Savvy Senior July 2019 Columns

Savvy Senior – July Columns

  1. Hiring an In-Home Caregiver
  2. How Seniors Can Spot Fake News
  3. Where to Get Help Paying Your Medicare Costs
  4. Men Get Osteoporosis Too
  5. Finding an Alternative to AARP

Hiring an In-Home Caregiver

Dear Savvy Senior,
I need to locate a good in-home caregiver for my 83-year-old mother. What’s the best way to find and hire one?
Looking for Care

Dear Looking,
Finding a good in-home caregiver for an elderly parent can be challenging. How can you find one that’s reliable and trustworthy, as well as someone your parent likes and is comfortable with? Here are some tips that can help.

Know Your Needs
Before you start the task of looking for an in-home caregiver, your first step is to determine the level of care your mom needs. This can pinpoint the type of help she’ll need. For example, if she only needs help with daily living tasks like shopping, cooking, doing laundry, bathing or dressing, a “homemaker” or “personal care aide” will do.

But if she needs health care services, there are “home health aides” that may do all the things a homemaker does, plus they also have training in administering medications, changing wound dressings and other medically related duties. Home health aides often work under a nurse’s supervision.

Once you settle on a level of care, you then need to decide how many hours of assistance she’ll need. For example, does your mom need someone to come in just a few mornings a week to help her cook, clean, run errands or perhaps bathe? Or does she need more continuous care that requires daily visits or a full-time aide?

After you determine her needs, there are two ways in which you can go about hiring someone. Either through an agency, or you can hire someone directly on your own.

Hiring Through an Agency
Hiring a personal care or home health aide through an agency is the safest and easiest option, but it’s more expensive. Costs typically run anywhere between $14 and $25 an hour depending on where you live and the qualification of the aide.

How it works is you pay the agency, and they handle everything including an assessment of your mom’s needs, assigning appropriately trained and pre-screened staff to care for her, and finding a fill-in on days her aide cannot come.

Some of the drawbacks, however, are that you may not have much input into the selection of the caregiver, and the caregivers may change or alternate, which can cause a disruption.

To find a home-care agency in your mom’s area ask for referrals through friends, family or doctor’s offices, or use the home-care locator service tool atPayingForSeniorCare.com – click on “Find Quality, Affordable Care.” In addition, Medicare offers a home health compare tool at Medicare.gov/HomeHealthCompare to help you find and compare home health care agencies.

You also need to be aware that original Medicare does not cover in-home caregiving services unless your mom is receiving doctor’s ordered skilled nursing or therapy services at home too. But, if your mom is in a certain Medicare Advantage plan, or is low-income and qualifies for Medicaid, she may be eligible for some coverage.

Hiring Directly
Hiring an independent caregiver on your own is the other option, and it’s less expensive. Costs typically range between $12 and $20 per hour. Hiring directly also gives you more control over who you hire so you can choose someone who you feel is right for your mom.

However, be aware that if you do hire someone on your own, you become the employer so there’s no agency support to fall back on if a problem occurs or if the aide doesn’t show up. You’re also responsible for paying payroll taxes and any worker-related injuries that may happen. If you choose this option make sure you check the aide’s references thoroughly, and do a criminal background check, which you can do sites like eNannySource.com.

To find someone, ask for referrals or try eldercare-matching services like Care.com or CareLinx.com. Or, for a fee, an aging life care expert (see AgingLifeCare.org) can help you find someone.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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How Seniors Can Spot Fake News

Dear Savvy Senior,
I recently read that seniors are the number one purveyor of fake news on the Internet. Is this true, or is it fake news too? If it’s true, how can seniors go about spotting fake news?
Faked Out Senior

Dear Faked Out,
Yes, it’s true. According to a recent study published in the journal Science Advances, people aged 65 and older are almost four times more likely to share fake news on social media than younger people.

Why do older users share fake news more often? There are two theories. The first is that seniors, who came to the Internet later, sometimes lack the digital literacy skills of their younger counterparts to identify false or misleading content. The second is that many older people experience cognitive decline as they age, making them more likely to fall for hoaxes.

What is Fake News?
Fake news is not new, but it is more prevalent than ever before because of the Internet and social networking, which enables it to spread like wildfire.

Fake news includes false news stories, hoaxes or propaganda created to deliberately misinform or deceive readers. Usually, these stories are created to either influence people’s views, push a political agenda or cause confusion.  It can often be a profitable business for online publishers.

Also note that some fake stories aren’t completely false, but rather distortions of real events. These deceitful claims can take a legitimate news story and twist what it says, or even claim that something that happened long ago is related to current events.

How to Spot Fake News
Here are some tips from the International Federation of Library Associations, Harvard University and Facebook that can help you spot fake news stories.

Be skeptical of headlines: False news stories often have catchy headlines in all caps with exclamation points. If shocking claims in the headline sound unbelievable, they probably are.

Look closely at the Web link: A phony or look-alike link may be a warning sign of false news. Many false news sites mimic authentic news sources by making small changes to the link, for example “abcnews.com.co” (an illegitimate site) versus the actual “abcnews.com.”

Investigate the source: Ensure that the story is written by a source that you trust with a reputation for accuracy. If the story comes from an unfamiliar organization, check their “About” section to learn more. You can also find a list of websites that post deceptive and fake content at FactCheck.org – type “misinformation directory” in their search feature to find it.

Watch for unusual formatting: Many false news sites have misspellings or awkward layouts. Read carefully if you see these signs.

Inspect the dates: False news stories may contain timelines that make no sense, or event dates that have been altered.

Check the evidence: Check the author’s sources to confirm that they are accurate. Lack of evidence or reliance on unnamed experts may indicate a false news story.

Look at other reports: If no other news source is reporting the same story, it may indicate that the story is false. If the story is reported by multiple sources you trust, it’s more likely to be true.

Is the story a joke? Sometimes false news stories can be hard to distinguish from humor or satire. Check whether the source is known for parody, and whether the story’s details and tone suggest it may be just for fun.

Do some fact checking: There are many good websites, like PolitiFact.com, Snopes.com and FactCheck.org that can help you fact check a story to help you identify fact versus fiction. These sites have most likely already fact-checked the latest viral claim to pop up in your news feed.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Where to Get Help Paying Your Medicare Costs

Dear Savvy Senior,
Are there any sources you know of that can help me save on my Medicare coverage? I’m 65, and live primarily on my Social Security, and am having a hard time paying my Medicare out-of-pocket costs.
Need Some Help

Dear Need,
There are several financial assistance programs that can help lower-income Medicare beneficiaries who are having a difficult time paying their out-of-pocket health care costs. Here’s what’s available, along with the eligibility requirements and how to apply.

Medicare Savings Programs
Let’s start with a program that helps pay premiums and out-of-pocket costs for Medicare Parts A and B. It’s called the Medicare Savings Program (MSP), and it has several different benefit levels for people based on their income and asset level. At its most generous the program will pay your Part A and B premiums and pretty much all your Medicare deductibles, coinsurance and copayments. At its least generous the program will pay just your Part B premium.

To qualify for a MSP, the minimum standard set by Medicare, is an income under 135 percent of the federal poverty level, which at the moment works out to around $1,426 a month for individuals (or $1,923 for married couples). Everything counts towards income, including payouts from 401(k) plans, pensions, Social Security, and help from family members.

Medicare also allows states to impose an asset test, which can be as little as $7,730 per individual ($11,600 for married couples), not counting your house or car but counting retirement savings and bank accounts.

But some states have made their MSP programs a lot more generous, with much higher income limits and in some cases no asset tests at all. And the program may be called something else in your state. To find out if you qualify or to apply, contact your state Medicaid program. Visit Medicare.gov/contacts or call all 800-633-4227 for contact information.

Medication Extra Help
For help with Medicare (Part D) prescription drug plan costs, there is another completely separate program called Extra Help. To get it, you’ll need to apply through your local Social Security office.

Depending on how low your income is, this program will pay part or all of your Part D prescription drug plan’s monthly premiums, annual deductibles and prescription co-payments. In 2019, individuals with a yearly income below $18,735 ($25,365 for a married couple), and assets under $14,390 ($28,720 for a married couple) can qualify for Extra Help.

If you’re eligible to be in a Medicare Savings Program, you will automatically qualify for Extra Help. But because the requirements are slightly different, even if you don’t qualify for a Medicare Savings Program for Part B you might be able to get Extra Help for Part D. For more information or to apply, visit SSA.gov/extrahelp or call Social Security at 800-772-1213.

Other Assistance Programs
Depending on your income level, needs and location there are many other financial assistance programs that can help like Medicaid, SSI (Supplemental Security Income), PACE (Program of All-inclusive Care for the Elderly), SNAP (Supplemental Nutrition Assistance Program), (LIHEAP) Low Income Home Energy Assistance Program and many others.

To help you find out what types of assistance programs you may be eligible for, and learn how to apply for them, go to BenefitsCheckUp.org. This is a free, confidential Web tool designed for people age 55 and older that contains more than 2,500 programs.

It’s also possible to get help in person at one of the 87 Benefits Enrollment Centers scattered across the U.S. Call 888-268-6706 or visitNCOA.org/centerforbenefits/becs to locate a center in your area. Some centers also offer assistance over the phone.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Men Get Osteoporosis, Too

Dear Savvy Senior,
Can men get osteoporosis or is it primarily a problem for women? When I fell and broke my wrist last winter the doctor that treated me told me I might have osteoporosis, but I never got it checked. What can you tell me?
Bony Bill

Dear Bill,
Many people think osteoporosis is a woman’s disease, but men can get it too, especially in their later years. Here’s what you should know.

Osteoporosis in Men
Osteoporosis is a disease that causes the bones to become weak and brittle and more susceptible to fractures. Though women are four times more likely to acquire it, around 2 million American men have osteoporosis today, and another 12 million have “pre-osteoporosis,” or osteopenia.

Unfortunately, men are much less likely than women to get the health of their bones checked even after they break a bone. That’s because doctors are often unaware of the many factors that put men at risk of osteoporosis.

While menopause is a major component that accelerates bone loss in women, some of the key risk factors for men developing osteoporosis include: being over age 70; being thin or underweight; smoking; consuming more than three alcoholic drinks a day; having a parental history of osteoporosis; and having a previous fracture.

Certain health conditions – such as rheumatoid arthritis, celiac disease, testosterone deficiency, hyperthyroidism, COPD, kidney or liver disease, and mobility disorders like Parkinson’s disease, multiple sclerosis or stroke – can also increase your risk. In addition, so can taking certain medications like anti-inflammatory steroids, prostate cancer drugs, proton pump inhibitors for GERDs, antidepressants, immunosuppressants, and anti-seizure drugs.

To help you determine your risk of osteoporosis, the International Osteoporosis Foundation has a quick, online quiz you can take atRiskCheck.IOFBoneHealth.org.

Prevention and Treatment
A good first step in preventing and treating osteoporosis is to get screened. All men over age 70 should have a bone density test, and those who’ve had a fracture or have other risk factors should be tested after age 50. Screening for osteoporosis is a simple, painless, bone density test, which takes about five minutes. Many health insurance companies will cover bone density tests, as does Medicare.

Here’s what else you can do to protect your bones.

Boost your calcium: The best way to get bone-building calcium is through your diet.  Dairy products (low-fat milk, cheeses and yogurt), dark green leafy vegetables (broccoli, kale, collards), sardines and salmon, cooked dried beans, soy foods, almonds and fortified cereals and juices are all good sources of calcium. Vitamin D is also important to help your body absorb calcium.

The National Osteoporosis Foundation recommends 1,000 mg of calcium daily for men under 70, and 1,200 mg for those over 71. They also recommend 800 to 1,000 international units (IU) of vitamin D if you’re over 50. If you’re not getting enough vitamin D through sunlight or food, consider taking a supplement. Most daily multivitamins contain at least 400 IU.

Exercise: Weight-bearing exercises like walking, and strength training with weights or resistant bands three or four times a week, can significantly improve your bone health and reduce the risk of a fall that could cause a fracture.

Control these vices: Avoid smoking, limit alcohol to no more than two or three drinks per day, and limit caffeine (coffee, tea or caffeinated soda) to three cups a day.

Consider medications: The same drugs to treat osteoporosis in women have also been approved for men. The most widely prescribed for osteoporosis are bisphosphonates, a class of drugs designed to slow or stop bone loss. Talk to your doctor about these and other medication options, as well as potential side effects.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Finding an Alternative to AARP

Dear Savvy Senior,
Can you recommend any conservative membership organizations for older adults that offer discounts too? AARP is way too liberal for my liking.
Discount-Seeking Conservative

Dear Conservative,
There are actually quite a few senior advocacy organizations out there promoting themselves as conservative alternatives to AARP, and many of them offer membership benefit too. Here’s what you should know.

Anti-AARP
While AARP, with a membership of around 38 million, is by far the biggest and most powerful advocacy group for people age 50 and older, there are millions of older Americans that don’t like or agree with their stance on various issues. Many believe AARP leans too far to the left despite its stated nonpartisan nature.

For seniors that disagree with AARP, there are other conservative leaning groups that you can join that may better represent your views. And, many of them offer their members discounts on things like travel, insurance, healthcare and more. Here are several to check into.

60 Plus: American Association of Senior Citizens (60plus.org): Established in 1992, this nonprofit group was founded to lobby for issues it holds dear, namely free enterprise, fewer taxes and less Government. Their main priority is to end the federal estate tax and preserve social security. Membership fees run $12, $24 or $48 per year, or $299 for a lifetime membership. They also offer a bevy of discounts on travel and entertainment, cable, Internet and satellite services, dental, vision and hearing packages, roadside assistance and more.

American Seniors Association (AmericanSeniors.org): Founded in 2005 for people age 50 and older, this conservative organization is built on five foundations, which includes rebuilding national values, Social Security reform, Medicare reform, tax code reform and control of government overspending. Fees to join run $15 for one year, $25 for two or $35 for three years, and members receive access to a variety of benefit on travel, home and auto insurance, security services, health and wellness (medical, dental, vision and hearing) and more.

Association of Mature American Citizens (AMAC.us): With more than one million members, this organization was started in 2007 for people 50 and older. Their mission is to help seniors fight high taxes, reduce excessive government involvement in our day-to-day lives, and preserve American values. They also offer a host of benefits on home, health and auto insurance, travel, vision and dental care, prescription drugs, retail savings, roadside assistance and more. Membership fees run $16 per year, or less if you join for multiple years.

The Seniors Coalition (Senior.org): Founded in 1990, this conservative public advocacy group claims to have around four million supporters. Their key issues are to protect Social Security benefits, stop Social Security payments to illegal aliens from Mexico, eliminate the death tax, and reform the Social Security COLA system. TSC offers very few membership benefits. Annual fees run $10 for one person per, or $13 per couple and you can join at any age.

Some other senior membership organizations to consider that offer discounts include the non-for-profit American Senior Benefits Association (ASBAonline.org), and the conservative leaning National Association of Conservative Seniors (NAOCS.us), and Christian Seniors Association (CSAbenefits.site-ym.com).

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior”book.

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