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

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.

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.

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.

What tips can you offer for downsizing? My husband and I would like to relocate from our house into a retirement community condo near our daughter, but need to get rid of a lot of personal possessions before we can move.

The process of weeding through a house full of stuff and parting with old possessions is difficult and overwhelming for most people. A good place to start is to see if your kids, grandkids or other family members would like any of your unused possessions. Here are a few tips and services that may help you downsize.

Sell It

Selling unneeded items is one way to downsize and pad your pocketbook at the same time. Your options may include selling your items through consignment shops, garage sales, estate sales or online marketplaces.

Consignment shops are good for selling old clothing, household furnishings and decorative items. The shop will typically receive 30% to 40% of the purchase price. A good old-fashion garage sale is another option. For large-scale downsizing you may want to consider hiring an estate sale company to come in and sell your items. Some estate sale companies will even pick up your stuff and sell it at their own location – they typically take about 35% of the profits as a fee.

Selling online is also a great option and opens you up to a wider audience. Many online marketplaces and platforms offer great options for selling locally, which can eliminate the costs and hassle of packing and shipping. These websites and apps do not take a cut of your sales, but you are responsible for connecting with your buyer and making the exchange of money and goods.

Donate It

If you itemize on your tax returns, donating your belongings to charitable organizations is another way to downsize and receive a tax deduction. Some of these charitable organizations may offer services to pick up the items you wish to donate.

If your charitable deductions exceed $500, you will need to file Form 8283, "Noncash Charitable Contributions" (IRS.gov/pub/irs-pdf/f8283.pdf). You will also need a receipt from the organization for every batch of items you donate and will need to create an itemized list of the items donated. For more information about charitable contributions, check out IRS Publication 526.

Toss It

If you have a lot of junk you want to get rid of, contact your municipal trash service to see if they provide bulk curbside pickup services. Depending on where you live, you may be able to hire a private company to come in and haul it off for a moderate fee.

Get Help

If you want or need some help with the moving process, consider hiring a senior move manager. These are professional organizers who help older adults and their families with the daunting process of downsizing and moving to a new residence. To locate one in your area, visit the National Association of Senior and Specialty Move Managers at NASMM.org or call 877-606-2766.

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.

Do you know where I can find discounted high-speed internet services for my home? I am 70-years old and live strictly on my Social Security and would like to find something faster and less expensive.

There are two new resources available that can help you save money on your home internet services. The options available to you will depend on your income level and where you live. Here is where to begin.

Internet Discounts

Depending on your financial situation, you may qualify for the new Emergency Broadband Benefit (EBB) program. This is a temporary federal benefit that provides a discount of up to $50 per month towards broadband service for eligible households and up to $75 per month for households on tribal lands.

Eligible households can also receive a one-time discount of up to $100 to purchase a laptop, desktop computer or tablet from participating providers if they contribute $10 to $50 toward the purchase price.

To qualify, your annual household income must be at or below 135% of the federal poverty guidelines, which is $17,388 for a single individual or $23,517 for a household of two. You may also qualify if you live on federally recognized tribal lands or are receiving certain types of government benefits such as Medicaid, food stamps (SNAP), SSI, public housing assistance, veterans' pension or survivors pension benefits.

Households that experienced a substantial loss of income since February 29, 2020 due to job loss or furlough may also qualify for the EBB program, as long as their household income for 2020 was at or below $99,000 for single filers and $198,000 for joint filers.

To apply, go to GetEmergencyBroadband.org, where you can apply online or print out an application and mail it in.

If you are already receiving assistance through the federal Lifeline benefit, which is a monthly subsidy for phone or internet costs, you automatically qualify for the EBB program and can receive both benefits at the same time. You can apply your EBB and your Lifeline benefit to the same or separate services.

If your broadband provider already has its own low-income or COVID-19 relief program, you may be able to qualify through this program as well. Talk to your broadband provider for more information.

Low-Cost Internet

If you are not eligible for the EBB program, another resource for locating discounted high-speed internet is Aging Connected, which has a higher income qualification for its program. Aging Connected is a nationwide campaign created to help lower-income adults find low-cost, in-home broadband options in their area.

Partnering with telecommunications companies, nonprofits and public entities, Aging Connected helps you search for services in your area that provide high-speed internet at a very low cost. Most participating companies charge around $10 to $15 per month, with no contract or equipment fee. Aging Connected also provides referrals to affordable desktop and laptop computers for under $160.

To qualify, your annual household income must be at or below 185% of the federal poverty guidelines, which is $23,800 for an individual or $32,200 for a household of two. As with the EBB program, you may also qualify if you are receiving certain types of government benefits.

You can reach Aging Connected online or call 877-745-1930.

Other Options

If you find that you are not eligible for the listed resources, you may still be able to save on your internet by shopping and comparing. The best way to do this is to search for websites that provide a list of low-cost internet providers in your area, along with pricing and download speeds.

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.

Parents have a number of reasons for making gifts to children. First, a parent should have sufficient resources for retirement and for long-term care needs before making substantial gifts. Once you have acquired a reasonable level of security, you might consider making gifts to children.

Your gifts to children will enable two types of education. First, your children will have the ability to learn to manage and hopefully invest the gifts to start building their estate. In addition, you will be able to understand better how a child will manage or use the gift property.

Finally, if you have a larger estate, the use of annual gift exclusions can be a very good strategy to save potential future estate taxes.

There are Seven Different Ways That Gifts Can be Made to Children.

1. Cash Gifts: You can simply write a check to children. Some parents give an amount up to the annual gift exclusion ($15,000 per child, per parent in 2021 and potentially larger amounts in future years). This is a very easy and convenient way to make a gift.

However, there are some concerns about cash gifts that you should understand. When gifts to children are in cash, they are quite frequently spent rather than being invested. If the regular gifts are made over a period of years, it may encourage your children to live at a higher than normal lifestyle. In many cases the child will benefit more from a gift of a property investment, rather than a gift of cash.

2. Stock Gifts: While it is possible for you to hold stock certificates, the overwhelming majority of stock is now held in a street account by a brokerage firm. The easiest method for transfer of stock is for the child to create an account with the same firm. The brokerage firm has the documentation necessary to make a transfer from your account to your child's account.

With a property gift, you will need to know the gift value. Because public stock is valued at the mean between the high and low prices on the date of the transfer, the value is quite easy to determine. Most parents will make stock gifts to children with value below the annual exclusion amount. Each parent will have one annual exclusion for each child, so the total allowable tax-free gift each year for a couple is double the exclusion. In addition, larger gifts can be made by filing an IRS Form 709 Gift Tax Return and using part of your lifetime gift exemption.

If stock or other appreciated property is transferred to children by gift, they take the same cost basis as the parents. Although the stock may be appreciated, there is no capital gains tax payable when the stock is transferred. However, the child has the same basis as the parent. If the stock is sold, the child will pay capital gains tax on the increase in value.

The dividends or income from the stock will be distributed to the child. If he or she is under age 19 or is a student under age 24, then in most cases the income will be taxed to the child at trust and estate tax rates. You may have heard this concept called the "kiddie" tax.

3. Mutual Funds: Many parents own mutual funds that are managed by a financial services firm. These may be a very good candidate for a gift to children. You can create a new mutual fund account and use the appropriate form from the financial services company to make a gift to the child. If the mutual fund is appreciated, then the potential capital gain and income tax rules are similar to those described for the gifts of stock.

4. Gifts of Land or Home: A gift of real property is accomplished through a deed. Depending upon your state's rules, a warranty or grant deed is normally used, but in some cases a quitclaim deed may be appropriate. You will identify the property being transferred on the deed. After you sign the gift deed, it will be notarized and recorded with the county registrar of deeds. This will produce clear evidence that the property has been given to your children.

In order to qualify for the gift exclusion limit, you may choose to transfer an undivided portion of the real estate. This is called an "undivided interest" in the property. For example, if a property is worth $100,000 a parent might deed 10% of that property each year for ten years to a child. The gifts will be less than the gift exclusion and after ten years the child owns the property. If the real property is substantial in value and gifts exceed the annual exclusion, then you will need an appraisal so that the property transferred can be correctly valued on IRS Form 709, Federal Gift Tax Return.

5. Uniform Transfers to Minors Act (UTMA): Under the UTMA, you may transfer property or assets to a custodian for the benefit of a child who is a minor. The custodian serves as the manager of the asset and can invest and spend funds as he or she considers advisable for the use and benefit of the minor. The custodian must maintain tax records and the income is taxed to the child.

When the child reaches legal age (18 in some states, although age 21 is required or permissible in most states), the child then has ownership of the assets.

The UTMA is convenient and relatively easy to manage. If assets are likely to be used for the child's education by age 21, the UTMA can be a good planning strategy. However, if there are fairly substantial assets you may be reluctant to permit a 21-year-old child to have access to large principal amounts.

6. Trust for Children: A child's trust can be quite flexible. Many parents have created trusts for the benefit of one child or even a "family pot" trust for multiple children. The trustee is frequently given permission to use the trust income for the education, living expenses and health needs of the child.

Trustees frequently have broad discretion over trust investments and the use of the funds. The goal of the parents is to provide for the needs of the child yet protect the funds until the child has reached the age of financial responsibility. As a parent, you have the ability to decide what the general guidelines on distributions will be for your trustee and at what age your children will receive their principal from the trust.

7. Tax-free Sale Trust for Children: An attractive option if you have appreciated property is to create a charitable remainder unitrust for a term of 20 years with income payable to children. For example, John and Mary Jones had three children and owned property with a value of $250,000. Because they had paid $50,000 for the property, they were reluctant to sell and pay a capital gains tax of over $45,000.

A much better plan for John and Mary was to transfer the property to a charitable remainder trust paying 6% to their three children for 20 years. They received an income tax deduction of approximately $75,000 and bypassed the capital gains tax. The children each received one-third of the 6% income for 20 years and their total income was approximately $330,000. After the 20 years, the trust had grown to $305,000 and it benefited the favorite charities of John and Mary.

John and Mary were able to enjoy very large tax savings now, transfer an income stream to children for 20 years and eventually benefit their favorite charities. Mary particularly appreciated the ability to give an income stream because one of the three children tended to "spend money like water" and had the opportunity over 20 years to acquire better financial management skills.

Do you know of any golfing equipment that can help older golfers? My dad, who is 76 and loves to play golf, but arthritis in his hands has made gripping the club challenging, and his fragile lower back makes stooping over to tee-up or retrieve the ball a problem too. Is there anything out there that can help?

There are a wide variety of adaptive golf equipment that can help older golfers who struggle with injuries, arthritis or loss of mobility. Here are several solutions that may help with different needs.

Gripping Solutions

Gripping a golf club is a very common problem for seniors with hand arthritis or those who have hand or elbow injuries. To help alleviate this problem there are specially designed golf gloves and grips that can make a big difference.

These specially designed gloves may have added features to improve grip, such as extra padding where the fingers attach to the palm, or a small strap attached to the glove that secures the golf club in hand. These often run between $20 and $30.

Another option is to get oversized grips installed on your dad's clubs. These can make gripping the club easier and more comfortable and are also very good at absorbing shock. Oversized grips are usually either 1/16" or 1/8" larger in diameter than a standard grip and cost around $10 per grip. You can find these grips and have them installed at your local golf store or pro shop.

Some products may combine both golf club grip and glove technology together. The club grip and the glove may come in a set to provide extra grip for the golfer.

Upright Tools

For golfers with back, hip or knee problems, there are a number of different tools that can eliminate the repetitive bending and stooping that comes with playing golf. For example, for teeing up the ball, consider products with an extended arm allowing the golfer to place the ball on the tee without bending over.

Golf companies also make products for picking up golf balls without bending over or attachments that can be affixed to your golf clubs to pick up balls, flagsticks, putters and green side chippers. There are many different brands that offer similar products at varying prices.

Reflective Golf Balls

If diminished vision makes locating the ball challenging, brightly colored and reflective golf balls can help. These golf balls are easier to locate by appearing larger and brighter.

Easy Carts

There are also ergonomically designed golf carts that can help older golfers tote their clubs around the course. If you like to walk, three and four-wheeled push/pull carts can help ease the burden of carrying clubs around the course. Costs typically range between $150 and $300. Many of these can be easily folded for storage.

There are specialized electric golf carts that provide the ability to play from a seated or standing-but-supported position. Public golf courses allow these carts for individuals with mobility challenges.

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.

I have had mild tinnitus – ringing in my ears – for years, but when I got COVID-19 in January it got worse. Are there any treatments that can help?

Unfortunately, new research indicates that tinnitus, a common hearing problem that affects around 50 million Americans, may be worsened or possibly triggered by COVID-19. Here is what you should know along with some tips and treatments that may help.

What is Tinnitus?

Tinnitus is the sensation of hearing a ringing, buzzing, roaring, hissing or whistling sound in one or both ears when no external sound is present.

The sounds, which can vary in pitch and volume, are usually worse when background noise is low. You may be more aware of it at night when you are trying to fall asleep in a quiet room. For most people, tinnitus is merely annoying, but for many others it can be extremely disturbing.

Tinnitus itself is not a disease, but rather a symptom of an underlying health condition. The best way to find out what is causing your tinnitus is to see an audiologist, or an otolaryngologist – a doctor who specializes in ear, nose and throat diseases (commonly called an ENT). The various causes of tinnitus are:

• Hearing loss, which is the most common cause.
• Middle ear obstructions usually caused by a buildup of earwax deep in the ear canal.
• Side effects from many different prescription and nonprescription medicines such as aspirin, ibuprofen, certain blood pressure medicines, diuretics, some antidepressants, cancer medicines and antibiotics.
• Various medical conditions such as high blood pressure, vascular disease, diabetes, allergies, thyroid problems, ear or sinus infections, Meniere's disease, Lyme disease, fibromyalgia, otosclerosis, temporomandibular joint (TMJ) disorder, a tumor, an injury to the head or neck, traumatic brain injury, depression, stress and more.

Treatments

While there is no cure for tinnitus, there are many ways to treat it, depending on the cause. For example, if your tinnitus is caused by a wax build-up in your ears or a medical condition like high blood pressure or a thyroid problem, treating the underlying problem may reduce or eliminate the noise. If you think a medication you are taking may be causing the problem, talk to your doctor about your symptoms. Your doctor may switch you to a different drug or lower the dosage to provide some relief. If you have hearing loss, getting a hearing aid can help mask your tinnitus by improving your ability to hear actual sounds.

Another good treatment option for tinnitus that can help suppress or mask the sound is "sound therapy." This can be as simple as running a fan or a white noise machine, listening to music or podcasts or leaving the television on.

There are also apps created by hearing aid companies which allow you to stream custom sounds directly to your hearing aids. If you do not use hearing aids, these custom sounds can be played through Bluetooth audio devices like headphones or speakers to help you manage your symptoms.

Cognitive behavioral therapy and psychological counseling can also be helpful. Your audiologist or ENT can help you figure out the best treatment options.

There are also certain medications that may help. While there are no FDA approved drugs specifically designed to treat tinnitus, some antianxiety medications and antidepressants have been effective in relieving symptoms.

Other things you can do to help quiet the noise is to avoid things that can aggravate the problem like salt, artificial sweeteners, sugar, alcohol, tonic water, tobacco and caffeine. Protect yourself from loud noises by wearing earplugs.

For more information on tinnitus treatments, visit the American Tinnitus Association at ATA.org.

What can you tell me about lung cancer screenings? I quit smoking years ago, but I am wondering if I should be checked out.

Lung cancer screening is used to detect the presence of lung cancer in otherwise healthy people with a high risk of developing lung cancer. Whether you should be screened depends on your age and your smoking history. Here is what you should know.

Screening Recommendations

The U.S. Preventive Services Task Force – an independent panel of medical experts that advises the government on health policies – recently expanded its recommendation for lung cancer screenings. It now recommends annual screenings for high-risk adults. Those considered high-risk are individuals between the ages of 50 and 80 who have a 20 pack-year history, who currently smoke or who have quit within the past 15 years. This is a change from the 2013 recommendation that referred to patients ages 55 to 80 with 30 pack-year histories.

A 20 pack-year history is the equivalent of smoking one pack a day for 20 years or two packs a day for 10 years.

In 2020, lung cancer killed more than 135,000 Americans making it the deadliest of all possible cancers. In fact, more people die of lung cancer than of colon, breast and prostate cancers combined.

Lung cancer also occurs predominantly in older adults. About two out of every three people diagnosed with lung cancer are age 65 or older.

Fortunately, many health insurance plans cover lung cancer screenings for high-risk patients, as does Medicare for ages 55 to 77.

Screening Pros and Cons

Doctors use a low-dose computed tomography scan, also called a low-dose CT scan (LDCT) to look for lung cancer. If lung cancer is detected at an early stage, it is more likely to be responsive to treatment. However, a LDCT scan is not recommended for every high-risk patient.

LDCT scans have a high rate of false positives, which means that many will undergo additional screening or medical procedures. This may include additional scans three, six or even 12 months later to check for changes in the shape or size of the suspicious area, which is an indication of tumor growth. For some patients, the anxiety or worry that goes along with waiting can be a real issue.

Instead, you may need a biopsy, which requires a removal of a small amount of lung tissue. Biopsies have some risks, especially for those with underlying health conditions, such as chronic obstructive pulmonary disease or emphysema. For example, for people with emphysema, there is a chance of a lung collapsing during the procedure.

If you meet the U.S. Preventive Services Task Force criteria for high-risk of lung cancer, look to free online tools or quizzes to help you decide if you should get a LDCT scan. It is important to discuss the benefits and risks with your primary care doctor before making a decision.

Tips for Testing

If you and your doctor determine that you should be screened, look for an imaging facility whose staff follows American College of Radiology requirements when performing LDCT scans. You can find accredited facilities at ACRaccreditation.org.

This can help to ensure your scans are reviewed by a highly trained, board-certified or board-eligible radiologist.

You may need a referral from your primary care provider prior to undergoing a screening. Some insurance companies, including Medicare, require a referral before they will cover the cost of screening.

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.