Does Medicare Cover Home Health Care?

How does Medicare cover in-home health care? My husband has a chronic health condition that makes it very difficult for him to leave the house, so I am wondering if he could qualify for Medicare home health care.

Medicare covers a wide variety of part-time or intermittent in-home health care services to beneficiaries in need, if they meet Medicare's criteria. Here is how it works:

In order for your husband to secure coverage for home health care, Medicare first requires that he be homebound. This means that it must be extremely difficult for him to leave home and that he needs help doing so either from another person or with the assistance of a medical device like a cane, wheelchair, walker or crutches.

He will need to have a face-to-face meeting with his doctor to get a home health certification confirming that he needs skilled-nursing care or skilled-therapy services from a physical or speech therapist on a part-time basis.

His doctor can also request the services of an occupational therapist and a personal care aide to assist with activities of daily living such as bathing, dressing and using the bathroom. His doctor must renew and certify his home health plan every 60 days.

Your husband will also need to use a home health agency that is certified by Medicare. If he meets all of the requirements, Medicare should pay for his in-home health care.

Be aware that Medicare will not pay for personal care aide services (for bathing, dressing, using the bathroom, etc.), if he does not need skilled-nursing or skilled-therapy services too. Homemaker services, such as shopping, meal preparation and cleaning are not covered either.

If your husband has original Medicare, you can locate a Medicare-certified home health agency by calling 800-633-4227 or by visiting Medicare.gov/care-compare. If he has a Medicare Advantage plan, you should contact his plan directly and ask which home health agencies work with the plan and are within the plan's network of providers.

For more detailed information on how Medicare covers in-home health, see the "Medicare and Home Health Care" online booklet at Medicare.gov/Pubs/pdf/10969-Medicare-and-Home-Health-Care.pdf.

Other Options


If your husband does not qualify for Medicare home health care coverage, there are other coverage options depending on your situation. Here are several that may apply to you:

Insurance: If you have long-term care insurance, check to see if it covers in-home care. If you have a life insurance policy, see if it covers pay for care.

Medicaid: If your income is low, your husband may qualify for Medicaid, which offers different home and community-based services that can pay for in-home care. To investigate this, contact your local Medicaid office.

Also see if Programs of All-Inclusive Care for the Elderly (PACE) is available in your area at Benefits.va.gov/benefits/offices.asp. PACE provides in-home care, including help with activities of daily living, such as meals. PACE also provides dental and medical care, among other benefits.

Veterans Benefits: If your husband is a veteran, the Department of Veterans Affairs (VA) offers some benefits that can help. Two programs to inquire about are "Aid and Attendance or Housebound Allowances" and the "Veteran-Directed Care" program. Both programs provide monthly financial benefits to eligible veterans that can help pay for in-home care. To learn more, contact your regional VA benefit office (see Benefits.va.gov/benefits/offices.asp or call 800–827–1000).

To search for additional programs in your area that can help pay for your husband's home care, use your favorite search engine. You may want to search phrases such as, "paying for senior care", "find financial assistance for in-home care" and "eldercare financial assistance locator."

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.

Planning with a Serious Illness

 
If at some point in life you have a serious illness, there are a number of planning options that should be considered.

With a serious illness, there are emotional, physical and mental challenges. The illness may be primarily physical, but the person will eventually start to suffer discouragement and even depression. His or her mental capabilities may also start to fail due to deterioration of the body.

Given these serious issues, it is important to consider the care of the person, care of his or her property, financial decisions, potential actions and securing assistance from advisors and family.

Care of the Person


There are several areas that are important in thinking through care of the person. You should check to make sure you have a current durable power of attorney for healthcare or advance directive. This document needs to be shared with the person who is designated as your healthcare proxy. A serious illness could lead to your hospitalization and a need for the healthcare proxy to make important medical decisions.

There also are potential physical changes for a home or a vehicle. If you have an illness but can operate a motorized wheelchair, it may be appropriate to modify or remodel your home to make it handicap accessible. Similarly, you may suffer from a major illness but are still capable of driving. However, it may be necessary to obtain or modify a vehicle so that you can still drive.

A primary concern for the ill person is, "Who will be my caregiver?" Initially, the seriously ill person may stay at home and a family member may be caregiver. However, he or she should have a plan in place in case it becomes necessary to move to assisted living, a nursing home or even a hospital.

Care of Your Property


If you have a serious illness, it will be important to have either a person who has a power of attorney to manage your property or a revocable living trust. With a revocable living trust, your property is transferred by deed or other document to the trustee. While you may be the initial trustee, your trust also lists a successor trustee to take over if you are no longer able to manage property. With a serious illness, you may wish to resign and have the successor trustee take over while you still have the ability to offer advice and counsel.

If you have a home with valuable art or other valuable collections, it will be important to prepare for management of your property. At any time in the future, you may need to move to nursing care or the hospital. Valuable property will need to be protected and preserved for your estate beneficiaries.

With a serious illness, it is a good time to review your will and all trusts. If you have a trust, you should make certain that the title and ownership of property is correct. The trust is effective only if property is legally transferred to the trustee. Similarly, some individuals hold property as joint tenants with right of survivorship with other family members. If this is the case and you pass away, the surviving family member will own the property outright. If that is your intention, this method is fine. However, you should check all titles to make sure that they are correct for the plan that you have created.

Financial Accounts


You may have bank accounts, securities accounts and other business accounts. Check to be certain that all of the accounts are listed on your financial records. If you have online access to the accounts, a trusted advisor should know all of the passwords. If you are in the hospital or nursing home, your advisor will need access to your accounts.

Potential Actions


You may have a current pattern of gifts to family or gifts to charity. If you wish to have your successor trustee or the person holding your power of attorney continue that gifting pattern, there will need to be a specific direction in your living trust or power of attorney to achieve that result.

In some states, there could be very significant income and estate taxes. Even though you have a serious illness, it may be worth considering changing your domicile to a state with a lower tax structure. This will require that you establish a new residence, change your driver's license and auto registration, file your income taxes and show that you are a permanent resident of the new state.

Advisors and Family


Particularly if you have a substantial estate and are quite ill, it is important to make sure that you have reliable and trustworthy advisors. Far too many elders who have substantial assets become weak and are victims of elder abuse. A group of trusted advisors and family members will protect you and your property.

Your advisors will discuss your vehicle use. There are several cases where seniors felt able to drive vehicles, but were progressively less capable. One individual in her 80s drove regularly to visit her daughter just one mile away. However, one day she made a wrong turn and became disoriented. A day and a half later, the highway patrol discovered the car idling at the side of the road several hundred miles away. Fortunately, she did not become lost during the winter or she very easily could have frozen to death before being discovered.

Advisors and family members will need to discuss with the seriously ill person the arrangements for transportation and the possibility of higher levels of care. This could mean moving from home into an assisted living facility or nursing home. These discussions are best undertaken while the seriously ill person is still able to think clearly and make good decisions.

Planning with a serious illness is a challenging process. Yet it is much better for the person and for the protection of the estate that the process is entered into openly and willingly by the individual and his or her advisors and family.

What to Ponder Before Remarrying Later in Life

What types of financial or legal snags should I be aware of when considering remarriage? I am 62 years old and have been seeing a nice man for about a year. We have been talking about getting married, but I want to make sure I understand all the possible consequences beforehand.

Getting remarried later in life can bring about a host of financial and legal issues that are much more complicated than they are for younger couples just starting out. Here are some common problem areas you need to think about, and some tips that can help you solve them.

Estate plan: Getting remarried can have a big impact on your estate plan. Even if your will leaves everything to your kids, in most states, spouses are automatically entitled to a share of your estate – usually one-third to one-half. If you do not want to leave a third or more of your assets to your new partner, choose to have an attorney draft a prenuptial agreement where you both agree not to take anything from the other's estate. If you want to leave something to your spouse and ensure your heirs receive their inheritance, you may consider speaking with an attorney to set up a trust.

Medical and long-term care: As a married couple, you and your spouse will be responsible for each other's medical and long-term care bills. Remaining unmarried will not impact your eligibility for public benefits, such as Medicaid (which pays nursing home costs). If you choose to remarry and can afford it, consider getting a long-term care insurance policy to protect your assets. See AALTCI.org to help you find one.

Home: If you are planning on living in your house, you need to think about what will happen to the house when you pass away. For example, if you both decide to live in your home, but you want your kids to inherit the place, putting the house in both of your names is not a wise option. However, you may also not want your heirs to evict your husband once you die. One solution is for you to give him a life estate. This will allow your husband the right to live on your property during his lifetime. Once he dies, the house will pass to your heirs.

Social Security: Getting remarried can also affect your Social Security benefits if you are divorced, widowed or are receiving SSI. For instance, getting remarried makes you ineligible for divorced spouse's benefits. Getting remarried before age 60 (50 if you are disabled) will cause widows and widowers to lose their right to survivor's benefits from their former spouse. For more information, see SSA.gov.

Pension benefits: Be aware that if you are receiving a survivor's annuity from a public employee's pension, getting remarried may cause you to lose it. In addition, widows and widowers of military personnel killed in the line of duty may lose their benefits if they remarry before age 57. Survivors of federal civil servants that receive a pension will forfeit it if they remarry before age 55.

Alimony: If you are receiving alimony from an ex-spouse, it will almost certainly end if you remarry.

College aid: If you have any children in college receiving financial aid, getting married and adding a new spouse's income to the family could affect your children's financial aid.

To get help with these issues, consider hiring an estate planning attorney who can draw up a plan to protect both you and your partner's interests.

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.

 

Published July 30, 2021

Living Wills and Advance Directives

 
As you approach end-of-life decisions, there are several steps that should be taken to make sure you receive the right type and level of care. To assist you in these decisions, most states now permit either an advance directive or a living will. Some seriously-ill persons also have a doctor sign a Physician Order for Life-Sustaining Treatment (POLST). These documents are designed to assist your family and doctors in making the decisions according to your preferences.

Senior Medical Planning


There are three important background areas that you should learn about before entering into senior medical care. These are the medical oath and principles of your care providers, the rules created by Congress to ensure your medical information is protected and the decisions by your state on the specific document that you use to convey your wishes.

Doctors will frequently follow a set of principles that were originally called the Hippocratic Oath. The first oath was written by Hippocrates, a Greek doctor who is considered the father of modern medicine.

A modern version of the Hippocratic Oath typically states, "To practice and prescribe to the best of my ability for the good of my patients." Following this principle, your doctor will attempt to restore you to good health.

Because of modern improvements in medicine, it is possible to prolong your life through the use of ventilators, intravenous feeding and other devices. While you certainly want your doctors and nurses to provide very good care, you may also need to offer some guidance on how extensively your family and doctors should use modern technology to prolong your life.

A second major area for you to understand is called HIPAA. The Health Insurance Portability and Accountability Act (HIPAA) was passed by Congress in 1996. It is designed to provide protection for you and to keep your health information private.

Under the HIPAA rules, you have the right to see your health records, but you must give written permission before your records are released to other individuals. The information provided by doctors or nurses about your care, medications or other personal information is protected. However, you will want to be certain that your designated healthcare proxy (the person who will assist in making healthcare decisions) has the right to review these records. You should sign a HIPAA release form in order to enable your advisors to give proper recommendations to your doctors and nurses.

Finally, you must understand the specific documents of your state. Some states use an advance directive in which you choose a combination of a durable power of attorney for healthcare and a living will. Other states have separate documents. It is very important that you use the appropriate document tailored for the laws of your state.

The Advance Directive


Your first key advisor is the person who will make your medical decisions if you are incapacitated. This individual is frequently called the healthcare proxy. He or she is your agent and holds your durable power of attorney for healthcare. Normally, you will select primary and secondary persons as your healthcare proxy agent.

You will want to list the persons, their addresses and phone numbers so they can be easily contacted. Your secondary healthcare proxy will assume the primary role if the first person is unable or unwilling to serve.

Part of your advance directive will also explain the level of authority that you have given. Your healthcare proxy usually does not have the authority to make decisions unless, in the view of your doctor, you are no longer able to make decisions yourself. However, many forms allow you to sign and empower that person immediately. The authority of your healthcare proxy may also extend after you pass away so that he or she can make appropriate decisions at that time.

Your healthcare proxy may be called upon to make significant decisions for your care. For example, it may be necessary to decide whether or not to use morphine or other types of pain medication. If the decision is to make use of morphine, then a second decision will be made on the use of a low dose or a high dose. With a lower dose of morphine or other types of pain medication, you may have greater clarity of mind but may be less comfortable. If you receive higher doses of medication, you may not be as clear-headed, even though you are at a higher comfort level. These decisions can only be made based on your condition at a given time, but they do directly impact the quality of your life in that circumstance.

A healthcare proxy may also be called upon to make very significant decisions about the hospital, nursing home or other care facility and the level of treatment. For example, some seniors have suffered broken hips or limbs at a time when their demise was near. A healthcare proxy will need to make decisions about the appropriate level of care or treatment under those circumstances.

A second section of an advance directive allows you to give counsel on the level of measures and technology that will be used to prolong your life. If you have an incurable or irreversible condition that will result in your death within a relatively short time, there are medical devices that can significantly prolong your life.

These are sometimes referred to as "heroic measures." If you desire all reasonable measures to be taken, you can generally request that care. If you do so, your life may be extended to the greatest extent possible under "generally accepted healthcare standards."

Your healthcare guidelines expressed in your advance directive will discuss your preferred level of nutrition and hydration. If you prefer to receive nutrition and hydration through intravenous methods, you may specifically request those options.

It is helpful for medical providers to have some level of direction for your pain management. If you prefer a higher level of pain management even though that gives you less clarity of thought, you may so indicate.

A third, fairly typical section of the advance directive covers donation of organs and designation of your primary doctor. If you would like to donate specific organs or designate specific purposes for the use of your body, you may identify the particular organs or discuss purposes. Common purposes include transplantation, therapy, research and education.

Advance directives and living wills may, under state law, be witnessed in a manner similar to the witnessing of your will. Some states require two witnesses or a notary to witness your advance directive. Check with your state law to make certain that you have complied with those requirements. A helpful website with state law requirements is caringinfo.org. It is maintained by the National Hospice and Palliative Care Organization and seeks to improve care at the end of life.

Physician Orders for Life-Sustaining Treatment (POLST)


A Physician Order for Life-Sustaining Treatment (POLST) is a medical order signed by your doctor or a medical staff person as authorized under your state law. While the name and provisions may be different in some states, the POLST option is generally available nationwide. If you have a serious illness or may pass away within one year, you may want to ask your doctor to sign this medical order.

The POLST typically covers cardiopulmonary resuscitation (CPR), medical interventions and nutrition. You may choose to have CPR or select "Do Not Resuscitate (DNR)." Your medical interventions may include full treatment to prolong your life, selective treatment that avoids burdensome procedures or comfort-focused treatment. Nutrition can be maintained long-term with feeding tubes, for a trial period or you may select no artificial means of nutrition.

All of these decisions should be made in consultation with your doctor. Both your doctor and you or your healthcare proxy must sign the POLST. Your POLST may reflect your values, religious beliefs and goals for care.

Even if you have a POLST signed by your healthcare provider, you still need an advance directive. The advance directive appoints your healthcare proxy (primary and secondary) and covers many medical circumstances not covered by the POLST. Everyone should sign an advance directive, while those who are seriously ill may benefit from a POLST.

Action Steps


After completing your living will or advance directive, you will sign and typically have witnesses for your original document. Prepare several copies of your advance directive. You will want to give a copy to your healthcare agent, your family, clergy, your doctors and other advisors who may be involved in assisting with your medical decisions.

At any time you may revoke the living will or advance directive. It generally is best to revoke the entire document and complete a new document. If you attempt to amend different parts of the advance directive, there is a risk that you may sign provisions that conflict or are inconsistent. If you are in need of urgent care or treatment, you do not want any conflicting provisions in your living will or advance directive.

Your living will or advance directive is a very important part of your personal planning. It is designed to help you receive the best possible care at the end of your life and still comply to the greatest extent with your personal healthcare preferences.

Why You Should Create a "My Social Security Account"

I am 58 years old and working on a plan for my retirement. I have read that I need to check my Social Security statement every year to validate its accuracy. How do I go about doing this?

Checking your official Social Security statement every year is a smart move to make sure your posted earnings are correct and ensure you get the benefits you are entitled to. Many Americans do not take this precaution. In fact, most U.S. workers have never created a digital "my Social Security account" to access their statement information. Here is what you should know.

Online Statements


In 2017, as a cost cutting measure, the Social Security Administration stopped mailing paper Social Security statements to everyone under age 60.

The only people who still get statements in the mail are those over age 60 who are not yet getting benefits and who have not set up an online account. Paper statements, however, are still available upon request to anyone who submits Form SSA-7004.

If you have not done so, you should create a "my Social Security account." This account will give you instant access to your personal Social Security statements. You can check your earning record and get estimates of your future retirement benefits at full retirement age, as well as at age 62 and age 70. Your statements will also let you know how much you would qualify for if you become disabled and how much your family members could receive in survivors benefits when you die.

How to Create an Account


To create a "my Social Security account," go to SSA.gov/myaccount. You will be asked to enter your Social Security number and birth date. You will also be prompted to answer a series of multiple-choice questions that might include inquiries about financial products you own and previous addresses to confirm your identity. Then you will receive a code either by email or text, which you will enter online to complete the process.

If you have a problem creating an online account, call 800-772-1213. After you establish an account, you will get an annual email reminder to log on and review your statement.

If you have a security freeze on your credit report to help ward off fraud, you must lift it temporarily to set up your online Social Security account. Specifically, you will need to thaw the freeze at Equifax, the company the Social Security Administration currently uses to help verify users' identities.

Creating an online account is also a good idea to prevent someone else from fraudulently creating one first and using it to steal benefit payments in the future. Given the number of security breaches in recent years, it is possible someone may be able to illegally obtain your sensitive personal information, like your Social Security number, and use it to set up an account in your name.

Once you get access to your statement, compare the earnings listed on your statement with your own tax records or W-2 statements. You must correct errors within 3 years, 3 months and 15 days following the year of the mistake. If you happen to spot a discrepancy within that timeframe, call 800-772-1213 to report the error. Some corrections can be made over the phone. You may need to schedule an appointment and visit your local branch with copies of your W-2 forms or tax returns to prove the mistake, or you can mail it in.

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.

 

Published July 23, 2021

WCCF offering $40,000.00 in Fall Grant Cycle

WCCF has opened their Fall Grant Cycle.  Funds for the $40,000 grant cycle are made possible through our generous donors and the Foundation’s Touch Tomorrow Funds.

Grant applications for the fall grant cycle are available on-line at wccf.biz or by calling the WCCF office.  The application deadline will be 3:30pm, September 10, 2021.

 For more information or to request an application, you may call Judy Johnson or Lindsey Wade-Swift at the Foundation office.  The number is (812) 883-7334.

Washington County Community Foundation is a nonprofit public charity established in 1993 to serve donors, award grants, and provide leadership to improve Washington County forever

End

Your Family Letter - Memorial Services

 
A family letter is a key part of a good estate plan. It is much more personal than many of your estate documents. A family letter allows you to share your heart and show appreciation and gratitude to family members. During a time when family members are grieving, it also helps them to complete many practical steps to protect your property.

The family letter may have up to ten different sections. Each section will cover an important but separate topic.

Estate Data


Your estate organizer usually has four parts. It will explain the family names and key information, identify your attorney, CPA and other financial and health advisors, cover all of your assets and financial information and outline your estate planning choices.

The estate organizer may be printed or you may use an online version. Your family letter should explain where the information is located. If you are using an online estate planner, it's important for your personal representative to know your account name and password so the information will be available.

Important Documents


Your important documents will generally be safeguarded in three different ways. First, many individuals have a safe deposit box. The safe deposit box typically holds birth certificates, death certificates, degrees and other legal agreements, marriage or divorce documents, military discharge records, property deeds, a personal property inventory, stock and bond certificates and vehicle titles.

Second, you may have a fireproof box at home. This box will frequently include your insurance policies, your living will, medical power of attorney or advance directive, trust documents and your will.

Third, there are some items that should be left with your attorney, friend, agent or another trusted person. These are items that may be needed while you are still living or will be necessary very soon after you pass away. These documents (or copies of documents) could include your financial power of attorney, a durable power of attorney for healthcare or advance directive, your living will, trusts and your will.

Accounts and Passwords


Because an increasing number of records and information are retained online in personal accounts, you will want to be certain that your personal letter lists all accounts. You may decide to include passwords with the personal letter. Alternatively, if you are entrusting all of this information to a specific person or other location, that should be identified.

With the rapid movement to online banking, online mutual funds and securities accounts, donor advised fund accounts, health savings accounts and your email accounts, you may have six to 10 accounts with various passwords. It will be important to have all of this information recorded.

Your Family History


While your estate organizer will include basic information about you and your family members, there is an excellent opportunity in your family letter to discuss your family history. This can include a few short paragraphs that give the names and background of your parents. List all of their children or other key relatives in your family. Your history may discuss marriages, divorces and any blended family relationships. Finally, the family history will show the date of death for persons who have passed away.

Family history can include discussions of your activities, interests and career. It enables all of your extended family to have a good picture of your entire life.

Care for Children, Grandchildren or Pets


If you are responsible for any children, grandchildren or pets, this is an opportunity for you to explain your plan for their care. While your estate planning documents will normally appoint guardians for your children or grandchildren who are under your care, it still may be beneficial for the guardian to receive recommendations from you on their education and other areas of development that you understand very well. If someone is to care for pets, you may have recommendations on the way in which that is done.

Memberships


You may have memberships in a number of organizations. Some memberships, such as for a country club or club that purchases sporting event tickets, are transferable to heirs. It would be helpful to your family for you to list any memberships that you have so they can handle them properly.

Care of Your Body


When you pass away, your body may be in the custody of a medical center or nursing home. If you have previously decided to make any organ donations, it is helpful to explain that decision in your family letter. The requirements for making organ donations are typically covered under state law. In many cases, decisions on organ donations are made when you sign your living will or advance medical directive.

Funeral or Memorial Services


The cost of many funerals now exceeds $10,000. If you would like to assist family members in the decisions surrounding your funeral or memorial service, the family letter is an excellent way to do so.

First, your family will need to decide whether to have a burial in a cemetery with a casket or to use cremation services and an urn. You may have personal or religious reasons for preferring one or the other.

With a casket and burial in a cemetery, your family will generally make use of a funeral home. Because there now is significant competition in the industry, funeral homes are starting to offer advance prices and package services. If you desire a specific range of services, type of casket or prefer not to be embalmed, those directions are helpful to your family.

There are funeral consumers' alliances in many locations. Your family may find assistance and guidance on www.funerals.org. This guidance may help them make good decisions during a very difficult time in the midst of grief over your loss.

If you are a veteran, your family may want to contact the Department of Veterans Affairs. You may qualify for a gravesite at no cost in one of the 155 national cemeteries for veterans and their spouses.

Obituary


In your funeral or memorial service, there will be eulogies. It is also customary to have a printed description of your lifetime. This will frequently include your basic history, awards, achievements, military service and lifetime employment. If you have specific requests for information to be included in the obituary, it is helpful to your family to give them guidance. You may have certain principles or values that are important to you that you would like to share through the obituary. This is an opportunity for you to communicate your values to the public.

Final Words and Blessings for Family


Your family letter may conclude with a word of blessing. It is a tradition in many cultures for the elders to provide a blessing for the next generation. This is frequently done when the elder is still living, but certainly your family letter provides a similar way to bless your children, grandchildren, nephews, nieces and other family members.

Your final words of wisdom and blessing for family members will be of great comfort as they grieve your loss. It is an appropriate and fitting way to conclude your family letter

The Hidden Dangers of Sleep Apnea

How can you know when someone has sleep apnea? My husband has become such a terrible snorer that he wakes himself up at night, and he keeps me up too.

If your husband is a loud snorer who wakes himself up during sleep, he probably needs to be tested for sleep apnea. Sleep apnea is a dangerous disorder that affects more than 22 million Americans, but often goes undiagnosed.

Sleep apnea may cause a person to stop breathing during sleep hundreds of times for 10 seconds or more at a time. Left untreated, it can cause extreme daytime sleepiness, as well as a host of serious health conditions like high blood pressure, heart attack, stroke, diabetes and dementia. It is estimated that every year around 38,000 Americans die in their sleep from a heart attack or stroke stemming from sleep apnea. The good news is that sleep apnea is usually very treatable and many insurance companies cover the treatment.

Who Has It?


There are three types of sleep apnea: obstructive, central and mixed. Of the three, obstructive sleep apnea (OSA) is by far the most common and occurs when the throat muscles relax during sleep, blocking the airway.

While anyone can have it, sleep apnea is most common in middle-aged or older males who are overweight. For women, the risk increases after menopause.

The symptoms include loud snoring (however not everyone who snores has sleep apnea), long pauses of breathing, gasping or choking during sleep and daytime drowsiness. Because most of these symptoms happen during sleep, most people do not recognize them. It is usually someone who sleeps in the same room who notices it.

Diagnosing Sleep Apnea


To help you diagnose sleep apnea, the American Sleep Apnea Association has several diagnostic tests to take at SleepApnea.org/treat. Click on "Test Yourself."

If the screening indicates that your husband may have sleep apnea, he should consult with his doctor or a sleep specialist, who will probably recommend an overnight diagnostic sleep test. This is called a polysomnography and can take place at a sleep center lab or at home using a portable device.

Treatment Options


Your husband is at greater risk for sleep apnea if he is overweight, smokes, or consumes excessive amounts of alcohol. Excess weight, especially around the neck, puts pressure on the airway, which can cause it to collapse. Smoking can increase the amount of inflammation and fluid retention in the upper airway. Alcohol and sleeping pills can relax the muscles in the back of the throat, interfering with breathing. Addressing these issues, if necessary, is usually the first line of treatment.

If that does not eliminate the problem, mild cases of sleep apnea may respond to oral devices, such as a removable mouth guard or retainer. These devices work by positioning the lower jaw slightly forward to keep the airway open during sleep.

There are newly FDA-approved noninvasive treatment options to consider as well. One treats sleep apnea and snoring by improving tongue muscle function through a mouthpiece that is worn for just 20 minutes during the day.

The most effective and commonly prescribed treatment for OSA is a continuous positive airway pressure (CPAP) device. This involves sleeping with a snorkel-like mask that is hooked up to a machine that gently blows air up the nose to keep the passages open.

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.

 

Published July 16, 2021

How to Pick the Best Place to Retire

My husband and I will both be retiring in a few years and are interested in relocating to a warmer climate but could use some help. What resources can you recommend for locating and researching good places to retire in the U.S.?

If you are interested in relocating when you retire, there are a wide variety of books and online resources that can help you find and research a new location that meet your preferences and budget. Here are several to help you get started.

Where to Retire?


If you are at the beginning of your search, a good starting point may be to take a retirement quiz that is geared toward helping you find your best place to retire. You can find a quiz using your preferred online search engine. Some quizzes ask questions about your preferences such as climate, recreation, community size and more. The results may suggest possible destinations that match your preferences.

Many media resources publish "best places to retire" lists on their websites each year. Be sure to review information on the best cities for aging, as some resources rank locations based on factors that are important to older adults.

There are also books you can purchase that rank the top best places to retire. These publications tend to look at a range of destinations, and some will group them into categories like best college towns, mountain towns, undiscovered towns and main street towns.

Once you find a few areas that interest you, your next step is research them. Here are some important areas to investigate.

Cost of living: Can you afford to live comfortably in the location where you want to retire? Your preferred online search engine may help you find tools to compare the cost of living at your current location with your desired location. You can compare housing costs, food, utilities, transportation and more.

Taxes: Some states are more tax friendly than others. If you are planning to move to another state, you may want to check out a tax guide for retirees to compare taxes state-by-state. You can find resources that cover income and sales taxes, any additional taxes on retirement income, Social Security benefits taxes, property taxes and inheritance and estate taxes.

Crime rate: To evaluate the safety of a community, you can search websites for crime data. The local police precinct may be a great resource for that information as well.

Climate: To research the climate in the areas you are considering, your preferred online search engine is again a great resource to find climate and weather comparisons.

Healthcare: Does the area you want to relocate to have easy access to good healthcare? To research doctors and hospitals in a new area, use Medicare's compare tool at Medicare.gov/care-compare. You may also want to check out other resources for reviews and detailed information on hospitals and doctors in the new location.

Transportation: If you plan to travel often or expect frequent visits from your kids or grandkids, convenient access to an airport or train station is a nice advantage. Since most retirees give up driving in their eighties, you should also investigate alternative transportation options. Some nonprofits may offer services. The local Area Agencies on Aging may provide information about senior transportation options in local communities throughout the U.S.

Once you have narrowed your choices down to two or three, spend a couple weeks in each location at different times of the year so you can get a feel for the seasonal weather changes, and to carefully weigh the pros and cons of living there. You may find that you like the area more as a vacation spot than as a year-round residence. It is also a good idea to rent for a year before buying a home or making a commitment to a retirement community.

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.

Smartphone Tips for Tech-Shy Users

Can you recommend some good smartphone features for older seniors? I would like to get my 78-year-old mother to upgrade to a smartphone but want something that's easy for her to see and use.

There are several smartphone features I can recommend that will provide your mother a simpler, less intimidating smartphone experience.

To set-up your mom's smartphone and make it senior-friendly, start by decluttering and organizing the home screen. You can delete apps your mom will not need and hide apps she will rarely use in labeled folders. You may also want to set up a small number of contacts (with photos and information) of family and friends.

Some smart phones have a wide variety of built-in accessibility features you can turn on depending on your mom's needs. These features, which you access through the phone's settings, can help users that have diminished vision, hearing impairment, hand dexterity problems or cognitive loss. Before purchasing a certain brand of phone, it would be good to research the accessibility features.

Some popular accessibility features include larger text and icon display, zoom (screen magnification), magnifier (turns the phone into a magnifying glass), increased volume and alerts, voice control, find my phone, and emergency SOS and medical ID set up. There are dozens of other tweaks you can make to enhance your mom's experience.

Some phones include an "easy mode" feature in the settings that simplifies the process of customizing the phone. Easy mode boosts the text and icon size and simplifies the home-screen layout and contacts, which makes these phones a nice option for seniors or tech-newbies.

You can also purchase a smartphone that is specifically designed for seniors. Some phones designed for seniors include a larger screen, large text and a simple list-based menu that provides one-touch access to frequently used features like video chat, camera, email and more.

Some phones may include optional health and safety features. Some phones feature a mobile medical alert service that would connect your mom to an agent standing by in emergency situations, 24 hours a day. The agent is usually able to confirm an individual's location and call for help. Some feature optional medical care, which would let your mom speak to a registered nurse or board-certified doctor anytime. There are alert apps that can be added to smart phones that will alert family or friends if your mom uses the feature. You may also find that voice activated assistants or a personal operator service is a helpful add on feature to assist your mom with tasks like finding addresses, setting up appointments, booking rides with rideshare platforms and much more.

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.

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