Welcome ...

All too many times overwhelmed caregivers are physically and emotionally depleted and need to take time to rest and care for themselves. Believing in a holistic approach to caregiver stress and a strong commitment to helping our members find the right solutions, we created this blog to help you connect with others who, like you, may be facing the same eldercare issues and challenges. Feel free to comment, ask questions, and submit articles. Please forward the blog link to your family and friends. They'll be glad you did.

Warm regards,

Patricia Grace
founder & CEO
Aging with Grace

Wednesday, June 29, 2011

One man's opinion about the future of Medicare

The following Op-Ed appears in the June 29, 2011 New York Times, Opinion Section

The “roar” and “popular political crusade” that Frederick R. Lynch calls for in “How AARP Can Get Its Groove Back” (Op-Ed, June 24) appear to be only a slightly veiled call on the elderly to resist any and all significant cuts to Social Security and Medicare.

That might be possible with Social Security, but policy analysts have for years shown that a sustainable financial future for Medicare will require a sharp cut in benefits, and no less necessary for deficit reduction.

That need will of necessity be painful, but need not be disastrous: more money has never guaranteed good health care.

Moreover, a continued rise in Medicare costs will have to be paid for by the children of the beneficiaries.

As someone who has reached the age of 80, I would hope that if there is any wisdom at all among my peer group, it will be to recognize that our duty is more to those coming after us than to ourselves. We have made it to old age, and if AARP can bring about a sober dialogue between the young and us about how best to allocate resources fairly while saving Medicare, that would not be a roar, but common civic sense.

Garrison, N.Y., June 24, 2011

The writer is president emeritus of the Hastings Center and the author of “Setting Limits: Medical Goals in an Aging Society.”

"Mr. Callahan offers a sound and common sense approach sans the usual scare tactics." Patricia Grace

Friday, June 24, 2011

Transportation can impact the decision to age in place

Many older Americans have expressed a strong desire to age in place, but instead they might get stuck in place by 2015, when more than 15.5 million Americans aged 65 and older will live in communities where public transportation service is poor or non-existent. There’s a huge senior mobility crisis threatening older Americans, a recent Transportation for America (T4 America) study finds, as high percentages of seniors in many metropolitan areas have limited transit options besides driving.

The report, titled Aging in Place, Stuck without Options, says that in four years, a staggering 90% of seniors in the Atlanta metro area will be lacking adequate transit access—the worst in any metropolitan area with a population of more than three million. The study also finds that Kansas City and Oklahoma City, with populations between one and three million, will have 88% and 86%, respectively, of seniors lacking transit access.

A significant percentage of older Americans have departed from cities in favor of suburbs, says T4 America, where the majority of residents are car-dependent. In fact, the study says that after the age of 55, only about 5% of Americans change residences, and a recent AARP poll finds that a majority of baby boomers are determined to remain in their homes and age in place.

As seniors continue to age, many are reticent to continue driving, or may no longer be able to drive. However, seniors without access to affordable travel options make 15% fewer doctor’s appointments, 59% fewer trips to go out to eat or to the store for necessary supplies, and 65% fewer trips to socialize with friends and family, the study finds. This can be unsafe, and unfortunately, says T4 America, many seniors lose their independence because of poor public transit options.

“The baby boom generation grew up and reared their own children in communities that, for the first time in human history, were built on the assumption that everyone would be able to drive an automobile,” said John Robert Smith, president and CEO of Reconnecting America and co-chair of T4 America. “What happens when people in this largest generation ever, with the longest predicted lifespan ever, outlive their ability to drive for everything? That’s one of the questions we set out to answer in this report.”

The 2011 Joint Center for Housing Studies State of the Nation’s Housing report says the number of seniors living in suburban areas will grow by millions in the next two decades, making the transportation issue something that must be addressed in the near future. In light of this upcoming predicament, the study outlined policies that would help make it possible for seniors to remain mobile and independent, including increasing funding support for communities looking to improve public transportation service, and encouraging state departments of transportation to involve seniors in developing plans to meet their mobility needs.

T4 America says Congress is preparing to adopt a new, long-term transportation authorization this summer, an important factor as state and local governments will be needing federal funding to improve transit access in their localities.

Monday, June 20, 2011

Money, still the number 1 retirement concern

A new Gallup poll shows that two-thirds of Americans worry they will not have enough money for retirement, making it their top concern out of eight possible financial items. This represents a 13% increase in a 10-year period.

In 2001, Americans’ top three concerns were related to retirement security, having enough funds in the event of a medical crisis, and maintaining their standard of living, and Gallup indicates these issues have remained top concerns, with increased amounts of worry.

A closer look into the 66% of all Americans concerned about their future shows a staggering 77% of Americans in the 30-49 age range who consider themselves moderately or very worried about retirement—the most of any age bracket.

Many of those in that same age group also believe Medicare and Social Security are in a crisis, and Gallup says 74% of nonretiree investors plan to rely more on an IRA, 401(k), or other retirement savings than on Social Security.

The poll shows that worry about maintaining an an enjoyable standard of living has reached a new high at 58% of all Americans, up from 43% in 2001. Concerns over medical costs have been high since the 2008 recession, with 60% of those polled expressing worry.

Wednesday, June 15, 2011

Reminiscence Therapy – by Karen Everett Watson

Remembering the past can bring a lot of satisfaction and understanding to anyone. For the elderly, it is a way to affirm who they are, what they’ve accomplished in their lives and a chance to relive happy times. For those who suffer with dementia, it is a way to talk easily about things they do remember. It is also a way for residents of assisted living facilities to become better acquainted with one another. This is helpful for caregivers as well as family members.

I began my Reminiscence Therapy classes with a group at a local assisted living facility. The group varies in size from 12 to 20 people. I think a smaller group would probably be more beneficial as it would give each individual a better chance to participate. However, everyone voices positive thoughts on the sessions so we’ll probably just continue as is. Sometimes this larger group has a little trouble hearing each others’ answers.

My preparation begins by me selecting three topics to talk about. This gives me options if the conversation begins to dwindle on one of the topics. I do some research for articles online. For example, this week I chose to talk about “wash days of long ago, trains and art in your childhood home.” I found two great stories online that I copied to recite in class. I try to bring along a physical prompt, such as an old object that will go with one of our topics. Once I brought an old clothes iron, a toy vintage tractor and telephone line insulator. These are fun to pass around as an ice breaker. I think about questions I might ask the elders on each of the topics, but I try to remain flexible and let the conversation take its own path.
I also try to bring along books that might interest the group. Last week, I took “To Kill a Mockingbird.” Another time, I took a book with the story of how “Gone with the Wind” was made. The later had large photos that were easily shared with the group.

But one of the most popular things that I bring is candy. I’ve got a small bucket and each week I just add another bag of wrapped candy to it. I plan on adding a sugar-free addition for those who are diabetic.

The venue I have for class is a medium sized room equipped with a long table and chairs. I believe a circle of chairs would better accommodate the class, but it is nice to have the table to pass things around on.

Originally I had hoped that many of the participants would endeavor to write down some of their life stories to both share with the group and to hand down to their family members. I’m still hoping that one of them will surprise me soon! We have two faithful attendees from outside the facility who do write stories. I am grateful that they are eager to share their stories with the group. An older gentleman surprised me last week by bringing in his mother’s “Guide for a New Bride” book. It was nearly 100 years old. It was a gift from the County of San Diego where his mother had been married.

I try to make eye contact with each person who attends and make sure everyone has a chance to share an experience on one of our topics. While I have three topics prepared for each class, I don’t feel compelled for us to talk about all three unless it seems expedient.
Here is an example of the notes I used in one class:

Wash Day, Trains, Art in your Childhood home

Ask about stories that people wish to read.

Both of these stories below were taken from the web – They did not include the name of the authors.

Wash Days of Long Ago

Story to share:

Monday was usually washday, and occupied most of the day. We heated water in a big oval-shaped galvanized or copper wash boiler on top of a wood cookstove. If our cistern had enough soft (rain) water, we'd heat that water. Then we'd dip the boiling water into the washing machine - a big round tub-like machine. We had a Briggs & Stratton gas motor to run the leather belt to make the dolly turn to rub the soil out of the clothes. The dolly was a paddle affair. Now days we can do laundry in cold water and not worry so much about colors mixing. It was a catastrophe if a red article that faded was washed with white underwear. Many a guy wore pink underwear!
Usually we had two round washtubs with rinse water in them. We used an old broomstick handle to pull the hot clothes from the washer into the wringer. A wringer had two hard rubber rollers that we put the clothes between to let most of the sudsy hot water run back into the washer.
Soap was Fels Naptha IF you could afford. We made our own soap out of old rancid bacon and sausage grease, and lye. If you splashed any of this recipe on your arms, you had instant burns. The liquid soap was stirred until it was a creamy mixture. Then it was poured into flat pans with edges, and left for days until it hardened.
Questions to ask
How many of you have had to use a rub board?
What were the hardest clothes to wash?
Where did your water come from? Well outside? Creek? Or indoor Plumbing?
How did you dry your clothes when you were young?
How many sets of clothes did you own on the average?
How long did it take your mother to wash clothes?
Did you help with the task?
Did the day include the ironing?

Another story to share -

My visits to the farm were usually in the summer; I only remember two winter visits. I remember the conversation around the dinner table about the summer weather; dire comments of family and friends that "if we don't get some rain soon the well will go dry." A dry well was a horrifying thought, so we had to take measures to prevent it. Needless to say I learned early on to conserve water both from the well and from rain barrels. Each of the two back corners of the house had its own rain barrel, the supply replenished by an occasional thunderstorm. This water, too, was used sparingly.

Wash day, in times of drought, became a problem solved by using natural water sources. Across two large fields, a cultivated one and a meadow, was a stand of tree which we called "The Woods." In these woods was a natural spring. On wash day Oliver, the hired man, would go over early, unearth from the underbrush a big black cauldron, set up a tripod on which to hang the black kettle and proceed to fill it with water from the spring. He built a fire under the cauldron to heat the water. Also stashed away in the underbrush was a bench and two wooden wash tubs. One tub had a wringer fastened to it by large vise-like screws. The wringer had two hard rubber rolls through which the clothes were run pressing out the water. The rolls were turned by a handle. I do not recall a wash board but there must have been one.

The power for turning the wringer was furnished by eager young helpers--my sister and me. We could also help in keeping the fire going which qualified as a responsible job; not a play job but fun to do. Needless to say wash day was an all day excursion where we trekked across the field carrying washing supplies and our lunch. After Oliver got all our washing equipment set-up, he would return to his farm chores leaving us with grandmother, the collie, Nell, and the job. While the clothes dried we were happy to explore the woods, watch for animals, pick wildflowers or berries in season or just nap in the sun.

In retrospect I see and appreciate the difficulties faced by my grandmother. Laundry to be washed included the heavy farm clothing, the household sheets and towels, the red checkered tablecloths our pinafores panties and nightgowns. Most difficult of all were the heavy roller towels used to dry hands. We had no paper products or plastic then. I remember that on the back porch near the kitchen door was a bench which held the men's wash basin with a roller towel. A roller towel is a long piece of toweling made of either huck or linen sewed together to make a circle and placed over a roller, similar to the T.P. holders we have now. The person using it just pulled the towel to a clean unused spot. We always had 2-3 heavy roller towels in the wash. It must have been a labor saver but our hygiene today would not approve it.

Monday, June 13, 2011

Electronic Health Records were key for patients in Joplin, MS tornado

In the days following last month's devastating tornado in Joplin, Mo., one of the reports widely shared locally was news of X-rays having been blown all the way to Springfield, some 70 miles away.

The hospital that lost those X-rays, St. John's Regional Medical Center, was badly damaged by the storm and has been shut down. But it still has its patient records intact. The hospital had completed its conversion to electronic health records on May 1 — three weeks before the storm.

A mobile field hospital has been set up in the St. John's parking lot, complete with CT scans and surgical theaters. And St. John's patients going to facilities elsewhere are finding that their prescriptions and treatment schedules are available to providers.

"The bottom line is, if we didn't have the electronic health records, we would not be back operational today," says Mike McCreary, chief of technology services for the Sisters of Mercy Health System, which runs St. John's.

Electronic health records have been seen as a tool to cut down both on costs and medical errors. They've been a priority for the Obama administration – witness the $19 billion devoted to health IT in the 2009 stimulus package.

Still, physicians continue to resist altering the way they've done things in the past. It's not just about changing the way patient encounters are documented, but changing the entire work flow of a practice.

Once providers do go electronic and gain some comfort with the process, however, they never seem to want to go back.

"There's a lot of angst in converting, there are security concerns," says Tony Rysinski, senior vice president of marketing for Sage Healthcare, an electronic records vendor. "We've found that once people have converted, those concerns are minimized."

The experience in Joplin suggests that patient records may be more securely preserved electronically than on paper or on film. But you still need power to access them.

"That night, we traded 500 patients in the first few hours," says a spokeswoman for Freeman Health System, Joplin's other hospital. "St. John's had their electronic medical records, but we were taking patient information by hand because the power was down."

All families should consider having a personal health record for their own peace of mind. For information on Personal Health Records visit - www.agingwithgrace.net

Friday, June 10, 2011

Affordable subsidized housing for the elderly continues to decline

While it’s no secret the Great Recession has been devastating to older Americans, it has also impacted the ability of U.S. communities to meet the needs of the aging population.

A new report published by the National Association of Area Agencies on Aging reveals that at best, communities have managed to maintain the status quo for the past six years due to the decline in the overall economy and local government budgets.

“Most communities have been able only to “hold the line”— maintaining policies, programs and services already established,” said the report. “Thus, they have not been able to move forward to the degree needed to address the nation’s current “age wave.”

Using information gathered for the survey, n4a found financial funding shortages, transportation, and housing are the top three challenges for local communities in meeting the needs of older adults.

As far as housing is concerned, the availability of programs to provide home maintenance and repair assistance, home modification and targeted service delivery to meet the needs of older adults (e.g. backyard trash collection, sidewalk snow removal) remains roughly the same as five years ago. However, subsidized housing availability slipped to 63% from 70% in 2005.

“This is bad news for the most vulnerable among a community’s elders. Subsidized older renters have been found to be twice as likely to be disabled as older homeowners, with over half reporting limitations in activities like walking and climbing stairs and a third reporting difficulty with shopping or going to the doctor,” said the report.

The report also reveals some positive advances that include a dramatic increase in specialized training for emergency and public safety staff in dealing with older adults; growth of in-home supportive services; greater support for advanced education and retooling for the workforce; and expanded volunteer opportunities.

Even so, with millions of Baby Boomers reaching retirement age every month, these advancements are nowhere near the level of progress that has to be made to ensure that communities are livable for people of all ages.

“These findings show that the country still has a tremendous amount of work to do in a very short amount of time to address America’s rapidly rising aging population,” said Sandy Markwood, CEO of n4a. “Although communities have done an admirable job to maintain the status quo considering the economic conditions we’ve faced, given the dramatic aging demographics, the status quo is not good enough. These findings should be a major wake-up call for local governments and should motivate them to take immediate actions that will address the challenge and opportunities at hand.”

Wednesday, June 08, 2011

Elder fraud on the rise

A new Metlife study on financial elder abuse estimates that the annual financial loss felt by victims increased 12 percent from the last time the study was conducted in 2008 and recognizes that elder abuse is still an underreported crime.

“The Metlife Study of Elder Abuse: Crimes of Occasion, Desperation, and Predation Against America’s Elders” indicates that older Americans are losing 2.9 billion dollars to predators, 51 percent of whom are strangers, often targeting victims who were out shopping or managing financial affairs. “In almost all instances, financial exploitation is achieved through deceit, threats and emotional manipulation of an elder,” said Sandra Timmermann, Ed.D., director of the MetLife Mature Market Institute. “In addition to this psychological mistreatment, physical and sexual violence frequently accompany the greed and disregard of financial abuse. The vigilance of friends and family can help protect elders from those who are predatory, which may, unfortunately, include strangers or even other loved ones.”

The report also describes the profile of a typical victim of financial abuse as a woman aged 80 to 89, who lives alone and exhibits signs of mild cognitive or physical impairment. Researchers believe that the low social support often available to these victims contribute to the underreporting of crimes and hope that newly passed legislation will help combat these vulnerabilities.

Wednesday, June 01, 2011

Choosing the right time to collect Social Security can boost your income

The following is an excerpt of an excellent article written by Mary Beth Franklin, Senior Editor, Kiplinger's Personal Finance

Not so long ago, some people planning for retirement wrote off Social Security as an endangered benefit and a marginal addition to their post-career income. But in an era of disappearing pensions and erratic stock-market returns, the idea of guaranteed income for life that keeps pace with inflation holds fresh appeal. Increasingly, near-retirees are becoming aware of the value of working longer and waiting to collect Social Security benefits until the benefits are worth more.
But there are also a few clever -- and perfectly legal -- ways to time the collection of your retirement benefits to increase monthly checks for you, your spouse and any minor dependents. Play your cards right and you could increase your household income by thousands of dollars a year now, plus ensure larger benefits later.

The Basics

Although you can collect Social Security benefits as early as age 62, you may not want to. Your retirement benefits will be reduced by 25% or more for the rest of your life. And if you continue to work, your benefits could be further reduced -- even wiped out completely -- if you earn more than the prescribed limit.

In 2011, you lose $1 in benefits for every $2 you earn over $14,160. A more generous earnings cap applies in the year you reach your normal retirement age: You lose $1 in benefits for every $3 you earn over $3,140 per month during the months leading up to your 66th birthday. Once you reach your normal retirement age, the earnings cap disappears. Other types of income, such as pensions, interest and dividends, do not reduce your Social Security benefits.

Of course, for some people, waiting to collect Social Security is not an option. If you need the money, or you are in poor health and fear that you may not live long enough to collect benefits at your full retirement age, you should collect your Social benefits as soon as you are eligible at age 62. That assumes you are no longer working or, if you are, your earnings don't exceed the annual earnings limit by much.

But if you're able, it pays to wait. After you reach your normal retirement age, you can increase your benefits by an additional eight percentage points for each year you delay collecting, up to age 70, creating a larger base for future cost-of-living adjustments and a bigger benefit for a surviving spouse.

No More Do-Over

In the past, retirees who collected benefits early and regretted the decision later could repay all the benefits they had received and restart their benefits at a much higher level based on their current age. But that is no longer an option. In December, the Social Security Administration revised its do-over rule. From now on, you can only suspend benefits once during your lifetime, and it must be within 12 months of your initial claim. You will no longer be able to repay past benefits, but once you resume collecting retirement benefits, Social Security will recalculate the amount to take into account the months or years you suspended them, resulting in a larger payment than your initial amount.

Combo Approach

For some married couples, a combination strategy may make sense. The lower-earning spouse (usually the wife) could collect Social Security benefits early, and the higher-earning spouse could delay claiming benefits for as long as possible, up to age 70. Although the wife's retirement benefits will be permanently reduced, collecting benefits early will have no impact on her survivor benefits as long as she is at least normal retirement age when she begins collecting survivor benefits. If her husband dies first, she will be entitled to 100% of the monthly amount he received during his lifetime -- with no reduction in benefits. Of course, her own retirement benefit would disappear at that point. Read on to discover a few more creative strategies.

File and Suspend

Sometimes, the spouse who has little or no work history (again, often the wife) may be eager to collect spousal benefits -- worth up to half of what the main breadwinner receives. Normally, the wife must wait for her husband to file for his Social Security benefits before she can collect her share. But there's a way for her to collect spousal benefits while her husband's retirement benefit continues to grow.

As long as he waits until he reaches his normal retirement age, the husband can exercise a strategy known as file and suspend. That means he can file for his benefits, entitling his wife to receive spousal benefits immediately; then he can suspend his own benefits and continue to accrue delayed-retirement credits until age 70. (Note: If the wife collects benefits before her normal retirement age, her spousal benefits -- normally worth half of her husband's benefit -- will be reduced by 25% or more.) At 70, his benefits would be worth 132% of what they would have been at 66, creating a larger base for future cost-of-living adjustments. (Spousal benefits are based on half of the worker's benefit at normal retirement age, not including the delayed credits. But survivor benefits are worth half of the husband's amount, including the delayed credits).

Let's say he is entitled to $2,000 a month at age 66. He could file and suspend so that she could collect half that amount -- $1,000 -- in spousal benefits at her normal retirement age. But if she claims benefits as soon as she is eligible at age 62, her share would be reduced by 25%, to $750 per month. The reduction for collecting benefits early at age 62 will increase to 30% when the normal retirement age rises to 67 under current law.

Search This Blog

Helpful Resources

Low Vision Therapy Services

Children of Aging Parents (CAPS)

Well Spouse Association

U.S. Administration on Aging


Nursing Home Compare

Senior Safety Online

Mature Market Institute

Connections for Women

50Plus Realtor

Alzheimer's Speaks

Official VA Website