Confronting Alzheimer’s
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From the beginning of this Growing Bolder adventure, we’ve always said that we won’t promote an unrealistic, pollyannaish view of aging, but we will choose to celebrate and not regret each new year. We will look at growing older through a lens of opportunity and possibility and not simply loss and limitation. We will lean into hope instead of embracing fear. That’s why we’ve decided it’s time to encourage a nationwide conversation about the one thing that everyone is afraid of and no one wants to talk about.
Our cover story shares the good news that Alzheimer’s can now be detected up to 20 years before any symptoms appear, providing a window of opportunity for new drugs to dramatically slow its progression. The key is early detection, but tragically, 97% of adults with Mild Cognitive Impairment (MCI) are undiagnosed, and the vast majority don’t want to be tested. That’s like not wanting to know if you have cancer as early as possible.
While MCI can be a normal part of aging, and most who have it don’t have Alzheimer’s, for those who do, there is more hope and help than ever. Science has proven that making some key lifestyle choices can delay or even prevent Alzheimer’s, and those who have been diagnosed can continue to enjoy a quality of life for many years.
This issue also shares the story of Lisa Nichols, a legend in the world of personal development. Lisa was a single mother on public assistance before transforming her own life and building a multimillion-dollar global enterprise, inspiring others to do the same.
We all have many different opportunities every day to start Growing Bolder!
From the CEO
“We all have many different opportunities every day to start Growing Bolder! ”
Photo by Mike Dunn for
I want you to challenge everyone and anything around you to say, "There isn't a box. There never was a box." We get to just play in the universe. We get to be all we can be. We get to press reset a thousand times.
– Lisa Nichols, Founder & CEO, Motivating the Masses, Inc.
LISTEN TO OUR FULL INTERVIEW WITH LISA ON THE GROWING BOLDER PODCAST @GrowingBolder
ORDINARY
Lisa Nichols
58
“We are in a season of reinvention. We get to re-choose the way we look at life. You get to reinvigorate your soul, your spirit with this chapter's assignment.”
Lisa Nichols knows a little something about reinvention. Today, she is an icon in the field of personal development. The founder and chief executive officer of Motivating the Masses, Nichols has a global platform that reaches over 170 countries and serves over 80 million people. She is a New York Times best-selling author of seven books and one of the world's most requested speakers. Her nonprofit foundation, Motivating the Teen Spirit, helps prevent teen suicides and supports dropouts to return to school and reunite with their families.
But Nichols hasn’t always run a multimillion-dollar business. Nearly 30 years ago, she was a single mother receiving government assistance, without enough money to buy diapers for her son. As she wrapped her son in a towel until she could afford diapers, Nichols made a promise to him and herself.
“I put my hand on his stomach and looked down at his little body and I said, ‘Mommy will never be this broke or broken again.’ And that initiated something that made me move into, ‘No matter what, do whatever you need to do, to leave this mental, physical, and financial and emotional space and move to a zip code of possibility, a zip code of urgency, a zip code of abundance, a zip code of prosperity," Nichols said.
She didn’t have a roadmap, a mentor, or a curriculum to follow. Nichols began reading Stephen Covey’s book, “The 7 Habits of Highly Effective People,” implementing
one habit at a time and giving herself five years to turn her life around. And turn it did.
“When I turned my crawl into a walk and my walk into a run and my run into a soar, it was proof in the pudding to me that if I can do it, anybody can do it,” Nichols said. “And your soar doesn't just happen at 20; it doesn't just happen at 30. Matter of fact, the best version of your soar can happen in your sixties, seventies, eighties or nineties, the best version of your walk, your run, your soar.”
Nichols says aging provides us with the opportunity to reassess and reinvent. What called us and inspired us in the beginning of adulthood has likely been fulfilled. Instead of letting boredom and aimlessness set in, she wants us to see these years as an opportunity for something new, bolstered by all we’ve learned in life thus far.
“You get to reinvigorate your soul, your spirit with this chapter's assignment. You get to look at the purpose and the calling on your life in this season of your life,” Nichols said.
“I don't think I'm doing good in spite of being 58; I think I'm doing my best because I'm 58. So, I invite people to look at aging from a different viewpoint. I want you to challenge everyone and anything around you to say, ‘There isn't a box. There never was a box.’ We get to just play in the universe. We get to be all we can be. We get to press reset a thousand times.”
Image Courtesy of Lisa Nichols
Confronting Alzheimer’s Breaking the Silence, Advancing
Hope & Saving Lives
It’s the conversation that no one wants to have but everyone needs to have. “Everybody’s at risk. This disease does not discriminate,” Dr. Brandon Lenox said. “I think the cost of not effectively addressing this issue will be unbearable,” added former U.S. Congresswoman Val Demings.
“This issue” is Alzheimer’s disease and related dementias. By 2050, its global economic burden is projected to exceed a staggering 10 trillion dollars. The burden to individuals and families is incalculable. Nowhere is the potential impact greater than in the state of Florida. Florida has the nation’s highest percentage of adults 65 and older and accounts for 10% of all Alzheimer’s cases in the U.S.
Public health officials are sounding the alarm, investment in research is exploding and companies like K2 Medical Research in Central Florida are working around the clock to inform and educate those in their community about major advancements in prevention and treatment.
“One in three people over the age of 65 now die with the disease. That’s unacceptable.”
- SEAN STANTON, K2 MEDICAL RESEARCH CO-FOUNDER
Lenox, along with Sean Stanton, is a co-founder of K2 and the two have dedicated their lives to finding treatments and, hopefully, a cure for Alzheimer’s. “One in three people over the age of 65 now die with the disease,” Stanton said. “That’s unacceptable.”
There is still no cure for Alzheimer’s, but there is more hope than ever. Unfortunately, there’s a major problem. As individuals, we don’t want to think about it, talk about it, or test for it.
“They tell you straight forward, I don't want to know if there's something serious waiting for me, when it should be the opposite,” said Dr. Sheila Baez-Torres, a specialist in neurodegenerative diseases and K2 Medical Director of Diversity. “People feel like there is no hope, but the hope is there,” adds Stanton. “There are multiple medications now that either slow or reverse the progression.”
Photo via Getty Images
The key to preserving brain health and preventing Alzheimer’s is lifestyle modification, and the key to slowing its progression is early detection. Research has revealed that the disease begins to occur almost two decades before the onset of symptoms.
Recent advances in both research and technology have led to multiple blood tests that can detect the presence of proteins that lead to Alzheimer’s 10 to 20 years prior to experiencing symptoms. New treatments make these years an unprecedented window of opportunity.
“We now have the potential to treat that disease early with the hopes of preventing symptoms from ever occurring,” Lenox noted. “The science is there. The treatments are there. And now, it's a lot of patients and community acceptance of being screened for early risk factors for Alzheimer's disease,” says Lenox.
For the most part, these screening tests and treatments are only available in clinical trials, which today are safe and highly controlled with multiple levels of oversight. “The level of care in a clinical trial is exceptional,” said Lenox. “It's like tomorrow's treatments today,” adds Stanton. “We have access to treatments that physicians will be using clinically in five years or 10 years.”
Clinical trials are not just for those who have been diagnosed. “We have studies for patients that have memory loss and for patients that don’t have memory loss but are interested in knowing if they're at risk for Alzheimer's disease and, if so, how can they prevent it,” said Baez-Torres.
“We are entering a new area of clinical trials around Alzheimer's disease where we're focusing on prevention,” Lenox said. “We’re identifying patients who are healthy and asymptomatic. They're living their best life, but they're at risk because they're in that 10-to-20-year period where the pathology of the disease is there but they have no signs and symptoms of the disease.”
“One of the reasons I enrolled in a trial is because my
“We are entering a new area of clinical trials around Alzheimer's disease where we're focusing on prevention.”
- DR. BRANDON LENNOX, K2 MEDICAL RESEARCH CO-FOUNDER
father passed away from complications of Alzheimer's,” shared clinical trial participant Jeffrey Pickard Beadles. “When I found out about the study, I said, ‘Yeah, let's find out if I might have any factors that could lead to having that myself.’”
Miriam Rosado enrolled in a study because her family has a history of Alzheimer’s, and she wanted to be proactive. “The gene is in the family because my grandmother had Alzheimer's. So, we want to take care of ourselves. I started the infusion last month and I'm on my second one now, and I feel much better. My mind already works a little better. My sister wants to do this, too and so does my cousin because it's in the family.”
“The gene is in the family because my grandmother had Alzheimer's. So, we want to take care of ourselves. I started the infusion last month and I'm on my second one now, and I feel much better. My mind already works a little better.”
- MIRIAM ROSADO CLINICAL TRIAL PARTICIPANT
provided by Jason
Photos
Morrow
Rapid advancements in medicine, science, and technology have all led to a growing number of promising treatments providing a great deal of hope where there was none not long ago. “You just have to be bold enough to take the test and see your healthcare provider on a regular basis, and so I try to do that,” said Orange County Mayor Jerry Demings. “This is the first clinical trial I've ever joined and I'm very satisfied with it,” Ralph Maresco said. “There's help out there. And that's the important thing. There's help out there.”
Other than fear, there are several issues preventing more widespread testing and treatment. “We understand that the basic barriers to participation in clinical research are transportation, accessibility, language and trust,” noted Sandra Torres, executive director for patient engagement at K2. “So, we knew that we had to do something to be able to reach our diverse communities.”
K2 solved that problem with Wanda, a state-of-the-art mobile unit that takes education, opportunity and hope into every community it serves. “The purpose of our team and Wanda is to bring valuable research to underserved communities, helping teach them about not just the different
options, but also educate them on the disease,” K2 Mobile Unit Manager Gisel Kautz said. “I want every single ethnicity and race out there to be aware of the risk factors, and be proactive about their health,” added Baez-Torres.
Growing Bolder and K2 are working together to create community-wide conversations about Alzheimer’s. We’re encouraging everyone to share their questions, fears, concerns, and personal experience with the disease. We’re doing it to share the good news that hope and help are available.
by Jason Morrow
“You can still sing and have dementia. You can still run and have dementia. You can still enjoy your favorite meal and have dementia. Don't be afraid of the symptoms. The diagnosis doesn't define you.”
- SANDRA TORRES, EXECUTIVE DIRECTOR FOR PATIENT ENGAGEMENT AT K2
If the fact that we can now slow and even prevent the onset of symptoms isn’t enough incentive to get tested, we want to destigmatize an actual diagnosis. Even with Alzheimer’s, it’s now possible to enjoy a high quality of life for many years. “Absolutely. This is not the end of your life,” Torres said. “You can still sing and have dementia. You can still run and have dementia. You can still enjoy your favorite
meal and have dementia. Don't be afraid of the symptoms. The diagnosis doesn't define you.”
“We can't do this alone as physicians and clinical researchers,” Stanton said. “We need everybody to step up and make a difference. We can change the course of this disease, but we need everyone’s help.”
What can you do? Join the conversation. Ask questions. Share your stories, your fears, and your hopes. Get tested, volunteer to participate in potentially life-saving studies, and make the kind of daily lifestyle choices that support a healthy brain.
“Get enough high-quality sleep, eat a balanced and nutritious diet, exercise regularly, drink plenty of water, be social - anything that we can do to reduce our risk is important,” noted K2 Community Connector Bridget Monroe.
“This disease takes so much from families,” Val Demings said. “I really think the time is now and the time is right for Central Florida as a community to come together and share those painful moments, share those fears, those uncertain moments; but also what we do best --- share the hope that we feel about the progress that we can make with this dreadful disease.”
- MIRIAM ROSADO
Photos provided
Move & Your Brain Will Thank You
Building a Bolder
Brain with Dr. Cody Sipe
An overwhelming amount of new research on Alzheimer's and dementia risk reduction provides conclusive evidence, that a strong connection exists between lifestyle choices and cognitive health. In other words, certain health behaviors can significantly delay and even prevent cognitive decline and dementia. So, what are those health behaviors?
Dr. Cody Sipe is one of the world's top cognitive fitness experts. He's a co-founder of the Functional Aging Institute and an author, professor and researcher. He says that, more than anything else, our brains love movement.
“So, get off the couch, get out of your chair, explore your world and just move as much as you can and in lots of different ways. And your brain will thank you for it.”
DR. CODY SIPE
WATCH THE ENTIRE BOLDER BRAIN SERIES WITH DR. CODY SIPE
“Unfortunately, as we get older, people tend to move less and less and less, and they also tend to move in less different ways,” Dr. Sipe said. “We have to reverse that process. Older adults stand to benefit the most from movement, so we want older adults to move as much as possible and in as many different ways as possible.
“So, get off the couch, get out of your chair, explore your world and just move as much as you can and in lots of different ways. And your brain will thank you for it.”
What Do the Brain Docs Say?
Dr. Dean Sherzai’s Tips for Building a Bolder Brain
When future husband and wife Dr. Dean Sherzai and Dr. Ayesha Sherzai first met in Afghanistan in 2003, the two bonded over their mutual loss of a grandparent to Alzheimer’s. Dean was helping rebuild the healthcare system of the war-torn country and Ayesha was working for the esteemed nonprofit, Doctors Without Borders; but their shared medical training, experience and passions lay in neurology.
“Under absolute optimal conditions, we think that as much as 90% of dementias can be prevented”
-
DR. DEAN SHERZAI
CO-FOUNDER ALZHEIMER'S PREVENTION PROGRAM AT LOMA LINDA UNIVERSITY
Returning to the U.S., they married and co-founded the renowned Alzheimer's Prevention Program at Loma Linda University where they have dedicated their lives to helping eradicate the disease. Together they lead the largest community-based brain health initiative in the country, helping tens of thousands of patients, from the partially cognitively impaired to those who are suffering from Alzheimer's, find hope through personal lifestyle intervention.
As researchers and scientists, the Sherzais were intent that their work would be supported by vast, robust data. They chose Loma Linda as the home for their program because of its Blue Zone designation, with a 50+ year ongoing study of over 97K people. As they studied
their own database of over 3,000 patients, the results of lifestyle changes were profound.
“Under absolute optimal conditions, we think that as much as 90% of dementias can be prevented. Definitely 60% has been proven, but as much as 90%, if you do all optimal,” Dean Sherzai said. “And the optimal is not finding the holes in your system and filling it in with some vitamin concoctions. It's simple lifestyle factors that one can start incorporating into your life.”
In an interview for the Growing Bolder podcast, we asked Dean for simple steps we can all begin taking to build a bolder brain. He shared five ways, under the acronym NEURO: Nutrition, Exercise, Unwind, Rest and Optimize Your Mental Activity.
Image Courtesy of The Sherzais
5 WAYS TO BEGIN BUILDING A BOLDER BRAIN TODAY:
1. NUTRITION: INCREASE YOUR GREENS.
Studies show that people who ate more spinach and dark leafy greens have brains that appear 11 years younger. Additionally, reduce your saturated fat and reduce your simple sugars, in a measurable way. “We all say it, but then we return to our normal habits. Do it measurably,” Sherzai outlined. “‘This day, this day and this day, I'm not going to have saturated fat and I'm not going to have sugar.’ That's measurable, that's retainable, that's great.”
2. EXERCISE: MOVE THROUGHOUT THE DAY.
You don’t have to go to a gym. Watch two of your shows while doing a few mini squats or steps in place. Slow steps are fine or even just standing. Work your way to 25 minutes daily of brisk walking. Research shows a 45% reduction from mild cognitive impairment to dementia in people who walk briskly and build their leg strength.
3. UNWIND: BUILD YOUR LIFE AROUND GOOD STRESS.
Our brains want to be challenged - don't get lazy. Take classes, learn to play a new musical instrument, discover new music, or learn to dance. And reduce the existing stressors in your life by identifying them and then systematically decreasing or eliminating them as much as possible.
4. REST: INVEST IN YOUR SLEEP.
Sleep is the ultimate cleanse and sleep hygiene is critical. Create a positive space, lower the sound and reduce the light before bed. We need four to five cycles of deep sleep every night. If you're sleeping seven to eight hours and still feel tired, or you're moving throughout the night go to a university-based sleep facility and get tested for sleep apnea.
5. OPTIMIZE: BUILD YOUR BRAIN AROUND PURPOSE.
Optimize your cognitive activity through social activities such as volunteering, joining groups, taking classes with others, learning a musical instrument, joining bands, or just learning new things, but in a social setting.
The Harvard Study of Adult Development has followed over 700 men for over 80 years and expanded to include their spouses and over 1300 children. The one variable that stands out the most regarding longevity and vitality is the nature of the individual’s connections. Conversations with people who matter to us, around topics that have meaning to us, involve every aspect of our brain’s limbic system and increase connections between our neurons. If our brains are not being challenged, they begin to withdraw, pull back those connections and start shrinking.
Implementing changes in these five areas all together will be powerful, but don’t let that overwhelm you. You can begin with just one. Dr. Sherzai says a good place to start is in the area in which you’re most deficient, because that is where your opportunity for most improvement exists.
Olympic Table Tennis Legend
Lily Yip Serves Up Inspiration
Table tennis is a sport that captures the soul of the National Senior Games. It’s wildly fun. It engages people socially. It activates the mind. It takes physical skill, yet it’s accessible to athletes of all ages and all abilities. It reminds us of our youth, rallying back and forth in our parents’ garage for bragging rights over friends and family.
It’s a game for everyone. But of all the senior table tennis players in the world, none loom quite as large as Lily Yip.
in how aging is treated around the globe and urges others to make their health a priority.
“In China, at 60, I am an elder. People are going to bow to me,” Yip explained. “They show you so much respect.
“For our seniors in America, it’s pretty individual. We have to take care of ourselves. Your health is the most important thing. Invest in your health. Eat well, watch your diet and listen to your body. Be sure to exercise. Always look
Yip started playing professionally at the age of 12 in her native China. This pingpong prodigy later moved to the United States and, after becoming a citizen in 1991, represented the U.S. at the 1992 and 1996 Olympic Games.
Yip won six career medals at the Pan American Games and was inducted into the Table Tennis Hall of Fame in 2004. Now in her 60s, despite racking up numerous medals over the past decade, she has embraced the National Senior Games as a chance to play for the love of the game.
“In my golden age, I just do it for fun now,” Yip told Growing Bolder at the 2023 National Senior Games. “I feel that my mind is still young. I still can compete, not only in pingpong but I also compete in table tennis. I want to be an inspiration for other seniors.”
Yip isn’t just inspiring people with her skills. She’s sharing her secrets. After spending years as an Olympic coach, she opened the Lily Yip Table Tennis Center in New Jersey, teaching players of all ages and skill levels to embrace the game.
She brings her students over the age of 50 with her to the National Senior Games, where they enjoy the competition and see firsthand how playing organized sports can lead to happy and healthy aging. Yip notices a difference
forward to the future.”
“Winning makes me smile the most, but so does being healthy. That’s the most important thing and it makes me smile.”
Yip leads by example. She admits she still feels a desire to win, but her focus now has shifted more to playing for the love of the game. In between rallies at the National Senior Games in Pittsburgh, Yip was easy to spot, with a smile beaming across her face.
“Even though I lost today, I’m still smiling,” Yip said. “I just have fun now. Winning makes me smile the most, but so does being healthy. That’s the most important thing and it makes me smile.”
- LILY YIP
Photo provided by Jason Marrow
Photo provided by Jason Marrow
Photo Eliot J. Schechter/Stringer
Walk This Way!
The Way We Walk Predicts Our Morbidity
Did you know that the way we walk and the quality of our gait cycle are predictors of our morbidity?
Find out why in this chat with Dr. Emily Splichal, author of “Barefoot Strong” and the CEO and founder of Naboso Technology, which creates products that focus on improving movement, performance, and recovery through stimulating thousands of nerve endings in our feet.
As Dr. Splichal explains there are three key indicators to check if you are on track to a longer, healthier life based on your movement:
Ability to balance on one leg for 10 seconds
Ability to maintain a relationship with ground reaction forces
Ability to maintain foot strength to create a rigid lever
Are you ready to begin your journey to a longer, healthier life? Visit Naboso.com/Bolder and use the code “BOLDER” to save 20% off insoles, Neuroballs and more to improve your movement longevity.
via Getty Images
HEAR MORE FROM DR. EMILY SPLICHAL
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Caring Transitions: 5 Ways Creating Healthier Homes Creates Healthier Lifestyles
A happy and healthy life starts from within. Our own daily choices and our own mindset play a profound role in our longevity and enjoyment of our later years, which is great news for all. It means that with simple lifestyle modification, we can all live a life full of joy, excitement, passion and purpose, no matter our age, abilities or circumstances.
The times of transition in our lives are a perfect opportunity to step back and think about the ways we can align a new chapter of our lifestyle with a new chapter of our location. By focusing on the ways we live, and the ways we spend our time in and around our community, we can bring about change for a happier and healthier future.
If you’re facing an upcoming life transition, such as a downsize to a smaller home, moving to a new location, helping older loved ones move to an active adult community or assisted living community, or even just need a home cleanout to declutter your life, don’t take on the stress alone. There are senior relocation experts from the team at Caring Transitions in over 350 locations across the country, ready to create an organized plan and tackle all the heavy lifting for whatever your family may need.
Here are five ways that Caring Transitions can help you create a healthier home and a healthier lifestyle:
1. A Blank Canvas
Embrace a life transition as a fresh start. If you’re moving to a new home, whether to be closer to family or friends or even for a new adventure in a new state, look at your later years through a prism of opportunity and excitement. While Caring Transitions takes care of the physical labor of your move, think of the ways you can reimagine your new home to embrace a healthier lifestyle. Create spaces that promote intellectual health and creativity like a place to read, write, create art or play music. Focus on your emotional health by creating peaceful areas with painted walls, artwork, plant life and plenty of natural light. Imagine a way to incorporate physical activity into your new home, by finding space for free weights, yoga mats, a stationary bike or any other fitness activity you enjoy.
2. Re-imagine Retirement
We are in the middle of a significant shift in the culture of aging, and many in their mid-to-late 60s are re-imagining retirement. Our later years are no longer just a time to withdraw from life, watch TV and fade from society. There is an entirely new lifestage available, and now we can lead healthy, active happy lives for decades longer than generations before. More people are choosing to move to active adult communities, which offer tremendous social and well-being benefits. These environments promote sports, entertainment, healthy eating, social clubs and more, and are full of people who also choose to continue working part-time as they age too. No matter where you are thinking of relocating to, Caring Transitions can formulate an individualized plan to make your dream a reality.
3. Decluttering Allows Space for a Fresh Start
While there are tremendous benefits to a move, there are also plenty of upsides to aging in place, too. If you’re happy in your home, take advantage of an opportunity for a fresh start with Caring Transitions home decluttering services. The experts at Caring Transitions can help you sift through years of accumulated odds and ends that are filling space in your attic, garage and more, and help you decide what to keep and what to discard. A tidier home with less clutter has been proven to improve focus and mindfulness, lower risk of depression, reduce stress and anxiety, boost immune systems, and improve sleep
4.
More Money to Spend on Your Passions
No matter if you are choosing to age in place or relocate to a new home, Caring Transitions can help you fund the life of your dreams in your next chapter. Through their online auction platform CTBids, the items that are taking up space in your home can be sold to buyers across the country looking for beautiful antiques. Caring Transitions can also manage an in-person estate sale, putting extra money in your wallet to be used on the passions you want to pursue in your next chapter, like travel, exploration, lifelong learning and more.
5.
Downsize Your Space Inside, Increase Your Time Outside
Life is about adaptation, and this is especially true when considering our living situation. The home we’ve owned for decades may no longer suit our needs in our later years. An oversized home can be difficult to keep up with both physically and financially. Downsizing to a smaller space cannot only benefit your wallet, but may lead to a healthier lifestyle, too. Less to do at home allows the opportunity for us to spend more time outdoors. Join a walking group or sports team in your community. Spend time in nature with hobbies like photography, hiking, fishing, golf, painting or gardening. Meet with friends for coffee in the park or a meal on your favorite patio. By being intentional about the ways you spend your time, you can add extra happy and healthy years onto your life.
There are more than 350 Caring Transitions franchises located across the country. To find the team nearest you, visit CaringTransitions.com
The ABCDs of Medicare Planning
All you need to know for Open Enrollment
Vanessa J. Skinner
Vanessa J. Skinner is a shareholder with the firm of Winderweedle, Haines, Ward & Woodman, P.A., where she chairs the firm’s Wills, Trusts & Estates Department. She was recently named one of the Best Lawyers in America in the area of Elder Law for the third consecutive year. She is the host of The Power of Planning Podcast, anchor.fm/thepowerofplanning
Every year, Medicare’s Open Enrollment Period is October 15 – December 7. You can always tell this time of year by the flurry of commercials you see on TV advertising the various plan options. The choices seem to be endless and it can be hard to determine what coverage option is best for you. Here is a roadmap to help you navigate this year’s Open Enrollment Period.
First established in 1965, Medicare is federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions. Medicare is different from private insurance because it does not offer plans for couples or families. It is considered an individual benefit. When you first sign up for Medicare and during certain times of the year, you can choose which way to get your Medicare coverage. There are two main ways: Original Medicare or Medicare Advantage.
Photo via Getty Images
Original Medicare
Original Medicare includes Part A and Part B coverage. Part A (hospital insurance) helps cover inpatient care in hospitals, limited skilled nursing facility care, hospice care and home health care. For most people, there is no cost for Part A coverage because they or a spouse paid Medicare taxes long enough while working – generally at least 10 years. Part B (medical insurance) helps cover services from doctors and other health care providers, outpatient care, home health care, durable medical equipment and many preventative services. In 2024, the Part B premium is $174.70 per month (or higher depending on your income). The amount can change each year.
With Original Medicare, you can join a separate Medicare drug plan run by private insurance companies to get Medicare drug (Part D) coverage, which helps cover the cost of prescription drugs. The premium amount varies by plan, and you may have to pay more, depending on your income.
Original Medicare enables you to go to any doctor or hospital that takes Medicare, anywhere in the U.S. It covers most, but not all, of the costs for approved health care services and supplies. After you meet your deductible, you pay your share of costs for services and supplies as you get them. There is no limit on what you will pay outof-pocket in a year unless you have other coverage from a former employer or union, or Medicaid.
To help pay your out-of-pocket costs in Original Medicare, you can also buy a Medicare Supplement Insurance (Medigap) policy. The premium varies based on which Medigap policy you buy, where you live and other factors. The amount can change each year. You must have Part B and keep paying your Part B premium to keep your Medigap policy. You will have Original Medicare unless you join a Medicare Advantage plan.
Medicare Advantage
Medicare Advantage (or Part C) offers an alternative to Original Medicare for your health and drug coverage. It bundles your Part A, Part B and usually Part D coverage into one plan. Plans may offer some extra benefits that Original Medicare doesn’t cover, including vision, hearing and dental services. You join a plan offered by Medicareapproved private insurance companies that follow rules set by Medicare. Each plan can have different rules for how you get services, such as needing referrals to see a specialist.
Medicare Advantage plans must cover all emergency urgent care, and almost all medically necessary services Original Medicare covers. Some plans tailor their benefit packages to offer additional benefits to treat specific conditions. In most cases, you need to use doctors who are in the plan’s network.
Costs for monthly premiums and services you receive vary depending on which plan you join and can change each year. You may pay a premium for the plan in addition to the monthly Part B premium. Plans may help pay all or part of your Part B premiums. Plans may have lower outof-pocket costs than Original Medicare. You cannot buy separate supplemental coverage like Medigap.
Medicare Enrollment
Your first chance to sign up for Medicare is generally when you turn 65. This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65. There are no penalties if you sign up during this time. There is a Special Enrollment Period that is only available for a limited time for those who work past age 65 and are covered by an employer group health plan, and there is no late enrollment penalty for such qualified individuals. The General Enrollment Period is when you miss the other periods and there is typically a life-long penalty if you sign up during this time. Since Medicare health and drug plans can make changes each year to cost, coverage and which providers and pharmacies are in their networks, during Open Enrollment Period Medicare recipients can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs.
Armed with these basics about Medicare coverage, hopefully you are now better prepared to make the decision that is best for you during this year’s Open Enrollment Period.
Photo via Getty Images
How to Be Happy
Dr. Katharine Esty on Being Eightysomething
The summer Dr. Katharine Esty turned 80, she was enjoying time with family at their home in the Adirondack mountains. The weather was perfect for their annual walk to the top of nearby Cat Mountain. But the previous night’s rain made the path slippery. Esty slipped and scraped her knee, then fell again. As the climb continued, she realized she couldn’t navigate the increasingly steep and rocky terrain. The year before, she’d climbed it easily, but now she couldn’t make it to the top.
“It was just this moment when I realized I am getting older and I am not going to be able to just keep on doing everything by pushing through. I have to accept I am older,” Esty remembered.
“I had to sit down, and all the kids, the grandkids, scrambled up the mountain. One of my sons sat with me and I actually had a cry. And then we got laughing after that, because of my failure to summit. But I came to terms, at that moment, that things would have to change for me. It was really a wake-up call that I needed to accept that I just couldn't keep going as usual.”
The experience got Esty, a retired clinical social worker and social psychologist, wondering how she could still flourish in this next stage of life. She thought there must be people who were thriving in their 80s and wanted to know how they were doing it. She looked for articles but only found accounts of people in their 60s and 70s.
“It was just this moment when I realized I am getting older and I am not going to be able to just keep on doing everything by pushing through. I have to accept I am older”
DR. KATHARINE ESTY
So Esty began her own interview project, starting with the residents in her retirement home, then talking with those she met as she traveled to Ohio and California and eventually calling contacts across the country. Word spread, Esty did more interviews and her database kept building. To Esty, the findings were surprising.
“It was amazing. I asked everyone, ‘On a scale of one to 10, how happy are you?’ 10 being extraordinarily happy, one not at all happy, and almost everybody said they were an eight or a nine or a 10,” Esty noted. “What I learned was that being happy did not depend on having avoided tragedy, upsets, failures, losses, losses of a spouse. People think it depends on not having bad things happen to you, but part of it is attitude and part of it is just learning how to mourn the losses. Not to deny them, not to jump over them, but just to accept them.”
Image Courtesy of Katharine Esty
“We used to say, ‘You can't teach an old dog new tricks,’ but I think it's not at all true. We all learn differently.”
DR. KATHARINE ESTY
Esty used her findings to author a book, “Eightysomethings: A Practical Guide to Letting Go, Aging Well, and Finding Unexpected Happiness.” Recent research backs up her interviews, showing happiness levels growing by the decade from our 50s on. Which is great news since modern medicine and other factors have helped increase life expectancy in the U.S. to 79 years old, providing the opportunity of many years past retirement age to continue to reinvent ourselves.
“We used to say, ‘You can't teach an old dog new tricks,’ but I think it's not at all true,” Esty said. “We learn
Dr. Esty’s Guidelines for Aging Well:
Understand that relationships matter most of all.
Multiple studies show that maintaining a strong social network as we age contributes to a longer, healthier life. As we get older, we have the gift of more time that we can spend with family and friends.
Take control of what you can control.
You can control your diet, your activities, and going to the doctor. Take control of what you can control and let go of the rest, including any regrets.
differently. We're slower, especially on this technology… but once we get it, we hold on to it. That's opened up worlds for people.
“There are all kinds of retirement institutes where people can learn and take courses. There are apps on our smartphones to learn the language. So, life just opens doors,” continued Esty. “Some doors do close. You can't decide to become a ballet dancer at 70, but when you look at what is open to you, all the possibilities, it's amazing.”
3.
Have a purpose.
German philosopher Immanuel Kant’s rules for happiness were something to do, someone to love, something to hope for. Esty observes that people don’t want to be helped, they want to keep contributing. We don’t have to be as goal oriented as we were when we were younger, and we can be more intentional about how we spend our time.
Have a positive attitude. Research shows that individuals with a positive attitude toward aging will live an average of 7.6 years longer than people with a negative attitude toward aging. The real prescription is simply attitude, curiosity and a never-ending enthusiasm for life's simple pleasures.
