Advocacy Groups

Legal and Financial Planning for People with Alzheimer's

Senior Help Desk helthcare blog credited to The National Institute on Aging, part of NIH   www.nia.nih.gov

Many people are unprepared to deal with the legal and financial consequences of a serious illness such as Alzheimer's disease. Legal and medical experts encourage people recently diagnosed with a serious illness—particularly one that is expected to cause declining mental and physical health—to examine and update their financial and healthcare arrangements as soon as possible. Basic legal and financial documents, such as a will, a living trust, and advance directives, are available to ensure that the person's late-stage or end-of-life health care and financial decisions are carried out.

A complication of diseases such as Alzheimer’s is that the person may lack or gradually lose the ability to think clearly. This change affects his or her ability to make decisions and participate in legal and financial planning.

People with early-stage Alzheimer’s disease can often understand many aspects and consequences of legal decision making. However, legal and medical experts say that many forms of planning can help the person and his or her family even if the person is diagnosed with later-stage Alzheimer’s.

There are good reasons to retain a lawyer when preparing advance planning documents. For example, a lawyer can help interpret different State laws and suggest ways to ensure that the person's and family's wishes are carried out. It's important to understand that laws vary by State, and changes in a person’s situation—for instance, a divorce, relocation, or death in the family—can influence how documents are prepared and maintained.

Legal, Financial, and Health Care Planning Documents

Families beginning the legal planning process should discuss a number of strategies and legal documents. Depending on the family situation and the applicable State laws, a lawyer may introduce some or all of the following terms and documents to assist in this process:

  • Documents that communicate the healthcare wishes of someone who can no longer make healthcare decisions
  • Documents that communicate the financial management and estate plan wishes of someone who can no longer make financial decisions

 Learn how to get your affairs in order:

Advance Directives for Health Care

Advance directives for health care are documents that communicate the healthcare wishes of a person with Alzheimer’s disease. These decisions are then carried out after the person no longer can make decisions. In most cases, these documents must be prepared while the person is legally able to execute them.

living will records a person's wishes for medical treatment near the end of life.

durable power of attorney for health care designates a person, sometimes called an agent or proxy, to make healthcare decisions when the person with Alzheimer’s disease no longer can do so.

In addition to these, there may be other documents discussing do not resuscitate orders, organ and tissue donation, dialysis, and blood transfusions.

Access to private medical information is closely regulated. The person with Alzheimer's disease must state in writing who can see or use personal medical records. For more information about advance directives for health care, see Advance Care Planning: Healthcare Directives. Link:  https://www.nia.nih.gov/health/advance-care-planning-healthcare-directives

Advance Directives for Financial and Estate Management

Advance directives for financial and estate management must be created while the person with Alzheimer’s still can make these decisions (sometimes referred to as "having legal capacity" to make decisions). These directives may include the following:

A will indicates how a person's assets and estate will be distributed upon death. It also can specify:

  • Arrangements for care of minors
  • Gifts
  • Trusts to manage the estate
  • Funeral and/or burial arrangements

Medical and legal experts say that the newly diagnosed person with Alzheimer’s and his or her family should move quickly to make or update a will and secure the estate.

durable power of attorney for finances names someone to make financial decisions when the person with Alzheimer’s disease no longer can. It can help people with the disease and their families avoid court actions that may take away control of financial affairs.

living trust provides instructions about the person's estate and appoints someone, called the trustee, to hold title to property and funds for the beneficiaries. The trustee follows these instructions after the person with Alzheimer’s no longer can manage his or her affairs.

The person with Alzheimer’s disease also can name the trustee as the healthcare proxy through the durable power of attorney for health care.

A living trust can:

  • Include a wide range of property
  • Provide a detailed plan for property disposition
  • Avoid the expense and delay of probate (in which the courts establish the validity of a will)
  • State how property should be distributed when the last beneficiary dies and whether the trust should continue to benefit others

Who Can Help?

Healthcare providers cannot act as legal or financial advisers, but they can encourage planning discussions between patients and their families. Qualified clinicians can also guide patients, families, the care team, attorneys, and judges regarding the patient's ability to make decisions.

An elder law attorney helps older people and families interpret State laws, plan how their wishes will be carried out, understand their financial options, and learn how to preserve financial assets while caring for a loved one.

The National Academy of Elder Law Attorneys and the American Bar Association can help families find qualified attorneys. See the resources at the end of this article for more information.

Geriatric care managers are trained social workers or nurses who can help people with Alzheimer’s disease and their families. Read more about geriatric care managers.

Other Advance Planning Advice

Start discussions early. The rate of decline differs for each person with Alzheimer’s disease, and his or her ability to be involved in planning will decline over time. People in the early stages of the disease may be able to understand the issues, but they may also be defensive or emotionally unable to deal with difficult questions. Remember that not all people are diagnosed at an early stage. Decision making already may be difficult when Alzheimer’s disease is diagnosed.

Review plans over time. Changes in personal situations—such as a divorce, relocation, or death in the family—and in State laws can affect how legal documents are prepared and maintained. Review plans regularly, and update documents as needed.

Reduce anxiety about funeral and burial arrangements. Advance planning for the funeral and burial can provide a sense of peace and reduce anxiety for both the person with Alzheimer’s and the family.

Resources for Low-Income Families

Families who cannot afford a lawyer still can do advance planning. Samples of basic health planning documents can be downloaded from State government websites. Area Agency on Aging officials may provide legal advice or help. Other possible sources of legal assistance and referral include State legal aid offices, the State bar association, local nonprofit agencies, foundations, and social service agencies.

Summary

Facing Alzheimer’s disease can be emotionally wrenching for all concerned. Legal and medical experts can help the person and family address tough questions about future treatment, caregiving, and legal arrangements.

 

For More Information About Advance Care Planning for a Person with Alzheimer's

NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center
1-800-438-4380 (toll-free)
adear@nia.nih.gov 
www.nia.nih.gov/alzheimers
The National Institute on Aging’s ADEAR Center offers information and free print publications about Alzheimer’s disease and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

AARP
1-888-687-2277 (toll-free)
1-877-434-7598 (TTY/toll-free)
1-877-342-2277 (español/línea gratis)
1-866-238-9488 (TTY/español/línea gratis)
member@aarp.org  
www.aarp.org/home-family/caregiving/

Aging with Dignity
1-850-681-2010
fivewishes@agingwithdignity.org 
www.agingwithdignity.org

Alzheimer's Association
1-800-272-3900 (toll-free, 24/7) 
1-866-403-3073 (TTY/toll-free)
info@alz.org 
www.alz.org

National Hospice and Palliative Care Organization
1-703-837-1500
nhpco_info@nhpco.org 
www.nhpco.org

Eldercare Locator
1-800-677-1116 (toll-free)
www.eldercare.gov

National Academy of Elder Law Attorneys
1-703-942-5711
naela@naela.org 
www.naela.org

OrganDonor.gov
Health Resources and Services Administration
1-888-275-4772 (toll-free)  
1-877-489-4772 (TTY/toll-free)
donation@hrsa.gov 
www.organdonor.gov

The National Institute on Aging, part of NIH leads the federal government effort conducting and supporting research on aging and the health and well-being of older people. The Institute seeks to understand the nature of aging and the aging process, and diseases and conditions associated with growing older, in order to extend the healthy, active years of life. For more information on research, aging, and health, go to www.nia.nih.gov.

 

About Senior Help Desk:  "The mission of Senior Help Desk is to enhance the lives of our seniors through the collaboration, organization and accessibility of resources. We strive to offer the most comprehensive, interactive, and shareable senior resource center for finding professionals, services and resources. We offer an interactive community timeline, resources directory, blogs, videos, articles, and a community events calendar."

Categories: 
Advocacy Groups
City: 
New Haven
States: 
Connecticut

How You Can Help Social Security Protect Your Information

By Jim Borland, Acting Deputy Commissioner for Communications​, Social Security Administration

Protecting your information is an important part of Social Security’s mission. You work hard and make a conscious effort to save and plan for retirement. Unfortunately, fraud and scams are a part of our current reality. Scammers try to stay a step ahead of us, but our cyber-security programs help us protect the information entrusted to us. Despite the techniques we use to thwart scams, we can’t do it alone. You can read Social Security’s joint press release with the Office of Inspector General about our new nationwide Public Service Announcement (PSA) campaign. This new PSA campaign addresses these telephone impersonation schemes in a series of video and audio ads. Watch the video above and learn how you can help us protect your information.​

For more information on Social Security visit:  https://www.ssa.gov

Categories: 
City: 
Tampa
States: 
Florida

Understanding Loneliness In Older Adults — And Tailoring A Solution

Seniorhelpdesk.com Healthcare Blog by Judith Graham and Kaiser Health News    http://khn.org  

 

For years, Dr. Linda Fried offered older patients who complained of being lonely what seemed to be sensible guidance. “Go out and find something that matters to you,” she would say.

But her well-meant advice didn’t work most of the time. What patients really wanted were close relationships with people they care about, satisfying social roles and a sense that their lives have value. And this wasn’t easy to find.

We need “new societal institutions that bring meaning and purpose” to older adults’ lives, Fried recently told a committee of the National Academies of Sciences investigating loneliness and social isolation among older adults. (Fried is a geriatrician and dean of the Mailman School of Public Health at Columbia University.)

The committee’s deliberations come amid growing interest in the topic. Four surveys (by Cigna, AARP, the Kaiser Family Foundation and the University of Michigan) have examined the extent of loneliness and social isolation in older adults in the past year. And health insurers, health care systems, senior housing operators and social service agencies are launching or expanding initiatives. (Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.)

Notably, Anthem Inc. is planning a national rollout to Medicare Advantage plans of a program addressing loneliness developed by its subsidiary CareMore Health, according to Robin Caruso, CareMore’s chief togetherness officer. UnitedHealthcare is making health navigators available to Medicare Advantage members at risk for social isolation. And Kaiser Permanente is starting a pilot program that will refer lonely or isolated older adults in its Northwest region to community services, with plans to eventually bring it to other regions, according to Lucy Savitz, vice president of health research at Kaiser Permanente Northwest. (KHN is not affiliated with Kaiser Permanente.)

The effectiveness of these programs and others remains to be seen. Few have been rigorously evaluated, and many assume increased social interaction will go a long way toward alleviating older adults’ distress at not having meaningful relationships. But that isn’t necessarily the case.

“Assuaging loneliness is not just about having random human contact; it’s about the quality of that contact and who you’re having contact with,” said Dr. Vyjeyanthi Periyakoil, an associate professor of medicine at Stanford University School of Medicine.

A one-size-fits-all approach won’t work for older adults, she and other experts agreed. Instead, varied approaches that recognize the different degrees, types and root causes of loneliness are needed.

Degrees of loneliness. The headlines are alarming: Between 33 and 43 percent of older Americans are lonely, they proclaim. But those figures combine two groups: people who are sometimes lonely and those who are always lonely.

The distinction matters because people who are sometimes lonely don’t necessarily stay that way; they can move in and out of this state. And the potential health impact of loneliness — a higher risk of heart disease, dementia, immune dysfunction, functional impairment and early death — depends on its severity.

People who are severely lonely are at “high risk,” while those who are moderately lonely are at lower risk, said Julianne Holt-Lunstad, a professor of psychology and neuroscience at Brigham Young University.

The number of people in the highest risk category is relatively small, as it turns out. When AARP asked adults who participated in its survey last year “How often do you feel lonely or isolated from those around you?” 4 percent said “always,” while 27 percent said “sometimes.” In the University of Michigan’s just-published survey on loneliness and social isolation, 8 percent of older adults (ages 50-80) said they often lacked companionship (a proxy for loneliness), while 26 percent said this was sometimes the case.

“If you compare loneliness to a toxin and ask ‘How much exposure is dangerous, at what dose and over what period of time?’ the truth is we don’t really know yet,” Periyakoil said.

Why it matters: Loneliness isn’t always negative, and seniors shouldn’t panic if they sometimes feel this way. Often, loneliness motivates people to find a way to connect with others, strengthening social bonds. More often than not, it’s inspired by circumstances that people adjust to over time, such as the death of a spouse, close family member or friend; a serious illness or injury; or a change in living situation.

Types of loneliness. Loneliness comes in different forms that call for different responses. According to a well-established framework, “emotional loneliness” occurs when someone feels the lack of intimate relationships. “Social loneliness” is the lack of satisfying contact with family members, friends, neighbors or other community members. “Collective loneliness” is the feeling of not being valued by the broader community.

Some experts add another category: “existential loneliness,” or the sense that life lacks meaning or purpose.

Dr. Carla Perissinotto, associate chief for geriatrics clinical programs at the University of California-San Francisco, has been thinking about the different types of loneliness recently because of her 75-year-old mother, Gloria. Widowed in September, then forced to stay home for three months after hip surgery, Gloria became profoundly lonely.

“If I were a clinician and said to my mother, ‘Go to a senior center,’ that wouldn’t get at the core underlying issues: my mother’s grief and her feeling, since she’s not a native to this country, that she’s not welcome here, given the political situation,” Perissinotto said.

What’s helped Gloria is “talking about and giving voice to what she’s experiencing,” Perissinotto continued. Also, friends, former co-workers, family members and some of Perissinotto’s high school buddies have rallied around Gloria. “She feels that she’s a valuable part of her community, and that’s what’s missing for so many people,” Perissinotto said.

“Look at the older people around you who’ve had a major life transition: a death, the diagnosis of a serious illness, a financial setback, a surgery putting them at risk,” she recommended. “Think about what you can offer as a friend or a colleague to help them feel valued.”

Why it matters: Listening to older adults and learning about the type of loneliness they’re experiencing is important before trying to intervene. “We need to understand what’s driving someone’s loneliness situation before suggesting options,” Perissinotto said.

Root causes of loneliness. One of the root causes of loneliness can be the perception that other people have rejected you or don’t care about you. Frequently, people who are lonely convey negativity or push others away because of perceived rejection, which only reinforces their isolation.

In a review of interventions to reduce loneliness, researchers from the University of Chicago note that interventions that address what they call “maladaptive social cognition” — distrust of other people, negativity and the expectation of rejection — are generally more effective than those that teach social skills or promote social interactions. Cognitive behavior therapy, which teaches people to recognize and question their assumptions, is often recommended.

Relationships that have become disappointing are another common cause of loneliness. This could be a spouse who’s become inattentive over time or adult children or friends who live at a distance and are rarely in touch.

“Figuring out how to promote quality relationships for older adults who are lonely is tricky,” Holt-Lunstad said. “While we have decades of research in relationship science that helps characterize quality relationships, there’s not a lot of evidence around effective ways to create those relationships or intervene” when problems surface.

Other contributors to loneliness are easier to address. A few examples: Someone who’s lost a sense of being meaningfully connected to other people because of hearing loss — the most common type of disability among older adults — can be encouraged to use a hearing aid. Someone who can’t drive anymore and has stopped getting out of the house can get assistance with transportation. Or someone who’s lost a sibling or a spouse can be directed to a bereavement program.

“We have to be very strategic about efforts to help people, what it is they need and what we’re trying to accomplish,” Holt-Lunstad said. “We can’t just throw programs at people and hope that something is better than nothing.”

She recommends that older adults take mental stock of the extent to which they feel lonely or socially isolated. Am I feeling left out? To what extent are my relationships supportive? Then, they should consider what underlies any problems. Why don’t I get together with friends? Why have I lost touch with people I once spoke with?

“When you identify these factors, then you can think about the most appropriate strategies to relieve your discomfort and handle any obstacles that are getting in the way,” Holt-Lunstad said.

We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips.

Author: Judith Graham: @judith_graham

About Judith Graham and Navigating Aging

 

Judith GrahamNAVIGATING AGING

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment use following link:  http://khn.org/columnists/

For more KHN coverage of aging, and for more information on Kaiser Health News, please visit our web page athttp://khn.org

KHN’s coverage related to aging & improving care of older adults is supported by The John A. Hartford Foundation.

Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.

Categories: 
Advocacy Groups
City: 
San Francisco
States: 
California

Romance Scams: Online Imposters Break Hearts and Bank Accounts, Often Targeting Older Adults

Seniorhelpdesk.com Blog Credited U.S. Department of Justice/FBI

 

They met online. He said he was a friend of a friend. The woman, in her 50s and struggling in her marriage, was happy to find someone to chat with. “He was saying all the right things,” she remembered. “He was interested in me. He was interested in getting to know me better. He was very positive, and I felt like there was a real connection there.”

That connection would end up costing the woman $2 million and an untold amount of heartache after the man she fell in love with—whom she never met in person—took her for every cent she had.

It’s called a romance scam, and this devastating Internet crime is on the rise. Victims—predominantly older widowed or divorced women targeted by criminal groups usually from Nigeria—are, for the most part, computer literate and educated. But they are also emotionally vulnerable. And con artists know exactly how to exploit that vulnerability because potential victims freely post details about their lives and personalities on dating and social media sites.

Trolling for victims online “is like throwing a fishing line,” said Special Agent Christine Beining, a veteran financial fraud investigator in the FBI’s Houston Division who has seen a substantial increase in the number of romance scam cases. “The Internet makes this type of crime easy because you can pretend to be anybody you want to be. You can be anywhere in the world and victimize people,” she said. “The perpetrators will reach out to a lot of people on various networking sites to find somebody who may be a good target. Then they use what the victims have on their profile pages and try to work those relationships and see which ones develop.”

“The Internet makes this type of crime easy because you can pretend to be anybody you want to be.”

In the case of the Texas woman who lost everything, it was her strong Christian faith—which she happily publicized on her Facebook profile—that gave “Charlie” an incredible advantage when he began courting her.

“I’m very active on Facebook,” said the woman, who agreed to share her story in the hopes that others might avoid becoming victims. “I thought it was safe.” After she friended Charlie—without verifying his bogus claim that they had a mutual friend—“he would read my wall, I would read his wall. We would post things, he would like things. Then it got to where we would share e-mails. We started sharing pictures.”

According to Beining, this is standard operating procedure for romance scammers, who assume other people’s identities to trick their victims. “They make themselves out to be average-looking people,” she said. “They are generally not trying to build themselves up too high.”

The scammer’s intention is to establish a relationship as quickly as possible, endear himself to the victim, gain trust, and propose marriage. He will make plans to meet in person, but that will never happen. Eventually, he will ask for money.

According to the FBI’s Internet Crime Complaint Center (IC3), which provides the public with a means of reporting Internet-facilitated crimes, romance scams—also called confidence fraud—result in the highest amount of financial losses to victims when compared to other online crimes.

In 2016, almost 15,000 complaints categorized as romance scams or confidence fraud were reported to IC3 (nearly 2,500 more than the previous year), and the losses associated with those complaints exceeded $230 million. The states with the highest numbers of victims were California, Texas, Florida, New York, and Pennsylvania. In Texas last year, the IC3 received more than 1,000 complaints from victims reporting more than $16 million in losses related to romance scams.

‘I was Looking for Happiness’

When she first encountered Charlie in 2014, the Texas woman recalled, “I was in an emotionally abusive marriage, and things had not been good for probably at least 10 years.” Her new online friend seemed to come along at just the right time. “I was looking for happiness,” she said. “I thought I could find that with Charlie.”

Romance scammers often say they are in the building and construction industry and are engaged in projects outside the U.S. That makes it easier to avoid meeting in person—and more plausible when they ask their victims for help. They will suddenly need money for a medical emergency or unexpected legal fee. “They promise to repay the loan immediately,” Beining said, “but the victims never get their money back.”

Charlie claimed to be in the construction field. “He was trying to finish up a job in California,” the woman said, “and he needed some money to help finish the job. I thought about it long and hard. I prayed about it. I’ve always been a very giving person, and I figured if I had money … I could send him some [money]. And he promised to have it back within 24 to 48 hours. I thought, ‘I could do that.’ It was kind of a statement of faith, too.”

She wired him $30,000. A day passed and then another, and she didn’t get her money back. “I still thought everything was okay,” she said, “just that he was the victim of some bad luck.” And then Charlie needed another $30,000.

Empty Promises

For the next two years, the woman believed Charlie’s stories after each new request for funds. Everything he said made sense, and, after all, they were in love. Eventually, the woman’s financial adviser became alarmed about her steadily dwindling accounts and, suspecting fraud, urged her to contact the FBI

The subsequent investigation led by Beining resulted in the arrest of two Nigerians posing as South African diplomats who had come to the U.S. to collect money from the woman on behalf of Charlie, who claimed he was paid $42 million for a construction project he completed in South Africa. The woman believed she would be paying to have the money—including the repayment of her $2 million—transferred to the U.S. from South Africa, where Charlie was still supposedly working.

In July 2016, the two Nigerian co-conspirators pleaded guilty in connection with their roles in the scam, and a federal judge sentenced them each to 36 months in prison last December. But Charlie is still at large, presumably in Nigeria, and there may be little hope of bringing him to justice.

“This is a very difficult crime to prove,” Beining said. “When someone is using a computer to hide behind, the hardest thing to find out is who they are. We can find out where in the world their computer is being used. It’s identifying who they actually are that’s the hard part. That is why this individual remains a fugitive.”

It also explains why romance scams are on the rise: It’s a lucrative and easy crime to commit, and easier still to remain anonymous and beyond the reach of authorities. “It’s not like going in a bank and holding a gun to the teller,” Beining explained, “because there are so many leads that you provide law enforcement when you do that. Even if you are able to get out of the bank, we can probably find out who you are and track you down. But with an Internet crime like this, it’s much more difficult.”

As for the Texas woman, she came forward “because I don’t want this to happen to anybody else. I not only invested money in this man but there is a big, huge piece of my heart that I invested in him,” she said. “It’s not just the finances, it’s the emotional part, too—being embarrassed, being ashamed, being humiliated.”

“I don’t want this to happen to anybody else. I not only invested money in this man but there is a big, huge piece of my heart that I invested in him.”

Romance scam victim

Even now, though, she remains conflicted. A part of her still wants to believe that Charlie is real and that their relationship was real—that the e-mail exchanges about church and the phone calls when they sang together and prayed together meant as much to him as they did to her. She even holds out hope that one day Charlie will repay her, as he promised to do so many times.

Otherwise, there is no doubt that he is a heartless criminal who robbed her and broke her heart—and who is almost certainly continuing to victimize other women in the same way.

“I can’t even imagine a man, a person, that could be this bad,” she said. “I can’t think of him that way. … There can’t be a man in this world that could be this horrible to have purposefully done what he’s done to me.”

Don’t Become a Victim

The criminals who carry out romance scams are experts at what they do. They spend hours honing their skills and sometimes keep journals on their victims to better understand how to manipulate and exploit them.

“Behind the veil of romance, it’s a criminal enterprise like any other,” said Special Agent Christine Beining. “And once a victim becomes a victim, in that they send money, they will often be placed on what’s called a ‘sucker list,’ ” she said. “Their names and identities are shared with other criminals, and they may be targeted in the future.”

To stay safe online, be careful what you post, because scammers can use that information against you. Always use reputable websites, but assume that con artists are trolling even the most reputable dating and social media sites. If you develop a romantic relationship with someone you meet online, consider the following:

  • Research the person’s photo and profile using online searches to see if the material has been used elsewhere.
  • Go slow and ask lots of questions.
  • Beware if the individual seems too perfect or quickly asks you to leave a dating service or Facebook to go “offline.”
  • Beware if the individual attempts to isolate you from friends and family or requests inappropriate photos or financial information that could later be used to extort you.
  • Beware if the individual promises to meet in person but then always comes up with an excuse why he or she can’t. If you haven’t met the person after a few months, for whatever reason, you have good reason to be suspicious.
  • Never send money to anyone you don’t know personally. “If you don’t know them, don’t send money,” Beining said. “You will see what their true intentions are after that.”

If you suspect an online relationship is a scam, stop all contact immediately. And if you are the victim of a romance scam, file a complaint with the FBI’s Internet Crime Complaint Center.

Link:  https://www.ic3.gov/default.aspx

Categories: 
Advocacy Groups
City: 
Westport
States: 
Connecticut

For Seniors, Teeth Need Care — But Insurance Coverage Is Rare

For Seniors, Teeth Need Care — But Insurance Coverage Is Rare

Article by Michelle Andrews and Kaiser Health News

Cover photo: Ada Anderson helps her mother, Violeta Anderson, brush her teeth before her dentist appointment in November 2015. (Photo by Heidi de Marco/KHN).

 

Aging can take a toll on teeth, and for many seniors paying for dental services is a serious concern because they can’t rely on their Medicare coverage.

Low-income seniors, in particular, are struggling. More than a third with incomes below 200 percent of the federal poverty level (about $23,000 annually) had untreated tooth decay between 2011 and 2014, according to an analysis of federal data by the American Dental Association.

“What ends up happening is that almost everybody, when they get to be 65, is sort of on their own and they have to pay for dental care out of pocket,” said Dr. Michael Helgeson, chief executive officer of Apple Tree Dental. Apple Tree is a Minneapolis-based nonprofit organization operating eight clinics in Minnesota and California that target underserved seniors, as well as mobile units that provide on-site dental care at nursing homes and other facilities.

Traditional Medicare doesn’t usually cover dental care unless it’s related to services received in a hospital. Medicare Advantage managed care plans generally provide some dental care, but the coverage can vary, and often is minimal, dental advocates say. The plans often are “a loss leader,” said Dr. Judith Jones, a professor of dentistry at Boston University. “It’s meant to attract people. It gets people in but the coverage is really limited.”

In a way, older people are victims of dentistry’s success. Regular visits to the dentist, along with daily tooth brushing and water fluoridation, have all contributed to improvements in oral health. In the first half of the 20th century, by the time people reached their 30s or 40s many had already lost all their teeth, Helgeson said, while today more than 60 percent of people in nursing homes still have at least one tooth.

But teeth need tending. Without regular dental care, tooth problems can cause pain and limit how much and what type of food people are able to eat. Similarly, gum disease can loosen teeth and allow bacteria to enter the body. A growing body of research has linked treating periodontal disease with lower medical costs for diabetes and heart disease, among other conditions.

People’s lives are affected in other ways by their oral health. “You use your mouth to eat and kiss and smile and interact socially,” said Jones. “It’s a source of great embarrassment and suffering for many adults without access to care.”

With limited income and no insurance, seniors may skip visiting the dentist regularly, even though many report that their mouths are dry and painful, and they have difficulty biting and chewing, not to mention avoiding smiling and social interaction if they have missing or damaged teeth.

Medicaid, the state-federal program for lower income people, covers dental care for children in every state, but coverage for adults is much spottier. Most states cover emergency dental care, but eight states offer no adult dental benefits at all, according to a study by Oral Health America, an advocacy group.

Even trying to purchase private dental insurance, which typically covers a few thousand dollars worth of dental care, may not provide good value, said Marko Vujicic, vice president of the American Dental Association’s Health Policy Institute. “When you add up the premiums and copays, for the vast majority of adults it’s not worthwhile to have dental insurance,” he said.

Seniors with traditional Medicare spent $737 on average out-of-pocket on dental care in 2012, said Tricia Neuman, director of the Program on Medicare Policy at the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)

But the figures may be much higher for people who need major restorative work.

“I know people who are spending sometimes more than $10,000 on what they consider essential dental care, like implants, none of which is covered,” Neuman said.

Seniors with limited means have few options for help affording dental care. Federally qualified health centers may provide geriatric dental services on a sliding-fee scale, and clinics like Apple Tree help a limited number of seniors who live in their service area. But they’re a band-aid, said Jones.

She and other advocates want Medicare to add a dental benefit to Medicare Part B. Their proposal would provide a basic bundle of diagnostic and preventive services through a premium increase, and seniors would only be responsible for copayments if they need pricey restorative work like crowns and bridges.

“Over the years, there has been some interest in expanding Medicare to include dental coverage,” Neuman said. But a dental benefit has faced stiff competition from other priorities, including adding a prescription drug benefit in 2006 and preventive coverage under the health law in 2010.

But some people think this time might be different. “There are 250,000 people every month who are turning 65, and 30 percent of dentists say they could use more business,” said Beth Truett, president and CEO of Oral Health America, which supports the proposal. “It’s a perfect storm.”

KHN’s coverage of aging and long-term care issues is supported by The SCAN Foundation.

Please visit khn.org/columnists to send comments or ideas for future topics for the Insuring Your Health column.

 

Author: Michelle Andrews: andrews.khn@gmail.com, @mandrews110

Michelle AndrewsINSURING YOUR HEALTH

KHN contributing columnist Michelle Andrews writes the series Insuring Your Health, which explores health care coverage and costs.

To contact Michelle with a question or comment visit:  http://khn.org/columnists/

Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.

To contact our columnists with a question or comment use following link: http://khn.org/columnists/

This story can be republished for free.  Details link: http://khn.org/syndication/

For more KHN coverage of aging, and for more information on Kaiser Health News, please visit our web page at: http://khn.org

Categories: 
Advocacy Groups
City: 
Stamford
States: 
Connecticut

Get Your Social Security Benefit Statement (SSA-1099)

Get Your Social Security Benefit Statement (SSA-1099)

Posted by Jim Borland, Acting Deputy Commissioner for Communications, Social Security Administration

Tax season is approaching, and Social Security has made replacing your annual Benefit Statement even easier. The Benefit Statement is also known as the SSA-1099 or the SSA-1042S. Now you can get a copy of your 1099 anytime and anywhere you want using our online services.

A Social Security 1099 is a tax form Social Security mails each year in January to people who receive Social Security benefits. It shows the total amount of benefits you received from Social Security in the previous year so you know how much Social Security income to report to the IRS on your tax return.

If you live in the United States and you need a replacement form SSA-1099 or SSA-1042S, simply go online and request an instant, printable replacement form through your personal my Social Security account, Link: https://www.ssa.gov/myaccount/

A replacement SSA-1099 or SSA-1042S is available for the previous tax year after February 1.

If you already have a my Social Security account, Link:  https://www.ssa.gov/myaccount/you can log in to your online account to view and print your SSA-1099 or SSA-1042S. If you don’t have access to a printer, you can save the document on your computer or laptop or even email it. If you don’t have a my Social Security account, creating one is very easy to do and usually takes less than 10 minutes.

If you receive benefits or have Medicare, your my Social Security account is also the best way to:

  • Get your benefit verification letter;
  • Check your benefit and payment information;
  • Change your address and phone number;
  • Change your direct deposit information;
  • Request a replacement Medicare card; or
  • Report your wages if you work and receive Social Security disability insurance or Supplemental Security Income (SSI) benefits.

If you’re a noncitizen who lives outside of the United States and you received or repaid Social Security benefits last year, we will send you form SSA-1042S in the mail. The forms SSA-1099 and SSA-1042S are not available for people who receive Supplemental Security Income (SSI).

With a personal my Social Security account, you can do much of your business with us online, on your time, like get a copy of your SSA-1099 form. Visit our my Social Security account website to find out more at: https://www.ssa.gov/myaccount/

For more information on Social Security visit:  https://www.ssa.gov

Categories: 
Advocacy Groups
City: 
Boston
States: 
Massachusetts

Like Hunger Or Thirst, Loneliness In Seniors Can Be Eased

Seniorhelpdesk.com Healthcare Blog by Judith Graham and Kaiser Health News    http://khn.org  

 

It’s widely believed that older age is darkened by persistent loneliness. But a considerable body of research confirms this isn’t the case.

In fact, loneliness is the exception rather than the rule in later life. And when it occurs, it can be alleviated: It’s a mutable psychological state.

Only 30 percent of older adults feel lonely fairly frequently, according to data from the National Social Life, Health and Aging Project, the most definitive study of seniors’ social circumstances and their health in the U.S.

The remaining 70 percent have enough fulfilling interactions with other people to meet their fundamental social and emotional needs

“If anything, the intensity of loneliness decreases from young adulthood through middle age and doesn’t become intense again until the oldest old age,” said Louise Hawkley, an internationally recognized authority on the topic and senior research scientist at the National Opinion Research Center (NORC) at the University of Chicago.

Understanding the extent of loneliness is important, insofar as this condition has been linked to elevated stress, impaired immune system function, inflammation, high blood pressure, depression, cognitive dysfunction and an earlier-than-expected death in older adults.

A new study, co-authored by Hawkley, highlights another underappreciated feature of this affliction: Loneliness is often transient, not permanent.

That study examined more than 2,200 Americans ages 57 to 85 in 2005 and again in 2010. Of the group who reported being lonely in 2005 (just under one-third of the sample), 40 percent had recovered from that state five years later while 60 percent were still lonely.

What helped older adults who had been lonely recover? Two factors: spending time with other people and eliminating discord and disturbances in family relationships.

Hawkley explains the result by noting that loneliness is a signal that an essential need — a desire for belonging — isn’t being met. Like hunger or thirst, it motivates people to act, and it’s likely that seniors reached out to the people they were closest to more often.

Her study also looked at protective factors that kept seniors from becoming lonely. What made a difference? Lots of support from family members and fewer physical problems that interfere with an individual’s independence and ability to get out and about.

To alleviate loneliness, one must first recognize the perceptions underlying the emotion, Hawkley and other experts said.

The fundamental perception is one of inadequacy. People who are lonely tend to feel that others aren’t meeting their expectations and that something essential is missing. And there’s usually a significant gap between the relationships these people want and those they actually have.

This isn’t the same as social isolation — a lack of contact with other people — although the two can be linked. People can be “lonely in a marriage” that’s characterized by conflict or “lonely in a crowd” when they’re surrounded by other people with whom they can’t connect.

Interventions to address loneliness have received heightened attention since 2011, when the Campaign to End Loneliness launched in Britain.

Here are two essential ways to mitigate this distressing sentiment:

Alter perceptions. Loneliness perpetuates itself through a gloomy feedback cycle. We think people don’t like us, so we convey negativity in their presence, which causes them to withdraw from us, which reinforces our perception that we’re not valued.

Changing the perceptions that underlie this cycle is the most effective way to relieve loneliness, according to a comprehensive evaluation of loneliness interventions published in 2011.

Heidi Grant, associate director of the Motivation Science Center at Columbia University, described this dynamic in an article published in 2010. “If co-worker Bob seems more quiet and distant than usual lately, a lonely person is likely to assume that he’s done something to offend Bob, or that Bob is intentionally giving him the cold shoulder,” she wrote.

With help, people can learn to examine the assumptions underlying their thoughts and ask questions such as “Am I sure Bob doesn’t like me? Could there be other, more likelyreasons for his quiet, reserved behavior at work?”

This kind of “cognitive restructuring” is an essential component of LISTEN, a promising intervention to treat loneliness developed by Laurie Theeke, an associate professor in the school of nursing at West Virginia University. In five two-hour sessions, small groups of lonely people probe their expectations of relationships, their needs, their thought patterns and their behaviors while telling their stories and listening to others.

Joining a group can be effective if there’s an educational component and people are actively engaged, experts said.

Invest in relationships. With loneliness, it’s not the quantity of relationships that counts most. It’s the quality.

If you’re married, your relationship with your spouse is critically important in sustaining a feeling of belonging and preventing loneliness, Hawkley said.

If you haven’t been getting along, it’s time to try to turn things around. Remember when you felt most connected to your spouse? How did that feel? Can you emphasize the positive and minimize the negative? If you’re badly stuck, seek professional help.

Investing in relationships with family members and friends is similarly important. This is the time to move beyond old grievances.

“If you want to recover from loneliness, try to deal with difficulties that are disrupting relationships,” Hawkley said.

Also, it’s a good idea to diversify your relationships so you’re not depending exclusively on a few people, according to Jenny de Jong Gierveld and Tineke Fokkema, loneliness researchers from the Netherlands.

Training in social skills can help lonely people deal with problems such as not knowing how to renew contact with an old friend or initiate conversation with a distant relative. And learning coping strategies can enlarge their arsenal of adaptive responses.

Both of these strategies are part of a six-week “friendship enrichment program” developed in the Netherlands. The goal is to help people become aware of their social needs, reflect on their expectations, analyze and improve the quality of existing relationships and develop new friendships.

One simple strategy can make a difference. “If you have good news, share it,” Hawkley said, “because that tends to bring people closer together.”

KHN’s coverage related to aging & improving care of older adults is supported by The John A. Hartford Foundation.

 

Judith GrahamNAVIGATING AGING

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment use following link:  http://khn.org/columnists/

For more KHN coverage of aging, and for more information on Kaiser Health News, please visit our web page at: http://khn.org

Categories: 
Advocacy Groups
City: 
Dallas
States: 
Texas

Carbon Monoxide Poisoning Prevention

Seniorhelpdesk.com Healthcare Blog Credited to The Centers for Disease Control and Prevention, CDC    https://www.cdc.gov

Daylight Saving Time begins Sunday, March 10, 2019.  As you prepare to set your clocks ahead one hour, remember to check the batteries in your carbon monoxide (CO) detector. If you don’t have a battery-powered or battery back-up CO alarm, now is a great time to buy one. More than 400 people die each year in the United States from unintentional, non-fire related CO poisoning.

CO is found in fumes produced by furnaces, vehicles, generators, stoves, lanterns, gas ranges, or burning charcoal or wood. CO from these sources can build up in enclosed or partially enclosed spaces. People and animals in these spaces can be poisoned and can die from breathing CO.

When power outages occur during emergencies such as hurricanes or severe storms, the use of alternative sources of power for heating, cooling, or cooking can cause CO to build up in a home, garage, or camper and to poison the people and animals inside.

Carbon monoxide alarm
Spring ahead by installing a battery-operated or battery back-up CO detector in your home or by checking the batteries, if you already have one, as you set your clocks ahead one hour.

You Can Prevent Carbon Monoxide Exposure

Do

  • Have your heating system, water heater and any other gas, oil, or coal burning appliances serviced by a qualified technician every year.
  • Install a battery-operated or battery back-up CO detector in your home and check or replace the battery when you change the time on your clocks each spring and fall.
  • Leave your home immediately and call 911 if your CO detector ever sounds. Seek prompt medical attention if you suspect CO poisoning and are feeling dizzy, light-headed, or nauseated.

Don’t

  • Run a car or truck inside a garage attached to your house, even if you leave the door open.
  • Burn anything in a stove or fireplace that isn’t vented.
  • Heat your house with a gas oven.
  • Use a generator, charcoal grill, camp stove, or other gasoline or charcoal-burning device inside your home, basement, or garage or outside less than 20 feet from a window, door, or vent.

CO poisoning is entirely preventable. You can protect yourself and your family by learning the symptoms of CO poisoning and acting wisely during a power outage.

For more information, please visit:    https://www.cdc.gov

Categories: 
Advocacy Groups
City: 
Washington D C

Fairfield Health & Fitness Expo 2019 on March 16, 2019 from 11:00 AM - 4:00 PM EDT. Located at Fairfield University RecPlex 1073 N. Benson Road, Fairfield, CT 06824

Name: Fairfield Health & Fitness Expo 2019

Date: March 16, 2019

Time: 11:00 AM - 4:00 PM EDT

Location: Fairfield University RecPlex
1073 N. Benson Road, Fairfield, CT 06824

Website: http://www.FairfieldCtChamber.com

Event Description:

FREE: Open to the Public!   Free parking too!   
· Fairfield University location!
· 65+ Exhibitors
· Lectures
· Health Screenings
· CPR Training throughout the day
· Fitness Demos 
· Fairfield Police Drug Take Back Program
· Kids activities including a Shamrock Fun Run & Touch-A-Truck
· Comfort and service dog
· Virtual Dementia Tour Experience​

 

Presented by the Fairfield Chamber of Commerce in PARTNERSHIP with the Town of Fairfield 
For more information visit: Website: http://www.FairfieldCtChamber.com

 

Categories: 
Advocacy Groups
City: 
Fairfield
States: 
Connecticut