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What is the best way to begin writing a living will? I am getting older and facing health challenges, so I would like to get this done without incurring significant expenses.

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.

Each year the Internal Revenue Service (IRS) reminds owners of traditional IRAs who are over 70½ that they may make a charitable gift from a traditional IRA. The IRS refers to an IRA charitable rollover gift as a qualified charitable distribution (QCD). An added benefit for those who are age 73 or older is that a QCD may fulfill part or all of your required minimum distribution (RMD) for the year.

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.

While Social Security will provide approximately 40% of the average person's retirement income, an Individual Retirement Account (IRA) is an essential addition for a successful retirement. Your IRA has two main benefits—contributions to a regular IRA are from pre-tax income and there is tax-free growth. There is another version of an IRA called a Roth IRA, which is funded with after-tax income.

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%.

Can a person in their early fifties develop osteoporosis? I fell and broke my wrist last winter, and my doctor told me I might have osteoporosis.

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.

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