Savvy Senior — March 2021 Columns

March 1, 2021

Savvy Senior – March Columns

  1. How to Choose a Quality Nursing Home During a Pandemic
  2. A Social Security Perk for Older Parents
  3. Technology That Can Help You Locate Things You Misplace
  4. Keeping Your Balance as You Age

How to Choose a Quality Nursing Home During a Pandemic

Dear Savvy Senior,
Can you give me some tips on how to pick a good nursing home in the COVID era? My mother had a stroke a while back and can’t use her legs any longer. I’ve been taking care of her at home, but her health has declined to the point that I absolutely can’t do it any longer.
Need Help

Dear Need,
COVID-19 has hit nursing homes hard over the past year, making it extremely difficult for people attempting to choose a nursing home during this time.

While many eldercare experts suggest avoiding nursing homes during the pandemic if at all possible, some families, like yours, find themselves in difficult situations needing long-term or rehabilitative care for their elder loved one now.

To help you find a good nursing home in the COVID era, and avoid a bad one, here are some steps to follow.

Make a list: There are several sources you can turn to for referrals to top nursing homes in your area including your mom’s doctor or nearby hospital discharge planner; friends or neighbors who may have had a loved one in a nursing home; and online at Medicare’s nursing home compare tool at Medicare.gov/care-compare. This tool will not only help you locate nursing homes in your area, it also provides a 5-star rating system on recent health inspections, staffing, quality of care, and overall rating.

Also keep in mind that it’s always best to choose a nursing home that’s close to family members and friends who can check in often, because residents with frequent visitors usually get better care.

Do some research: To research the nursing homes on your list, put a call into your long-term care ombudsman. This is a government official who investigates nursing home complaints and advocates for residents and their families. This person can tell you which nursing homes have had complaints or problems in the past. To find your local ombudsman, call your area aging agency (800-677-1116) or visitLTCombudsman.org.

You should also visit the Centers for Medicare and Medicaid Services website (data.cms.gov), which provides updated data on U.S. nursing home reported COVID-19 cases and deaths.

Contact the nursing homes: Once you’ve identified a few good nursing homes, call them to see if they have any vacancies, what they charge, and if they accept Medicaid.

Also, find out their staff-to-patient ratio and staff turnover rate; their COVID infection-control procedures; the percentage of residents and staff that have been vaccinated for COVID; and their facility visitation policy.

If visitor restrictions are in place, see if they offer smartphone, tablet or laptop technology assistance so you can have Facetime, Zoom or Skype video calls with your mom.

Tour your top choices: The best way to evaluate a nursing home is to visit it in person, but because of COVID, some facilities may offer limited or virtual tours only. To help you evaluate and rate a facility, Medicare offers a terrific checklist of questions that you can print at Medicare.gov/NursingHomeCompare/Checklist.pdf.

Paying for Care
With nursing home costs now averaging $255 per day nationally for a semi-private room and nearly $290 for a private room, paying for care is another area you may have questions about or need assistance with. Medicare only helps pay up to 100 days of rehabilitative nursing home care, which must occur after a hospital stay of at least three days.

Most nursing home residents pay for care from either personal savings, a long-term care insurance policy, or through Medicaid once their savings are depleted.

The National Clearinghouse for Long-Term Care Information website (LongTermCare.acl.gov) is a good resource that can help you understand and research your financial options. You can also get help from your State Health Insurance Assistance Program (SHIP), which provides free counseling on all Medicare and Medicaid issues. To find a local SHIP counselor visit ShiptaCenter.org or call 877-839-2675.

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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A Social Security Perk for Older Parents

Dear Savvy Senior,
I’ve been told that my two children, ages 14 and 16, may be eligible for Social Security when I file for my retirement benefits. Is this true? What can you tell me?
Viagra Daddy

Dear Viagra,
It’s true. If you’re age 62 or older and are still raising young children, there’s a Social Security benefit strategy that can put some extra money in your family coffers.

Here’s how it works. When you file for Social Security retirement benefits, your minor children can get money on your work record equaling half of what you would receive at full retirement age, now gradually rising from 66 to 67. Even if you were to take a smaller benefit by claiming earlier, your kids will still get half of your full-retirement age amount.

To qualify, your daughter – whether she’s biological, adopted or a stepdaughter – must be unmarried and under age 18. Kids that are over 18 but still in high school, can collect too until they graduate or turn 19, whichever comes first. (Other rules apply to kids that are disabled.)

But that’s not all.

Because one of your children is only 14, your wife (if you’re married) can collect Social Security benefits on your work record too, and it doesn’t matter if she’s just 40 years old. The minimum age requirements to collect retirement benefits (62) or survivor benefits (60) does not apply when it comes to collecting benefits as the caregiver of a young child. The spouse’s benefit, which is also worth up to half of your benefit, will stop when your daughter turns 16.

But note that there are limits to the amount of money that can be paid to a family. The Social Security “family maximum payment” is determined by a complex formula and can range from 150 to 180 percent of your full retirement benefit amount. If the total exceeds that, each person’s benefit, except yours, is cut proportionately until it equals the maximum.

Here’s an example of how that’s figured. Let’s say, for example, that your full retirement age benefit is $2,400 per month. That would make your family maximum benefit (according to the Social Security formula at SSA.gov/oact/cola/familymax.html) roughly $4,200 per month.

Subtract your $2,400 benefit from the $4,200 family maximum benefit, which leaves $1,800. That’s the monthly amount that can be split between your two children – $900 each. If your wife wants in on it too, the individual checks are smaller, at $600 a piece, but the family amount is the same.

You should also know that minor children can collect up to half of a disabled parent’s Social Security disability benefit. And if the parent dies, they will get a survivor’s benefit, which is up to 75 percent of the deceased parent’s basic Social Security benefit.

To learn more, see the SSA publication (No. 05-10085) “Benefits for Children” at SSA.gov/pubs/EN-05-10085.pdf.

One Caveat: Social Security benefits for your kids may not be available before full retirement age if you are still working. In 2021, you will lose $1 in benefits for every $2 earned over $18,960, except in the year you reach full retirement age. In that case, the earnings limit is $50,520, with $1 in benefits withheld for every $3 earned over the limit.

If you lose your benefits, your dependents also lose theirs. You can recoup those payments later, but your kids can’t.

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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Technology That Can Help You Locate Things You Misplace

Dear Savvy Senior,
Can you recommend any good devices that help seniors with tracking down misplaced items? My wife misplaces everything including her car keys, eyeglasses, cell phone, purse and more.
Always Searching

Dear Always,
There’s actually a wide variety of tracking devices that can help you and your wife find items that are commonly misplaced. Here are some top options to consider depending on how tech savvy you are.

Bluetooth Trackers
If you or your wife uses a smartphone or tablet, you can easily track down lost or misplaced items like keys, a purse or wallet, remote control, smartphone, tablet or even a laptop with a Bluetooth tracker. While there are several different types of tracker products on the market today, the best is Tile (TheTileApp.com), which pairs with Apple and Android apps to help you locate missing items.

All you do is attach a small battery-powered Tile to the items you want to keep track of with an adhesive sticker, a key ring or you can just slip it inside the item.

Then, when a tagged item goes missing, you simply access the app on your smartphone or tablet to see how far away you are from the item or last known location on the map. If you’re within 150 to 200 feet, you can make the Tile ring so you can follow the sound to easily find it.

Or, if your wife loses her phone, the Tile work in reverse, allowing her to double press the button on her Tile to make her phone ring (even if it’s on silent) as long as it’s nearby.  Tile also works with Google Assistant, Amazon Alexa or Siri to find misplaced items. All you have to do is ask.

To fit your tracking needs, Tile offers a variety of different sized trackers including the Tile Mate ($25) that’s ideal for keeping track of keys, purses or backpacks; Tile Slim ($25), which is the size of a credit card that can be put into a wallet or attached to a laptop; Tile Sticker ($40 for a 2-pack), the smallest finder that can attach to things like remotes, bikes and more; and Tile Pro ($35), which is the most durable tacker that has a 400-foot range and extra loud ringer.

Glasses Tracker
Since Tile doesn’t offer a glasses tracker, a great product to help your wife keep tabs on her eyeglasses is Orbit Glasses (FindOrbit.com; $40). This is a tiny rechargeable Bluetooh device that sticks to the inside arm of the glasses so it’s not noticeable.

So, when your wife’s glasses aren’t on her head, but are nearby, she can use the free Orbit app to make them ring so she can find them quickly. Or, if she’s out of Bluetooth range, she can check the last known location that will be shown on the map.

Radio Frequency Finders
If you or your wife don’t have a smartphone or tablet, there are also radio frequency devices like the Esky Key Finders (EskyNow.com), sold through Amazon.com, that can help you find misplaced items.

These devices come with an item locator remote and four to six tags with prices ranging between $20 and $30. Attach a tag to the items you want to keep track of with a key ring or adhesive. Each tag is color-coded and corresponds to a colored button on the finder.

When an item goes missing, you simply press the colored button on the locator remote and the tag will flash and beep. The signal will go through walls and cushions and have a tracking range of around 100 feet. Make sure you keep the finder fob in a safe spot, because if you misplace it, you won’t be able to find the tagged items.

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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Keeping Your Balance as You Age

Dear Savvy Senior,
What can you tell me about balance exercises? I’ve fallen a few times over the past year and have read that balance exercises can help me regain my steadiness, but I’m not exactly sure what to do.
Unsteady at 70

Dear Unsteady,
Most people don’t think much about practicing their balance, but they need to. As we age, our balance declines if it isn’t practiced, which can lead to falls that often result in a broken bone.

Every year more than one in four people age 65 and older fall, and the risk increases with age. Here’s what you should know about balance problems, along with some different exercises that can help you improve it.

Aging Affects Balance
Balance is something most people take for granted until it’s challenged by a medical condition, medication or advanced age, which dulls our balance senses and causes most seniors to gradually become less stable on their feet over time.

Poor balance can also lead to a vicious cycle of inactivity. You feel a little unsteady, so you curtail certain activities. If you’re inactive, you’re not challenging your balance systems or using your muscles. As a result, both balance and strength suffer. Simple acts like strolling through a grocery store or getting up from a chair become trickier. That shakes your confidence, so you become even less active.

Balance Exercises

If you have a balance problem that is not tied to illness, medication or some other specific cause, simple exercises can help preserve and improve your balance. Here are four exercises you can do that will help:

  • One-legged stands: Stand on one foot for 30 seconds, or longer, then switch to the other foot. In the beginning, you might want to have a wall or chair to hold on to. Or, for an extra challenge try closing your eyes, or standing on a throw pillow or Bosu ball (an inflated rubber disc on a stable platform).
  • Heel-to-toe walking: Take 20 steps while looking straight ahead. Think of a sobriety test.
  • Standing up: Without using your hands, get up from a straight-backed chair and sit back down 10 to 20 times. This improves balance and leg strength.
  • Tai chi: Research has shown that the Asian practice of tai chi – which uses a combination of slow, graceful movements, meditation and deep breathing – can help reduce the risk of falls.

For more information on different balance exercises you can do at home, there are a variety of balance and strength exercises and beginner Tai Chi DVDs you can purchase at Amazon.com or through Amazon Prime video.

There are also senior fitness programs, like SilverSneakers (silversneakers.com) and Silver&Fit (silverandfit.com), that offer online classes that can guide you through a series of exercises you can do at home during the pandemic.

See a Doctor
I do, however, want to emphasize that if you’ve already fallen, are noticeably dizzy or unsteady, or have a medical condition affecting your balance, you need to see a doctor. They might refer you to a physical therapist or to an appropriate balance-training class in your community. It’s also important to know that many medicines and medical conditions – from Parkinson’s disease to diabetes to inner-ear disorders – can affect balance.

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.

NEW “Savvy Senior” Columns for February

February 3, 2021

Savvy Senior – February 2021 Columns

  1. How Much Do You Have to Make to File Income Taxes?
  2. How to Choose a Medical Alert System
  3. Do I Need to Sign-Up for Medicare If I’m Still Working?
  4. How to Choose a Hospice Care Program

How Much Do You Have to Make to File Income Taxes?

Dear Savvy Senior,
What are the IRS income tax filing requirements for retirees in 2020? My income dropped way down when I was forced into retirement last March due to COVID, so I’m wondering if I need to file a tax return this year.
Unexpected Retiree

Dear Unexpected,
Whether or not you are required to file a federal income tax return this year actually depends on several factors: How much you earned last year (in 2020), the source of that income, your age and your filing status.

Here’s a rundown of this tax season’s IRS tax filing requirement thresholds. For most people, this is pretty straightforward. If your 2020 gross income – which includes all taxable income, not counting your Social Security benefits, unless you are married and filing separately – was below the threshold for your filing status and age, you may not have to file. But if it’s over, you will.

  • Single: $12,400 ($14,050 if you’re 65 or older by Jan. 1, 2021).
  • Married filing jointly: $24,800 ($26,100 if you or your spouse is 65 or older; or $27,400 if you’re both over 65).
  • Married filing separately: $5 at any age.
  • Head of household: $18,650 ($20,300 if age 65 or older).
  • Qualifying widow(er) with dependent child: $24,800 ($26,100 if age 65 or older).

To get a detailed breakdown on federal filing requirements, along with information on taxable and nontaxable income, call the IRS at 800-829-3676 and ask them to mail you a free copy of the “1040 and 1040-SR Instructions for Tax Year 2020,” or you can get it online at IRS.gov.

Check Here Too
There are, however, some other financial situations that can require you to file a tax return, even if your gross income falls below the IRS filing requirements. For example, if you earned more than $400 from self-employment in 2020, owe any special taxes like an alternative minimum tax, or get premium tax credits because you, your spouse or a dependent is enrolled in a Health Insurance Marketplace (aka Obamacare) plan, you’ll need to file.

You’ll also need to file if you’re receiving Social Security benefits, and one-half of your benefits plus your other gross income and any tax-exempt interest exceeds $25,000, or $32,000 if you’re married and filing jointly.

To figure all this out, the IRS offers an interactive tax assistant tool on their website that asks a series of questions that will help you determine if you’re required to file, or if you should file because you’re due a refund. It takes less than 15 minutes to complete.

You can access this tool at IRS.gov/Help/ITA – click on “Do I Need to File a Tax Return?”  Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040.

Check Your State
Even if you’re not required to file a federal tax return this year, don’t assume that you’re also excused from filing state income taxes. The rules for your state might be very different. Check with your state tax agency before concluding that you’re entirely in the clear. For links to state tax agencies see Taxadmin.org/state-tax-agencies.

Tax Prep Assistance
If you find that you do need to file a tax return this year, you can free file through the IRS at IRS.gov/FreeFile if your 2020 adjusted gross income was below $72,000.

Or, if you need some help, contact the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TCE provides free tax preparation and counseling to middle and low-income taxpayers, age 60 and older. Call 800-906-9887 or visit IRS.treasury.gov/freetaxprep to find out about services near you.

You can also get help through the AARP Foundation Tax-Aide service, a participant in the TCE program that provides free tax preparation in-person, online and by phone. To find out about service options in your area, call 888-227-7669 or visit AARP.org/findtaxhelp. You don’t have to be an AARP member to use this service.

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 to Choose a Medical Alert System

Dear Savvy Senior,
I am interested in getting my mom, who lives alone, a medical alert system with a wearable pendant button that will let her call for help if she falls or has a medical emergency. What can you tell me to help me choose one?
Too Many Choices

Dear Too Many,
A good medical alert system is an effective and affordable tool that can help keep your mom safe and living in her own home longer. But with all the different products and features available today, choosing one can be challenging. Here are some tips that can help.

Three Key Questions
Medical alert systems, which have been around since the 1980s, provide a wearable help button – usually in the form of a neck pendant or wristband – that would put your mom in touch with a dispatcher who could summon emergency help or contact a friend or family member as needed.

To help you narrow down your options and choose a system that best fits your mom’s needs, here are three key questions you’ll need to ask, along with some top-rated companies that offer these products.

Does your mom want a home-based or mobile system?
Medical alert systems were originally designed to work inside the home with a landline telephone, which is still an option. But since fewer and fewer households have landlines these days, most companies today also offer home-based systems that work over a cellular network. With these systems, pressing the wearable help button allows you to speak to a dispatcher through a base unit located in your home.

In addition, many companies offer mobile medical alert options, too. You can use these systems at home, but they’ll also allow you to call for help while you’re out and about.

Mobile alerts operate over cellular networks and incorporate GPS technology. They allow you to talk and listen to the operator directly through the pendant button, and because of the GPS, your location would be known in order for help to be sent.

If your mom doesn’t leave the house very often, she may not need a mobile system, but if she is still active, she may want added protection outside the home.

Should her system be monitored or not?
The best medical alert systems are monitored, meaning that the help button connects you with a trained operator at a 24/7 dispatching center.

But you also have the option to choose a system that isn’t monitored. With these, when you press the help button, the device automatically dials a friend or family member on your programmed emergency call list.

These products can often be set up to call multiple people and to contact emergency services if you don’t get an answer from someone on your list.

Should you add a fall-detection feature?
Most medical alert companies today now offer the option of an automatic fall detection pendant for an additional fee of $10 to $15 per month. These pendants sense falls when they occur and automatically contact the dispatch center, just as they would if you had pressed the call button.

But be aware that this technology isn’t full proof. In some cases, this feature may register something as a fall that isn’t. The alarm might go off if you drop it or momentarily lose your balance but don’t actually land on the ground.

Top Rated Systems
Here are four top companies, rated by Consumer Reports, that offer home and mobile monitored medical alert systems:

  • Bay Alarm Medical: Fees range between $20 and $40 per month; BayAlarmMedical.com; 877-522-9633.
  • GreatCall’s Lively Mobile Plus: The device costs $50 plus a $25 to $40 monthly service fee; GreatCall.com; 800-650-5921.
  • MobileHelp: Monthly fees run $20 to $45; MobileHelp.com; 800-809-9664.
  • Phillips Lifeline: $30 to $50/month, plus a onetime device/activation fee of $50 to $100; Lifeline.Philips.com; 855-681-5351.

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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Do I Need to Sign Up for Medicare If I’m Still Working?

Dear Savvy Senior,
I will turn 65 in a few months and plan to keep working for several more years. I have good health insurance from my employer now. Do I have to sign up for Medicare when I reach 65?
Looking Ahead

Dear Looking,
Whether you need to enroll in Medicare at 65 if you continue to work and have health insurance through your job depends on how large your employer is. The same rules apply if your health insurance comes from your spouse’s job.

But first, let’s review the basics. Remember that original Medicare has two parts: Part A, which provides hospital coverage and is free for most people. And Part B, which covers doctor’s bills, lab tests and outpatient care. Part B also has a monthly premium, which is $148.50 for most beneficiaries in 2021, but is higher for individuals earning above $88,000.

If you’re already receiving Social Security, you’ll automatically be enrolled in parts A and B when you turn 65, and you’ll receive your Medicare card in the mail. It will include instructions to return it if you have work coverage that qualifies you for late enrollment. If you aren’t yet receiving Social Security, you will have to apply, which you can do online at SSA.gov/medicare.

If you plan to continue working past the age of 65 and have health insurance from your job, your first step is to ask your benefits manager or human resources department how your employer insurance works with Medicare. In most cases, you should at least take Medicare Part A because it’s free. (Note: If you’re funding a health savings account you may not want to take Part A because you can’t make contributions after you enroll). But to decide whether to take Part B or not will depend on the size of your employer.

Small Employer
If your current employer has fewer than 20 employees, Medicare will be your primary insurer and you should enroll in Medicare Part B during your initial enrollment period. This is a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday.

If you miss the seven-month sign-up window, you’ll have to wait until the next general enrollment period, which runs from Jan. 1 to March 31 with benefits beginning the following July 1. You’ll also incur a 10 percent penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium.

Large Employer
If your employer has 20 or more employees, your employer’s group health plan will be your primary insurer as long as you remain an active employee. If this is the case, you don’t need to enroll in Part B when you turn 65 if you’re satisfied with the coverage you are getting through your job. But if you do decide to enroll in Medicare, it will supplement your employer insurance by paying secondary on all of your claims.

Once your employment or group health coverage ends, you will then have eight months to sign up for Part B without a penalty. This is known as the Special Enrollment Period.

Check Drug Coverage
You also need to verify your prescription drug coverage. Call your benefits manager or insurance company to find out if your employer’s prescription drug coverage is considered “creditable.” If it is, you don’t need to enroll in a Medicare Part D prescription drug plan. If it isn’t, you should purchase a plan (see Medicare.gov/plan-compare) during your initial enrollment period or you’ll incur a premium penalty (1 percent of the average national premium for every month you don’t have coverage) if you enroll later.

If you have more questions or need help, contact your State Health Insurance Assistance Program (see ShiptaCenter.org), which offers free Medicare counseling. Or call the Medicare Rights Center helpline at 800-333-4114.

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 to Choose a Hospice Care Program

Dear Savvy Senior,
Where can I turn to find a good Medicare covered hospice provider? My husband’s mother has a terminal condition and wants to die at home, if possible, so I’m helping out where I can.
Sad Sandy

Dear Sandy,
Hospice is a wonderful option in the last months of life because it offers a variety of services, not only to those who are dying, but also to those left behind. Here’s what you should know about hospice care, along with some tips to help you choose one.

Understanding Hospice
Hospice care is a unique service that provides medical care, pain management, and emotional and spiritual support to people who are in the last stages of a terminal illness – it does not speed up or slow down the process of dying. Hospice’s goal is to simply keep the patient as comfortable and pain-free as possible, with loved ones nearby until death.

The various services provided by a hospice program comes from a team of professionals that works together to accommodate all the patients’ end-of-life needs.

The team typically includes hospice doctors that will work with the primary physician and family members to draft up a care plan; nurses who dispense medication for pain control; home care aids that attend to personal needs like eating and bathing; social workers who help the patient and the family prepare for end of life; clergy members who provide spiritual counseling, if desired; and volunteers that fill a variety of niches, from sitting with the patient to helping clean and maintain their property.

Some hospices even offer massage or music therapy, and nearly all provide bereavement services for relatives and short-term inpatient respite care to give family caregivers a break.

Most hospice patients receive care in their own home. However, hospice will go wherever the patient is – hospital, nursing home or assisted living residence. Some even have their own facility to use as an option.

To receive hospice, your mother-in-law must get a referral from her physician stating that her life expectancy is six months or less.

It’s also important to know that home-based hospice care does not mean that a hospice nurse or volunteer is in the home 24 hours a day. Services are based on need and/or what you request. Hospice care can also be stopped at any time if your mother-in-law’s health improves or if she decides to re-enter cure-oriented treatments.

How to Choose
The best time to prepare for hospice and consider your options is before it’s necessary, so you’re not making decisions during a stressful time. There are more than 4,300 hospice care agencies in the U.S., so depending on where you live, you may have several options from which to choose.

To locate a good hospice in your area, ask your mother-in-law’s doctor or the discharge planner at your local hospital for a referral, or you can search online at Medicare.gov/care-compare, which provides lists and ratings of hospice providers in your area.

When choosing, look for an established hospice that has been operating for a few years and one that is certified by Medicare. To help you select one, the National Hospice and Palliative Care Organization offers a worksheet of questions to ask CaringInfo.org.

Medicare Coverage
Medicare covers all aspects of hospice care and services for its beneficiaries. There is no deductible for hospice services although there may be a very small co-payment – such as $5 for each prescription drug for pain and symptom control, or a 5 percent share for inpatient respite care. Medicaid also covers hospice in most states, as do most private health insurance plans.

For more information, see the “Medicare Hospice Benefits” online booklet at Medicare.gov/pubs/pdf/02154-medicare-hospice-benefits.pdf.

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.

“Savvy Senior” Columns for January 2021

December 22, 2020

Savvy Senior – January 2021 Columns

  1. What Caregivers Should Know About Medicare
  2. Is Social Security Income Taxable?
  3. How Seniors Can Make Their Bathrooms Safer and Easier to Use
  4. Acupuncture: Does It Work and Is It Covered by Medicare?
  5. How to Find Affordable Housing for Seniors

What Caregivers Should Know About Medicare

Dear Savvy Senior,
I am the caregiver for my 81-year-old mother, who recently fell and broke her hip, and have a lot of questions about how original Medicare works and what it covers. Where can I get some help understanding this program?
Overwhelmed Caregiver                                                                   

Dear Caregiver,
Excellent question! Having a working knowledge of Medicare can help you take full advantage of the coverage and services it provides to ensure your mom receives the best care possible. Here’s what you should know.

Medicare Assistance
A good starting point to get familiar with Medicare is the official “Medicare & You” handbook that overviews the program. It’s mailed to all beneficiaries every fall and provides an up-to-date description of all services and benefits. You can also see it online at Medicare.gov/medicare-and-you.

If you have a particular question, you can call and visit with a Medicare customer service representative at 800-633-4227. Medicare also works closely with State Health Insurance Assistance Programs (SHIP) to provide free health insurance counseling. To find a SHIP counselor in your area visit ShiptaCenter.org or call 877-839-2675.

Caregivers also find Medicare’s secure website – MyMedicare.gov – especially useful. After setting up a personal account for your mom, you can view the details of her coverage, track recent health care claims and keep up to date on the preventive services she qualifies for.

Compare Tools
Medicare can also help you locate the right health care providers for your mother. At Medicare.gov/care-compare you can find and compare doctors, hospitals, home health agencies, dialysis facilities, inpatient rehab facilities, long-term care hospitals and nursing homes in your mom’s area.

What Medicare Covers
Medicare can reduce many out-of-pocket medical expenses your mom incurs, but it doesn’t cover everything. Understanding what Medicare does and doesn’t cover can save you time and spare you frustration when navigating the caregiving maze. Here are some key points for caregivers:

Besides basic hospital and physician services (which includes telehealth services) and optional prescription drug benefits, Medicare covers home health care too. To qualify, your mom must be homebound, under a physician’s care and in need of part-time skilled nursing care or rehabilitative services like physical therapy.

Medicare also helps pay for oxygen, catheters and other medical supplies that a doctor prescribes for home use. The same is true for medically necessary equipment like oxygen machines, wheelchairs and walkers.

In addition, Medicare covers skilled care in a nursing home for limited periods – up to 100 days – following hospital stays. But it doesn’t cover long-term stays. Patients who need custodial care (room and board) must pay out of pocket unless they’re eligible for Medicaid or have private long-term care insurance.

Medicare pays for hospice care too, for someone with a terminal illness whose doctor expects to live six months or less. The hospice benefit also includes brief periods of respite care at a hospice facility, hospital or nursing home to give the patient’s caregivers an occasional rest.

Besides long-term nursing home stays, original Medicare typically doesn’t cover regular dental care or dentures, regular eye exams or eyeglasses, and hearing exams and hearing aids. Likewise, it won’t pay for nonemergency ambulance trips unless a doctor certifies they’re medically necessary.

To find out what Medicare covers, visit Medicare.gov/coverage and type in the test, item or service you have questions about, or download the Medicare “What’s covered” app in either the App Store or Google Play.

Financial Assistance
If your mom lives on a limited income, you should check whether she qualifies for help with prescription drug costs or with other Medicare-related premiums, deductibles and copayments.

For help with drug costs, visit SSA.gov/prescriptionhelp or contact Social Security at 800-772-1213 and ask about the “Extra Help Program.” For help with other Medicare costs, go to Medicare.gov or call 800-633-4227 and ask about the “Medicare Savings Programs.”

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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Is Social Security Income Taxable?

Dear Savvy Senior,
I understand that a portion of my Social Security benefits may be taxable when I retire. Can you tell me how to calculate this?
Ready to Retire

Dear Ready,
Whether or not you’ll be required to pay federal income tax on your Social Security benefits will depend on your income and filing status. About 35 percent of Social Security recipients have total incomes high enough to trigger federal income tax on their benefits.

To figure out if your benefits will be taxable, you’ll need to add up all of your “provisional income,” which includes wages, taxable and non-taxable interest, dividends, pensions and taxable retirement-plan distributions, self-employment, and other taxable income, plus half your annual Social Security benefits, minus certain deductions used in figuring your adjusted gross income.

How to Calculate
To help you with the calculations, get a copy of IRS Publication 915 “Social Security and Equivalent Railroad Retirement Benefits,” which provides detailed instructions and worksheets. You can download it at IRS.gov/pub/irs-pdf/p915.pdf or call the IRS at 800-829-3676 and ask them to mail you a free copy.

After you do the calculations, the IRS says that if you’re single and your total income from all of the listed sources is:

  • Less than $25,000, your Social Security will not be subject to federal income tax.
  • Between $25,000 and $34,000, up to 50 percent of your Social Security benefits will be taxed at your regular income-tax rate.
  • More than $34,000, up to 85 percent of your benefits will be taxed.

If you’re married and filing jointly and the total from all sources is:

  • Less than $32,000, your Social Security won’t be taxed.
  • Between $32,000 and $44,000, up to 50 percent of your Social Security benefits will be taxed.
  • More than $44,000, up to 85 percent of your benefits will be taxed.

If you’re married and file a separate return, you probably will pay taxes on your benefits.

To limit potential taxes on your benefits, you’ll need to be cautious when taking distributions from retirement accounts or other sources. In addition to triggering ordinary income tax, a distribution that significantly raises your gross income can bump the proportion of your Social Security benefits subject to taxes.

How to File
If you find that part of your Social Security benefits will be taxable, you’ll need to file using Form 1040 or Form 1040-SR. You also need to know that if you do owe taxes, you’ll need to make quarterly estimated tax payments to the IRS, or you can choose to have it automatically withheld from your benefits.

To have it withheld, you’ll need to complete IRS Form W-4V, Voluntary Withholding Request (IRS.gov/pub/irs-pdf/fw4v.pdf), and file it with your local Social Security office. You can choose to have 7 percent, 10 percent, 12 percent or 22 percent of your total benefit payment withheld. If you subsequently decide you don’t want the taxes withheld, you can file another W-4V to stop the withholding.

If you have additional questions on taxable Social Security benefits call the IRS help line at 800-829-1040.

State Taxation
In addition to the federal government, 13 states – Colorado, Connecticut, Kansas, Minnesota, Missouri, Montana, Nebraska, New Mexico, North Dakota, Rhode Island, Utah, Vermont and West Virginia – tax Social Security benefits to some extent too. If you live in one of these states, check with your state tax agency for details. For links to state tax agencies see TaxAdmin.org/state-tax-agencies.

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 Make Their Bathrooms Safer and Easier to Use

Dear Savvy Senior,
What tips can you recommend for making a bathroom senior-friendly? My 78-year-old mother has mobility problems and fell getting out of the bathtub last month. I’d like to modify her bathroom with some safety features that can help keep her safe.
Concerned Daughter                                                                          

Dear Concerned,
Great question! Because more accidents and injuries happen in the bathroom than any other room in the house, this is a very important room to modify, especially for seniors with mobility or balance problems.

Depending on your mom’s needs and budget, here are some simple tips and product recommendations that can make her bathroom safer and easier to use.

Floor: To avoid slipping, a simple fix is to get non-skid bath rugs for the floors. Or if you want to put in a new floor get slip-resistant tiles, rubber or vinyl flooring, or install wall-to-wall carpeting.

Lights: Good lighting is also very important, so install the highest wattage bulbs allowed for your mom’s bathroom fixtures and get a plug-in nightlight that automatically turns on when the room gets dark.

Bathtub/shower: To make bathing safer, purchase a rubber suction-grip mat, or put down adhesive nonskid tape on the tub/shower floor. And have a carpenter install grab bars in and around the tub/shower for support.

If your mom uses a shower curtain, install a screw or bolt-mounted curtain rod, versus a tension-mounted rod, so that if she loses her balance and grabs the shower curtain the rod won’t spring loose.

For easier access and safer bathing, consider getting your mom a shower or bathtub chair so she can bathe from a seated position. In addition, you should also have a handheld, adjustable-height showerhead installed that makes chair bathing easier.

If your mom has the budget for it, another good option is to install a curb-less shower or a walk-in-bathtub. Curb-less showers have no threshold to step over, and come with a built-in seat, grab bars, slip resistant floors and an adjustable handheld showerhead. While walk-in tubs have a door in front that provides a much lower threshold to step over than a standard tub. They also have a built-in seat, handrails and a slip resistant bottom, and some have therapeutic features like whirlpool water jets and/or bubble massage air jets.

Curb-less showers and walk-in-tubs run anywhere between $2,500 and $10,000 installed.

Toilet: Most standard toilets are around 15 inches high and can be an issue for taller seniors with arthritis, back, hip or knee problems. If your mom has trouble getting on or off the toilet, a simple solution is to purchase a raised toilet seat that clamps to the toilet bowl, and/or purchase toilet safety rails that sit on each side of the seat for support. Or, you can install a new ADA compliant “comfort height” toilet that is 16-to-19 inches high.

Faucets: If your mom has twist handles on the sink, bathtub or shower faucets, consider replacing them with lever handle faucets, or with a touch, motion or digital smart faucet. They’re easier to operate, especially if she has hand arthritis or gripping problems. Also note that it only takes 130-degree water to scald someone, so turn her hot water heater down to 120 degrees.

Doorway: If your mom needs a wider bathroom entrance to accommodate a walker or wheelchair, an inexpensive solution is to install some swing clear offset hinges on the door which will expand the doorway an additional two inches.

Emergency assistance: As a safety precaution, you should also consider purchasing a voice-enabled medical alert system like Get Safe (GetSafe.com) for her bathroom. This device would let her call for help by simple voice command, or by pushing a button or pulling a cord.

You can find all of these suggested products at either medical supply stores, pharmacies, big-box stores, home improvement stores, hardware and plumbing supply stores, as well as online.

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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Acupuncture: Does It Work and Is It Covered by Medicare?

Dear Savvy Senior,
Is acupuncture a viable treatment for pain and is it covered by Medicare? Since the pandemic hit, I have a lot of lower back and neck pain and am wondering if it’s worth trying. What can you tell me?
Looking for Solutions

Dear Looking,
Many studies over the years – funded by the National Institutes of Health – have found acupuncture to be very effective in easing pain and can help with a variety of other ailments too. Here’s what you should know.

Acupuncture Treatment
First used in China more than 2,000 years ago, acupuncture has become increasingly popular in the United States over the past decade.

While acupuncture isn’t a cure-all treatment, it is a safe, drug-free option for relieving many different types of pain including low back pain, neck pain, osteoarthritis, migraine headaches, fibromyalgia, postoperative pain, tennis elbow, carpel tunnel syndrome, dental pain and more. Studies have also shown that it can be helpful in treating asthma, depression, digestive disorders, menopause symptoms like hot flashes, and nausea caused by chemotherapy or anesthesia.

Exactly how or why acupuncture works isn’t fully understood, but it’s based on the traditional Eastern theory that vital energy flows through pathways in the body, and when any of these pathways get blocked, pain and illness result. Acupuncture unblocks the pathways to restore health.

However, today most Western practitioners believe that acupuncture works because it stimulates the nerves causing the release of endorphins, which are the body’s natural painkiller hormones. It’s also shown to increase blood circulation, decrease inflammation and stimulate the immune system.

What to Expect
During acupuncture, practitioners stimulate specific points on the body by inserting thin needles through the skin. The needles are solid, sterile and disposable (used only once), and as thin as a cat’s whisker.

The number of needles used for each treatment can vary anywhere from a few, up to a dozen or more. And where the needles are actually stuck depends on the condition being treated, but they are typically inserted about one-quarter to 1-inch deep and are left in place for about 20 minutes. After placement, the needles are sometimes twirled or manipulated, or stimulated with electricity or heat.

You may feel a brief, sharp sensation when the needle is inserted, but generally it’s not painful. Once the needle is in place, however, you may feel a tingling sensation, numbness, mild pressure or warmth.

How many treatments you’ll need will depend on the severity of your condition – 12 treatments done weekly or biweekly is very common. It’s also important to know that acupuncture can be used in conjunction with other conventional medical treatments, or by itself.

Cost and Coverage
The cost per treatment typically runs anywhere from $40 to $150, depending on where you are in the country and what style of treatment you are receiving.

Today, an increasing number of private insurance plans, including some Medicare Advantage plans, and policies provided by employers offer some type of acupuncture coverage.

You’ll also be happy to know that last January (2020), the Centers for Medicare and Medicaid Services announced that original Medicare will now cover up to 12 acupuncture sessions in 90 days for patients with chronic lower back pain. Eight additional sessions can be added if patients show improvement.

But in order to receive Medicare coverage, you must use a licensed acupuncturist who is supervised by a medical doctor, physician assistant or nurse practitioner trained in acupuncture, who will need to process the acupuncture claim. Currently, licensed acupuncturists can’t directly bill Medicare.

To find an acupuncturist in your area ask your doctor for a referral, or you can do a search online. Two good resources are the National Certification Commission for Acupuncture and Oriental Medicine (nccaom.org), and the American Academy of Medical Acupuncturists (medicalacupuncture.org), which offers a directory of MDs and DOs who are certified to practice acupuncture.

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 to Find Affordable Housing for Seniors

Dear Savvy Senior,
Are there any resources to help seniors find and pay for senior apartments? My aunt, who’s 75 years old, needs to find a new place to live but has very little money. What can you tell me?
Searching Sarah

Dear Sarah,
Finding affordable senior housing options can be difficult depending on where your aunt lives. Senior apartments for some retirees are a good option, and you’ll be happy to know that there are a number of government programs that can help out financially. Here are some tips that can help you and your aunt find a low-income senior apartment that fits her budget and living preferences.

Start with HUD
There are several different government programs available today that can help individuals who qualify to locate and pay for housing, including:

  • Housing Choice Voucher Program (Section 8): This program allows you to find the housing you want. The government provides the amount allowed by your voucher to the landlord each month.
  • Privately owned subsidized housing: HUD helps some apartment owners offer reduced rents to low-income tenants.
  • Public Housing: These communities are generally apartment buildings or complexes that are overseen by a city or county public housing agency, and are available to low-income families, the elderly and those with disabilities.
  • Low-Income Housing Tax Credit: This program provides housing to low income families and includes rents that don’t exceed a fixed amount.
  • Section 202 Supportive Housing for the Elderly: This initiative helps seniors and the disabled. It offers housing for individuals who are able to live mostly on their own but need assistance with certain daily tasks like cleaning and cooking.

For more information about these programs and to locate apartments in your aunt’s area that may offer them, visit the U.S. Department of Housing and Urban Development rental assistance page at HUD.gov/topics/rental_assistance.

You can also search for low-income housing at senior living sites like After55.com and SeniorHousingNet.com.

If you or your aunt don’t have internet access or have troubling maneuvering the internet, you can also locate nearby affordable housing options by calling your local housing authority – call 800-955-2232 to get your local number. If your aunt lives in a location that spans multiple counties, check with the housing authority in each one to compare.

How to Choose
If you or your aunt find several apartment choices that fall within her budget, she should consider what’s important to her. She may want housing that’s close to family, religious organizations, senior centers, or places she visits regularly, like grocery stores, parks or gyms.

Or, if she has a disabling condition, it may be especially critical for her to find a living space that has easy access to important services like senior transportation and health care centers.

In your housing search, you may also come across some red flags that indicate a retirement community wouldn’t be a good fit for your aunt. Keep an eye out for extra fees that may be applied to everyday items or perks you normally wouldn’t think about like laundry service, parking or pets.

You should also make sure the apartment is in good condition and then scout out the neighborhood. Ask yourself if the community is clean and well maintained and if there is any debris or messy landscaping. If you notice anything out of the ordinary, follow up with questions before your aunt signs a rental contract.

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.

Savvy Senior Columns for December 2020

December 1, 2020

Savvy Senior – December Columns

  1. What You’ll Pay for Medicare in 2021
  2. How to Write an Online Will
  3. Noticing Memory Problems? What to Do Next
  4. How Robotic Pets Can Help Isolated Seniors Avoid Loneliness

What You’ll Pay for Medicare in 2021

Dear Savvy Senior,
I know there will be a small cost-of-living increase in Social Security benefits next year but what about Medicare? What will the Medicare Part B monthly premiums be in 2021, and when do the surcharges kick in for higher income beneficiaries?
Inquiring Senior

Dear Inquiring Senior,
The Centers for Medicare and Medicaid Services recently announced their cost adjustments for 2021 and the increases for premiums and out-of-pocket costs for most beneficiaries will be modest. But if you’re a high earner, you’ll pay more. Here’s what you can expect starting in January.

Medicare Part B
While Medicare Part A, which pays for hospital care, is premium-free for most beneficiaries, Part B, which covers doctor visits and outpatient services does have a monthly premium. Starting in 2021, the standard monthly Part B premium will be $148.50, up from $144.60 in 2020. That $3.90 bump represents a 2.7 percent increase, which is more than double the most recent Social Security cost-of-living adjustment which was 1.3 percent.

But if you’re a high earning beneficiary, which makes up about 7 percent of all Medicare recipients, you’ll have to pay more. Medicare surcharges for high earners are based on adjusted gross income from two years earlier, which means that 2021 Part B premiums are determined by 2019 annual income.

So, if your 2019 income was above $88,00 up to $111,000 ($176,000 up to $222,000 for married couples filing jointly), your 2021 Part B monthly premium will be $207.90, up from $202.40 in 2020.

Monthly premiums for singles with an income between $111,000 and $138,000 ($222,000 and $276,000 for joint filers) will rise from $289.20 to $297. Individuals earning above $138,000 up to $165,000 ($276,000 to $330,000 for joint filers) will see their monthly premium increase from $376 to $386.10.

Those with incomes above $165,000 up to $500,000 ($320,000 to $750,000 for joint filers), you’ll pay $475.20 per month in 2021. And single filers with income of $500,000 or more ($750,000 or more for joint filers) will pay $504.90 per month next year.

Medicare Part D
If you have a Medicare (Part D) prescription drug plan, the average premium in 2021 will be about $30 per month for most beneficiaries. But, again for high earner with annual incomes above $88,000 ($176,000 for joint filers) you’ll pay a $12.30 to $77.10 monthly surcharge on top of your regular Part D premiums.

How to Contest Income
Beneficiaries that fall into any of the high-income categories and have experienced certain life-changing events that have reduced their income since 2019, such as retirement, divorce or the death of a spouse, can contest the surcharge. For more information on how to do this, see “Medicare Premiums: Rules for Higher-Income Beneficiaries” at SSA.gov/benefits/medicare/medicare-premiums.html.

Other Medicare Increases
In addition to the Part B and Part D premium increases, there are other cost increases you should be aware of. For example, the annual deductible for Medicare Part B will see a bump from $198 to $203 in 2021. The deductible for Medicare Part A, which covers hospital services, will increase from $1,408 in 2020 to $1,484 in 2021. There are no surcharges on Medicare deductibles for high earners.

For more information on all the Medicare costs for 2021 visit Medicare.gov and click on “2021 Medicare Costs,” or call 800-633-4227.

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 to Write an Online Will

Dear Savvy Senior,
Writing a will has never been a high priority to me but this lingering coronavirus crisis has changed my thinking. Can you recommend some good do-it-yourself resources to help me write a simple will?
Getting Older

Dear Getting Older,
The coronavirus crisis has changed the way a lot of people look at things, including wills. Currently, fewer than half of American adults have prepared a will. But having a last will and testament is important because it ensures that your money and property will be distributed to the people you want to receive it after your death.

If you die without a will, your estate will be settled in accordance with state law. Details vary by state, but assets typically are distributed using a hierarchy of survivors. Assets go to first to a spouse, then to children, then your siblings, and so on.

You also need to be aware that certain accounts take precedence over a will. If you jointly own a home or a bank account, for example, the house, and the funds in the account, will go to the joint holder, even if your will directs otherwise. Similarly, retirement accounts and life insurance policies are distributed to the beneficiaries you designate, so it is important to keep them up to date too.

Online Will Makers
If you have a simple, straightforward estate and an uncomplicated family situation, writing your own will – with the help of a good online will making program – is a viable alternative to hiring an attorney and much cheaper. Like tax software, these online tools will guide you through a series of questions and will insert your answers into a will for you, and it usually takes less that 20 minutes from start to finish.

Three top-rated do-it-yourself options include the Quicken WillMaker & Trust 2021 downloadable software (available at nolo.com) that costs $100 and works with Windows and Macs and is valid in every state except Louisiana; LegalZoom (legalzoom.com), which offers basic wills for $89 or $99 if you’d like assistance from an independent attorney; and Trust & Will (trustandwill.com) which charges $89 for a basic will.

If that’s more than you’re willing to pay, consider FreeWill (freewill.com), which is a completely free will making resource made possible with the support of nonprofit organizations.

When to Hire a Lawyer
If you have considerable financial assets or a complex family situation, like a blended family or child with special needs, it would be smart for you to seek professional advice. An experienced lawyer can make sure you cover all your bases, which can help avoid family confusion and squabbles after you’re gone.

The National Academy of Elder Law Attorneys (naela.org) and the National Association of Estate Planners & Councils (naepc.org) websites are good resources that have directories to help you find someone in your area.

Costs will vary depending on your location and the complexity of your situation, but you can expect to pay somewhere between $200 and $1,000 to get your will made. To help you save, shop around and get price quotes from several different firms. And before you meet with an attorney, make a detailed list of your assets and accounts to help make your visit more efficient.

Make it Valid
Be aware that to make your will valid, you must sign and date it and have it witnessed according to the laws of your state. Most states require two witnesses who are not listed as beneficiaries in your will to watch you sign it. Some states also require that a notary witness the signing as well. Nationalnotary.org can tell you if a notary is needed to legalize a will in your state, if remote notary services are available, and how to access such online services to execute your will if you are sheltering at home during the pandemic.

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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Noticing Memory Problems? What to Do Next

Dear Savvy Senior,
My mom, who’s 76, has become more forgetful lately and is worried she may be getting Alzheimer’s disease. What resources can you recommend to help us get a handle on this?
Oldest Daughter

Dear Oldest Daughter,
Many seniors worry about memory lapses as they get older, fearing it may be the first signs of Alzheimer’s disease or some other type of dementia. To get some insight on the seriousness of your mom’s problem, here are some key warning signs to be vigilant of and some resources you can turn to for help.

Warning Signs
As we grow older, some memory difficulties – such as trouble remembering names of people or places or forgetting where you put your glasses or car keys – are associated with normal aging. But the symptoms of Alzheimer’s disease are much more than simple memory lapses.

Knowing the early warning signs is a good first step in recognizing the difference between typical age-related memory loss and a more serious problem. To help you evaluate your mom’s condition, here’s a checklist of some common early symptoms to watch for:

  • Asking the same questions repeatedly.
  • Getting lost in familiar areas.
  • Failing to recognize familiar people.
  • Having difficulty following directions.
  • Misplaces items in inappropriate places, for example putting her keys in the microwave.
  • Having difficulty completing familiar tasks like cooking a meal or paying a bill.
  • Having trouble remembering common words when speaking or mixing up words.

For more information, see the Alzheimer’s Association list of 10 early signs and symptoms at 10signs.org.

Another good tool to help you evaluate your mom is the Self-Administered Gerocognitive Exam (SAGE test) that was developed at The Ohio State University Wexner Medical Center. This free test helps identify mild cognitive impairment and early dementia and can be taken at home in about 10 to 15 minutes. The SAGE test can be taken online at BrainTest.com.

Get Help
If you would rather have professional assistance in evaluating your mom, the Alzheimer’s Foundation of America (see alzfdn.org) is another good resource you can turn to.

Every Monday, Wednesday and Friday they provide free, confidential virtual memory screenings done via video chat in real time. Your mother will need a phone, tablet or computer with a webcam and internet capability to complete the screening.

The screenings are given by healthcare professionals and take about 10 to 15 minutes to complete. Once the screening is complete, the screener will review the results with her and let her know if she should see a doctor for further evaluation. To set up a memory screening for your mom call 866-232-8484 and make an appointment.

If you find that your mom does need further evaluation, make an appointment with her primary care doctor for a cognitive checkup and medical examination. Depending on what’s found, she may be referred to a geriatrician or neurologist who specializes in diagnosing and treating memory loss or Alzheimer’s disease.

Keep in mind that even if your mom is experiencing some memory problems, it doesn’t necessarily mean she has early-stage Alzheimer’s. Many memory problems are brought on by other factors like stress, depression, thyroid disease, side effects of medications, sleep disorders, vitamin deficiencies and other medical conditions. And by treating these conditions she can reduce or eliminate the problem.

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 Robotic Pets Can Help Isolated Seniors Avoid Loneliness

Dear Savvy Senior,
I recently read an article about robotic pets being a great substitute for pet-loving seniors who can’t have or take care of a pet any longer. What do you think of this? My mother, who has some dementia, is living in an assisted living facility that doesn’t allow pets. And because of COVID, we haven’t been allowed inside the facility to visit her since March. I’ve been thinking about getting her a robot pet to help cheer her up but would like to know if they are worth buying, and if so, where can I go to find one.
Locked Out Daughter

Dear Locked Out,
There have actually been several studies on this topic that has shown that robotic pets – which are lifelike interactive pets – can have a positive impact on many lonely, socially isolated seniors, especially those who have dementia. This is particularly important now as the pandemic has caused millions of high-risk, vulnerable seniors to isolate as a means to protect themselves from the coronavirus. Here’s what you should know.

Robotic Pet Studies
In 2018, the New York State Office for the Aging was the first state in the U.S. to test the robotic pets with isolated seniors and results showed that using pets to lower social isolation was highly successful, with 70 percent of pilot participants reporting a decrease in isolation after one year. Subsequent programs done in aging agencies in Alabama, Florida and Pennsylvania have also shown positive results

Other clinical studies conducted by AARP, UnitedHealthcare, and other clinicians and have also found that robotic pets can help to enhance the well-being and quality of life of lonely or isolated individuals and those living with dementia and other forms of cognitive decline, by providing a level of interaction and comfort from a lifelike companion.

Where to Look
If you’re interested in getting your mom a robotic pet, a top option is Ageless Innovation’s Joy for All Companion Pets – see JoyForAll.com.

They offer cats, a kitten and a pup that look, feel and sound like the real thing – minus the feeding, watering, litter box or backyard cleanup, and the vet bills. With prices ranging between $65 and $130, these soft, plush animals have built-in sensors, “vibrapurr” or “barkback” technology, and brushable fur, making them surprisingly realistic.

Insert four batteries, and the cats, which come in four different shades to mimic real breeds, can open and close their eyes, lift their paws, and move their head and body. If you pet them in the right spot – like on their belly or back side – they’ll let out a purr.

If your mom is more of a dog person, you can also buy a stuffed golden puppy, accessorized with a red bandana, that will bark if he’s feeling happy, sad, or needy. At only four pounds, the stuffed pup is easy to play with and won’t weigh down even the most fragile frame.

Some other robotic pet options you should look into include Tombot’s Jennie ($399; tombot.com), a lapdog that barks on command and has realistic facial features; AIBO ($2,900; us.aibo.com) by Sony, which is a plastic puppy that has lifelike expressions and a dynamic array of movements; and Paro the Seal ($6,120; parorobots.com), which is marketed as a “carebot,” designed specifically for people with dementia.

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.

NEW Savvy Senior Columns for November 2020

October 27, 2020

Savvy Senior – November Columns

  1. How Seniors can Save Money on Prescription Eyeglasses
  2. What Happens to Medicare if Obamacare is Overturned?
  3. How to Track Down Old Friends Online
  4. How to Claim Social Security Benefits During the Pandemic

How Seniors can Save Money on Prescription Eyeglasses

Dear Savvy Senior,
What tips can you recommend for finding affordable prescription eyeglasses? I used to have vision insurance through my work but lost it when I turned 65 and signed up for Medicare.
Need Spectacles

Dear Need,
Unfortunately, in 2020 it’s still true that original Medicare does not cover vision services, which includes routine eye exams and prescription eyeglasses – unless you’ve just had cataract surgery. While there’s no one solution to this common need, here are a few tips that can help you save.

Medicare Advantage
While original Medicare doesn’t cover vision services, there are Medicare Advantage plans that do. Medicare Advantage plans, which are sold through private insurance companies, cover all the same medical and hospital services that original Medicare does, but many of them also provide vision as well as dental, hearing and prescription drugs too.

To locate Advantage plans in your area that provide vision coverage, go to Medicare.gov/plan-compare or call 800-633-4227. But before enrolling in a plan, check the benefit details to ensure the plan’s vision coverage includes routine eye exams, eyeglass frames and lenses.

If you are currently enrolled in original Medicare you can switch to a Medicare Advantage plan each year during the open enrollment period, which is between Oct. 15 and Dec. 7. Or, if you already have an Advantage plan that doesn’t provide adequate vision coverage, you can swap to another plan between Jan. 1 and March 31.

If you don’t want to change your Medicare plan, you can still get coverage by purchasing a vision insurance policy – see eHealthInsurance.com. Vision policies typically start at around $11 to $13 per month for an individual, but before signing up make sure your savings potential is worth the cost of the monthly premiums and required copays.

Discount Stores
Purchasing eyeglasses from discount retailers is another way to save. Costco Optical is one of the best discount stores for good eyewear and low prices. Eyeglasses cost an average of around $184, but to shop there you have to pay a $60 annual membership fee. Some other good retail options for low prices include Sam’s Club Optical and Walmart Vision Centers.

You also need to find out if you are eligible for any discounts. Some retailers provide discounts to membership groups like AARP and AAA. AARP members, for example, can get 30 percent off a pair of glasses (frames and lenses) at LensCrafters and Glasses.com, and you save an additional $10 on a complete pair at Target Optical. AARP also offers $55 comprehensive eye exams (dilation included) at participating eye doctors. See AARPVisionDiscounts.com for more information.

Buy Online
Buying eyeglasses online can also offer huge savings. Stores like ZenniOptical.com and EyeBuyDirect.com sell prescription eyeglasses for as little as $6 and $7. These sites let you upload a photo of your face, so you can see what you’d look like in different frames.

Or, for a snappier choice of frames see WarbyParker.com, which offers single-vision glasses starting at $95. They even offer a free program where you can request up to five pairs to try on at home for five days.

To purchase glasses online, you’ll need a valid prescription from an eye doctor (typically no more than a year old), plus your pupillary distance number, which is the distance, measured in millimeters, between the centers of your pupils in each eye.

Low-Income Assistance
If your income is low, depending on where you live, there may be some local clinics that provide free or discounted eye exams and eyeglasses. Put in a call to your local Lions Club to see what’s available in your area. See Directory.LionsClubs.org for contact information.

You may also be able to get free eyeglasses through New Eyes (New-Eyes.org, 973-376-4903), a nonprofit organization that provides free eyeglasses through a voucher program to people in financial need.

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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What Happens to Medicare if Obamacare is Overturned?

Dear Savvy Senior,
Will my Medicare benefits be affected if Obamacare is overturned by the Supreme Court?
Concerned Beneficiary

Dear Concerned,

Unfortunately, yes. If the Affordable Care Act (ACA) – also known as Obamacare – gets repealed by the Supreme Court next year, it will weaken Medicare and increase costs for beneficiaries. Here’s what you should know.

Currently, about 60 million people are covered under Medicare, the federal health insurance program for people 65 and older and people of all ages with disabilities. Even though the main aim of the ACA was to overhaul the health insurance markets, most people don’t realize that the law also touches virtually every part of Medicare.

Without the ACA, Medicare beneficiaries will have to pay more for preventive care services, which are now free; they’ll have to pay more toward their prescription drugs; their premiums and deductibles will rise faster; and Medicare will face insolvency much sooner because of lost funding and cost cutting measures. With the help of Kiplinger’s Retirement Report, here is a more detailed breakdown of what happens to Medicare if the court invalidates the law.

Preventive care services will no longer be free: Thanks to the ACA, there’s no copayment or deductible for potentially life-saving screenings for cancer, diabetes, cardiovascular disease and other illnesses. Flu shots and annual wellness visits are also free. Before the ACA, beneficiaries had to pay 20 percent of the cost for most preventive care services, after their deductible was met.

The doughnut hole will return: Since 2011 the ACA has been steadily closing the prescription drug coverage gap, also known as the doughnut hole, in Medicare Part D by requiring drug manufacturers and insurers to pick up more of the cost. The hole was finally closed this year with seniors paying 25 percent of the cost for both generic and brand-name medications and manufacturers picking up 70 percent of the tab, while insurers kick in the remaining 5 percent. Before the ACA, seniors paid 100 percent of Part D prescription drug expenses while in the doughnut hole.

Medicare premiums and deductibles will rise faster: The ACA also curbed Medicare payments to providers to help keep Medicare Part A deductibles and copayments in check. Similarly, Part B premiums and deductibles are much lower than projected before the ACA became law. From 2011 to 2020, Part B premiums increased 23 percent. From 2000 to 2009 – the nine years before the law’s passage – Part B premiums rose almost five times faster, increasing 112 percent over that period.

Medicare Advantage plans will be more expensive: The ACA requires Medicare Advantage plans to spend 85 percent of premium dollars on health care, not profits or overhead. The plans also can’t charge more than traditional Medicare for chemotherapy, renal dialysis, skilled nursing care and other specialized services.

Those restrictions dramatically lowered costs for Medicare Advantage plan enrollees. Since the ACA became law in 2010, the average Medicare Advantage premium has decreased by 43 percent while enrollment has increased 117 percent.

Insolvency accelerates: The ACA extended the solvency of the program’s trust fund by eight years to 2026, mostly by finding new sources of revenue and slowing the growth of payments to all providers. The Congressional Budget Office estimates that reversing those changes would cost the program $700 billion over 10 years, which would make Medicare almost immediate insolvent.

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 to Track Down Old Friends Online

Dear Savvy Senior,
I’m interested in tracking down some old friends I’ve lost touch with over the years but could use some help. What websites can you recommend that can help me find them?
Tracking Tom

Dear Tom,
Thanks to the Internet, tracking down long-lost friends from many years ago is relatively easy to do and, in most cases, it won’t cost you a cent. Here are some tips and online tools to help you get started.

Remembering the Details
Before you begin your search, a good first step is to jot down any information you can remember or find out about the people you’re trying to locate. Things like their full name (maiden and married), age or birth date, last known address or phone number, old e-mail address, names of family members, and so forth. Knowing details can help you turn up clues while you search.

Social Media and Search Engines
After you compile your information, a good place to start your search is at social media sites like Facebook, LinkedIn, Twitter and Instagram. And search engines like Google and Yahoo.

When using search engines, type in the name of the person you’re searching for in quotation marks, for example, “John Smith.” You can narrow your search by adding other criteria like their nickname or middle name, the city or state they may live in, or even their occupation.

People Search Sites
If your initial search comes up empty, you can also use people searches like AnyWho.com, Intelius.com or WhitePages.com. These sites will provide a list of potential matches from across the U.S.

Because many people share the same name, these sites will also supply details to help identify the right person, perhaps including their age, prior hometowns, names of relatives, colleges attended or employer.

While these sites are free to use at a basic level, they charge a small fee for providing certain details like the persons contact information. WhitePages, however, sometimes provides home phone numbers for free.

Niche Finding Sites
Here are a few other niche people-finding websites to help you with your search.

To look for old high school classmates, try Classmates.com. This site has contact information only for people who have registered with it. But even if your friend hasn’t registered, it could provide contact info for another classmate who remains in touch with your friend.

Another option is to check out your high school alumni website. Not every school has its own site, but some do, and you can look for it by going to any search engine and typing in the name of the school with the city and state it’s located in. You can also search at AlumniClass.com, a huge hosting site for thousands of high schools across the U.S.

If you’re looking for old college friends, look for an alumni directory on the school’s website. You might be able to access your friend’s contact info by completing an online registration. Or, try calling or emailing your alumni relations department and ask them to pass on your contact info to your friend.

If you’re looking for someone you served with in the military, Military.com offers a free “Buddy Finder” service that has a database of more than 20 million records – visit Military.com/buddy-finder. You can also search for free at GIsearch.com, TogetherWeServed.com and VetFriends.com.

If you can’t find any current information about the person you’re searching for, it could be that he or she is dead. To find out if that’s the case, use obituary databases such as Tributes.com and Legacy.com, which has a newspaper obituary search tool from hundreds of U.S. newspapers.

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 to Claim Social Security Benefits During the Pandemic

Dear Savvy Senior,
With my local Social Security offices being closed due to COVID-19, what is the best way to apply for my Social Security retirement benefits?
Approaching 62

Dear Approaching,
Because of the pandemic, all Social Security field offices across the country have been closed since March, so you can’t just walk-in, talk to a counselor and apply for benefits in person right now. But there are other ways to claim your benefits that are much easier and quicker. Here’s what you should know.

How to Apply?
The easiest and most convenient way to apply for your Social Security benefits during the pandemic is to do it yourself online at SocialSecurity.gov. It usually takes around 15 minutes to complete the application, as long as you’ve gathered all of the required information and documentation (more on that at the bottom of the column). You can also save your application as you go, so you can take a break at any time.

If your situation is complicated or you’re uncomfortable using the Internet to apply, you can have a Social Security employee assist with the process via telephone. To make an appointment call 800-772-1213. (If you’re hearing impaired, you can call 800-325-0778.) The phones are monitored Monday through Friday, 7 a.m. to 7 p.m. At the time of your appointment, the representative will call you.

If you start to complete the online application form but find that it’s too confusing or complicated, call the agency and set up a phone appointment.

Once you have submitted your application, a representative may contact you with updates or questions about your application. You can also check the status of your application by signing in to your “my Social Security” account at SSA.gov/myaccount.

When to Apply?
You should file one or two months before you want benefits to begin, but if you’re the worrying type, you can do it up to three or four months before. It takes a little time to process the paperwork, so by putting in your application a few months early, you can fix any problems that come up without it interfering with your starting date.

It’s also worth noting that if you start receiving your Social Security retirement benefits before age 65, you will automatically be enrolled in Medicare Part A and Part B, and you’ll receive your Medicare card about three months before your 65th birthday. It will include instructions to return it if you have work coverage that qualifies you for late enrollment.

But if you decide to delay your retirement benefits, you’ll need to sign up just for Medicare at age 65, which you can also do at SocialSecurity.gov or over the phone at 800-772-1213.

Needed Information
In order to apply for Social Security benefits online or over the phone, you’ll need to be able to document some information about your identity and work history. So before applying, have the following information handy:

  • Your Social Security number.
  • Your birth certificate (original or certified).
  • Proof of U.S. citizenship or lawful alien status if you were not born in the United States.
  • A copy of your U.S. military service papers if you had military service before 1968.
  • A copy of your W-2 forms and/or self-employment tax return for last year.
  • Your bank information (including your account number and the bank routing number) where you want your benefits direct deposited to.

For a complete checklist of what you’ll need to complete your application, see SSA.gov/hlp/isba/10/isba-checklist.pdf.

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.

Savvy Senior Columns — October 2020

October 1, 2020

Savvy Senior – October Columns

  1. Coronavirus Versus Flu: How to Tell the Difference
  2. Helping Seniors Recognize Fake News and Propaganda
  3. How to Create an Online Memorial for a Departed Loved One
  4. How to Find an Online Therapist
  5. How to Recognize and Stop Elder Abuse in the COVID Era

 

Coronavirus Versus Flu: How to Tell the Difference

Dear Savvy Senior,
Can you explain the differences between the coronavirus and seasonal flu? I’m 70-years-old, and usually get a standard flu shot, but would like to find out what else I can do to protect myself this winter.
Worried Senior                                                                                     

Dear Worried,
Great question! Because of the dual danger of Influenza (flu) and COVID-19, the Center for Disease Control and Prevention (CDC) recently warned that this fall and winter could be the worst ever for public health. Understanding this, knowing the differences and similarities between the viruses, and knowing what you can do to protect yourself is the best way to stay healthy and safe through this difficult time.

Flu vs COVID
Because many of the symptoms of flu and COVID-19 are similar, it may be hard to tell the difference between them based on symptoms alone, so testing may be needed to help confirm a diagnosis. With that said, here are some similarities and differences you should know.

For starters, seasonal flu symptoms come on pretty quickly, whereas COVID-19 develops gradually over a period of a few days and then either fades out or gets worse. Common shared symptoms include fever, sore throat, muscle aches, cough, headache, fatigue and even chest pain. Pinkeye and a dry cough are associated with COVID-19, while it’s now thought that a fever is more likely with the flu, as are diarrhea and nausea.

Many people are having their temperatures taken these days before entering public spaces. But fever occurs in only half of COVID-19 cases. Fever does not rule out COVID-19, but the absence of fever makes flu unlikely.

You’re also unlikely to have a runny or stuffy nose with the flu, but you may with COVID-19. What sometimes happens within the nose with COVID-19 is loss of smell and, often as a consequence, loss of taste, too.

To learn more about the similarities and differences between flu and COVID-19, visit the CDC website ​at CDC.gov/flu/symptoms/flu-vs-covid19.htm.

How to Protect Yourself
While there is currently no vaccine available yet to prevent COVID-19, the best way to prevent illness is to avoid being exposed to this virus. So, stay home as much as you can. If you have to go out, wear a mask and keep at least 6 feet away from other people. And every time you come home, wash your hands with warm water and soap for at least 20 seconds.

There’s also evidence that suggests that people who are deficient in vitamin D may be at higher risk of getting COVID-19, than those with sufficient levels. So, make sure you take in around 800 to 1,000 international units (IUs) of vitamin D from food or supplements daily, and get outside as much as you can.

And to help guard against the flu this year, you should consider getting a flu shot that’s specifically designed for people 65 and older. The “Fluzone High Dose Quadrivalent” or the “FLUAD Quadrivalent” are the two options that provide extra protection beyond what a standard flu shot offers. You only need one flu shot, and if you haven’t already gotten it, you should do it now because takes up to two weeks to build immunity after you receive it.

Pneumonia Vaccines
If you haven’t been vaccinated for pneumonia, you should also consider getting the pneumococcal vaccines. Both flu and COVID-19 can lead to pneumonia, which hospitalizes around 250,000 Americans, and kills around 50,000 people each year. But these numbers could be much higher this year.

The CDC recommends that all seniors, 65 or older, get two vaccinations – Prevnar 13 and Pneumovax 23. Both vaccines, which are administered one year apart, protect against different strains of the bacteria to provide maximum protection.

Medicare Part B covers both flu and pneumonia shots.

To locate a vaccination site that offers any of these shots, visit VaccineFinder.org and type in your location.

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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Helping Seniors Recognize Fake News and Propaganda

Dear Savvy Senior,
Are there any resources that you know of that can help seniors detect fake news? My 75-year-old mother shares a lot of misinformation with her family and friends that she sees on Facebook. I’ve talked to her about it, but for some reason she has a difficult time deciphering real news from fake news and propaganda.
Frustrated Daughter

Dear Frustrated,
Unfortunately, the digital misinformation problem your mom is experiencing is not uncommon. According to researchers from Princeton and New York University, people aged 65 and older are up to seven times more likely to share fake news and dubious links on social media than their younger counterparts.

Why?
There are several theories. The first is that many seniors started using social media sites like Facebook only within the past five or six years and may lack the digital literacy skills to identify false or misleading content.

Some other possible theories are that most seniors experience some cognitive decline as they age, making them more likely to fall for hoaxes. Many older Americans also suffer from chronic loneliness which can cause them to share misinformation as an attempt to make connections with other people. And studies have shown that older people are generally more trusting than younger generations, which can make them more gullible.

All this is particularly concerning now as we sit in the midst of a global health pandemic and a 2020 election season, both of which are ripe with misinformation, rumors and conspiracy theories. And seniors are prime targets of this false/misleading information because they are much more likely to vote than their younger cohorts and are much more vulnerable to getting sick and dying if they contract COVID-19.

Where to Get Help
To help your mom detect and combat online misinformation there are several great resources she can turn to that offer free courses and tips.

One is MediaWise for Seniors, a project of the Poynter Institute, which offers two free online courses to help seniors detect and combat online misinformation – see Poynter.org/mediawise-for-seniors.

The first four-week course has already filled up, but your mom can still enroll in a self-directed course called “Hands-On Lessons to Separate Fact and Fiction Online.” It is hosted by Christiane Amanpour and Joan Lunden, and is scheduled to begin Sept. 24, but she can take the course anytime.

In addition, Poynter has worked with AARP to produce Fact Tracker interactive videos and a webinar on spotting and filtering misinformation at AARP.org/facttracker.

Some other free course options you should look into include Senior Planet, which is offering a one-hour online course on “How to Spot Fake News” at SeniorPlanet.org.

The News Literacy Project that provides the Checkology virtual classroom, which was initially created for middle and high school students, is now offering an independent learners option that is ideal for older adults – see Get.Checkology.org. Their lessons will help your mom detect the difference between news, opinion and propaganda.

And Coursera, a free world-wide online learning platform, which offers an in-depth six-week course called “Making Sense of the News: News Literacy Lessons for Digital Citizens,” which she can access at Coursera.org/learn/news-literacy.

There are also many good websites, like PolitiFact.com, Snopes.com and FactCheck.org that will let your mom fact check a story to help her identify fact versus fiction. These sites have most likely already fact-checked the latest viral claim to pop up in her 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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How to Create an Online Memorial for a Departed Loved One

Dear Savvy Senior,
My mother passed away last week, and because of COVID we didn’t have a funeral. I would like to create some type of online memorial for her so family and friends can express their condolences and share their stories. What can you tell me about making an online memorial for my mom?
Grieving Daughter

Dear Grieving,
I’m very sorry for your loss. Creating an online memorial for your mom is a great idea and one that’s become increasingly popular in the age of COVID-19. Thousands of families have created them for their departed loved ones, especially those who didn’t have a proper funeral because of the pandemic. Here’s what you should know.

What is an Online Memorial?
An online memorial is a website created for a deceased person that provides a central location where their family and friends can visit to share stories, fond memories, photographs, comfort one another and grieve. The memorial can remain online for life, or a specific period of time, allowing people to visit and contribute any time in the privacy of their own space.

Online memorials started popping up on the Internet in the late 1990s but were created primarily for people who were well known. But now, these sites are for anyone who wants to pay tribute to their departed family member or friend and ensure they will be remembered.

Content typically posted on an online memorial includes a biography, pictures and stories from family and friends, timelines of key events in their life, along with favorite music and even videos.

Another common feature is an online guestbook where visitors sign their names and write tributes to the departed. Online memorials can also direct visitors to the departed person’s favorite charity or cause to make a donation, as an alternative to sending funeral flowers.

Some online memorial sites today even offer virtual funeral/event capabilities as a replacement for an in-person funeral. And they’ll help you get the word out by offering invitations and RSVP tracking.

Top Online Memorials
To make an online memorial there are a wide variety of websites available that make it easier than ever to create a thoughtful, personalized profile for your mom to celebrate and honor her life, and the process of creating it can be very satisfying.

You also need to know that some online memorial sites are completely free to use, while others offer a free and a paid version that provides additional features.

Some of the best sites that offer both free and paid options are MyKeeper.com (free or $75) and iLasting.com (free or $49/year or $99 for a lifetime membership).

Or, if you’re interested in one that’s completely free to use, some top options are GatheringUs.com (they do charge for virtual events), Memories.net, InMemori.com and WeRemember.com.

Memorialize Facebook
If your mom used Facebook, you can also turn her profile into a memorialized account for free when you show proof of death. This option will let your mom’s family and friends share stories, photos or memories to celebrate her life, with the word “Remembering” shown next to her name.

Once her account is memorialized, the content she shared is still visible on Facebook to the audience it was originally shared with, however, her profile will not show up in public spaces such as people she may know, ads or birthday reminders.

In addition, you can also request a Look Back video, which is a short video created by Facebook highlighting your mom’s pictures and most liked status messages.

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 to Find an Online Therapist

Dear Savvy Senior,
What is the best way to find online therapy services for my anxiety and depression? I just turned 63 and have become increasingly hopeless since the COVID pandemic hit and cost me my job. I need to get some professional help, but I’m also high risk for illness and very concerned about leaving the house.
Need Help

Dear Need,
I’m sorry to hear about your job loss and the difficulties you’re going through right now, but you’re not alone. Because of the coronavirus pandemic and resulting economic downturn, fear, anxiety and depression is being reported by 45 percent of Americans, according a Kaiser Family Foundation tracking poll.

To help you through this difficult time there are a variety of therapists, psychologists, and other mental health providers you can turn to. And because of the pandemic, most of them are now offering counsel to their clients online through teletherapy services. This will allow you to interact virtually with a therapist from the comfort of your home using only a smartphone, tablet or computer.

How to Find a Therapist
A good first step to locating a therapist is to ask your primary care provider or family and friends for a referral. You can also look on your insurer’s website for a list of therapists covered under your plan. But be aware that some insurers have limited, or even no coverage for mental health, and many mental healthcare providers don’t participate in insurance plans. (Medicare does cover mental health services.)

Other resources to help you find a good therapist include online finder tools at the American Psychological Association (locator.apa.org) and the American Psychiatric Association (finder.psychiatry.org).

If you want some help, there are also online platforms that can help match you with a licensed mental health provider. For example, Talkspace (talkspace.com) and BetterHelp (betterhelp.com), are virtual services you can access through your phone or computer, that contracts with thousands of licensed and credentialed therapists.

The process starts with a few questions to assess your goals, your condition, and your preferences, and then matches you with some top therapists in your state.

If you don’t have insurance coverage or can’t afford therapy, you can call or text 211 (or go to 211.org) anytime for a referral to a provider who offers support at no cost or on a sliding scale, based on your budget.

You can also call the National Suicide Prevention Lifeline 24/7 and ask for a referral to a local resource or provider or ask to be transferred to their “warm line” for non-emergency calls, where you can talk anonymously to a trained professional at no cost.

Another possible option is Federally Qualified Health Centers, which are community-based health centers, some of which may offer teletherapy services at no-cost. To search for centers in your area visit FindAHealthCenter.hrsa.gov.

There’s also this website called Open Path Collective (openpathcollective.org), where therapists offer low-cost online sessions for between $30 and $60.

Interview Your Therapist
Before you start sessions with a therapist, it’s important to make sure he or she meets your needs. If you’re not comfortable with the person, you’re unlikely to benefit from the therapy. So, schedule a call or a video chat to get a feel for each other, and to ask about the therapist’s training, years in practice, specialties, therapy techniques and fee. Ideally the therapist you choose will be a good personality fit for you and will be within your budget and/or covered by your insurance.

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 to Recognize and Stop Elder Abuse in the COVID Era

Dear Savvy Senior,
Can you write a column on how to recognize elder abuse and what to do if you suspect it?
Concerned Relative

Dear Concerned,
Elder abuse is a big problem in the United States that has escalated during the COVID-19 pandemic. According to the National Council on Aging, as many as 5 million seniors are victims of abuse each year, but studies suggest this crime is significantly under-reported. Only 1-in-14 cases of elder abuse ever get reported to the authorities because victims are usually too afraid, too embarrassed, too helpless or too trusting to call for help.

The term “elder abuse” is defined as intentional or negligent acts by a caregiver or trusted individual that causes or can cause harm to a vulnerable senior. Elder abuse also comes in many different forms: emotional, psychological, physical or sexual abuse, abandonment, neglect and self-neglect, and financial exploitation.

Those most vulnerable are seniors that are ill, frail, disabled, socially isolated or mentally impaired due to dementia or Alzheimer’s disease.

It’s also important to know that while elder abuse does happen in nursing homes and other long-term care facilities, the vast majority of incidents take place at home where the senior lives. And tragically, the abusers are most often their own family members (usually the victim’s adult child or spouse) or caregiver.

How to Recognize Abuse
So, how can you tell if an elderly relative or friend is being abused, and what can you do to help?

A change in general behavior is a universal warning sign that a problem exists. If you notice that your relative or friend has become very depressed, withdrawn or gets upset or agitated easily, you need to start asking questions. Here are some additional warning signs on the different types of elder abuse that can help you spot a possible problem.

  • Physical or sexual abuse: Suspicious bruises or other injuries that can’t be explained. Sudden changes in behavior (upset, withdrawn, fearful). Broken eyeglasses. Caregiver’s refusal to allow visitors to see an elder alone.
  • Neglect or self-neglect: Weight loss, poor hygiene, unattended medical needs, and unsanitary, unsafe living conditions.
  • Emotional or psychological abuse: The senior is extremely upset, agitated, withdrawn, unresponsive, fearful or depressed, or demonstrates some other unusual behavior.
  • Financial exploitation: Missing money or valuables. Unexplained withdrawals from bank accounts, or transfers between accounts. Unauthorized use of credit, debit or ATM card. Unpaid bills despite available funds. Checks written as a loan or gift. Abrupt changes in a will or other documents.

For more tips on how to recognize the warning signs of abuse during the pandemic, see the National Center on Elder Abuse website at NCEA.acl.gov/Resources/COVID-19.aspx.

What to Do
The best ways to help stop elder abuse is to be in touch and keep the lines of communication open. If you suspect any type of abuse or neglect in your relative’s or friend’s home, report it to your local protective services agency.

Adult Protective Services is the government agency responsible for investigating elder abuse cases and providing help and guidance. Call the Eldercare Locator at 800-677-1116 to get the agency contact number in your area or visit NCEA.acl.gov/Resources/State.aspx.

The agency will ask what you observed, who was involved, and who they can contact to learn more. You don’t need to prove that abuse is occurring; it is up to the professional.

Or, to report suspected abuse in a nursing home or assisted living facility, call the local Long-Term Care Ombudsman – see LTCombudsman.org for contact information.

However, if you feel the person is in immediate danger, call 911 or the local police for immediate help.

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.

Savvy Senior Columns for September 2020

September 1, 2020

Savvy Senior – September Columns

  1. How to Prevent Falls During a Pandemic
  2. Should Seniors Consider a Reverse Mortgage Now?
  3. Is There an Age Limit for Organ Donation?
  4. Should I Buy Long-Term Care Insurance?

How to Prevent Falls During a Pandemic

Dear Savvy Senior,
My 80-year-old mother, who lives alone and is self-isolating during the coronavirus pandemic, has fallen several times. Are there any extra precautions you recommend that can help prevent this?
Concerned Daughter

Dear Concerned,
Falls are a common concern for many elderly adults and their families, especially during the coronavirus pandemic when many seniors are sheltering at home alone.

Each year, more than 1-in-4 older Americans fall, making it the leading cause of both fatal and nonfatal injuries for those age 65 and older. But many falls can be prevented. Depending on what’s causing your mom to fall, here are some different tips that can help prevent it.

Encourage exercise: Weak leg muscles and poor balance are two of the biggest risk factors that cause seniors to fall. Walking, strength training and tai chi are all good for improving balance and strength, as are a number of balance exercises your mom can do anytime like standing on one foot for 30 seconds then switching to the other foot, and walking heel-to-toe across the room.

For additional balance and leg strengthening exercises, see AgeBold.com.

Review her medications: Does your mom take any medicine, or combination of medicines, that make her dizzy, sleepy or lightheaded? If so, make a list or gather up all the drugs she takes – prescriptions and over the counter – and contact her doctor or pharmacist for a drug review and adjustment.

Get a vision test: Poor vision can be another contributor to falls, so your mom should get her eyes checked once a year and be sure to update her eyeglasses if needed. Also be aware that if your mom wears bifocal or progressive lenses, they too can cause falls, especially when walking outside or going down steps. These lenses can affect depth perception, so she may want to get a pair of glasses with only her distance prescription for outdoor activities.

If your mom is concerned about a trip into her eye doctor during the pandemic, she can get her vision tested online. Put a call her eye doctor about this option, or consider some online vision testing sites likeEssilor.com or 6over6.com. And to buy eyeglasses online, some popular options include WarbyParker.com and ZenniOptical.com.

Fall-proof her home: There are a number of simple household modifications you can do to make your mom’s living area safer. Start by helping her arrange or move the furniture so there are clear pathways to walk through and pick up items on the floor that could cause her to trip like newspapers, shoes, clothes, electrical or phone cords.

If she has throw rugs, remove them or use double-sided tape to secure them.

In the bathroom buy some non-skid rugs for the floors and a rubber suction-grip mat or adhesive non-skid tape for the floor of the tub or shower, and have a carpenter install grab bars in and around the tub/shower for support.

Also, make sure the lighting throughout the house is good, purchase some inexpensive plug-in nightlights for the bathrooms and hallways, and if she has stairs, put handrails on both sides.

For more tips, see the NIA “fall-proofing your home” web page at NIA.NIH.gov/health/fall-proofing-your-home.

Choose safe footwear: Going barefoot or wearing slippers or socks at home can also cause falls, as can wearing backless shoes, high heels, and shoes with smooth leather soles. The safest option for your mom is rubber-sole, low-heel shoes.

Purchase some helpful aids: If your mom needs some additional help getting around, get her a cane or walker. Also, to help ensure your mom’s safety, and provide you some peace of mind, consider getting her a medical alert device that comes with a wearable emergency button that would allow her to call for help if she were to fall or need assistance.

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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Should Seniors Consider a Reverse Mortgage Now?

Dear Savvy Senior,
What can you tell me about reverse mortgages? The coronavirus damage to my retirement account has me considering it but want to make sure I know what I’m getting into.
Cash-Strapped Senior

Dear Cash-Strapped,
Massive job losses, a volatile stock market and low interest rates caused by the coronavirus pandemic has caused many cash-strapped retirees to consider a reverse mortgage. But there’s a lot to consider to be sure it’s a good option for you now.

Let’s start with the basics.

A reverse mortgage is a unique type of loan that allows older homeowners to borrow money against the equity in their house (or condo) that doesn’t have to be repaid until the homeowner dies, sells the house or moves out for at least 12 months. At that point, you or your heirs will have to pay back the loan plus accrued interest and fees, but you will never owe more than the value of your home.

It’s also important to understand that with a reverse mortgage, you, not the bank, own the house, so you’re still required to pay your property taxes and homeowners insurance. Not paying them can result in foreclosure.

To be eligible, you must be 62 years of age or older, own your own home (or owe only a small balance) and currently be living there.

You will also need to undergo a financial assessment to determine whether you can afford to continue paying your property taxes and insurance. Depending on your financial situation, you may be required to put part of your loan into an escrow account to pay future bills. If the financial assessment finds that you cannot pay your insurance and taxes and have enough cash left to live on, you’ll be denied.

Loan Details
Around 95 percent of all reverse mortgages offered are Home Equity Conversion Mortgages (HECM), which are FHA insured and offered through private mortgage lenders and banks. HECM’s also have home value limits that vary by county but cannot exceed $765,600.

How much you can actually get through a reverse mortgage depends on your age (the older you are the more you can get), your home’s value and the prevailing interest rates. Generally, most people can borrow somewhere between 50 and 60 percent of the home’s value. To estimate how much you can borrow, use the reverse mortgage calculator at ReverseMortgage.org.

To receive your money, you can opt for a lump sum, a line of credit, regular monthly checks or a combination of these.

But be aware the reverse mortgages aren’t cheap. HECM loans require a 2 percent upfront mortgage insurance payment, plus an additional 0.5 percent annual charge, on top of origination costs and lenders’ fees. Any amount you borrow, including these fees and insurance, accrues interest, which means your debt grows over time.

To learn more, read the National Council on Aging’s online booklet “Use Your Home to Stay at Home” at NCOA.org/home-equity.

Also note that because reverse mortgages are complex loans, all borrowers are required to get counseling through a HUD approved independent counseling agency before taking one out. Most agencies charge between $125 and $250. To locate one near you, visit Go.usa.gov/v2H, or call 800-569-4287.

Other Options
If you have a short-term need for cash, there are other options you should look into. For example, many low-income seniors don’t realize they qualify for the earned income tax credit, a refundable tax break that can put cash in your pocket. You also could use BenefitsCheckUp.org to search for financial assistant programs you may be eligible for.

Another possibility is a regular home equity loan or line of credit. This type of borrowing requires you to make payments, and lenders can freeze or lower limits on lines of credit, but the borrowing costs are much lower.

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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Is There an Age Limit for Organ Donation?

Dear Savvy Senior,
I never thought about becoming an organ donor until my brother died of kidney failure last year. But at age 78, I would like to know if I’m too old to be a donor, or if they would even use my organs if I were to die from COVID-19. What can you tell me?
Potential Donor

Dear Potential,
There’s no cutoff age for being an organ donor. Anyone, regardless of age or medical history, can sign up. In fact, there are many people well up into their 80’s that donate. The decision to use your organs is based on health of the organ, not age. So, don’t disqualify yourself prematurely. Let the doctors decide at your time of death whether your organs and tissues are suitable for transplantation.

Regarding the COVID-19 part of your question, as of right now, the Organ Procurement and Transplantation Network (OPTN) does not recommend transplantation of organs from donors known to have the virus. So, if you were to contract the coronavirus and die, your organs would probably not be used, however, this may change as treatments are developed.

Here’s what else you should know about becoming a donor.

Donating Facts
In the United States alone, more than 112,000 people are on the waiting list for organ transplants. But because the demand is so much greater than the supply, those on the list routinely wait three to seven years for an organ, and more than 7,000 of them die each year.

Organs that can be donated include the kidneys, liver, lungs, heart, pancreas and intestines. Tissue is also needed to replace bone, tendons and ligaments. Corneas are needed to restore sight. Skin grafts help burn patients heal and often mean the difference between life and death. And heart valves repair cardiac defects and damage.

By donating your organs after you die, you can save or improve as many as 50 lives. The United Network for Organ Sharing maintains the OPTN, a national computer registry that matches donors to waiting recipients.

Some other things you should know about being an organ donor are that it does not in any way compromise the medical care you would receive in a hospital if you are sick or injured, nor does it interfere with having an open-casket funeral if you want that option. And, most major religions in the United States support organ donation and consider it as the final act of love and generosity toward others.

How to Donate
If you would like to become a donor, there are several steps you should take to ensure your wishes are carried out, including:

Registering: Add your name to your state or regional organ and tissue donor registry. You can do this online at either OrganDonor.gov or DonateLife.net. If you don’t have Internet access, call Donate Life America at 804-377-3580 and they can sign you up over the phone.

Identify yourself: Designate your decision to become an organ donor on your driver’s license, which you can do when you go in to renew it. If, however, you don’t drive anymore or if your renewal isn’t due for a while, consider getting a state ID card – this also lets you indicate you want to be a donor. You can get an ID card for a few dollars at your nearby driver’s license office.

Tell your family: Even if you are a registered donor, in many states, family members have the ultimate say whether your organs may be donated after you die. So, clarify your wishes to family. Also tell your doctors and indicate your wishes in your advance directives. These are legal documents that spell out your wishes regarding your end-of-life medical treatment when you can no longer make decisions for yourself. If you don’t have an advance directive, go to MyDirectives.com where you can create one for free.

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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Should I Buy Long-Term Care Insurance?

Dear Savvy Senior,
My wife and I have thought about purchasing a long-term care insurance policy, but we hate the idea of paying expensive monthly premiums for a policy we may never use. Is there a good rule of thumb on who should or shouldn’t buy long-term care insurance?
Getting Old

Dear Getting Old,
There are two key factors you need to consider that can help you determine if purchasing a long-term care (LTC) insurance policy is a smart decision for you and your wife. One factor is your financial situation and second is your health history. Currently, around 8 million Americans own a policy.

Who Needs LTC Insurance?
As the cost of LTC – which includes nursing home, assisted living and in-home care – continues to rise, it’s important to know that most people pay for LTC either from personal savings or Medicaid when their savings is depleted, or through a LTC insurance policy. National median average costs for nursing home care today is around $92,000 per year, while assisted living averages around $50,000/year.

While national statistics show that about 70 percent of Americans 65 and older will need some kind of LTC, the fact is, many people don’t need to purchase a LTC insurance policy.

The reasons stem from a range of factors, including the fact that relatively few people have enough wealth to protect to make purchasing a policy worthwhile. Seniors with limited financial resources who need LTC turn to Medicaid to pick up the tab after they run out of money.

Another important factor is that most seniors who need LTC only need it for a short period of time, for example, when they’re recovering from surgery. For those people, Medicare covers in-home health care and nursing home stays of 100 days or less following a hospital stay of more than 3 consecutive days.

So, who should consider buying a policy?

LTC insurance policies make the most sense for people who can afford the monthly premiums, and who have assets of at least $150,000 to $200,000 or more that they want to protect, not counting their home and vehicles.

Another factor to weigh is your personal health and family health history. The two most common reasons seniors need extended long-term care is because of dementia and/or disability. And, almost half of all people who live in nursing homes are 85 years or older. So, what’s your family history for Alzheimer’s, stroke or some other disabling health condition, and do you have a family history of longevity?

You also need to factor in gender too. Because women tend to live longer than men, they are at greater risk of needing extended LTC.

Choosing LTC Insurance
After evaluating your situation, if you’re leaning towards buying a LTC policy, be sure to do your homework. The cost of premiums can vary greatly ranging anywhere between $2,500 and $8,000 per year for a couple depending on your age, the insurer, and the policy’s provisions.

Also note that because of coronavirus, it may be more difficult to qualify for coverage now if you’re age 70 or older, in a high-risk group or have had a positive COVID-19 test.

To find a policy, get a LTC insurance specialist who works with a variety of companies. See the American Association of Long-Term Care Insurance website (AALTCI.org) to locate one. Also shop insurers like Northwestern Mutual and New York Life, who work only with their own agents.

Another option you may want to consider are Hybrid policies that combine long-term care coverage with life-insurance benefits. These policies promise that if you don’t end up needing long-term care, your beneficiaries will receive a death benefit.

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.

Savvy Senior Columns for August 2020

August 1, 2020

Savvy Senior – August Columns

  1. Financial Help for Retirees Affected by COVID-19
  2. How to Keep a Watchful Eye on an Aging Parent
  3. How Medicare and Other Tools Can Help Older Smokers Kick the Habit
  4. An Executor’s Guide to Settling A Loved One’s Estate

 

Financial Help for Retirees Affected by COVID-19

Dear Savvy Senior,
Are there any financial assistance programs you can refer me to? The coronavirus pandemic has cost me my part-time retirement job and has shrunk my measly IRA account.
Needy Retiree

Dear Needy,
Absolutely! In addition to the $1,200 federal coronavirus stimulus check that was distributed in April and May, there are many other financial-assistance programs (both public and private) that can help struggling retirees, as well as give relief to family members who help provide financial support for their loved ones.

To find out what types of assistance you may be eligible for, just go to BenefitsCheckUp.org, a free, confidential Web tool designed for adults 55 and older and their families. It will help you locate federal, state and private benefits programs that can assist with paying for food, medications, utilities, health care, housing and other needs. This site – created by the National Council on Aging – contains more than 2,500 programs across the country.

To identify benefits, you’ll first need to fill out an online questionnaire that asks a series of questions like your date of birth, ZIP code, expenses, income, assets, veteran status, the medications you take and a few other factors. It takes about 15 minutes.

Once completed, you’ll get a report detailing all the programs and services you may qualify for, along with detailed information on how to apply.

Some programs can be applied for online; some have downloadable application forms that you can print and mail in; and some require that you contact the program’s administrative office directly (they provide the necessary contact information).

If you don’t have Internet access, you can also get help in-person at any of the 84 Benefit Enrollment Centers located throughout the U.S. Call 888-268-6706 or visit NCOA.org/centerforbenefits/becs to locate a center in your area. Some centers also offer assistance over the phone.

Types of Benefits
Depending on your income level and where you live, here are some benefits you may be eligible for:

Food assistance: Programs like the Supplemental Nutrition Assistance Program (SNAP) can help pay for groceries. The average SNAP benefit for 60-and-older households is around $125 per month. Other programs that may be available include the Emergency Food Assistance Program, Commodity Supplemental Food Program, and the Senior Farmers Market Nutrition Program.

Healthcare: Medicaid and Medicare Savings Programs can help or completely pay for out-of-pocket health care costs. And, there are special Medicaid waiver programs that provide in-home care and assistance too.

Prescription drugs: There are hundreds of programs offered through pharmaceutical companies, government agencies and charitable organizations that help lower or eliminate prescription drug costs, including the federal Low-Income Subsidy known as “Extra Help” that pays premiums, deductibles and prescription copayments for Medicare Part D beneficiaries.

Utility assistance: There’s the Low-Income Home Energy Assistance Program (LIHEAP), as well as local utility companies and charitable organizations that provide assistance in lowering home heating and cooling costs.

Supplemental Security Income (SSI): Administered by the Social Security Administration, SSI provides monthly payments to very low-income seniors, age 65 and older, as well as to those who are blind and disabled. In 2020, SSI pays up to $783 per month for a single person and up to $1,175 for couples.

In addition to these programs, there are numerous other benefits they can help you locate such as HUD housing, home weatherization assistance, tax relief, veteran’s benefits, senior transportation, respite care, free legal assistance, job training and employment and debt counseling.

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 to Keep a Watchful Eye on an Aging Parent

Dear Savvy Senior,
Can you recommend any services or technology that help me monitor my elderly mother who lives alone? Since the coronavirus pandemic started last March, my sister and I have noticed that my mom’s health has slipped a bit, so we would like to find something that helps us keep tabs on her when we’re not around.
Concerned Daughter

Dear Concerned
Depending on how closely you want to monitor your mother, and what she’s comfortable with as well, there are check-in call services along with some new monitoring technology devices you can turn to for help. Here are several to consider.

Check-In Calls
If you just want a simple check to make sure your mom is OK every day, consider signing her up with a daily check-in call service program. These are telephone reassurance programs run by police or sheriff’s departments in hundreds of counties across the country and are usually provided free of charge.

Here’s how they work. A computer automated phone system would call your mom at a designated time each day to check-in. If she answers, the system would assume everything is OK. But if she didn’t pick up or if the call goes to voice mail after repeated tries, you (or her other designee) would get a notification call. If you are not reachable, calls are then made to backup people who’ve also agreed to check on your mom if necessary.

The fallback is if no one can be reached, the police or other emergency services personnel will be dispatched to her home.

To find out if this service is available in your mom’s community, call her local police department’s nonemergency number. If it’s not offered, there are other organizations or companies you can turn to that provide similar services.

One that I love that’s completely free to use is Mon Ani (monami.io, 650-267-2474), which offers a volunteer phone bank that provides phone or video calls daily, weekly or anything in between. The volunteer will connect with your mom, provide companionship and make sure everything is OK. And, they’ll let you know if they detect a problem.

Monitoring Technology
Technology also offers a variety of new ways to help you keep an eye on your mom when you can’t be there.

One nifty new option is the Electronic Caregiver’s (electroniccaregiver.com) “Premier” product, which is a wearable wrist device that provides activity monitoring, a 24/7 emergency help button, medication reminders and a GPS locator so you can determine your mom’s whereabouts when she’s away from home.

It’s also linked to a family caregiver app to keep you and other loved ones in the loop. The device is free with a monthly subscription that costs $40 to $60 a month, depending on the level of monitoring.

If your mom is primarily homebound, another option to consider is a sensor-monitoring system like Caregiver Smart Solutions (caregiversmartsolutions.com). This uses small sensors (not cameras) placed in key areas of your mom’s home to track her activities – everything from whether she used the coffee pot to how much she’s watching TV – and will let you know if something out of the ordinary is happening. For instance, if she went to the bathroom and didn’t leave, it could indicate a fall or other emergency.

You can also check up on her patterns anytime you want through the system’s website or app. And for additional protection, it offers emergency call buttons that can be placed around the house. Caregiver Smart Solutions starts at $99 for their activity sensors, plus a $29 monthly service fee.

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 Medicare and Other Tools Can Help Older Smokers Kick the Habit

Dear Savvy Senior,
I understand that COVID-19 hits smokers a lot harder than nonsmokers but quitting at my age is very difficult. Does Medicare offer any coverage that helps beneficiaries quit smoking?
Must Quit

Dear Must,
It’s true. Smokers and vapers have a higher risk of severe COVID-19 infection as the coronavirus attacks the lungs. That’s why quitting now is more important than ever before.

If you are a Medicare beneficiary, you’ll be happy to know that Medicare Part B covers up to eight face-to-face counseling sessions a year to help you quit smoking. And, if you have a Medicare Part D prescription drug plan, certain smoking-cessation medications are covered too. Here are some other tips that can help you kick the habit.

It’s Never Too Late
According to the Center of Disease Control and Prevention (CDC) 12.5 percent of Medicare beneficiaries smoke. Many older smokers, like yourself, indicate that they would like to quit, but because of the nicotine, which is extremely addictive, it’s very difficult to do.

Tobacco use is the leading cause of preventable illness, responsible for an estimated one-fifth of deaths in the United States each year.

But research shows that quitting, even after age 65, greatly reduces your risk of heart disease, stroke, cancer, osteoporosis and many other diseases including COVID-19. It also helps you breathe easier, smell and taste food better, not to mention saves you quite a bit of money. A $6 pack-a-day smoker, for example, saves about $180 after one month without cigarettes, and nearly $2,200 after one year.

How to Quit
The first step you need to take is to set a “quit date,” but give yourself a few weeks to get ready. During that time, you may want to start by reducing the number or the strength of cigarettes you smoke to begin weaning yourself.

Also check out over-the-counter nicotine replacement products – patches, gum and lozenges – to help curb your cravings (these are not covered by Medicare). And just prior to your quit day get rid of all cigarettes and ashtrays in your home, car, and place of work, and try to clean up and even spray air freshener. The smell of smoke can be a powerful trigger.

Get Help
Studies have shown that you have a much better chance of quitting if you have help. So, tell your friends, family, and coworkers of your plan to quit. Others knowing can be a helpful reminder and motivator.

Then get some counseling. Don’t go it alone. Start by contacting your doctor about smoking cessation counseling covered by Medicare and find out about the prescription antismoking drugs that can help reduce your nicotine craving.

You can also get free one-on-one telephone counseling and referrals to local smoking cessation programs through your state quit line at 800-QUIT-NOW or call the National Cancer Institute free smoking quit line at 877-44U-QUIT.

It’s also important to identify and write down the times and situations you’re most likely to smoke and make a list of things you can do to replace it or distract yourself. Some helpful suggestions when the smoking urge arises are to call a friend or one of the free quit lines, keep your mouth occupied with some sugar-free gum, sunflower seeds, carrots, fruit or hard candy, go for a walk, read a magazine, listen to music or take a hot bath.

The intense urge to smoke lasts about three to five minutes, so do what you can to wait it out. It’s also wise to avoid drinking alcohol and steer clear of other smokers while you’re trying to quit. Both can trigger powerful urges to smoke.

For more tips on how to quit, including managing your cravings, withdrawal symptoms and what to do if you relapse, visit 60plus.SmokeFree.gov. There are also a variety of helpful quit smoking apps you can download like SmokeFreeApp.com and QuitGenius.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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An Executor’s Guide to Settling A Loved One’s Estate

Dear Savvy Senior,
My aunt recently asked me to be the executor of her will when she dies. I’m flattered that she asked, but I’m not sure what exactly the job entails. What can you tell me about this?
Inquiring Niece

Dear Inquiring,
Serving as the executor of your aunt’s estate may seem like an honor, but it can also be a lot of work. Here’s what you should know to help you prepare for this job.

As the executor of your aunt’s will, you’re essentially responsible for winding up her affairs after she dies. While this may sound simple enough, you need to be aware that the job can be time consuming and difficult depending on the complexity of her financial and family situation. Some of the duties required include:

  • Filing court papers to start the probate process (this is generally required by law to determine the will’s validity).
  • Taking an inventory of everything in her estate.
  • Using her estate’s funds to pay bills, including taxes, funeral costs, etc.
  • Handling details like terminating her credit cards and notifying banks and government agencies like Social Security and the post office of her death.
  • Preparing and filing her final income tax returns.
  • Distributing assets to the beneficiaries named in her will.

Be aware that each state has specific laws and timetables on an executor’s responsibilities. Your state or local bar association may have an online law library that details the rules and requirements. The American Bar Association website also offers guidance on how to settle an estate. Go to AmericanBar.org and type in “guidelines for individual executors and trustees” in the search bar to find it.

Get Organized
If you agree to take on the responsibility as executor of your aunt’s estate, your first step is to make sure she has an updated will and find out where all her important documents and financial information is located. Being able to quickly put your hands on deeds, brokerage statements and insurance policies after she dies will save you a lot of time and hassle.

If she has a complex estate, you may want to hire an attorney or tax accountant to guide you through the process, with the estate picking up the cost. If you need help locating a pro, the National Association of Estate Planners and Councils (naepc.org) and the National Academy of Elder Law Attorneys (naela.org) are good resources that provide directories on their websites to help you find someone.

Avoid Conflicts
Find out if there are any conflicts between the beneficiaries of your aunt’s estate. If there are some potential problems, you can make your job as executor much easier if everyone knows in advance who’s getting what, and why. So, ask your aunt to tell her beneficiaries what they can expect. This includes the personal items too, because wills often leave it up to the executor to dole out heirlooms. If there’s no distribution plan for personal property, suggest she make one and put it in writing.

Executor Fees
As the executor, you’re entitled to a fee paid by the estate. In most states, executors are entitled to take a percentage of the estate’s value, which often ranges anywhere from 1 to 5 percent depending on the size of the estate. But, if you’re a beneficiary, it may make sense for you to forgo the fee. That’s because fees are taxable, but Uncle Sam in most states doesn’t tax inheritances.

For more information on the duties of an executor, get a copy of the book “The Executor’s Guide: Settling A Loved One’s Estate or Trust” at Nolo.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.

Savvy Senior Columns — July 2020

June 22, 2020

Savvy Senior – July Columns

  1. RV Travel Tips in the Summer of COVID-19
  2. Can I Stop Social Security if I Go Back to Work?
  3. Video Calling Solutions for Tech-Challenged Seniors
  4. What Happens if You Die Without a Will?
  5. Stretching Tips to Help Seniors Gain Flexibility and Reduce Pain

RV Travel Tips in the Summer of COVID-19

Dear Savvy Senior,
Can you write a column on RV travel for novices? My husband and I have been cooped up all spring and summer because of the coronavirus and would like to take a trip using a rented RV but could use some tips and want to be safe.
Recently Retired

Dear Recently,
Recreational-vehicle (or RV) travel has become a very popular option among U.S. retirees over the past few decades and is probably one of the safest and most convenient ways to get away this summer.

Because it’s a small home on wheels, RV travel will allow you to distance yourself from crowds of people and reduce your risk of COVID exposure that comes with other forms of travel, i.e. air/train travel, hotel/Airbnb lodging and eating in restaurants. But there are still risks – especially in public places like gas stations, shared restrooms and picnic areas – so exercise caution. If you’ve never traveled by motor home or RV, here are a few tips to consider.

Renting an RV
To help you determine the RV size and model you need for your trip, consider your budget, destination and the number of travelers. If it’s just you and your husband, and you’re visiting several locations and driving lots of miles you may want a smaller motor home with better fuel economy. But if you’re taking other family members or friends, you may want a larger RV with slide outs and more sleeping areas. See GoRVing.com for a breakdown of all the different types of RVs available today.

To locate an RV rental dealer near you visit CruiseAmerica.com, one of the largest RV rental companies in the world or search the Recreation Vehicle Rental Association at RVRA.org. Or use peer-to-peer RV rental sites like RVshare.com or Outdoorsy.com, which are usually a little cheaper.

Rental costs will vary greatly depending on what you choose and how far you drive, ranging anywhere from $50 up to $500 per day.

When renting a rig, be sure you get detailed instructions from the owner or rental company on how to use the RV’s systems, including the generator, air-conditioning, leveling, slide outs, electric and entertainment, as well as how to empty waste tanks and refill fresh water.

You should also know that because of COVID-19, most RV rental companies are vigilant about cleaning and disinfecting their units. But if you want to be extra safe, the CDC offers tips at CDC.gov/COVID19 – type “Cleaning and Disinfecting Your Home” in the search bar.

Trip Planning Tips
It’s always wise to map out your trip route and reserve your campgrounds in advance, especially now during the pandemic, because some campgrounds and RV parks, as well as local, state, and national public parks may be closed or operating with restrictions.

A free tool that can help you plan your trip is Roadtrippers.com, which lets you plot out routes, calculate mileage and travel time, and will identify RV campgrounds, points of interest and restaurants along the way.

You should also consider becoming a Good Sam Club member (GoodSam.com/club, $29/year), which provides access to its web-based trip planner, camping and fuel discounts, and a copy of the Good Sam Guide Series that features detailed information on more than 12,000 private RV parks and public campgrounds.

Most RV parks rent spaces on a nightly or weekly basis with rates typically ranging from $30 to $50 per night, however some in city and country parks may be $10 or even free.

RV parks can also range from rustic facilities with limited or no utility hookups, as are more often found in state and national parks, to luxury resorts with amenities that rival fine hotels.

For first-time RV renters, staying at a fully loaded RV park or campground with full hookups, a dump station, and staff on site is highly recommended. Look at Kampgrounds of America (KOA.com) or ReserveAmerica.com to browse the accommodations.

And for more safe travel tips this summer, visit Coronavirus.gov – click on “specific resources for travelers.”

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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Can I Stop Social Security if I Go Back to Work?

Dear Savvy Senior,
I lost my job last month because of the coronavirus crisis. With little savings, I’ve been thinking about starting my Social Security benefits early to help me get by. But my question is, if I find a new job can I stop my Social Security benefits and restart them at a later date so they can continue to grow?
Almost 63

Dear Almost,
Yes, there are actually two ways you can stop your Social Security retirement benefits (once you’ve started collecting them) and restart them at a later date, which would boost your benefits. But in order to do this certain rules and conditions must be met. Here are your options.

Withdraw your benefits: One way to pause your Social Security benefits is to simply withdraw your Social Security application. But this must be done within 12 months of starting your benefits and you’ll also have to repay what you’ve received so far. If you choose this option, Social Security will treat your application for early benefits as if it never happened.

To withdraw your benefits, you’ll need to complete Form SSA-521 (SSA.gov/forms/ssa-521.pdf) and send it to your local Social Security office. Also be aware that you can only withdraw benefits once in a lifetime.

Suspend your benefits: If you aren’t eligible for withdrawal, but you’ve reached your full retirement age and have not yet reached age 70, another option is to voluntarily suspend your retirement benefits. With the suspension option you don’t have to repay the benefits you’ve received, and you can restart them anytime you wish, or they will be automatically be reinstated at age 70. (See SSA.gov/planners/retire/ageincrease.html to find your full retirement age.)

By suspending your benefits you’ll earn delayed retirement credits, which means your benefit amount increases for every month of the suspension. Your payment will go up by two-thirds of 1 percent monthly or 8 percent annually. A benefit of $1,500 monthly, for example, increases by $10 for each month you have benefits suspended.

You can request a suspension by phone (800-772-1213) or in person at your local Social Security office.

Working and Collecting Benefits
If you start collecting Social Security and you do go back to work, but your income is modest, you may want to continue drawing your benefits while working at the same time. But if your earnings are higher, it makes sense to stop your benefits.

Social Security has a “retirement earnings test” that says if you’re under your full retirement age and you earn more than $18,240 in 2020, Social Security will deduct $1 from your benefits for every $2 you earn over that amount. Those who reach full retirement age in 2020 a less stringent rule applies. In this case, $1 gets taken out for every $3 you make above $48,600 until you reach the month of your birthday.

It’s also important to know that if you were to lose some or all of your Social Security benefits because of the earning limits, they aren’t lost forever. When you reach full retirement age, your benefits will be recalculated to a higher amount to make up for what was withheld.

Also, if you do decide to work and collect Social Security benefits at the same time, you need to factor in Uncle Sam too. Because working increases your income, it might make your Social Security benefits taxable.

Here’s how this works. If your combined income is between $25,000 and $34,000 as an individual or between $32,000 and $44,000 as joint filers, you will pay tax on up to 50 percent of your Social Security benefits. If you earn above the upper limit of these ranges, you will pay tax on up to 85 percent of your benefits. To help you calculate this see the IRS publication 915 at IRS.gov/pub/irs-pdf/p915.pdf.

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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Video Calling Solutions for Tech-Challenged Seniors

Dear Savvy Senior,
Can you recommend some simple devices that can help tech-challenged seniors with video calls? My 80-year-old mother has been isolating herself for months now in fear of the coronavirus and I haven’t been able to see her face-to-face in quite a while.
Concerned Daughter

Dear Concerned,
Video chatting is a great way to stay connected and keep tabs on an elder parent when you can’t be there, but it’s even more important now during this pandemic as many isolated seniors are also suffering from chronic loneliness.

To help connect you and your mom virtually, there are various products on the market that offer simple video calling for seniors who have limited ability or experience with technology. Here are four devices to consider.

GrandPad: This is a top option for simple video calling, and much more. The GrandPad is an 8-inch tablet specifically designed for seniors, ages 75 and older. It comes with a stylus, a charging cradle and 4G LTE built-in so it works anywhere within the Consumer Cellular network – home Wi-Fi is not required.

Ready to go right out of the box, GrandPad provides a simplified menu of big icons and large text for only essential features, providing clutter-free, one-touch access to make and receive video calls, send voice emails, view photos and videos, listen to personalized music, check the weather, play games, browse the Internet and more.

A GrandPad tablet costs $250 plus $40 monthly service fee and is sold through Consumer Cellular at GrandPad.net or call 888-545-1425.

Amazon’s Echo Show: With its built-in camera and screen, the voice-command Echo Show also provides a simple way to have face-to-face chats with your mom, but she’ll need home Wi-Fi installed.

Echo Shows, which come in three screen sizes – 5-inch ($90), 8-inch ($130) and 10-inch ($230) – will let your mom make and receive video calls to those who have their own device, or who have the Alexa app installed on their smartphone or tablet.

Once you set up her contacts, to make a call your mom could simply say, “Alexa, call my daughter” And when you call her, she would ask Alexa to answer the call (or ignore it). There’s also a feature called “drop-in” that would let you video call your mom’s device anytime without her having to answer it.

Available at Amazon.com, the Echo Show also offers thousands of other features your mom would enjoy like voice-activated access to news, weather, her favorite music and much more.

If you decide to order an Echo Show device for mom, be sure your ask Amazon to mark it as a gift so it doesn’t get tied to your Amazon account. For instructions to help your mom set it up, or if she doesn’t have a smartphone, go to Amazon.com/gp/help/customer/display.html, and type in “Help Loved Ones Set Up Their Echo Show Remotely” in the “find more solutions” bar.

ViewClix: This is a smart picture frame specifically designed for elderly seniors that lets family members make video calls, send photos and post virtual sticky notes with messages to their loved ones ViewClix from their smartphone, tablet or computer. Seniors, however, cannot initiate video calls from their ViewClix. Home Wi-Fi is also required.  Available in two sizes – 10-inch for $199, and 15-inch for $299 – you can learn more about this product at ViewClix.com.

Facebook Portal: If your mom is a Facebook user, a voice-command Facebook portal (see portal.facebook.com) is another simple way to stay connected – home Wi-Fi is needed.

Portals, which come in three sizes – the original 10-inch Portal ($179), the 8-inch Mini ($129) and the massive 15-and-a-half-inch Portal Plus ($279) – are like Echo Shows, except they connect through Facebook. With a Portal, your mom can video call your smartphone or tablet (and vice versa) using Facebook Messenger or WhatsApp.

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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What Happens if You Die Without a Will?

Dear Savvy Senior,
What happens to a person’s possessions if they die without a will? I’m almost 60 years old and have never gotten around to making one, but the coronavirus crisis has made it a priority.
Will-less Willie

Dear Willie,
The coronavirus crisis has lit a fire under many Americans when it comes to getting their affairs in older. Currently, fewer than half of American adults have prepared a will or living trust.

If you die without a will, the state you reside in will determine what happens to your assets. Every state has intestacy laws in place that parcel out property and assets to a deceased person’s closest living relatives when there’s no will or trust in place. But these laws vary from state-to-state.

Here is a general breakdown of what can happen to a person’s assets, depending on whom they leave behind.

Married with children: When a married person with children dies without a will, all property, investments and financial accounts that are “jointly owned” automatically goes to the surviving co-owner without going through probate, which is the legal process that distributes a deceased person’s assets.  But for all other separately owned property or individual financial accounts, the laws of most states award one-third to one-half to the surviving spouse, while the rest goes to the children.

Married with no children or grandchildren: Some states award the entire estate to the surviving spouse, or everything up to a certain amount (for example the first $100,000). But many other states award only one-third to one-half of the decedent’s separately owned assets to the surviving spouse, with the remainder generally going to the deceased person’s parents, or if the parents are dead, to brothers and sisters.  Jointly owned property, investments, financial accounts, or community property automatically goes to the surviving co-owner.

Single with children: All state laws provide that the entire estate goes to the children, in equal shares. If an adult child of the decedent has died, then that child’s children (the decedent’s grandchildren) split their parent’s share.

Single with no children or grandchildren: In this situation, most state laws favor the deceased person’s parents. If both parents are deceased, many states divide the property among the brothers and sisters, or if they are not living, their children (your nieces and nephews). If there are none of them, it goes to the next of kin, and if there is no living family, the state takes it.

Make a Will
To ensure your assets go to those you want to receive them, you need to create a will or trust. If you have a simple estate and an uncomplicated family situation, there are do-it-yourself resources that can help you create all these documents for very little money.

Some top-rated options include the Quicken WillMaker & Trust 2020 downloadable software (available at nolo.com) that costs $90 and works with Windows and Macs and is valid in every state except Louisiana; LegalZoom (legalzoom.com), which offers basic wills for $89 or $99 if you’d like assistance from an independent attorney; and Trust & Will (trustandwill.com) which charges $89 for a basic will.

If, however, you want or need assistance or if you have a complicated financial situation, blended family or have considerable assets, you should hire an attorney. An experienced attorney can make sure you cover all your bases, which can help avoid family confusion and squabbles after you’re gone.

Costs will vary depending on where you live, but you can expect to pay anywhere between $200 and $1,000 for a will.

The National Academy of Elder Law Attorneys (naela.org) and the American College of Trust and Estate Counsel (actec.org) websites are good resources that have directories to help you find someone in your area.

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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Stretching Tips to Help Seniors Gain Flexibility and Reduce Pain

Dear Savvy Senior,
Can you offer some good stretching tips for seniors who are staying home during the pandemic? I’ve gotten so stiff and achy in recent years that I have a hard time doing basic activities like bending over to tie my shoes.
Stiff as a Board

Dear Stiff,
Of all possible exercises, stretching tends to be the most neglected, yet nothing is more vital to keeping an aging body limber and injury free.  As we age, our muscles naturally lose their elasticity if you’re not active, which can make common day-to-day activities like reaching down to tie your shoes or looking over your shoulder to back your car out of the driveway, difficult.

But the good news is, by incorporating some simple stretching exercises into your routine (at least three times a week) you can greatly improve your flexibility, as well as enhance your balance, posture and circulation, relieve pain and stress, and prevent injuries. In addition, stretching is also important as a warm-up and cool-down for more vigorous activities, and leg stretching is an excellent way to prevent nighttime leg cramps too.

Simple Stretches
Stretching exercises should focus on the muscles in your neck, shoulders, arms, chest, back, hips, thighs, hamstrings and calves. If you’ve had hip or back surgery, you should talk to your doctor before doing lower-back flexibility exercises.

While stretching, it’s very important to listen to your body. You want to stretch each muscle group to the point where the muscle feels tight. If it hurts, you’ve gone too far. Back off to the point where you don’t feel any pain, then hold the stretch for 10 to 20 seconds. Relax, then repeat it three to five times, trying to stretch a little farther, but don’t bounce. Bouncing greatly increases your chance of injury.

It’s also a good idea to warm up a little before you start stretching by walking in place and pumping your arms. And remember to breathe when you stretch. Also, keep in mind that muscles that have not been stretched in a while take time to regain their flexibility. So be patient and go slow.

If you don’t have much experience with stretching, the National Institute on Aging offers a free guide that provides illustrated examples of flexibility exercises to help you get started. Go to order.nia.nih.gov, and type in “Exercise & Physical Activity: Your Everyday Guide from The National Institute on Aging” to view it online.

There are also senior fitness programs, like SilverSneakers (silversneakers.com) and Silver&Fit (silverandfit.com), that are currently offering online flexibility and balance videos that can guide you through a series of stretching exercises you can do at home during the pandemic.

There are also a wide variety of stretching exercise DVDs or videos you could purchase at sites like CollageVideo.com or Amazon.com.

Yoga and Tai Chi
Another great way to improve your flexibility is through gentle yoga or chair yoga. In chair yoga you replace the yoga mat with a chair where most poses can be duplicated. This is much easier on tight, inflexible muscles. Tai chi and qi gong are also great exercise options for improving balance and flexibility.

To get started, there are many DVDs and videos that offer instructions and routines for seniors you can do at home. The YMCA has also launched a new series of free, online health and fitness videos at YMCA360.org that includes gentle yoga, chair yoga and tai chi videos.

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.

Savvy Senior Columns — June 2020

May 22, 2020

Savvy Senior – June Columns

  1. How to Find Health Insurance After a Job Loss
  2. How to Make the Most of Your Telehealth Appointment
  3. What to Know About Advance Care Planning in the Age of Coronavirus
  4. Why High Blood Pressure is Even More Dangerous in the COVID-19 Era

How to Find Health Insurance After a Job Loss

Dear Savvy Senior,
Because of the coronavirus pandemic, I just got laid off from my job of 22 years and need to find health insurance until I can get another job or enroll in Medicare at age 65. What are my options?
Scared to Death                                                                                   

Dear Scared,
I’m very sorry about your job loss. It’s estimated that as many as 45 million Americans could lose their health insurance as businesses continue to lay off workers due to repercussions of the coronavirus pandemic. Here’s where you can find health insurance coverage while you’re looking for new employment or waiting for Medicare.

The Affordable Care Act Marketplace
Your best option for getting affordable health insurance is through Affordable Care Act (ACA) Marketplaces, also known as Obamacare. Or, if your income is very low you may qualify for Medicaid.

Normally, enrollment in an ACA Marketplace is limited to the short window for Open Enrollment, which is between Nov. 1 and Dec. 15 each year. But there’s an exception for people who’ve lost their jobs, known as the Special Enrollment Period, which allows you to apply because your layoff meant a loss of health insurance. To do so, you must enroll within 60 days of when your coverage stopped and prove that you lost your health insurance.

There is no limited enrollment period for Medicaid.

Eleven of the states with their own health-insurance marketplaces (California, Colorado, Connecticut, Maryland, Massachusetts, Minnesota, Nevada, New York, Rhode Island, Vermont and Washington), plus the District of Columbia, are also offering special enrollment periods, allowing anyone who is eligible under the ACA rules to sign up.

ACA health insurance is major medical insurance that covers essential health benefits with no annual or lifetime coverage maximums. And they can’t charge you more or deny you coverage because of a pre-existing health condition.

You also need to know that if your annual income will fall below the 400 percent poverty level, the ACA provides premium subsidies, which will reduce the amount you’ll have to pay for a policy.

To qualify for subsidies your household’s estimated income for 2020 must be under $49,960 for an individual, $67,640 for a couple, or $103,000 for a family of four. The lower your income is under these limits the higher your subsidy will be. Unemployment benefits count toward income.

To see how much subsidy you may qualify for, use Kaiser Family Foundation health insurance marketplace calculator at KFF.org/interactive/subsidy-calculator.  Or, if your income is very low – below the 138 percent poverty level – you may qualify for free, or low-cost health coverage through expanded Medicaid services, which is available in many states.

To apply for ACA Marketplace health plans or Medicaid, go to HealthCare.gov. Or, you can call their toll-free number at 800-318-2596 and get help over the phone.

COBRA
If you need health insurance coverage for less than 18 months, another option you may want to consider is COBRA, which allows you to remain on your former employer’s group health plan, but not every employer plan is COBRA-eligible. Contact your employer benefits administrator to find out if yours is.

In most cases COBRA is expensive, requiring you to pay the full monthly premium yourself. But, if you’ve already met or nearly met your employer plan’s deductible and/or out-of-pocket maximum for the year, and don’t want to start over with a new plan; or if you find your employer’s health plan to be better or more affordable than the marketplace options, it makes sense to keep your current coverage under COBRA.

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 to Make the Most of Your Telehealth Appointment

Dear Savvy Senior,
I manage a large doctor’s clinic that treats hundreds of seniors each month. We are moving to more telehealth visits to help keep our patients safe at home during the coronavirus pandemic, but this new way of seeing a doctor is befuddling to many of our elder patients. Can you write a column educating patients on how to prepare for a telehealth appointment?
Regular Reader

Dear Reader,
I’d be happy to help! To help keep patients safe and at home during the coronavirus crisis more and more doctors and other health care providers are turning to telehealth (a.k.a. telemedicine) appointments, which are remote e-visits using a digital communication device like a smartphone, tablet or computer.

Although telehealth has been around for a few years now, recent updates to regulations and a surge in demand has made it the easiest way to get many different types of medical care. Most telehealth appointments today tend to be primary care or follow-up visits that can assess symptoms or check on people who have had a medical procedure. Telehealth also works well for some specialties like dermatology or mental health care (counseling/therapy) services.

So, what can patients expect from a telehealth visit, and how should they prepare?

The first step is to call your doctor’s office to find out whether telemedicine visits are available and whether you will need to set up an account or install special software on your computer, phone or tablet.

Until recently, doctors were required to conduct telehealth visits through platforms such as Doxy, Thera-Link or MyChart that were compliant with the Health Insurance Portability and Accountability Act, or HIPAA. But some of those requirements have been relaxed in the current crisis, so many providers are using popular apps such as FaceTime, Skype and Zoom to conduct visits.

Once you know what technology you will be using, get familiar with it. You don’t want to spend the first 10 minutes of your visit trying to figure out how to unmute the audio.

For older patients that aren’t familiar or comfortable with technology, ask a relative or friend with a smartphone, tablet or laptop to assist you.

Take the time to clarify the purpose of the televisit before it begins. Prioritize a written list of three or four issues you want to discuss with your doctor and make a list of the medicines you’re taking, along with the dosages.  Also, have relevant medical devices or logs on hand, such as a penlight or smartphone flashlight for viewing a sore throat, a blood-pressure cuff and thermometer (or recent readings), blood-sugar logs if you’re diabetic or a food log if you have gastrointestinal problems.

If you’ve received medical care at different places, such as an urgent care facility or another doctor’s office, have your latest medical records with you during the telemedicine visit.

Wear loose clothing that will allow you to show your medical provider what is concerning you.

The length of the appointment may depend on the problem. A routine visit could be very quick, while others, such as a physical-therapy appointment, may last as long as a session at a clinic. Waiting rooms are sometimes replaced by virtual waiting rooms.

Before the visit ends, make sure you know the follow-up plan. Do you need to schedule an in-office visit, fill a prescription or get a referral to a specialist?

Right now, Medicare and Medicaid are covering the cost of telehealth visits (see medicare.gov/coverage/telehealth for details), and most private insurers are following suit.

If you don’t have a primary care physician or need urgent care, you can get help through virtual health care service like Doctor on Demand (doctorondemand.com) or TeleDoc (teladoc.com). These services currently do not accept original Medicare, but they may be covered by private insurers including some Medicare Advantage plans – be sure you check.

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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What to Know About Advance Care Planning in the Age of Coronavirus

Dear Savvy Senior,
All this horrible coronavirus carnage got me thinking about my own end-of-life decisions if I were to get sick. Can you recommend some good resources that can help me create a living will or advance directive, or other pertinent documents? I’ve put it off long enough.
Almost 70

Dear Almost,
Creating a living will (also known as an advance directive) is one of those things most people plan to do, but rarely get around to actually doing. Only about one-third of Americans currently have one. But the cold hard reality of the novel coronavirus may be changing that. Here’s what you should know along with some resources to help you create an advance directive.

Advance Directives
To adequately spell out your wishes regarding your end-of-life medical treatment are two key documents: A “living will” which tells your doctor what kind of care you want to receive if you become incapacitated, and a “health care power of attorney” (or health care proxy), which names a person you authorize to make medical decisions on your behalf if you become unable to.

These two documents are known as an “advance directive,” and will only be utilized if you are too ill to make medical decisions yourself. You can also change or update it whenever you please.

It isn’t necessary to hire a lawyer to prepare an advance directive. There are free or low-cost resources available today to help you create one, and it takes only a few minutes from start to finish.

One that I highly recommend that’s completely free to use is My Directives (MyDirectives.com). This is an online tool and mobile app that will help you create, store and share a detailed, customized digital advance directive. Their easy-to-use platform combines eight thoughtful questions to guide you through the process. If you’re not computer savvy, ask a family member or trusted friend to help you.

The advantage of having a digital advance directive versus a paper document is being able to access it quickly and easily via smartphone, which is crucial in emergency situations when they’re most often needed.

However, if you’d rather have a paper document, one of the best do-it-yourself options is the Five Wishes advance directive (they offer online forms too). Created by Aging with Dignity, a nonprofit advocacy organization, Five Wishes costs $5, and is available in many languages. To learn more or to receive a copy, visit FiveWishes.org or call 850-681-2010.

Another tool you should know about that will compliment your advance directive is the Physician Orders for Life-Sustaining Treatment, or POLST (sometimes called Medical Orders for Life-Sustaining Treatment, or MOLST). A POLST form translates your end-of-life wishes into medical orders to be honored by your doctors. To learn more about your state’s program or set one up, see POLST.org.

Readers should also know that if you’ve already prepared an advanced directive paper document, a POLST form or the VA advance directive form 10-0137, you can upload, store and share these documents too at MyDirectives.com.

And finally, to ensure your final wishes are followed, make sure to tell your family members, health care proxy and doctors. If you make a digital advance directive or have uploaded your existing forms, you can easily share them electronically to everyone involved. Or, if you make a paper advance directive that isn’t uploaded, you should provide everyone copies to help prevent stress and arguments later.

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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Why High Blood Pressure is Even More Dangerous in the COVID-19 Era

Dear Savvy Senior,
Are people with high blood pressure at increased risk of getting coronavirus?
Hypertensive Helen

Dear Helen,
If you have high blood pressure, you definitely need to take extra care to protect yourself during the coronavirus (COVID-19) pandemic. Research shows that people with hypertension are more susceptible to getting COVID-19, are more likely to develop severe symptoms if they do get sick, and are more likely to die from the infection, especially if they’re older.

High Risk Links
A weaker immune system is the key reason people with high blood pressure and other health problems are at higher risk for coronavirus. Long-term health conditions and aging weaken the immune system so it’s less able to fight off the virus. Nearly two-thirds of Americans over 60 have high blood pressure.

Another concern that has been circulating, but was put to rest last month, were theories that the medications that are commonly prescribed to treat high blood pressure – ACE inhibitors and angiotensin receptor blockers (ARBs) – could make patients more vulnerable to contracting COVID-19, and more susceptible to severe illness if they did become infected.

But new research published in The New England Journal of Medicine last month found no risk linked to these medications.

COVID Complications
While pneumonia is the most common complication of the virus, it can also damage the cardiovascular system. That’s why people with high blood pressure, heart disease, and heart failure are at risk.

High blood pressure damages arteries and reduces the flow of blood to your heart. That means your heart has to work harder to pump enough blood. Over time, this extra work can weaken your heart to the point where it can’t pump as much oxygen-rich blood to your body.

Coronavirus can also damage the heart directly, which can be especially risky if your heart is already weakened by the effects of high blood pressure. The virus may cause inflammation of the heart muscle, which makes it harder for the heart to pump.

If you also have plaque buildup in your arteries, the virus may make those plaques more likely to break apart and cause a heart attack. Studies have shown that people with heart disease who get a respiratory illness like the flu or earlier types of coronavirus are at higher risk for a heart attack.

What to Do?
While everyone needs to take precautions to prevent coronavirus, people with high blood pressure and other health conditions need to be extra careful.

The best way to avoid getting sick is to stay home as much as you can. If you have to go out, wear a mask and keep at least 6 feet away from other people. And every time you come home, wash your hands with warm water and soap for at least 20 seconds. Also, clean and disinfect all frequently touched surfaces like cell phones, countertops and doorknobs.

The CDC also recommends that you have enough medicine on hand to treat high blood pressure and other health conditions. And stock up on over-the-counter medicines to treat a fever and other symptoms if you get sick.

While a coronavirus vaccine isn’t available yet, you should stay up to date on your other important vaccines. The pneumococcal vaccines – Prevnar 13 and Pneumovax 23 – will prevent you from catching pneumonia on top of coronavirus. Also get a flu shot in September or early October. Its symptoms are easy to confuse with coronavirus, which could make it harder for doctors to diagnose you if you do get sick.

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.