriatrics Society, called for increased awareness of this important issue. Said UCSF professor Dr. Alexander Smith, “The extensive challenges associated with the assessment and treatment of pain in older adults with dementia will require creative solutions from researchers, clinicians and policymakers to ensure pain is being adequately managed in this vulnerable population.”

Source: IlluminAge AgeWise reporting on studies from University of California, San Francisco, University of Alberta and Indiana University School of Medicine.

Preventing Falls

Most serious falls occur in and around the home, but some simple precautions can help reduce your risk of falling.  For instance, make sure that handrails in stairways are securely fastened and that all rugs are secured to the floor with tacks, nonskid pads or double-sided tape.

Falling can lead to life-changing injuries and could result in having to give up some independence, but a brochure called “Preventing Falls at Home” can help. It offers these additional tips:

1. Be sure that you can move safely in the bathroom area, and in and out of the tub or shower.

2. Keep frequently used kitchen items, such as dishes and food, within easy reach.

3. Place night-lights in hallways, bedrooms, bathrooms and stairways.

Contact the Eldercare Locator at (800) 677-1116 or visit http://www.eldercare.gov to order the “Preventing Falls at Home” brochure. The Eldercare Locator is a free, public service of the U.S. Administration on Aging and is administered by the National Association of Area Agencies on Aging (n4a).

Children of the 30s & 40s - The Last Ones

A Short Memoir

Born in the 1930s and early 40s, we exist as a very special age cohort.  We
are the last ones.  We are the last, climbing out of the depression, who
can remember the winds of war and the war itself with fathers and uncles going
off.  We are the last to remember ration books for everything from sugar
to shoes to stoves. We saved tin foil and poured fat into tin cans.  We
saw cars up on blocks because tires weren't available.  My mother
delivered milk in a horse drawn cart.

We are the last to hear Roosevelt's radio assurances and to see gold stars in the
front windows of our grieving neighbors.  We can also remember the
parades on August 15, 1945; VJ Day.

We saw the boys home from the war build their Cape Cod style houses, pouring the
cellar, tar papering it over and living there until they could afford the time
and money to build it out.

We are the last who spent childhood without television; instead imagining what we
heard on the radio.   As we all like to brag, with no TV, we spent
our childhood playing outside until the street lights came on.   We
did play outside and we did play on our own.  There was no little
league.

The lack of television in our early years meant, for most of us, that we had
little real understanding of what the world was like.  Our Saturday
afternoons, if at the movies, gave us newsreels of the war and the holocaust
sandwiched in between westerns and cartoons.  Newspapers and magazines
were written for adults.   We are the last who had to find out for
ourselves.

As we grew up, the country was exploding with growth.   The G.I. Bill
gave returning veterans the means to get an education and spurred colleges to
grow. VA loans fanned a housing boom.  Pent up demand coupled with new
installment payment plans put factories to work. New highways would bring jobs
and mobility.  The veterans joined civic clubs and became active in
politics.  In the late 40s and early 50s the country seemed to lie in the
embrace of brisk but quiet order as it gave birth to its new middle
class.  Our parents understandably became absorbed with their own new
lives.  They were free from the confines of the depression and the
war.  They threw themselves into exploring opportunities they had never
imagined.

We weren't neglected but we weren't today's all-consuming family focus.
They were glad we played by ourselves until the street lights came on.
They were busy discovering the post war world.

Most of us had no life plan, but with the unexpected virtue of ignorance and an
economic rising tide we simply stepped into the world and went to find
out.  We entered a world of overflowing plenty and opportunity; a world
where we were welcomed.  Based on our naive belief that there was more
where this came from, we shaped life as we went.

We enjoyed a luxury; we felt secure in our future.  Of course, just as
today, not all Americans shared in this experience.  Depression poverty
was deep rooted.  Polio was still a crippler.  The Korean War was a
dark presage in the early 50s and by mid-decade school children were ducking
under desks.   China became Red China.  Eisenhower sent the
first "advisors" to Vietnam.  Castro set up camp in Cuba and Khrushchev
came to power.

We are the last to experience an interlude when there were no existential threats
to our homeland.  We came of age in the late 40s and early 50s.  The
war was over and the cold war, terrorism, climate change, technological
upheaval and perpetual economic insecurity had yet to haunt life with
insistent unease.

Only we can remember both a time of apocalyptic war and a time when our world was
secure and full of bright promise and plenty.   We experienced
both.

We grew up at the best possible time, a time when the world was getting better
not worse.

We are the "last ones."

- Author Unknown

A Positive Attitude Can Change Your World

Norman Vincent Peale, author of the book The Power of Positive Thinking, once said, “Change your thoughts and you can change your world.” Repetitive thoughts – such as “Life is hard,” “I’m a failure,” or “I’m not good enough” – form neural pathways in the brain. The more you think them, the more ingrained they become in your psyche, and your unconscious mind will continue playing these thoughts over and over until they become who you are.

Fortunately, you can “rewire” your brain by actively thinking positive thoughts and focusing your attention on the good things in your life. Positive thinking doesn’t mean you are necessarily constantly happy or that you ignore life’s unpleasantness – it simply means you approach life’s challenges in a more positive and productive way. A positive attitude not only helps reframe our thoughts about life’s circumstances, it also has major health benefits. According to the Mayo Clinic, positive thinking can:

• Increase your lifespan
• Decrease depression
• Lower your risk of death from cardiovascular disease
• Provide greater resistance to the common cold
• Increase your psychological and physical well-being

According to a study at Yale University, researchers discovered that people who had positive thoughts about aging lived 7½ years longer than those who saw aging in a negative way. A separate Yale study showed that people who had negative thoughts and feelings about aging had an increased risk of developing Alzheimer’s.

But shifting one’s attitudes can be difficult. Exactly how does one start reprogramming one’s brain? Here are a few tips to help you develop and maintain a positive attitude.

See challenges as an opportunity

We don’t always have control over the things that happen to us, but we do control our response to them. So, if you lost your job, instead of reacting with fear, take a step back and allow yourself to feel the new possibilities available to you. If we learn to recognize challenges as a way to learn and to grow, we are better able to deal with them and have a more positive response to them.

Practice gratitude

Recognizing all we have to be thankful for is good medicine. One way to incorporate gratitude into your life is to keep a gratitude journal. Each day, just jot down a few things for which you are grateful. Robert A. Emmons at the University of Davis and Michael E. McCullough of the University of Miami conducted a study that discovered that those who kept a gratitude journal – just a single sentence of five things each day for which they were grateful – were more optimistic and felt happier about life.

Watch what you say

Words are powerful and can shape the way you feel about things. Try replacing the phrase “have to” with the phrase “get to.” Instead of saying (and thinking) “I have to go to work” or “I have to mow the lawn,” reframe your thoughts by saying “I get to go to work” (many people are unemployed and hurting) and “I get to mow the lawn” (many people don’t have their own yards to mow). This simple shift in consciousness can help you realize how much you have to be thankful for.

Become conscious of your thoughts

Just as your words are powerful, so are your thoughts. If you find yourself thinking “Life is hard,” notice what you’re thinking and reframe it. You may choose to shift your thoughts to “Life is hard and I continue to experience joy every day” or “Life is a blast and the challenges I face simply make me stronger.” If you change your thoughts, you can form new pathways in the brain which may, in turn, change your experience of life.

Senior Volunteer Service Goes International

During April’s National Volunteer Month, we have been reminded about the many health benefits older adults gain through service to others. Many experts have referred to an “epidemic” of loneliness and isolation among seniors, which raises the risk of many health conditions, including dementia. Volunteer service is a great way to connect with others.

Volunteering also promotes healthy aging by providing a sense of purpose, which benefits the mind, body and spirit. It feels good to do good, and volunteering is a perfect way to get that helping high! Seniors are volunteering in record numbers; according to the U.S. Administration on Aging, one-fourth of all older adults volunteer, representing 10 million pairs of helping hands. They’re providing their time and expertise to schools, healthcare organizations, charities, civic groups, faith communities, and many other organizations that serve the needy.

Now, a new study by University of Illinois researchers has found that more older Americans are volunteering abroad—close to 300,000 at last count. This is more than double the number of seniors who provided volunteer service in foreign countries a decade ago. Social work professor Benjamin Lough and doctoral student Xiaoling Xiang offered several reasons for this new trend:

Retired baby boomers have free time to spare. Host organizations prefer volunteers who can stay for a longer period of time. The boomer volunteers are also financially well-off enough to afford to do this; many report annual household incomes of $150,000 or more.

The boomers value civic engagement and giving back to others—but they also have a “thirst for adventure,” which makes overseas volunteer service a perfect match. Lough and Xiang reported that many older volunteers said they were “interested in learning about other cultures, but from in-depth, relational perspectives that usually are not experienced through tourism.”

According to Lough, “Host countries consistently express a preference for older workers, who have greater skills and experience to offer.” The team reports that nearly half of older adults in the study had advanced degrees. Lough adds, “Host organizations and communities are less interested in hosting young people who have fewer skills—they want competent people who can contribute something really useful, who have lifelong experience doing things.” Coming from an often youth-centric country like the U.S., these older volunteers no doubt find this refreshing!

The U.S. Peace Corps began targeting older adults in a marketing campaign that began in 2006. That effort has paid off, and close to 10 percent of applications for overseas service now come from older adults.

Lough reported, “The single most important predictor of whether a person volunteers or not is if they are asked, so being asked is really important, as is having access to institutions that will ask for volunteers. If we really think that productive aging is something that people want to do and should do, a key question of recruitment is, do we ask them? How do we increase the access for older adults to be productive, give back to society, and tap into the potential that they have developed over a lifetime of experience?” He and Xiang reported that awareness is key, and that even more older adults would volunteer abroad if financial and healthcare-access barriers were removed.

Source: IlluminAge AgeWise reporting on a news release and study from University of Illinois

Give Your Medicine Cabinet a Spring Cleaning

Yes, it’s time for the annual spring cleaning ritual, and what better place to start than your medicine cabinet? In addition to getting rid of things you no longer use—like that six-year-old box of teeth-whitening strips and empty bottles of travel-sized shampoo—getting rid of prescription and over-the-counter medications that have long since expired can keep your family safer.

Many people don’t see the harm in taking a medication that is slightly out of date, assuming that the drug will still have some effect on their current ailment. And if it’s a bottle of aspirin that expired a month ago, they’re probably right. But here are just some of the problems with keeping expired medications around the home:

• Some medications undergo chemical changes over time, which may actually make them dangerous. The problem is that no one really knows what happens to drugs over time, so there’s no real way to know. Better to be safe and throw them out.
• Expired medications—which neither your doctor nor your pharmacist knows you’re taking—may produce harmful effects with other drugs you’re currently on. For instance, if you’re on a medication that has a side effect of lowering your blood pressure, and the expired medication has the same side effect, this could cause serious problems.
• If the medication is something that could potentially be life-saving, such as nitroglycerin or insulin, and you delay buying new medication because you still “have some left,” the medication may not perform the way it’s supposed to, with potentially dangerous results.

And while you’re at it, this is a good time to take an inventory of the drugs you’re taking—both prescription and over-the-counter. According to the Centers for Disease Control and Prevention’s report “Health, United States, 2013,” nearly half of all Americans take one or more prescription medications. By the time a person reaches age 65, that number reaches nearly 90 percent. The more drugs you take, the greater the chance of an adverse interaction. By taking stock of what you’re taking and sharing that information with your doctor or pharmacist, you lower the risk of a dangerous situation.

Finally, be sure to dispose of expired and no-longer-used medications safely. Find out if your community or pharmacist has a drug take-back program. The U.S. Drug Enforcement Administration (DEA) periodically holds a drug take-back day; the next event is scheduled for April 30, 2016. Visit the Office of Diversion Control’s National Take-Back Initiative web page to see if there’s a convenient location where you can dispose of any unwanted drugs you find during your medicine chest spring cleaning. During the last Take-Back Day, consumers turned in more than 350 tons of unused, expired or unwanted drugs!

The U.S. Food and Drug Administration and the Environmental Protection Agency DO NOT recommend that consumers flush medications down the toilet, as this can have harmful effects on our ecosystem. So if a take-back program is not readily available, take the unwanted medication out of its container, put it in a sealable bag or disposable container and put in the trash. The DEA suggests mixing pills with coffee grounds or kitty litter to make them undesirable to substance abusers. Remove any personal/private information from the pill bottle and place that in the trash as well.