For this reason, the eventual distribution options for an IRA or 401(k) are quite important. For many individuals, the IRA or 401(k) may be the largest asset in their estate.

IRAs and 401(k)s are transferred to a designated beneficiary that is selected on an IRA or 401(k) custodian's form. The five common choices for designated beneficiary are the surviving spouse, children, charity, a trust for children or a trust for spouse and children.

1. Spouse as Beneficiary

The most common choice for a married couple is to select the surviving spouse as the designated beneficiary of an IRA or 401(k). When the IRA or 401(k) owner passes away, the surviving spouse usually chooses to roll the decedent’s IRA over into his or her IRA.

Assume that Harry Smith is the IRA owner and he passes away with Helen Smith as his designated beneficiary. Helen is age 68 when Harry passes away and she rolls over the IRA into her plan.

When Helen reaches age 73, she must start taking required minimum distributions. The initial minimum distribution must be taken by April 1 of the next year and is just under 4%. Her distribution will steadily increase as she becomes more senior.

Because Helen rolled over Harry's IRA into her IRA, she qualifies for the lower required minimum distributions under the uniform table. Helen often selects children or charities as designated beneficiaries after she passes away.

If you are in a community property state and plan to leave your IRA to a trust or other beneficiary that is not your spouse, then it is essential to obtain a written consent from your spouse. In many states, attorneys who prepare estate plans will frequently use a waiver if the spouse is not the designated beneficiary of an IRA.

2. Children

For a surviving spouse or single person, an IRA or 401(k) may be transferred to children, nephews, nieces, other heirs or charity. Each child or other heir may take distributions for a period of up to ten years. With the exception of a spouse, a minor child, a child with a disability or chronic illness or an heir who is less than ten years younger than the IRA owner, the full IRA must be distributed within ten years of the death of the IRA owner.

Prior to 2020, a child was able to “stretch” the IRA payout over his or her life expectancy. A 60-year-old child of the IRA owner would have been able to start distributions at age 61 at approximately 4% and stretch those payouts over 26 years. Now, a child or other heir of the IRA owner must usually take all distributions within ten years.

Unfortunately, with many children the ten-year stretch plan will not be successful. CPAs report to the author that approximately one-half of children choose to take the traditional IRA distribution early, even though that means paying the income tax earlier and losing the benefit of the tax-free growth over the maximum distribution period.

3. Charity

For an IRA or 401(k) owner, the qualified plan is a wonderful benefit and a very good asset. However, when the owner passes away, a traditional IRA or 401(k) is often transferred to children with a large "you owe the IRS" tax bill attached (unlike the Roth IRA, which is income tax-free). For the vast majority of qualified plans, the child will pay income tax. Worse yet, the IRA or 401(k) distributions may even push the child into a higher tax bracket.

With income tax on the traditional IRA or 401(k) and no income tax paid on an inherited home, land or stocks, the IRA or 401(k) is a less desirable asset for children. In fact, many children consider this a "bad asset" because of the income tax on most IRA payouts to children.

For this reason, children would prefer to receive a home, land or stock because there is no income tax bill attached. The wise planning decision is to transfer the home, stocks or land (the good assets) to children and save all the IRA income tax by transferring it to charity.

Because charities are tax exempt, there is no payment of income tax or estate tax on a traditional IRA or 401(k). The charity receives the full value tax free. By transferring the IRA or 401(k) to charity, it is possible to turn a bad asset into a good asset.

4. "Give It Twice" Trust

What plan could protect children from spending the IRA amounts and paying maximum income tax? Could a plan combine the tax-saving benefits of a stretch IRA with a term-of-years or life payout to children or other heirs? Could this plan also have the tax-free growth benefit of a stretch IRA?

A wonderful solution is an IRA to testamentary unitrust plan, which includes all of these benefits. A single person or surviving spouse may create an unfunded lifetime unitrust or testamentary unitrust in a will or living trust. The IRA beneficiary designation is to the trustee of that unitrust.

When the IRA owner passes away, the unitrust is funded with the traditional IRA. Because the unitrust is tax-exempt, there is a bypass of the income tax on the traditional IRA and any future growth. The children or other heirs receive new taxable income from the trust investments. The 5% unitrust payouts may last for a term of 20 years or for their lifetimes.

A very good plan for parents who have made lifetime gifts to charity is to combine a benefit to children with a future benefit to charity. This plan is called a "Give It Twice" trust.

For example, Mary Smith had an $800,000 estate. She lived in a home worth $200,000, had a CD for $200,000 and $400,000 in her traditional IRA. Her IRA was substantial because when her husband Bill passed away, she rolled over his IRA into her IRA. The combined IRA is now half of her estate.

Mary has two children and decides to transfer the home and CDs to the children in equal shares when she passes away. They each receive $200,000 in value from the home and CDs with no income or estate tax.

After Mary passes away, the $400,000 IRA is transferred into a charitable remainder trust. It receives the IRA proceeds and invests the full $400,000. The trust pays 5%, which is divided between the two children for a term of 20 years. At the end of 20 years, the trust principal plus growth is given to charity.

Mary was pleased with her plan because she had achieved several goals. First, she provided both principal and income to her children. This is a very good plan because some children will benefit from time to improve their money management skills. Second, she saved income tax on the traditional IRA. Because a unitrust is tax exempt, it receives the entire IRA tax free. The trust earns income for the children for a term of 20 years and is then transferred tax free to charity.

Because the trust benefits the children with more than $400,000 in income and then is given to charity, it truly may be called a "Give It Twice" trust.

5. Trust for Spouse and Children

For individuals with larger estates, it may make good sense to create a trust for surviving spouse and then a term of years for children. After the first person passes away, the IRA is transferred into the trust for the surviving spouse. The trust will distribute income for his or her lifetime and then to children for a term of 20 years. Following the life of the spouse plus 20 years for the children, the trust remainder is distributed to charity.

This trust has several benefits. First, it may save very large income taxes because the trust is tax exempt. Second, the trust can be a "net plus makeup" plan that allows the spouse to choose to save taxes by taking reduced income during life. This will allow the trust principal to continue to grow and build up the trust so there is greater income to children.

This plan is an excellent way to benefit the surviving spouse, children and charity.

Pill boxes, or pill organizers, can play an important role in maintaining good health as they help you stay on top of your medication regimen. While there are many options, here are a few tips to help you choose.

Identify Your Needs

When choosing an appropriate pill box, ask yourself a few questions, such as:

• What is the number and size of pills you take? If you take only a few medications, a smaller pill box may be sufficient. If you are taking multiple medications and large vitamin supplements, you will want to get a large compartment pill box. Pill boxes often come with different color patterns, allowing users to assign specific colors to particular medications or times of day.
• Do you take your pills once a day or multiple times a day? If you take medications only once a day, a simple pill box with one compartment is practical. If you require medications multiple times a day, a pill box with multiple compartments for each day of the week will work best.
• Do you have trouble remembering to take your medications? Some organizers have built-in alarms and reminder features. Alternatively, there are free smartphone applications that can help set up a schedule for reminders.
• Do you have a difficult time opening your medication containers? There are easy-to-open pill boxes or automated medication dispensers that are ideal for those with dexterity challenges.
• Do you need a portable pill box for travel? Compact portable pill boxes are designed for travel, some of which include sealed cases that prevent moisture and dust from entering.

High-Tech Pill Organizers

If you need more help keeping up with your medication regimen, smart pill boxes will organize your pills, remind you to take them, track your progress and text or email caregivers if the pills are not taken. If you need additional help, consider an automated medication dispenser which is comprehensive, Wi-Fi connected and app-based that reminds you when to take your pills and dispenses them to you. Search for these pill boxes online using key words like “smart pill box.”

Medication Reminding Apps

If you are interested in a medication reminder app, there are free apps that you can download in the Apple or Google Play app stores that will send you timely notifications to take your pills and reminders to refill your prescriptions. A simple solution is to create a daily alarm in the clock app with a reminder to take medications.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

In addition, traditional IRA owners who are age 73 or older have a required minimum distribution (RMD). The RMD starts at approximately 3.8% and increases each year as the IRA owner becomes older. The QCD from an IRA will count towards a taxpayer’s RMD.

To qualify as a QCD, the distribution must be sent directly to a qualified charity. Some IRA custodians will send a check to the IRA owner for distribution to the charity, however, the check must be payable only to a qualified exempt organization. Because it may take time for some custodians to process the request, the IRS urges IRA owners to initiate the QCD process by early December. This ensures sufficient time to make certain that the transaction has been completed by December 31, 2024.

The maximum QCD, which is indexed each year for inflation, is $105,000 in 2024. If a married couple are both over age 70½, they could potentially contribute double the limit to charity, up to $210,000.

For IRA owners who are planning for next year, the IRS has released the inflation-adjusted number for 2025. In 2025, individuals will be able to transfer $108,000 from an IRA to charity as a QCD.

If the IRA custodian does make a transfer to a charity, the IRA owner will receive IRS Form 1099-R, Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans. The IRS Form 1040 for tax year 2024 will require the IRA distribution to be reported on Line 4a. If the full distribution is a QCD, the taxpayer will enter "0" on Line 4b of his or her tax return.

A charity must send the donor a written acknowledgment of the IRA contribution. This is not a receipt because the gift is not included in the donor’s income and is not deductible. However, the written acknowledgment from the charity must state that "no goods or services were received" in return for the IRA gift.

IRS Publication 526, Charitable Contributions and IRS Publication 590-B, Distributions from Individual Retirement Arrangements (IRAs) have additional information on the procedures for substantiating a gift from your IRA.

Not only was this process rather cumbersome, it also resulted in increased adjusted gross income. With higher income, you may pay more income tax on Social Security or pay a higher Medicare Part B premium. That’s why an IRA charitable rollover may be a great option.

The IRA charitable rollover is very simple. An IRA owner who has reached the age of 70½ may transfer up to $105,000 per year. The transfer is made directly from the IRA to a qualified public charity. The IRA rollover is not taxable on your income tax return, so there is no need for a tax deduction. It is a simple and effective way to make a charitable gift.

The IRA charitable rollover or qualified charitable distribution (QCD) limit of $105,000 will be indexed for inflation in 2025. The Secure 2.0 Act expanded the QCD by allowing a one-time transfer of up to $53,000 to a charitable remainder annuity trust, standard charitable remainder unitrust or immediate charitable gift annuity.

Mary Makes a Convenient Gift

Mary Smith is a retired teacher who recently turned 73. She regularly volunteers for her favorite charity and makes a gift each year of $2,000. Last year, Mary withdrew $2,000 from her IRA, reported that amount in her taxable income and then wrote a check to charity. Because the gift was over $250, the charity sent Mary a receipt. She deducted the $2,000 charitable gift on her tax return.

Mary heard from a friend about the IRA rollover option. She called the development director at the charity and asked about using an IRA rollover to make her annual gift. Mary would simply need to contact her IRA custodian and have the IRA gift transferred to her favorite charity.

Mary contacted the large financial company that managed her IRA and filled out a distribution form. She asked that the financial company make a “qualified charitable distribution” of $2,000 to her favorite charity. The financial company then transferred the $2,000 directly to her favorite charity. The balance of her required minimum distribution for that year was distributed to Mary. She reported her IRA distribution on her tax return, but did not pay tax on the $2,000 gift to charity.

Mary loved the simplicity of the IRA charitable rollover. The $2,000 gift to charity was not taxed on her income tax return and she did not have to itemize to take the deduction. The simplicity and convenience of this gift was a wonderful benefit for Mary.

Judy Takes the Standard Deduction

Judy is a retired nurse and a volunteer for her favorite charity. During her working years, Judy had sufficient income and lived a moderate lifestyle. She saved regularly and contributed to her IRA. With good investments and tax-free growth, Judy's retirement plan has increased to over $435,000.

Judy is age 78, owns her home and has more income than she needs. Each year she makes a gift of $1,000 to charity. Because she does not report home mortgage interest or have enough other deductions to itemize, Judy takes the standard deduction. But she has heard about the IRA charitable rollover and wonders if that will be a good option. She asked her best friend, “Do you think that I should give the $1,000 from my IRA?”

Each year Judy withdraws the $1,000 from her IRA. It increases her income by $1,000. Because she gives the $1,000 to charity and takes the standard deduction, Judy does not reduce her income taxes with her charitable gift. The $1,000 IRA withdrawal increases her income, but Judy does not benefit from a charitable deduction.

A better plan is for Judy to give $1,000 directly from her IRA to charity. The IRA charitable rollover reduces her income by $1,000 and saves taxes.

Judy was pleased to learn that she could roll over $1,000 from her IRA to her favorite charity. Best of all, Judy was able to make the gift and reduce her current taxes. Judy spoke with her best friend and noted, “An IRA charitable rollover is a great plan. I helped those in need through my favorite charity and also lowered my taxes!”

Bruce is a Very Generous Donor

Bruce retired several years ago, but remained active during his retirement years. Recently, Bruce started volunteering with a local charity. He devotes several hours a week to his volunteer work and receives great satisfaction through helping others.

Since Bruce lives moderately and has good income from his retirement plan and investments, he is a generous donor. In fact, Bruce donates 60% of his income each year and lives on the balance. He feels that this is an opportunity for him to “give back” to society for the good life he has been able to lead. But Bruce would like to do more. Is there a way for Bruce to help even more?

The charity has a special project underway. Bruce understands the importance of this charitable project and would like to make an additional gift of $20,000. He checked with his CPA, who explained that he qualifies for a tax-free IRA charitable rollover. As a result, Bruce was able to contact his IRA custodian and have a gift of $20,000 sent to the charity. The charity honored Bruce for his generous gift. Bruce is happy with his rollover gift. It was not included in his taxable income and he was able to deduct his regular charitable gifts.

Bruce noted, “I am very pleased with my IRA gift. Because it was not included in my income, I am able to deduct my regular gifts and still help with an added gift of $20,000!”

Claire Simplifies Her Taxes

Claire is a retired investment advisor. Over the years, she watched her IRA blossom and grow into the largest asset in her estate. Based on her age of 78 and the increased IRA value, her required distribution this year is nearly $105,000!

Claire is a frequent volunteer for her favorite charity and wants to make a major gift to a special project. In November, she decided that she had sufficient other income and did not actually need the IRA distribution for this year. With the growth of her IRA, it was logical to make the charitable gift from her IRA. But how can this work? Is this a good tax planning strategy?

Claire contacted her CPA Susan to discuss the best way to make her major gift. Susan explained to Claire the benefits of making a tax-free IRA charitable rollover. By not taking the $105,000 into her income, Claire will benefit in several ways. Her income will be lower and she will not have other tax benefits phased out. She will have a reduced income level and pay a lower Medicare Part B premium.

Claire responded, “I don’t understand all of that tax talk, but it does make sense that with $105,000 less in taxable income, my return will be easier to complete. Plus, there are those other savings that you mentioned. This sounds like a great idea!”

The next day, Claire contacted her IRA custodian and had the full $105,000 IRA distribution sent to her favorite charity. She and her CPA Susan were both delighted. Claire made a wonderful gift and her tax situation was simplified.

How to Give From an IRA

The IRA rollover requires a payment by your IRA custodian to a qualified public charity. IRA custodians are generally familiar with the IRA charitable rollover and may use the IRS term, the “qualified charitable distribution.”

Your first step is to contact the IRA custodian. Most IRA custodians have a standard IRA distribution form. Some IRA custodians have added the IRA charitable rollover as an option to this form. As the IRA owner, you will need to sign the application and indicate the amount of the gift and the correct legal name, city and state of the public charity.

After your IRA custodian has received the form and processed the transfer, it will pay the specified amount to the public charity. This gift can be made for a specific purpose. For example, the gift could be to a specific relief fund, to a scholarship fund or to another “field of interest fund” with a charity. If you have a specific goal for your IRA charitable gift, you will want to contact the charity to confirm the gift will be used for that purpose.

Preparing a living will is a smart decision that gives you a say in how you want to be treated at the end of your life. Here is what you should know, along with some resources to help you write one.

What to Prepare

To adequately explain your wishes regarding your end-of-life medical treatment you need two legal documents: A “living will” which outlines the 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.

In some states, these two documents are known as an “advance directive” and will only be utilized if you are too ill to make medical decisions for yourself. You can also amend it at any time in the future.

It is not necessary to hire a lawyer to prepare an advance directive. Each state has its own laws relating to signing and witness requirements, and some states have standard forms that you may use. In addition, there are several free or low-cost “do-it-yourself” resources available to help you create one, and it takes only a few minutes from start to finish. These resources are offered by various companies and not-for-profit agencies.

You should search online to find assistance using key search terms such as “make a living will” or other variations. You will want to look for well-established organizations and review the services they provide and any associated fees. For ease of access, consider using a company that will electronically create and store your living will. If you are a veteran, the VA also provides a free advance directive form specifically at VA.gov/find-forms/about-form-10-0137.

Add-ons

You should also consider executing a do-not-resuscitate order (DNR) as part of your health care planning. A DNR may protect you from unwanted emergency care like cardiopulmonary resuscitation (CPR). To create a DNR, your doctor must fill out a state-approved form and you both will need to sign it.

Another tool that will complement your advance directive is the Physician Orders for Life-Sustaining Treatment (POLST) or the Medical Orders for Life-Sustaining Treatment (MOLST). A POLST or MOLST translates your end-of-life wishes into medical orders that must be honored by your doctors. These are prepared by your medical provider and address concerns relating to specific conditions. To learn more about these documents and to see if they are appropriate for you, consult with your medical provider.

Inform Your Family

To ensure your final wishes are followed, make sure to inform your family members, health care proxy and doctors of your preferences. You should also provide each of them with a copy of your advance directive or, if you create a digital version, make sure you share it electronically.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

It is helpful for owners of traditional IRAs to understand how to do a QCD, what is required to report a QCD on your tax return and the required information on your acknowledgment from the nonprofit.

1. How to Set Up a QCD — A traditional IRA owner may contact his or her IRA custodian to start the process for a QCD. While your distributions from a traditional IRA are normally taxable, the QCD payouts will be tax-free as long as they are paid directly to a qualified nonprofit. The QCD is made through a check payable to the nonprofit. An electronic payment or a check made out to the IRA owner does not qualify as a QCD. The owner must be age 70½ or over and the 2024 limit is $105,000. If both spouses are over age 70½, and have their own IRA, then the $105,000 per person limit may allow a couple to distribute up to $210,000 per year to the nonprofit. Since QCDs are not taxable, there will be no charitable deduction for making the gift.
2. How to Report Your QCD — Your QCD must be reported on your 2024 federal income tax return. You can expect to receive an IRS Form 1099-R from your IRA custodian. This will show the traditional IRA distribution in Box 1. Generally, you will report the IRA distribution on Line 4 of IRS Form 1040 (the final IRS 2024 tax return may use a different line but is likely to use Line 4). You will enter the total amount of the IRA distribution on Line 4a. If the full amount is a QCD, you then enter zero on line 4b. If part of the distribution is a QCD, the taxable portion is normally entered on Line 4b. You must enter "QCD" next to Line 4. If you have entered zero on Line 4b, the entire QCD will not be taxable.
3. How To Receive a QCD Acknowledgment — Your QCD is not deductible as a charitable contribution. However, you are required to obtain a written QCD acknowledgment from the nonprofit prior to filing your return. This acknowledgment should state the date and amount of the QCD and that the donor has received "no goods or services in exchange for the gift." You should retain the acknowledgment with your other 2024 tax records.

Editor's Note: Many individuals will fulfill part or all their RMD this year through a gift to charity from a traditional IRA. It is best to start the gift process in November or early December. Some IRA custodians may take longer than expected to process the transfer. If a donor has the right to make distributions from his or her traditional IRA through a checkbook, it will be important to send the check directly to the charity. A donor must allow sufficient time for the charity to deposit the check and for the financial institution to process the check. This process must be completed by December 31, 2024 to qualify as an RMD for 2024.

Linda is in her middle working years and anticipates receiving Social Security when she retires. But she has several questions about whether she should also start funding an IRA.

• How should I fund my IRA?
• Is it a good idea to do an IRA rollover?
• At what age should I start taking IRA distributions?
• Should I take the minimum required distribution or a larger amount?

Funding the IRA

If you are not actively participating in another type of qualified retirement plan and are within an adjusted gross income limit, you may qualify to transfer a substantial sum each year into an IRA. The IRA contribution amount is $7,000 this year. If you are over age 50, you may also make an additional $1,000 "catch-up" contribution. The maximum IRA contribution amounts are indexed for inflation in increments of $500. In future years, the contribution amount will increase.

Because Linda is over age 50, she is able to contribute $7,000 and her catch-up amount of $1,000, for a total of $8,000 to her IRA this year.

Linda considers the options to create a regular IRA or a Roth IRA. Because she wants to receive the income tax deduction, she transfers the funds into a regular IRA and deducts the $8,000 on her federal tax returns.

IRA Rollovers

The majority of larger IRAs are funded through rollovers from retirement plans through your employer. If you have a qualified plan through your employment, upon separation from service or reaching a specific age, such as 70, you will usually have an option to rollover to a self-directed IRA.

Normally, your qualified plan through a business has been funded with pretax income. The IRA account also benefits from tax free growth. Therefore, the rollover will be from the other qualified plan into a regular IRA. Your IRA will continue to grow tax free, but future distributions to you will be taxable.

IRAs may be rolled over to a new custodian. The preferred method is to have a custodian-to-custodian transfer. If the funds are transferred directly from one IRA custodian to the new custodian, there is no tax.

While it is permissible for your custodian to transfer funds to you and then for you to make the rollover, your IRA custodian will withhold 20%. Because of the 20% withholding requirement, virtually all IRA rollovers are completed with the custodian-to-custodian method.

An IRA to Roth IRA rollover may also be permissible for you. Generally speaking, people with any adjusted gross income are permitted to transfer a regular IRA to a Roth IRA. The value of the IRA will be included in your taxable income, so you may owe a substantial income tax for the conversion.

The primary benefit of the conversion to the Roth is that a Roth IRA does not have a mandatory distribution requirement at age 73. The funds may be permitted to grow tax free and, at the discretion of the owner, may be withdrawn tax free during retirement years. If the owner of a Roth IRA does not make withdrawals, then the Roth may be transferred to children, who may make tax-free withdrawals over a term of ten years.

IRA Distributions

For a traditional IRA, there are specific rules on both contributions and withdrawals. Withdrawals for distributions are generally not taken before age 59½. With limited exceptions—such as uniform distributions over a lifetime, disability, separation from employment after age 55, or other exceptions—there is a 10% excise tax in addition to the regular ordinary income tax on withdrawals before age 59½. Therefore, very few individuals take early withdrawals before age 59½.

Between ages 59½ and 73, there is an optional period for withdrawals. The withdrawals are not required, but you may withdraw any amount. Of course, for a traditional IRA the amount withdrawn is taxable to you and no longer grows tax free in the fund. Therefore, you may not want to take withdrawals unless you actually need the funds for living expenses.

After you reach age 73, there are required minimum distributions (RMDs). The distributions start at approximately 3.8% at age 73 but increase with age each year. The distribution is calculated using your balance on December 31 multiplied by the appropriate percentage and must be taken by the end of the next year. The penalty for failing to take a required minimum distribution is 25%. If the plan participant corrects the failure in a timely manner, the excise tax on the penalty is further reduced to 10%.

While osteoporosis is more common in adults over the age of 60, it can also affect younger individuals as well. In fact, according to the Bone Health & Osteoporosis Foundation (BHOF), 50% of women and up to 25% of men in the U.S. over the age of 50 will break a bone due to osteoporosis. Here is what you should know.

Osteoporosis, called a “silent” disease, weakens your bones with no warning signs until a fracture occurs. Around 10 million Americans who are 50 or older have osteoporosis, and an additional 44 million have osteopenia (lower than normal bone density) – 80% of whom are women.

By the time most individuals reach their late 30’s, they gradually start losing some of their bone mass. For women, the biggest decline happens in the five to seven years following menopause, when estrogen levels—important for maintaining bone strength—drop sharply. Bone loss for men occurs much more gradually but, by age 70, osteoporosis is as common in men as it is in women.

To help you determine your risk of osteoporosis, the International Osteoporosis Foundation has a quick, online test you can take at RiskCheck.Osteoporosis.Foundation.

Bone Checkup

According to BHOF, women over 65 and men over 70 should have a dual energy X-ray absorptiometry (DXA) scan, which is a painless measurement of the calcium in your bones. Those at high risk should start around age 50. Factors that support early screening include a family history of osteoporosis, a broken bone after age 50, vitamin D deficiency, smoking, rheumatoid arthritis or use of medications that can weaken bones, such as steroid prednisone and certain antidepressants. Most bone density tests are covered by health insurance companies, including Medicare, and are done in hospital radiology departments, private radiology practices and stand-alone clinics.

Bone-Builders

If your bone scan finds that you have osteopenia but have a low to moderate 10-year fracture risk, lifestyle measures are usually the best course of action. Three important things you can do to boost your bone health include:

Get enough calcium and vitamin D: Calcium helps keep bones strong, and vitamin D helps us absorb calcium. Women over 50 and men over 70 need at least 1,200 mg of calcium per day from foods like dairy, canned sardines, kale, and fortified orange juice. All adults should get between 600 to 800 international units (IU) of vitamin D daily. Since this amount is not often obtained from just food, it is recommended to have your levels checked to see if you need a supplement.

Exercise: Low impact weight-bearing exercises, like walking, and strength training with light weights or resistant bands several times a week can help build bone strength, as well as improve balance and muscle strength.

Do not smoke: Women who smoke a pack of cigarettes per day as adults have less dense bones at menopause.

Osteoporosis Meds

If your bone density test finds that you have osteoporosis, your doctor will probably recommend medications. The first line of treatment is usually bisphosphonates such as alendronate (Binosto and Fosamax), risedronate (Actonel and Atelvia), and ibandronate (Boniva). These oral or injectable drugs slow the breakdown of bone but will not build it back.

For severe osteoporosis your doctor may prescribe an anabolic: teriparatide (Forteo), abaloparatide (Tymlos), or romosozumab (Evenity). These are typically given as daily or monthly injections, and increase the amount and strength of bones.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

October is National Cybersecurity Awareness Month. During this season, the IRS and Security Summit partners focus on protecting individuals from identity theft and fraud.

The holidays are a season of celebration. Millions of Americans shop online and browse on social media. However, fraudsters delight in knowing many individuals do not understand the best practices for online security. The holiday season can be an open door for swindlers who are "eager to swipe people's personal information” and use it for identity theft.

Security Summit members urge everyone to be vigilant and encourage parents to teach children and teens how to recognize and avoid online scams. Many children and teens have smartphones and spend time every day texting friends and using social media.

The IRS and the Security Summit Members offer specific tips for both individuals and their families. These tips are helpful and essential to protect yourself against fraudsters and scanmmers.

1. Learn to Recognize Scams — Fraudsters frequently claim they are from your bank or the IRS. You should recognize that scammers can trick your caller-ID to show the call is coming from your bank or the IRS. The IRS does not use email or social media to discuss your personal tax issues. If you receive a text or phishing email that looks suspicious, do not click on any attachments. You can forward phishing emails to phishing@IRS.gov.
2. Protect Personal Information (PI) — A fraudster will ask carefully-crafted questions that are designed to encourage you to disclose personal information. He or she may offer information initially to build a relationship with you. However, at some point, the fraudster will ask for your birthdate, address, age or financial information. He or she may also encourage you to log in to your bank account and disclose information from your bank account or your Social Security Number. You should be cautious and not share information. If you are contacted by phone, you should hang up and then call your financial institution or the IRS.
3. Update Passwords — Many individuals have 10 to 80 different online accounts. Nearly all major businesses ask you to create an account to track your online orders. It is important to maintain and update your passwords for these financial and business accounts. A good password contains a combination of capital letters, lower case letters, numbers and special characters. To help you keep track of multiple accounts with different passwords, it is convenient to use a password manager. The password managers on your smartphone, tablet or computer have high levels of encryption to store your passwords. You simply need to remember one master password for your password manager account. You must be very careful not to write down or disclose your master password.
4. Two-Factor Authentication — You should create extra security for all your financial accounts. These financial organizations offer two-factor authentication. You enter a password to log in to the account and then a text is sent to your phone with a six-digit number. After you enter both the password and the number, you will be able to access your account. While no security is perfect, two-factor authentication is a significant increase in security and should be used for your financial accounts.
5. Update Computer Software — Many hacking attempts succeed because the fraudster finds a "hole" in your computer or phone software. It is generally possible with most operating systems to enable automatic updates. Your computer and phone software will usually be updated once or twice a week by the main vendor. These updates are necessary because there are always new potential security risks with the complex software on your computer or your phone.
6. Avoid Public Wi-Fi — Many restaurants and commercial organizations allow access to public Wi-Fi. This public Wi-Fi may be used if you are simply browsing the internet, and your device has updated antivirus software. However, you should never log in to any personal accounts, especially your financial accounts, on public Wi-Fi. With your financial accounts, you should use a virtual private network (VPN) for access or password-protected Wi-Fi in your home or place of business.

Most memory care units, or special care units, are housed within assisted living or nursing home facilities. They provide many benefits including staff that are trained in dementia care, offer individualized care that minimizes the use of risky psychotropic medications, and create a home-like environment with activities designed to improve residents’ quality of life. To assist you in finding a suitable facility, consider the following steps.

Make a list: To identify memory care residential units in your area, ask your parent’s doctor for a referral or use an online search tool. It is beneficial if the facilities on your list are close to family and friends who can visit often, as regular visits often enhance residents’ overall wellbeing.

Research your options: Once you have made a list, call your local long-term care ombudsman. Long-term care ombudsman regularly visit assisted living and nursing homes and address complaints and advocate for quality care. They also provide information to the public regarding facilities, including which facilities have experienced problems in the past.

If you are considering a memory care unit within a nursing home facility, use Medicare’s nursing home compare tool (Medicare.gov/care-compare). This online tool provides a five-star rating system that can utilize maps and filters to help identify providers that fit your parent’s needs.

Call the facilities: Once you have identified a few potential facilities, contact them to find out if they have any vacancies. Also, you should ask other questions such as if they provide the types of services your parent needs, their fees and if they accept Medicaid.

Tour your top choices: During your tour, notice the cleanliness and smell of the facility. Is it homey and inviting? Does the staff seem responsive and kind to its residents? Taste the food and if possible, talk to the current residents’ family members.

Other areas to ask about are staff screening and training procedures, turnover rates and their staff-to-resident ratios. Confirm that they provide quality activities to keep your parent engaged and learn how they respond to residents who may wander or become confused. It is also a good idea to make multiple visits to the facility including an unscheduled visit in the evening or weekend when the facility is more likely to be understaffed.

Since transitions can be unsettling it is best to find a facility that your parent will be able to stay at for the foreseeable future. It is best to find out what, if any, health conditions might require your parent to leave the facility or move to a higher and more expansive level of care.

To help you choose a facility, the Alzheimer’s Association provides a list of questions to ask at CommunityResourceFinder.org/Alz/Tips – click on “Tips for choosing a residential care facility” under Housing Options.

Paying for care: The average cost for memory care in an assisted living facility is approximately $6,000 per month. The average cost increases to over $8,500 per month for memory care at a nursing home care. However, keep in mind though that the costs can vary widely depending on location and services.

Given that Medicare does not cover long-term care, most residents pay for care from either personal savings, a long-term care insurance policy or through Medicaid (if available) once their savings are depleted. If your parent is a veteran, they may be able to get funds through the Veteran Affairs’ Aid and Attendance benefit. To learn more, ask the facility director or contact the regional VA benefit office at 1-800-827-1000.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living” book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization’s official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.