Sandy's on the way. Are you prepared?

No part of the country is immune from the effects of Mother Nature.

You don't have to become a survivalist, do you know what you would need if there is an evacuation and you 10 minutes or two days to prepare for an evacuation? The value of preparation, which includes having a plan A, B, C, D and E can be the difference between life and death for you and your pets. The devastating tornado that wiped out communities in and around Joplin, Mo., in 2011 offers another shocking reality check. When disaster strikes, you must be your own first responder. The right tools and the right plan can make a big difference.

Here are 10 tips to help kick-start your emergency plans.

1. Create an emergency contact list. Start with friends or family members who live nearby and can reach you or your pets quickly. Make sure they have keys, necessary codes or other information to access your home, grab the pets and evacuate. For every Plan A, have a Plan E. Most Plan A's don't happen, so Plan C has to be just as good.

2. Make an emergency kit. Fill a backpack with at least two weeks' worth of food for your pets and plan for at least a gallon of water per day, per pet. If your animal eats wet food, then it will consume less water.

3. Try camping, or at least learn a few skills. Hotels frequently change their policies during emergencies, so have a camping kit to set up wherever it is save, dry and unaffected by the current disaster event. If you lack that wilderness gene, stop by an outdoor shop for primers on purifying water or other survival skills. While you are there, stock up on a few tools, plates and a utility knife.

4. Practice makes perfect. Take a weekend and rehearse your emergency evacuation plan. It should include finding alternate exit routes for your neighborhood, just in case a downed tree or other issue creates an obstacle.

5. Take a certification course. For the best experience in planning for a disaster, learn from the experts. Sign up for a FEMA certification course or join your county emergency response team. It's one way to guarantee that you have first-hand info.

6. Invest in sturdy pet carriers. Whether your pet goes to a relative or an emergency shelter, it needs a safe place to stay, says Toni McNulty, team lead for animals in disaster with HumanityRoad.org @Redcrossdog on Twitter, a nonprofit organization that uses social media to fill the communications gap between those affected by disaster and those responding to disaster. Try a collapsible crate that is large enough to hold food and water bowls, and allows your pet to stand and turn around. "Get it ahead of time and let your pet get used to it. Mark with contact information. If your pet winds up in an emergency shelter, that contact information is necessary." It also helps to include a few favorite toys or bedding.

7. Stock the basics in an emergency bag. Be sure to include a leash (for dogs and cats), a collar with identification information, a harness and a muzzle, even if your pet is the sweetest in the land. "If an animal rescue person tries to pick up your pet, you don't want your pet biting," McNulty says. "Pets pick up stress, just like people in an emergency, and they can behave in a way that they normally don't."

8. Carry copies of documentation. Grab a waterproof container and use it to hold copies of your pet's vital information, McNulty says. The container should hold pictures of your pet, as well as a list of medications, allergies, vaccination records, a rabies certificate, and disaster contacts — inside and outside of the disaster area. When Johnnie Richey was killed in the Joplin tornado, his 9-year-old cocker spaniel was eventually reunited with the owner's sister, Kerri Simms. "Even though her brother is gone, she could retrieve his pet and have a little bit of her brother through that pet," McNulty says. "That's why it's so important that you have pictures and out-of-area contacts."

9. Carry photos that show you with your pet. To alleviate any confusion when it's time to recover your pet from an emergency facility, be sure to carry photos that show you and your pet together. McNulty says to attach those photos as proof of ownership on your pet's crate.

10. Don't wait for the second or third warning. If you live in an area that's known for weather emergencies, act as soon as you hear a warning, McNulty says. "When pets sense urgency, they hide and you lose valuable time trying to find them," she says. Keep leashes, collars and crates ready at a moment's notice, particularly if you live in a mobile home or vulnerable structure.

It also helps to bookmark a few key websites and Twitter addresses. Here are a few worth noting:
FEMA: For information regarding pets, check out the FEMA.org site before and during an emergency. (@FEMA on Twitter)

Pet-friendly lodging: In addition to checking HumanityRoad.org for frequent updates, McNulty often recommends Petswelcome.com and BringFido.com because these sites list hotels that accept multiple pets, exotic animals, birds and gerbils. But keep in mind that rules may change during emergencies.

The Red Cross: Although the Red Cross does not accept pets during emergencies, it's important to bookmark the site for evacuation information regarding your area.

Falls could indicate early onset Alzheimer's

Compared with older people with no signs of Alzheimer's, those whose brains show early signs of the disease are twice as likely to experience a fall, researchers have found.

In the new study, investigators looked at brain scans of 125 older adults who were participating in a study of memory and aging. The seniors were also asked to keep track of how many times they fell over the course of eight months.

An increased risk of falls was noted among individuals whose scans showed early signs of Alzheimer's. The study authors suggested that falls could indicate the need for an evaluation for the memory-robbing disease.

"To our knowledge, this is the first study to identify a risk of increased falls related to a diagnosis of preclinical Alzheimer's disease," study author Susan Stark, an assistant professor of occupational therapy and neurology at Washington University in St. Louis, said in a news release from the Alzheimer's Association International Conference.

"This finding is consistent with previous studies of mobility problems among persons with very early symptomatic Alzheimer's or mild cognitive impairment. It suggests that higher rates of falls can occur very early in the disease process," Stark added.

The study, which was slated for presentation Sunday at the Alzheimer's Association International Conference in Paris, found that of the 125 adults studied, 48 people experienced at least one fall.

The brain scans of the participants showed that higher levels of an imaging agent that binds to the abnormal protein growth that is a signature of Alzheimer's disease, was associated with a 2.7 times higher risk of a fall for each unit of increase on the scan.

The researchers noted that Alzheimer's has been linked to balance and gait disorders, as well as problems with visual and spatial perception, which could put people with the disease at higher risk for falls. Based on their findings, they added, these symptoms may appear before other more obvious signs of the disease, such as memory loss and impaired thinking.

"Growing scientific evidence suggests that 'silent' biological changes may be occurring in the brain a decade or more before we can see the outward symptoms of Alzheimer's," Maria Carrillo, Alzheimer's Association senior director of medical and scientific relations, said in the news release. "According to this study, a fall by an older adult who otherwise has a low risk of falling may signal a need for diagnostic evaluation for Alzheimer's."

The study authors concluded that additional research is needed to improve early detection and intervention in Alzheimer's disease. Lowering the risk of falls, they added, could also have an economic impact since these incidents contribute to higher rates of disability among older adults, premature placements in nursing homes and more than $19 billion in direct medical costs in 2000 alone.

Insomnia Major Driver of Costly Workplace Accidents & Errors

A national study led by Harvard Medical School researchers found that insomnia was associated with a much higher percentage of workplace accidents and errors than any other chronic condition. These errors were also more costly. Researchers estimate that insomnia costs employers $31.1 billion annually.

Researchers conducted a cross-sectional survey of commercially insured individuals. Participants were asked about nineteen chronic conditions including diabetes, arthritis, and depression. Researchers looked into medical and pharmaceutical claims to confirm these conditions, and those that reported insomnia were then screened to ensure that their insomnia was not caused by other chronic conditions. Participants were also asked if they caused damage, work disruption, or mistakes that cost their company $500 or more.

Those who suffered insomnia were responsible for 7.2 percent of all costly workplace accidents or errors, which is a 40 percent higher risk than workers with any other condition. These mistakes were also associated with higher costs. 23.7 percent of all costs spent on workplace accidents or errors were generated by individuals with insomnia.  Insomnia related errors cost on average $32,062, while non-insomnia errors cost $21,914 on average. This difference was even seen when researchers controlled for educational level, age, and other demographic factors.

To learn more about this read Time Magazine article.

Medicare open enrollment starts today...

Medicare open enrollment is just around the corner Oct. 15 - Dec. 7. Whether you’re a person with Medicare, a caregiver, or professional helping clients to review their coverage options, we’ve got some helpful tips for you to keep in mind this season.

Tips for Consumers

1. Start early - Yes, open enrollment runs until Dec. 7. But the best time to start thinking about whether you want to change your drug or health coverage is now. If your circumstances have changed—for example, you’re taking different medications, or you’ve heard that your plan is changing—it’s important to have time to review all your options. And if you need personalized assistance, it’s easier to schedule an appointment now than if you wait until after Thanksgiving.

2. Pay attention to your mail - This is the time of year that you’ll start to get a lot of information.
Your Part D or Medicare Advantage plan sends out an Annual Notice of Coverage in September, which explains any changes happening to your plan and/or to your benefits in 2013.
If you get help paying for your Medicare, such as through the Medicare Part D Low Income Subsidy (Extra Help) or Medicare Savings Programs, you may receive mail from Social Security or Medicare asking you to verify your income or informing you of changes to your subsidy. You may also get a letter if your plan is ending service in your area, or has not met quality standards for three years. Save all of these letters, and have them on hand as you discuss your options with an SGIA (Strategic Growth Insurance Associates) counselor.

3. Review, review, review - Many people are happy with their current coverage, and would rather not check what other options are available to them. But this is a very important step, and can save you money. What should you look for? We like to remind people of the 4 Cs:

• Cost - How much have you spent in premiums, deductibles, and co-payments in 2012? How will these amounts change in 2013??
• Coverage - Does your plan cover all of the medications you believe you will need in 2013?? Do you want to get your health care and drug coverage through one single plan? If so, you should review your Medicare Advantage options.
• Convenience - To what extent will your plan restrict access to certain medications you need in 2013, such as through prior authorization or quantity limits? Can you use the plan at the pharmacy of your choice? Can you get your prescriptions through the mail if you prefer to?
• Customer service - Is your plan responsive when you have a question?

It's that time of year...get your flu shot

Just as they do every year, the CDC strongly recommends a seasonal flu shot to almost everyone, but it's especially important for seniors who are more vulnerable. The flu puts more than 200,000 people in the hospital each year and kills around 24,000 — 90 percent of whom are seniors.

This year, all seniors 65 and older have two flu vaccine options from which to choose. A traditional flu shot, or a shot of Fluzone High-Dose. The high-dose vaccine contains four times the amount of antigen (the part of the vaccine that prompts the body to make antibody) as a regular flu shot does, which creates a stronger immune response for better protection.

And if you're under age 65, your two options are a regular flu shot, or a shot of Fluzone Intradermal. The intradermal vaccine uses a shorter, thinner needle to inject the vaccine just under the skin, rather than in the muscle like other flu shots. If you're squeamish about needles, this is a nice option.

You also need to be aware that if you're allergic to chicken eggs or if you have had a severe reaction to a flu vaccine in the past you should not get vaccinated without consulting your doctor first.

To locate a vaccination site that offers regular, high-dose and intradermal flu shots, ask your doctor or pharmacist, or check the online flu-shot locator at flu.gov. Most chains like CVS, Walgreens, Safeway, Kmart, Walmart, Rite Aid and Kroger offer all types of shots.

The importance of a special needs trust

The following is an excerpt from an excellent article that appears in the NY Times, October 5, 2012.

An estimated 6.9 million non elderly disabled people receive Social Security payments under the Supplemental Security Income program, according to federal government figures.

 For every one of those people, many of whom draw from multiple sources of government aid, there are often several family members helping to sort out the financial details of that relative’s care. They navigate a confounding thicket of tasks and rules. On one side, there is the bureaucracy that government program administrators may erect at any moment. On the other, there are specialized trust accounts and estate planning issues to consider. Even sophisticated investors and ace budget masters find themselves lost when encountering all of this for the first time.

 There are few well-marked road maps for these people, as there are for those trying to invest their 401(k) money or refinance a mortgage. But there are a growing number of financial advisers and other professionals who themselves have special needs children or siblings. Because they’ve been there, they know the practical steps that most families need to take.  

Read full article... 

Eeking out a living on social security

For the millions of Americans who rely solely—or heavily—on Social Security as income, life is tough, according to a New York Times article published this week. As retirees weigh the most basic living expenses including food, housing and medical needs, many are finding there is simply no leeway in the budget. It can lead to choices impacting where seniors are living and what they are doing with their home equity.

The reality is, most have few other options with nearly three quarters of unmarried people receiving at least half their income from the program, and nearly a quarter of married couples receiving 90% or more, NY Times reports.

For some, it works, but for many it presents a struggle as rent or housing, medical bills and food take top priorities for spending.

“It gets hard for a lot of people to imagine getting along on just the Social Security check, but obviously millions of people are doing it,” said David Certner, legislative policy director for AARP. “They’re really living month to month and relying on that check. Some people have a paid-off home, but they’re still dealing with upkeep, insurance, taxes, plus utilities and health care.”

With an average monthly payment of $1,200 per individual (the actual amount is determined from one’s earnings record), nobody is getting rich on Social Security; that’s $14,400 a year, not much above the federal individual poverty line of $10,890, and payments aren’t adjusted by regional differences in the cost of living.

Modest as that average income is, someone would need about $300,000 to buy an equivalent annuity with a built-in cost-of-living increase, Mr. Certner said. Few retirees have savings like that.

 Read the full Times article. 

Who determines when the elderly stop driving...families or doctors?

Families may have to watch for dings in the car and plead with an older driver to give up the keys — but there’s new evidence that doctors could have more of an influence on one of the most wrenching decisions facing a rapidly aging population.

A recent study in the New England Journal of Medicine found that when doctors warn patients, and tell driving authorities, that the older folks may be medically unfit to be on the road, there’s a drop in serious crash injuries among those drivers.

The study, could not tell if the improvement was because those patients drove less, or drove more carefully once the doctors pointed out the risk.

But as the number of older drivers surges, it raises the question of how families and doctors could be working together to determine if and when age-related health problems — from arthritis to frailty to Alzheimer’s disease — are bad enough to impair driving.

Often, families are making that tough choice between safety and independence on their own.

By one U.S. estimate, about 600,000 older drivers a year quit because of health conditions. The problem: There are no clear-cut guidelines to tell who really needs to — and given the lack of transportation options in much of the country, quitting too soon can be detrimental for someone who might have functioned well for several more years.

Doctors aren’t trained to evaluate driving ability, and the study couldn’t tell if some drivers were targeted needlessly, noted Dr. Matthew Rizzo of the University of Iowa. Yet he called the research valuable.

“The message from this paper is that doctors have some wisdom in knowing when to restrict drivers,” said Rizzo. His own research shows some cognitive tests might help them better identify who’s at risk, such as by measuring “useful field of view,” essentially how much your brain gleans at a glance — important for safety in intersections.

Today, the American Medical Association recommends that doctors administer a few simple tests in advising older drivers. Among them:

—Walk 10 feet down the hallway, turn around and come back. Taking longer than 9 seconds is linked to driving problems.

—On a page with the letters A to L and the numbers 1 to 13 randomly arranged, see how quickly and accurately you draw a line from 1 to A, then to 2, then to B and so on. This so-called trail-making test measures memory, spatial processing and other brain skills, and doing poorly has been linked to at-fault crashes.

—Check if people can turn their necks far enough to change lanes, and have the strength to slam on brakes.

Dr. Gary Kennedy, geriatric psychiatry chief at New York’s Montefiore Medical Center, often adds another question: Are his patients allowed to drive their grandchildren?

“If the answer to that is no, that’s telling me the people who know the patient best have made a decision that they’re not safe,” said Kennedy, who offers “to be the bad cop” for families or primary care physicians having trouble delivering the news.

There are no statistics on how often doctors do these kinds of assessment.

“It’s this touchy subject that nobody wants to talk about,” said Dr. Marian Betz of the University of Colorado, whose surveys show most senior drivers don’t think their doctors know whether they drive. She is testing if an advance directive would help get older adults talking with their doctors about how to keep watch on their driving fitness before trouble arises.

More objective measures are needed — and to help find them, hundreds of older drivers are letting scientists install video cameras, GPS systems and other gadgets in their cars as part of massive studies of everyday driving behavior.

Identifying who needs to quit should be a last resort, said Jon Antin of the Virginia Tech Transportation Institute. He helps oversee data collection for a study that’s enrolling 3,000 participants, including hundreds of seniors, in Florida, Indiana, New York, North Carolina, Pennsylvania and Washington. The drivers undergo a battery of medical checks before their driving patterns are recorded for 12 to 24 months.

For now, advocacy groups like the Alzheimer’s Association and KeepingUs Safe offer programs to help family’s spot signs of driving problems and determine how to talk about it. 

Founded in 2008, Keeping Us Safe is an organization that serves older drivers and their families across both the United States and Canada. "Beyond Driving with Dignity is a workbook to help your family make driving-related decisions that are in the best interest of the older driver", says founder & President Matt Gurwell.