Low property values still plague seniors

A new report from Smart Money shows that after almost five years of falling home pries, many retirees must consider what to do with their homes should prices continue to collapse.

Many who are approaching retirement have been counting on their home equity as a way to finance their golden years, but the real estate downturn has made it more difficult.

In the past, Americans hoped to age in place and viewed the equity in their home as the break-in-case-of-emergency asset, the one asset they would use to pay for long-term care or nursing homes.

Today, however, aging in place isn’t the option it once was, especially given the possibility that the equity in one’s home might be falling in value, while the cost of keeping a home real estate taxes, property insurance premiums and utilities is rising.

“The vast majority of people are looking to age in place,” said Kenn Tacchino, a professor at Widener University as well as the director the New York Life Center for Retirement Income at the American College. Unfortunately, keeping a home a person used to raise his or her family “may not be the most cost-effective or accommodating place for retirement living,” he said.

Addiction knows no age

The following article appeared in the Wall Street Journal on May 18, 2011 and speaks to the growing problem of drug and alcohol abuse among our older citizens.

"I retired, I started drinking more," one man said. "I lost my father, my mother, my dog, and it gave me a good excuse," said another.

A remarkable shift in the number of older adults reporting substance abuse problems is making this scene more common. Between 1992 and 2008, treatment admissions for those 50 and older more than doubled in the U.S. That number will continue to grow, experts say, as the massive baby boom generation ages.

"There is a level of societal denial around the issue," said Peter Provet, the head of Odyssey House in New York, another center offering specialized substance abuse treatment programs for seniors. "No one wants to look at their grandparent, no one wants to think about their grandparent or their elderly parent, and see that person as an addict."

All told, 231,200 people aged 50 and over sought treatment for substance abuse in 2008, up from 102,700 in 1992, according to the federal Substance Abuse and Mental Health Services Administration. Older adults accounted for about one of every eight seeking help for substance abuse in 2008, meaning their share of treatment admissions has doubled over the 16-year period as other age groups' proportions shrunk slightly.

The growth outpaces overall population gains among older demographics. Between 2000 and 2008, substance abuse treatment admissions among those 50 and older increased by 70 percent while the overall 50-plus population grew by 21 percent. Experts say that's because boomers have historically high rates of substance abuse, often developed three or four decades ago, that comes to a head later in life.

"The baby boom population has some experience with substance misuse and is more comfortable with these substances," said Dr. Westley Clark, director of SAMHSA's center on substance abuse treatment.

Treatment professionals believe the actual number of older people with substance abuse problems is many times larger than the amount seeking help.

While the number of older people with substance abuse problems is booming, relatively few facilities offer treatment programs specifically for their age group. Most pool people of all ages together; many divide by gender. Those that do offer age-specific programs say it helps participants relate to one another and keeps them focused on themselves, rather than mentoring younger addicts.

Provet said some have questioned whether it's worthwhile to target efforts at seniors, who generally have fewer years left to benefit from treatment than younger people. He dismisses that reasoning, comparing it to arguing that a cancer patient should be turned away from chemotherapy or radiation treatments simply because they're 65.

Besides, older participants at Odyssey House have the highest completion rate — 85 percent during the last fiscal year.

"It's almost as if they say, 'This now is my last shot. Let me see if I can get my life right finally,'" he said.

Among those taking that approach is Henry Dennis, who at 70 has used heroin for the past 50 years. He came to Odyssey before, relapsed and was arrested for drug possession. Dennis says he's seen at least a dozen friends die of drug use, but it wasn't enough to make him stop.

Now in his eighth month of treatment, he says he finally has the resolve to quit.

"I'm going to get it right this time," said Dennis, who has worked a variety of odd jobs. "I don't want to die, not just yet."

Dennis' treatment is paid for by the state of New York. Many pay out of pocket. Medicare offers some coverage for outpatient treatment but generally doesn't cover inpatient programs.

Experts have observed a rise in illicit drug use, while treatment for alcohol has dropped even though it remains the chief addiction among older adults. The 2008 statistics show 59.9 percent of those 50 and older seeking treatment cited alcohol as their primary substance, down from 84.6 percent in 1992. Heroin came in second, accounting for 16 percent of admissions in that age group, more than double its share in the earlier survey. Cocaine was third, at 11.4 percent, more than four times its 1992 rate.

Surveys show the vast majority of older drug addicts and alcoholics reported first using their substance of choice many years earlier, like Dennis. That lifelong use can lead to liver damage, memory loss, hepatitis and a host of other medical issues. A minority of people find comfort in drugs and alcohol far later, fueled by drastic life changes, loneliness or legitimate physical pain.

Don Walsh, a participant at Hanley's support group, falls into the latter category. He is among 19 men and women who gather on this day in the room with pale blue walls and the calming whir of a fish tank. One comes in a wheelchair, another with a walker; one dozes off during the session.

Walsh, a 77-year-old lawyer, says he didn't develop a problem with alcohol until he retired a year ago. His relentless schedule of 12- to 14-hour days disappeared into a series of leisurely lunches and dinners where the wine flowed freely. One day, he blacked out in his garage. Had it happened while he was driving home, he thought, he might have killed himself and others.

After six weeks of treatment, Walsh says he no longer craves alcohol.

"I have a new lease on life," he said.

Primary care physician help keep seniors out of the hospital

As the primary-care workforce continues to be strained, new research shows that areas with higher levels of primary care have fewer patient deaths and preventable hospitalizations, according to a study in The Journal of the American Medical Association.

Researchers evaluated seniors with Medicare benefits who live in areas with higher levels of adult primary care physicians and physicians providing primary care. They found that elder patients were less likely to die or land in the hospital.

Experts agree that graduating medical students electing other specialties other than primary care results in a primary care vacuum that must be filled.
If the United States could fulfill the primary-care need, it would result in 50,000 fewer deaths and 436,000 fewer hospitalizations in a year, notes Reuters.

Seniors are staying in their homes longer...less likely to sell

Great information from our friends at Senior Housing News, written by Alyssa Gerace

A March 2011 report from Harvard University’s Joint Center for Housing Studies shows that many seniors who had planned to retire and move to a different home deferred that decision after the recent financial crisis took a toll on both the equity in their homes and their retirement accounts. Mobility rates, or the rate at which households report having moved, have declined for the senior population as a result.

The report states that mobility rates have been trending downward since the mid-1980s, and that the chance of a homeowner moving any given year decreased from about 10% (between 1986-87) to 5.5% for 2007-08.

“The 2008-2009 national economic recession further accelerated the downward trend in mobility because so many owners were left underwater (or nearly so) on their mortgages, making it difficult for households to move,” the report states. “Mobility rates among older owners posted the sharpest drop.”

According to one figure, the mobility rate among those aged 55 or older dropped 37.5% between 2005 and 2009.

“Many seniors who planned to retire and move to a different home deferred that decision after the recent financial crisis took a toll on both the equity in their homes and their retirement accounts,” the report says. However, the study goes on to say that many of those who had owned their homes for long periods of time “had paid down significant amounts of debt,” meaning they would still have home equity and be candidates for a reverse mortgage.

Tabulated results from a 1995-2007 American Housing Survey show that 62% of the 75 and older crowd had been residing in the same home for 20 or more years. And, the report says, these homes are typically less valuable since older homeowners are less likely to remodel their homes to modern standards or expectations. This, in addition to a depressed housing market, makes it less likely that seniors will find it worthwhile to sell their home, but more likely that they may want to obtain a reverse mortgage.

Although the baby boomer generation generally lives in newer (and thus more valuable) housing, trends suggest that as they near retirement age, they may have more incentive to remain in their homes to stay close to grandchildren or continue to work, and less incentive to move because of their home’s decreased value in the overall market.

“In the near-term, we are likely to see mobility rates remain below their long-term trend,” the report states. “Until house prices begin to recover, a large share of the population will continue to owe more on their mortgage than their house is worth, limiting their ability to move.”

The elderly are better off than advertised

The following is a very good article that appeared in the Washington Post on May 15 by opinion columnist Robert Samuelson

When House Speaker John Boehner calls for trillions of dollars of spending cuts, the message is clear. Any deal to raise the federal debt ceiling must include significant savings in Social Security and Medicare benefits. Subsidizing the elderly is the biggest piece of federal spending (more than two-fifths of the total), but trimming benefits for well-off seniors isn’t just budget arithmetic. It’s also the right thing to do.

I have been urging higher eligibility ages and more means-testing for Social Security and Medicare for so long that I forget that many Americans still accept the outdated and propagandistic notion that old age automatically impoverishes people. Asks one reader: Who are these “well-off” elderly you keep writing about? The suggestion is that they are figments of my imagination, invented to justify harsh cutbacks in Social Security and Medicare on the needy.
Just the opposite. We see every day that many people in their 60s and older live comfortably — and still would if they received a little less in Social Security and paid a little more for Medicare. The trouble is that what’s intuitively obvious becomes lost in the political debate; it’s overwhelmed by selective and self-serving statistics that cast almost everyone over 65 as being on the edge of insolvency. The result: Government over-subsidizes the affluent elderly. It transfers resources from the struggling young to the secure old.

To correct the stereotype, consult a government publication called “Older Americans 2010, Key Indicators of Well-Being.” It reminds us that Americans live longer and have gotten healthier. In 1930, life expectancy was 59.2 years at birth and 12.2 years at 65; in 2006, those figures were 77.7 and 18.5. Since 1981, death rates for heart disease and stroke have fallen by half for those 65 and over. In this population, about three-quarters rate their own health as “good” or “excellent.”

“Most older people are enjoying greater prosperity than any previous generation,” the report says. Consider:

l From 1959 to 2007, the proportion of the 65-plus population with incomes under the government’s poverty line ($12,968 for a couple in 2009) dropped from 35.2 percent to 9.7 percent, which was half the poverty rate for children under 18 (18 percent).

l  The proportion of elderly living in the “high income” group — defined as four times the poverty line, or almost $52,000 for a couple in 2009 — rose from 18.4 percent in 1980 to 30.6 percent in 2007.

l  In 2007, the median net worth (that is, assets minus debts) of 65-plus households was $237,000, about twice the amount for households aged 45 to 54. Among 65-plus married couples, median net worth was $385,000.

Indeed, half the nation’s wealth is owned by people 55 and older (a third of the adult population), report Eugene Steuerle and Stephanie Rennane of the Urban Institute. The old feel more secure. The National Opinion Research Center regularly surveys Americans about their financial “satisfaction.” In 2010, 82 percent of those 65 and over said they were “satisfied” or “more or less” satisfied. For those under 65, the comparable figure was 66 percent.

Older Americans also fared better in the recession, a 2009 Pew survey found. Among those 18 to 49, 68 percent reported that they “cut back spending” in the past year; for those 65-plus, that was 36 percent.

Social Security and Medicare explain much of this well-being. For millions of older Americans, they are essential; among the poorest two-fifths, Social Security provides 83 percent of their income. But among the richest fifth, its share is only 18 percent.

The problems of old age (chronic illness, outliving savings, loneliness) are real, but age by itself is not an indicator of need. The blanket defense of existing Social Security and Medicare isn’t “liberal” or “progressive.” It’s simply a political expedient with ruinous consequences. It enlarges budget deficits and forces an unfair share of adjustment — higher taxes, lower spending — on workers and other government programs. This is the morality of the ballot box.

People do not lose their obligations to the larger society by turning 65. We need to refocus these programs on their original purposes. Social Security was intended to prevent poverty, not finance recipients’ extra cable channels. Medicare provides peace of mind as well as health insurance; wealthier recipients can afford to pay more for their peace of mind. Burden-sharing needs to include the elderly. This is the crux of the budget problem.

Facing it is both a moral and financial imperative. With the 2012 election looming, major overhauls of these programs seem unlikely. Still, more modest changes (slow increases in eligibility ages, added taxation of Social Security benefits, costlier Medicare for upscale beneficiaries) could produce significant savings. If even these are absent, the meaning will be plain: Old stereotypes continue to trump new realities.

Aging parents prefer living with daughters more than sons

Aging parents think they can depend more on their daughters than their sons, according to the results of a new study commissioned by Senior Helpers, a national in-home care provider.

While almost 95 percent of older people would prefer to remain living independently, 70 percent of aging mothers - and 52 percent of aging dads - said that if they rather move in with a daughter than a son, according to the study. Meanwhile, 65 percent of mothers and almost 60 percent of fathers said their adult daughters would welcome their into their households if they needed care.

The best news? According to the research, an overwhelming number of older moms and dads alike - 80 percent -- said they had no doubt that their adult children would provide care for them just as they have for their own elders.

Physicians focus on the importance of mental health for the elderly

The Merry Widows, as they call themselves, were blinged out, Florida-style, to celebrate Elayne Weisburd’s 79th birthday at a sprawling community for seniors. Mylar balloons levitated above their table, and sparklers twinkled from a cake.

The guest of honor and her two friends were beaming when Dr. Marc E. Agronin, a geriatric psychiatrist and the director of mental health, arrived with a hug for everyone long after what would be normal office hours.

The Merry Widows moved to the community when their husbands developed Alzheimer’s disease and looked to Dr. Agronin to prepare them for what lay ahead. But while treating their husbands’ disease, he became their psychiatrist, too. He urged the women to attend therapy groups, made suggestions about medication for anxiety and encouraged new bonds of friendship.

Dr. Agronin calls them his graduates — a trio of success stories 3,700 patients he is responsible for, in what, by all accounts, is the largest geriatric in the nation, at the Miami Jewish Health Systems.

The doctor is a rare breed even in Florida, which has the highest proportion of people older than 65. There are only 17 board-certified geriatric psychiatrists in the state, and a mere six here in southeast Florida, where snowbirds from New York often come to perch. In March, acknowledging the crisis in care, the federal Institute of Medicine began a study of the shortage of geriatric mental health workers nationwide.

Report warns that older Americans will face a lack of geriatric specialists

The report, published this month in the Journal of the American Geriatric Society, warns that as the proportion of older adults spikes from 12% to a projected 20% by 2030, caring for 70 million people 65 and older and 10 million 85 and older will be a challenge.

Other types of health care providers will need to work in teams with the doctors to help coordinate patient care, according to the report.

"There are not going to be enough geriatricians," says physician Gregg Warshaw, an author of the report and chair of the division of geriatrics at the University of Cincinnati. Currently, he says, "80% of pediatric patients see pediatricians, while 80% of geriatric patients see primary care doctors or internists."

Earlier studies by physicians groups predicted 36,000 additional geriatricians will be needed by 2030. But the new report calls that "impossible and unrealistic." Fewer than 320 physicians entered geriatric medicine fellowship training from 2004 to 2008, the report said, noting a lack of geriatricians in some rural areas is acute.

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