Help Parents Avoid Unwanted Medical Treatment...

A study shows older adults aren’t getting the care they want at life’s end A new poll shows that almost one in four older Americans — approximately 25 million people — experience excessive or unwanted medical treatment. This is especially true in the last year and very last days of life. During their final 24 to 48 hours, many terminally ill patients go to the hospital and receive treatments that don’t improve quality of life, says Daniel Wilson, national and federal programs director for Compassion & Choices, a nonprofit end-of-life advocacy organization. In fact, a person’s last days in the hospital are often “more traumatic than peaceful,” he says. Why, when 70 percent of us say we want to die at home, are we so often dying in the hospital? Several factors are driving the trend. A main issue is cultural discomfort with death and dying. “In America, we avoid these conversations,” says Wilson. A Need to Start Talking A 2012 survey  conducted by the California HealthCare Foundation found that 60 percent of respondents feel it is “extremely important” that their families not be burdened by tough decisions about their end of life care. Yet, 56 percent of those surveyed had not communicated their end-of-life wishes with their families. Anxiety about death also keeps people from talking openly with their doctors, leaving patients with incomplete or false information about many palliative care and end-of-life alternatives that would keep them out of the hospital in their last days. “This is your body, your health,” says Wilson. “You need to have the comfort level with your doctor.” If you don’t feel comfortable asking questions and having these types of conversations with your healthcare practitioner, he says, it might be time to...

Retirement Health Costs: Planning for the Wild Card...

What you might owe and 8 ways to prepare Be honest, now: When you do your retirement planning, do you factor in potential health care costs and long-term care costs? Odds are, you don’t, figuring there’s no way to know what they might be — not to mention the subject is depressing and the numbers could be scary. But ignoring what Ken Dychtwald, CEO of the aging consultancy Age Wave agewave.com, calls “the retirement wild card” could be the biggest retirement planning mistake you’ll ever make. And you actually can plan for health and long-term care costs; I’ll give you eight ways shortly. Age Wave and Merrill Lynch today released a fascinating, if disconcerting report (Health and Retirement: Planning for the Great Unknown) based on a comprehensive survey of 3,303 adults. They call health care expenses “the missing link in retirement planning.” The Survey Says… Five of the survey’s striking findings: Health care expenses are the top financial concern for retirement among Americans age 50+, regardless of their wealth level Only 15 percent of pre-retirees have tried estimating how much money they might need for health care and long-term care in retirement Just 7 percent of those 55 to 64 feel very knowledgeable about Medicare options; a mere 19 percent of Medicare recipients do 71 percent of couples age 50+ haven’t discussed how much they need to save to pay for health care during retirement Health problems were the No. 1 reason people retired earlier than expected Nationwide Insurance has also polled boomers about retirement health care costs. “The one word that comes up is ‘terrified,’” says Kevin McGarry, director of the Nationwide Financial Retirement Institute. The danger of not penciling out health- and long-term care costs, and taking...

When Should You Push For a Geriatric Assessment?...

Taking a team approach can net the best results for your parents Navigating the maze of eldercare options can be challenging. A geriatric assessment can help you figure out the level of care your loved one needs. “The phrase geriatric assessment is a bit confusing,” says Norbert “Bert” Rahl , director of mental health services at the Benjamin Rose Institute on Aging. Sometimes an assessment looks at just one issue that’s causing problems for a loved one. For instance: If you are concerned about your mother’s physical status, the medications she is taking or how she is (or isn’t) managing a chronic condition, a physical assessment may be in order. If your father has mobility issues and you’re worried about how well he is (or isn’t ) getting around on his own, he may need a functional assessment. If you are worried about the psychological and emotional well-being of your loved one, a mental health assessment could be helpful. If your aging relative is displaying issues with memory, decision making and financial management skills, a cognitive assessment should be scheduled. Or, to get the whole-person “picture” of what’s going on, Rahl suggests a comprehensive assessment, which looks at all those things and how they are interacting and overlapping in your older loved one’s life. A comprehensive assessment could be coordinated by your loved one’s primary care physician. However, since these assessments require the skills and expertise of a team of specialists, they are best coordinated by a geriatrician: a physician who has trained and specialized in the care and treatment of older adults. Ask for a referral from the primary care physician or click here to find a geriatrician in your area. Who’s On Your Team? The composition of...

Planning to Enhance Life Purpose During Your Advanced Years...

Life is rich when we have a purpose in our lives. Science is now proving just this, even though many wise ones have known this over past centuries. As we move into the second half of life, this means redefining so much of who we are. During our earlier years, meaning seems to be in life so naturally with our families and careers. When children are grown, careers have wound down, spouses may be gone, and we are not physically able to do the things that we used to be able to do. I’ve spent some very rich time with my 83-year-old aunt, who just recently passed away. I was struck with how deeply she longed for the days when she was able to help others, and how she wondered why she was still here. She had always been one to create fun experiences for her blind foster brother, Jack, and his good friend. Jack had been blind since birth, and his good buddy had mental challenges. They both lived in a hotel for seniors with low incomes. She would take them to their favorite hangouts for burgers and fries; go with them on excursions around the city, to her house in the foothills, or even shopping for the everyday things. This brought them such great joy. When Jack passed away, she continued to take his buddy to do things. She also would pick up her 94-year old sister to take her to her monthly reunion with her high school class. She continued to do many kindnesses for others. It was her joy in life. Then the day came when she lost her driver’s license. She lived in the foothills of Colorado where there were no bus lines, stores, or...