Conversation Starters for Boomers and their Loved Ones

Our friends at Home Instead Senior Care have published a very handy booklet which is designed to help adult children and their aging parents deal with those sensitive life topics that often make conversations difficult.   Check it out here 






"Digital Assets" and your Estate Plan

A recent article from the Hook Law Center regarding digital assets and your estate plan (http://www.hooklawcenter.com/newsletter/news-2014/digital-assets-and-your-estate-plan) raised some good questions regarding access to our social media and other accounts.  Have you considered what would happen to all your on-line accounts/web pages should you become incapacitated or die? I personally have observed how confusing and upsetting it is to those left behind to be scrambling to find passwords to disable Facebook or Linked-In accounts.

It would be a huge service to your loved ones that you consider utilizing your Will and Power of Attorney to permit others to manage your digital assets and that you create a master list of your accounts, log-in information and passwords to make it easier for the people you have named to take control of those assets.  It doesn't seem like a high priority but it will go a long way towards providing peace of mind during a difficult time should you make this information easily accessible to them.



Helping our Older Loved Ones Enjoy the Holidays

We loved this article written by Sharon O'Brien for About.com's Senior Living page.  It does an excellent job of helping ensure happier holidays for those in our families who are older or who have special needs.

For most of us, the holidays are a wonderful time to share the joys of family life and friendship. But for many older adults the holidays can be highly stressful, confusing, or even depressing if their mental, physical and emotional needs are not taken into account.

If you have older friends and family members with underlying health issues, you can help them enjoy the holiday season more by following these simple tips, based on advice from specialists in senior medicine at the University of California, San Diego (UCSD) School of Medicine:

  1. Stroll down memory lane. Holidays provoke memories, which can be especially powerful in the later years of life. “Leading authorities have observed that memory and ‘life review’ are important parts of the aging process,” says Barry Lebowitz, Ph.D., deputy director of UCSD’s Stein Institute for Research on Aging. “Older people whose memories are impaired may have difficulty remembering recent events, but they are often able to share stories and observations from the past. These shared memories are important for the young as well—children enjoy hearing about how it was ‘when your parents were your age…’.” He suggests using picture albums, family videos and music, even theme songs from old radio or TV programs, to help stimulate memories and encourage older seniors to share their stories and experiences.


  2. Plan ahead. If older family members tire easily or are vulnerable to over-stimulation, limit the number of activities they are involved in or the length of time they are included. The noise and confusion of a large family gathering can lead to irritability or exhaustion, so schedule time for a nap, if necessary, and consider designating a “quiet room” where an older person can take a break. “Assign someone to be the day’s companion to the older person, to make sure the individual is comfortable,” says Daniel Sewell, M.D., director of the Senior Behavior Health Unit at the UCSD Medical Center, who adds that these guidelines work well for young children as well as adults with mental, emotional and physical health issues.


  3. Eliminate obstacles. If a holiday get-together is held in the home of an older person with memory impairment or behavioral problems, don’t rearrange the furniture. This could be a source of confusion and anxiety. If the gathering is in a place unfamiliar to an older person, remove slippery throw rugs and other items that could present barriers to someone with balance problems or who has difficulty walking.


  4. Avoid embarrassing moments. Try to avoid making comments that could inadvertently embarrass an older friend or family member who may be experiencing short-term memory problems. If an older person forgets a recent conversation, for example, don’t make it worse by saying, “Don’t you remember?”


  5. Create new memories. In addition to memories, seniors need new things to anticipate. Add something new to the holiday celebration, or volunteer for your family to help others. Enjoy activities that are free, such as taking a drive to look at holiday decorations, or window-shopping at the mall or along a festive downtown street.


  6. Be inclusive. Involve everyone in holiday meal preparation, breaking down tasks to include the youngest and oldest family members. “Older adults with physical limitations can still be included in kitchen activities by asking them to do a simple, helpful task, like greasing cooking pans, peeling vegetables, folding napkins or arranging flowers,” Sewell says.


  7. Reach out. Social connectedness is especially important at holiday times. “Reaching out to older relatives and friends who are alone is something all of us should do,” Lebowitz says. “Loneliness is a difficult emotion for anyone. Recent research with older people has documented that loneliness is associated with major depression and with suicidal thoughts and impulses.”


  8. Beat the blues. “Holiday blues” are feelings of profound sadness that can be provoked by all the activities of the holiday season. Seasonal blues can have a particular impact in the lives of older people, according to Lebowitz. “In some people, the ‘holiday blues’ represent the exacerbation of an ongoing depressive illness,” he says. “Depression is a dangerous and life-threatening illness in older people. Tragically, suicide rates increase with age, specifically for older men. Depression is not a normal part of aging and should never be ignored or written off.”


  9. Keep on the sunny side. Seasonal affective disorder (SAD) or winter depression is an illness that can be provoked by reductions in sunlight during the short days of winter. It is important for people confined indoors, especially those at risk for winter depression, to make time for activities that will increase exposure to daylight, according to Lebowitz.


  10. Monitor medications and alcohol. If you have senior family members, be sure to help them adhere to their regular schedule of medications during the frenzy of the holidays. Also, pay attention to their alcohol consumption during holiday parties and family gatherings. According to Sewell, alcohol can provoke inappropriate behavior or interfere with medications.

“Older family members with special needs can get lost in the shuffle and chaos of happy family gatherings,” Sewell says. “So, with all the hustle and bustle of the season, just remember to be sensitive and loving. And plan ahead.”


Who will look after Boomer?

(Deb's yellow Lab, Boomer)

We were reminded by our friends at Needham, Mitnick and Pollack, a Northern Virginia elder law practice, that you can make provision for your pets in your Powers of Attorney. For example, you can designate a person to handle a pet's care or placement in the event you can no longer care for your pet. A provision can also be included that authorizes the designated Agent to pay for such expenses as veterinarian services, pet daycare, boarding, and medication. A provision can also be included for the pet's care in the event the pet owner will be permanently unable to care for the pet.

How wise it would be for us to plan ahead for this!  Your pet will thank you!




What to do with Mom and Dad's stuff

Researching best ways to settle family estate issues, we came across this very practical article by Liz Pullian Weston, a personal finance columnist for MSN Money.  The ideas she presesnts will hopefully go a long way toward saving your time, sanity and family realtionsips. 

Sometimes, it comes down to empty Cool Whip containers.

Appraiser Julie Hall has seen thousands in her career, spilling out of kitchen cabinets and jockeying for space with other flotsam -- margarine tubs, bread twist ties, string, rubber bands, plastic bags, pencil nubs -- accumulated by the parents of her clients.

Hall's job is to help these adult children clear out the family home after their folks have died or moved to nursing homes. But the sheer amount of stuff, worthless and valuable, piled up by Depression-era parents is often overwhelming.

"This generation is a generation that doesn't get rid of much," Hall said, "and some of them are downright hoarders."

Children facing this task often often react in a way they hadn't expected -- not with grief, Hall said, but with anger.

"They feel Mom and Dad had plenty of time to deal with this stuff during their life," Hall said. "They're furious. Then they feel guilty because they're angry."

Family relationships can suffer

And that's just the start of the bad feelings that clearing an estate can provoke. Fights among siblings over stuff can end in lifelong estrangements. Even those who get along can disagree over what to keep and what to discard, dragging the home-clearing process out for months or even years.

Hall has seen enough discord and problems in her years as an "estate contents specialist" that she authored a book, "The Boomer Burden: Dealing with Your Parents' Lifetime Accumulation of Stuff," filled with advice for surviving the process.Among her tips:

Focus on family unity. Most likely, your parents wanted their children to get along, not bicker over stuff. When making decisions, focus on respecting your parents' memory and consider each others' feelings, rather than just your own agenda.

Beware the vultures. That said, there may be neighbors, relatives or "friends of the family" ready to swoop in on the goodies. Some may even justify their actions as "saving" valuables from other, less worthy heirs. If your parents didn't leave someone in charge, such as an executor, appoint someone to secure the house immediately and change the locks. Make sure everyone understands that taking items without the others' consent is theft.

Hire an appraiser. As Hall is fond of saying, just because something's old doesn't mean it's valuable. Likewise, some stuff that looks like junk may not be. (Hall once rescued an old, valuable Louis Vuitton trunk from a garbage bin after an overwhelmed heir threw it out.) You want a professional to help you identify what's worth keeping (or selling) and what isn't.

Decide what to do with the valuable stuff. If your parents didn't designate who gets what, that task falls to the executor, unless you can work something out an equitable distribution with your siblings. The valuable items no one wants (or that no one can agree on) can be sold at an estate sale or auction, with the cash distributed to the heirs.

Here's what you need to think about when your folks leave behind a home.

Try to have all your siblings present for the clear-out day. Once the valuable items have been sold or removed for sale, you can schedule a day to clear out the rest of the house. Include everybody, if possible: You need the help, and having everyone present to make decisions can help prevent later recriminations.

Arrange for charitable and trash pickup two or three weeks in advance. Charities often require advance notice for at-home pickups. You'll also want to find out whether the city will haul away a lot of extra trash or whether you'll need to rent a Dumpster. If there are paint cans, pesticides or other hazardous materials in the home -- and there probably are -- contact the nearest hazardous-waste disposal site for its location and hours.

Arrange for a shredding service. The cost varies by community, but you can often get a commercial shredding service to come to a home for less than $100, Hall said. Any discarded paperwork with personal financial information, including Social Security and account numbers, should be shredded.

Bomb the place. Attics and basements may be overrun with insects and spiders; if so, Hall recommends setting off bug bombs a week in advance.

Accumulate the necessary supplies. Hall recommends getting:

  • Thirty to 50 sturdy boxes.
  • A box of 100 heavy-duty trash bags.
  • At least six rolls of packing tape.
  • Permanent markers for labeling boxes.
  • A tool kit with screwdrivers, pliers, a measuring tape and a hammer.
  • A hand truck.
  • A wheelbarrow.

Those working in the house should wear work clothes and be supplied with:

  • Leather and latex gloves.
  • Respirators or dust masks.
  • Kneepads and back supports.

Also supply plenty of water, soft drinks and snacks along with any meals your crew might need.

Designate a "safe" room and a "donate" room. Items that have been promised to the heirs get moved to the safe room; everything that's going to charity moves to the donate room.Look for hidden treasures. Hall, who has found diamond jewelry atop attic rafters, money between the pages of books and valuables buried in flour, recommends checking the following:

  • Clothing and shoes.
  • Drapery hems.
  • Canister sets (dump the flour or sugar through a colander).
  • Books.
  • Ice cube trays.
  • Toilet tanks.
  • Balls of duct tape.
  • Picture frames (between the mats and the pictures).
  • Attic rafters.

Take each bag of trash immediately to the curb. You don't want people tripping over bags, and getting the junk out of the house will give you a much-needed sense of progress.

Get your own house in order

Use the experience to simplify your own estate. There's nothing like sorting through someone else's clutter to inspire you to get rid of your own.

In fact, if you have kids, Hall suggests making their life easier by starting to:

  • Get rid of the junk. If you haven't used it in the past year, ditch it.
  • Give away family heirlooms while you're alive (and can enjoy the reaction).
  • Make a list of who gets what when you die.

Hall recommends hiring an appraiser to go through your home and give you approximate fair market values for your better stuff. Also include on the list items that have sentimental value.

If your children are adults, you can circulate this list among them, letting them tell you what items they'd like (with the understanding that asking for something doesn't mean they'll get it).

Here's what you need to think about when your folks leave behind a home.

Then you, the parent, should decide who gets what, using the values the appraiser has given to keep things approximately equal. Don't bother with putting stickers on the items, Hall said, since stickers can fade, fall off or be switched. Print up a new list with this information and give copies to all your kids so there are no surprises.

Will they fuss? Probably. "But they'll get over it," Hall said. But because you've made the tough decisions, she said, "they won't end up hating each other."

Liz Pulliam Weston's new book, "Easy Money: How to Simplify Your Finances and Get What You Want Out of Life," is now available. Columns by Weston, the Web's most-read personal-finance writer and winner of the 2007 Clarion Award for online journalism, appear every Monday and Thursday, exclusively on MSN Money. She also answers reader questions on the Your Money message board.



Good "read" - Final Gifts

I recently picked up a copy of Final Gifts: Understanding the Special Awareness, Needs and Communications of the Dying.  I know, it's not exactly a "summer read" but its insight into what we can expect during the last days of a loved one's life is invaluable.  Here is the Kirkus Review:

Impressive insights into the experience of dying, offered by two hospice nurses with a gift for listening. The ``final gifts'' of the title are the comfort and enlightenment offered by the dying to those attending them, and in return, the peace and reassurance offered to the dying by those who hear their needs. Callanan and Kelley describe a phenomenon they term ``Nearing Death Awareness''--which resembles somewhat the near-death experience sometimes reported by individuals revived after being clinically dead. Nearing Death Awareness, however, develops slowly, and the dying person seemingly drifts for a time between two worlds. Attempts by the dying to communicate about this awareness, often expressed in symbolic language or gestures, may be misunderstood by those around them, who dismiss the expressions as mere ``confusion.'' According to the authors, dying messages fall into two categories: descriptions of what they are experiencing (such as the places they see, the presence of others no longer alive, or their knowledge of when death will occur) and requests for what the dying need for a peaceful death (a reconciliation, for instance, or the removal of some barrier to departure). To illustrate, Callanan and Kelley include numerous examples of Nearing Death Awareness from their years of caring for the dying. And they offer practical advice not only to involved family members but also to professional caregivers on how to recognize, understand, and respond to a dying person's messages. No lugubriousness or false cheerfulness here, but acute observations and astute advice on a difficult topic. -- Copyright ©1992, Kirkus Associates


Planning for Long Term Care

People generally think that Medicare or Medicaid will pay for long term care.  If you are one of those relying on these programs to provide services for you as you age, you  need to be aware of their limitations.  Medicare may pay up to 100 days of care in a skilled nursing facility per benefit period - 100% for the first 20 days (if skilled care is needed AFTER a 3-day hospital admittance/stay).  For Days 21-100, Medicare requires a co-payment.  Medicaid generally pays for certain health services and nursing home care for individuals with low incomes and limited resources.  Should you not be able to take advantage of either of these public programs, you may want to consider private long term care insurance.  Without it, the high cost of long term care is unafforable for most Americans.

The Estate Planning and Elder Law Firm, PC (http://chroniccareadvocacy.com) recently posted a newsletter article written by Jeffrey Gump entitled "What You Need to Know about Long Term Care Planning".  Here are some pertinent facts related in it: 

According to a Genworth Financial 2012 Cost of Care Study, in Virginia:  the average cost of a private room in a nursing home was $82,125/year; the base rate for Assisted Living Facilites averaged $41,775/year; adult day services averaged $55/day; and hourly home care agency rates averaged $18 for a licensed home health aide.  Considering that a 65 year old female has a 2.6% chance of a major house fire, 18% chance of a severe car accident, and a 72% chance of needing some kind of long-term care, Americans need to think twice about purchasing Long-Term Care Insurance. Only 8 million Americans currently own it.

Long Term Care Insurance (LTCI) helps provide the cost of long-term care beyond a pre-determined period.  LTCI covers care generally not covered by health insurance, Medicare or Medicaid.  People who need it are generally not sick in the traditional sense, but instead, have a severe cognitive impairment or are unable to perform at least 2 of the 6 basic activities of daily living (ADL): eating, bathing, getting dressed, using the restroom, transferring/moving in and out of bed/chair, and continence issues.

The younger you are when you purchase these policies, the less expensive they are.  However, LTCI premiums are tax-deductible up to a certain amount that is determined by the insured's attained age on December 31, 2013 using the following table:

$360: 40 years old or under
$680: 41 to 50 years old
$1,360: 51 to 60 years old
$3,640: 61 to 70 years old
$4,550: 71 years old or older

Something for us all to think about...


Making the iPad more Accessible for Older Adults

During the May 24th, 2013 edition of the National Public Radio’s Science Friday program, Therese Willkomm, director of New Hampshire's State Assistive Technology Program, which is housed in the Institute on Disability at the University of New Hampshire offers some great ideas on tackling new technology in the golden years. She is also the author of Assistive Technology Solutions in Minutes.

Here’s what she suggests for making the iPad a bit more accessible:

  1. Build an iPad stand. Older adults who have trouble holding the iPad for long periods will benefit from a customized iPad stand that you can build with about $2 worth of corrugated plastic, says Willkomm. Users with limited arm strength will also benefit from hanging the iPad over the back of a chair using a 75-cent padded industrial twist tie.

  2. Flag hard-to-see buttons. Use tiny, high-contrast stickers to label the home button, volume button and power button on the iPad. This will make those buttons much easier to find and use. “It’s really hard to find that black home button on that black glass,” says Willkomm.

  3. Wear gloves for more restful surfing. People with arthritis may feel more comfortable resting a hand on the iPad screen when using the device for long periods. But such rest periods can cause users to “inadvertently hit buttons that you didn't want to hit,” says Willkomm. Rather than getting frustrated by unintended commands, she recommends buying an inexpensive pair of knit gloves. Cut off the tip of the middle finger. Use the uncovered fingertip to navigate the iPad. Resting a gloved hand of the screen won’t activate any iPad commands.

  4. Use voice instead of fingers. Navigating the iPad or iPhone keyboard can be challenging for even the most nimble-fingered users. The Siri voice-activated software can help older users avoid the keyboard altogether when surfing the Internet. Tapping the microphone icon available in many iPad programs allows users to speak, rather than type, emails and text messages. 

  5. Get rid of ads and enlarge the type. Use the “Reader” button in the iPad web browser to get rid of screen clutter and make reading easier. Open one website using the Safari web browser. Tap the purple “Reader” button in the URL window. The web page will appear in a new window and will be stripped of all advertisements and other screen clutter. Tap the upper-left corner of the screen to enlarge the type size.

Tom Kamber, executive director of  Older Adults Technology Service (OATS) , says that participating in training programs and social groups with other technology users can also help make technology more accessible to older adults. The nonprofit organization promotes computer use among older adults in New York City.

“When people come in for iPad training, many of them are starting with the barrier of being an older individual who may not really have connections with their own friends and peers that are using these devices,” says Kamber. “So they haven't been able to observe people succeeding with them. They haven't been able to see what people are getting out of the use of these new tools.”

Some people will need assistive supports to help them use an iPad, says Kamber. But most people just need some basic training in how to use the device.

Technology experts aren’t actually the best people to offer that training, he warns.

“You don’t need someone with a computer science degree,” he says. “What you really want is somebody who enjoys the experience of talking and being patient with an older person on their learning track and their learning pace, and can relate it to the things that older people need. This notion of relevance is so powerful and so important for older learners, many of whom feel really alienated by the technology and the way that we market it and design it.”


TO HEAR THE ENTIRE BROADCAST, CHECK OUT http://www.npr.org/2013/05/24/186450899/tackling-new-tech-in-the-golden-years


Everyone must leave something behind...

Some food for thought from Ray Bradbury:

 “Everyone must leave something behind when he dies, my grandfather said. A child or a book or a painting or a house or a wall built or a pair of shoes made. Or a garden planted. . .  It doesn't matter what you do, he said, so long as you change something from the way it was before you touched it into something that's like you after you take your hands away. The difference between the man who just cuts lawns and a real gardener is in the touching, he said. The lawn-cutter might just as well not have been there at all; the gardener will be there a lifetime.” 


Sequestration Cuts and Seniors

The law firm of Needham, Mitnick & Pollack, PLC of Falls Church, Virginia offers some insight into what sequester cuts will mean for seniors.  Below is an excerpt of their analysis from their March 2013 newsletter.
As a consequence of congressional gridlock, $85 billion in automatic, across-the-board spending cuts are starting to take effect.  
How will programs that seniors rely on be affected?   The good news is that big chunks of the budget are exempt from the sequester's cuts, including Social Security, Medicaid, and veterans' programs.  But while there will be no change in benefits for these programs, the federal workforce that administers them will be slashed, leading to delays and frustration.  
In the case of Social Security, for example, visitors to field offices or callers to the program's 800-number will have longer waits, and some offices may close altogether.  Checks for first-time Social Security beneficiaries will take longer to arrive and the backlog of Social Security disability claims will start ballooning again.  
Medicare benefits will not change either, but there could be more crowded waiting rooms and fewer practitioners participating in the program because payments to Medicare providers will be cut by 2 percent across-the-board.  It is estimated that the Medicare reductions will cost the medical sector more than 200,000 jobs this year alone. The 2 percent cut for doctors follows a series of previous reductions, which may translate into more doctors refusing to take Medicare patients.
The harshest impact will be on seniors who rely on federal programs to keep fed, stay warm (or cool), perform basic tasks like dressing and bathing, and keep in contact with the outside world. Senior nutrition programs like Meals on Wheels face cuts resulting in 18.6 million fewer congregate and home-delivered meals. Meanwhile, an estimated 400,000 households will be severed from the Low Income Home Energy Assistance Program, which assists low-income seniors and other households with their heating and cooling bills. Other vital services administered by Area Agencies on Aging will be cut, including rides to medical appointments or shopping trips, and in-home support for daily chores like dressing, cleaning, or cooking.  
The $85 billion in cuts on March 1 was just the beginning. Under the terms of the sequester, federal spending would be cut by $1.2 trillion from March 2013 to March 2021 in this same blunt fashion.