www.cumberlink.com
Annual
Dollars & Sense
The Sentinel www.cumberlink.com
How to maximize your budget and plan for your future
Carlisle, Pa. March 3, 2013
2013
Their Future
5/5
Everyone’s Saying... What’s coming next?
The weather is wacky.
Times just aren’t the same.
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G2 • The Sentinel
Sunday, March 3, 2013
Their Future • March 3, 2013 • Section G
2013
Annual Report Dollars & Sense
How to maximize your budget and plan for your future
Inside this issue... 4 Juggling finances, health for aging parents 4 Legal issues for aging parents/senior citizens 4 Eldercare options 4 End-of-life care and hospice 4 Taking care of pets as they age, and the cost
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Annual
Sunday, March 3, 2013
The Sentinel • G3
Their Future
Considering a pet? Consider carefully BY JOSEPH CRESS THE SENTINEL
jcress@cumberlink.com
Before being taken in by a cute furry face, know that you are in for a commitment of time and money. “People do not do enough homework,” said Steve
Knisely, manager of Knisely Pet and Farm Center. “They don’t ask enough questions. We see a lot of the mistakes that people make.” He recalled the older couple who adopted a Doberman Pinscher only to discover he was too much dog for their age. Then there
were the customers who kept a one-year-old German Shepherd cooped up all day inside. Prior to setting your paws in a pet store or local shelter, take the time to figure out what kind of pet you want and what kind of expense the animal could incur.
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Selecting a pet “Do not even take a free pet unless you’re committed,” Knisely said. “A free kitten could end having unexpected bills. You are the caregiver. Pets can’t take care of themselves. They are relying on us.” In selecting a pet, always
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consider your lifestyle and your family, said Dr. Dwayne Albin, a veterinarian with the Gettysburg Road Animal Hospital. This is especially true of dogs because of the time commitment. For example, a traveling salesman would probably be better off with a cat while a
Great Dane would be a bad fit for a person living in a one-bedroom condo on the second floor, Knisely said. He added older animals may be calmer in temperament, but have health issues more sooner.
• See Pet health, G4
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Her own mother was diagnosed with cancer when Dr. Sachelarie was finishing her residency. That may explain her choice of specialty and her focus on making patients feel comfortable. “Patients develop closer relationships with their oncologists. They feel the actions we take save their lives,” she said. Today, she notes there are multiple treatment options for different cancers. “One model doesn’t fit everyone. We customize each treatment plan.” For more information or to find a physician, please go to CarlisleRMC.com or call 1-855-249-CRMC.
Positively.
Annual
G4 • The Sentinel
Sunday, March 3, 2013
Pet health • Continued from G3
Both experts recommend people research the breed before adopting a dog. Purebred animals often are prone to certain conditions that could require more of a future financial commitment, Albin said. He recommended that when selecting a mutt, spend time with the animal and assess its personality. Keep in mind that a dog that is quiet and scared at the shelter may be the complete opposite in your home. “With regards to cats, I look at their overall physical appearance,” Albin said. “You can tell a lot based on that.” Specific things to look for include energy level, temperament, clear eyes, a clear nose and a body that is neither too heavy or too thin. Do not completely disqualify a shelter cat with an
upper respiratory infection since that may be readily treatable, Albin said. He also recommends taking a close look at the condition of the cat’s teeth and gums since that is a big indicator of potential health problems. Albin also suggested would-be pet owners have a veterinarian check out the animal prior to adoption or introduction to the family. On average, pre-adoption exams cost about $52 locally, but can identify health conditions that could cost hundreds of dollars to treat. Stray pets often carry parasites or infections that could endanger other pets in the household, Albin said. He said that while shelters test cats for feline leukemia and FIV (feline immunodeficiency virus), it may take six to eight weeks before the
• See Pet health, G5
Love food?
Jason Malmont/The Sentinel
Frankie, a Yorkshire and Shih Tzu mix, owned by Alan Manwiller of Mechanicsburg, left, gets a routine checkup from Dr. Dwayne Albin of the Gettysburg Road Animal Hospital in Mechanicsburg.
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HOMETO-HOME WITH CARE Zeigler’s Storage & Transfer, Inc. is one of the oldest moving companies in the state of Pennsylvania. The firm is a fifth generation family owned business. Services were started in 1887 by James Calvin Zeigler by hauling mail over Sterretts Gap to Perry County in a stage coach. As people requested their belongings and other items hauled back to Carlisle, the first team of horses and open wagons began his moving business. Since that time Zeigler’s has come a long way. Today the company includes tractor trailer units and straight trucks complete with all the equipment to move anything from household goods to office and plant
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equipment. They provide local and long distance, commercial, residential and military moving services. Their modern warehouse has palletized storage, a full service record storage center, and a Senior Citizen Relocation Division. Although the firm has its own interstate and intrastate moving rights, as an Agent of American Red Ball Transit, Co. they can provide services to all 50 states and foreign countries. They were recently honored with an award for sixty years of service. As Zeigler’s continues to grow and become more diversified, they are still committed to providing the best services to the Carlisle community and surrounding areas.
1235 RITNER HIGHWAY CARLISLE, PA 17013
717-243-2033 1-800-566-8663
Annual
Sunday, March 3, 2013
The Sentinel • G5
Pet health • Continued from G4
results come back. Meanwhile, the infected cat could be within the general shelter population.
Caring for a pet
From day one, the pet owner should set up a regular schedule of routine check-ups to head off health problems before treatment options become too expensive, Albin said. “Pets are good at hiding illnesses.” He explained how this is a basic survival instinct carried over from the wild where any sign of sickness or injury makes the animal vulnerable to attack. Instead of showing that they are suffering, the animal is
liable to tough it out until the health issue becomes too overwhelming for them to handle. Routine checkups help to establish a relationship where the veterinarian can help the pet owner recognize symptoms early and then tailor diagnostic tests and treatments to that particular pet, Albin said. “When a client says their pet is not acting right. I tend to believe them. They know what the normal habits are. They can pick up on certain cues.” He also encourages pet owners to consider regular teeth cleanings and exams for their animals. “People don’t think about that, but dental disease can lead to other diseases throughout
the body,” Albin said. When selecting food, look on the bag for information from the American Association of Feed Control Officials. If the label says “all life stages,” that means it is puppy or kitten food and is too high in fat or calories for adult and senior animals, Albin said. Look instead for food that is balanced for adult pets or tested by feeding trials. The word “formulated” just means that the manufacturer followed a cookbook. “If you have a question, bring the empty bag in for the vet to look at,” Albin said. Above all, table scraps
• See Pet health, G6 Jason Malmont/The Sentinel
Above, right: Dr. Dwayne Albin looks at bacteria under a microscope. Below: Albin, left, and Emily Miller, a veterinary assistant, clean Frankie’s ears.
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www.wschamber.org 4211 Trindle Road, Camp Hill, PA 17011
www.kniselys.com
(717) 761-0702
Come Worship With Us. LOCAL CHURCH DIRECTORY
CHURCH OF GOD • CHURCHTOWN CHURCH OF GOD
Pastor Brian Warner 351 Old Stonehouse Road in the village of Churchtown Worship Service, Sunday Morning, 10 AM Individual Worship & Prayer, Wednesday Evenings, 6:30- 8 PM Bible Study, Monday Evenings, 6:30 PM For more information, please call 258-5337
EVANGELICAL FREE • CARLISLE EVANGELICAL FREE CHURCH 290 Petersburg Road, Carlisle Website: www.carlislefreechurch.org Phone: 717.243.6001 E-mail: cefc@carlislefreechurch.org
• NEWVILLE FIRST CHURCH OF GOD 475 Shippensburg Road, Newville 717-776-5223 Email: info@newvillecog.com Web: www.newvillecog.com Wednesday - 7:00 pm – Connection Groups Sunday – 8:30 am & 10:30 am – Worship Service Sunday – 9:30 am – Connection Groups
CHURCH OF CHRIST • GRACE UNITED CHURCH OF CHRIST Rev. George Heckard 121-123 East Orange Street, Shippensburg 717-532-6221
EPISCOPAL • ST. JOHNS EPISCOPAL CHURCH On the Square, Carlisle • 243-4220 Sunday Services 8:00 am Traditional Eucharist 10:15 am Family Eucharist 10:15 am Children’s Service Wednesday Services Holy Eucharist 7:00 am and 12:10 pm Saturday Services Holy Eucharist 5:00 pm
• ST. LUKE’S EPISCOPAL CHURCH 8 East Keller Street, Mechanicsburg Phone: 766-5182 The Rev. Z. Mark Smith Holy Eucharist Sunday 8:00am & 10:30am Sunday School and Adult Forum 9:15am Wed. Eucharist and Prayer Group 9:30am Celtic Eucharist 2nd Saturday 6:00pm Taize 4th Sunday 7:00pm
• • • •
Shad Baker, Senior Pastor Hugh Ansley, Executive Pastor Trevor Steele, Discipleship Pastor Steven Wilmert, Worship Pastor Chad Storr, Youth Pastor Joni Behrendt, Director of Children’s Ministries A place to develop your faith in Christ and your love for others. Practical teaching from the Bible. Lots of opportunities for children, teens and adults Active in the community
Sunday Worship Services 9:15 and 11:00 am 9:15 Nursery Children’s Worship: “Kingdom Kid’s Praise” Adult Learn & Live Classes 11:00 Nursery Children’s Sunday School: “Kingdom Connection” Youth Classes: G2Twenty (Galatians 2:20) Adult Learn & Live Classes Wednesdays (According to School Calendar) Kingdom Builders (Age 4 – Grade 6)—6:15-8:00 pm Youth Group: G2Twenty (Galatians 2:20)—6:30-8:15 pm 2nd & 4th Wednesdays: MOPS (Mother’s of Preschoolers)--9:00 – 11:00 am
LUTHERAN • FIRST LUTHERAN CHURCH
High and South Bedford Streets, Carlisle Rev. Charles A. Brophy 8:00 am Holy Communion 9:00 am Sunday School 10:15 am Holy Communion Nursery 10:00 am Wednesday 7:30 am Communion Handicapped Accessible www.firstlutherancarlisle.org • 717-249-3310
• ST. PAUL EVANGELICAL LUTHERAN CHURCH
West and Louther Streets – Carlisle, PA 717-243-2319 Rev. Timothy Sadler, Lead Pastor Rev. Carol Bowman, Associate Pastor Sunday Worship 8:00 & 10:45 am w/nursery available Sunday Church School for Children & Adults 9:30 am Bible Study Monday 1:00 pm and Tuesday 1:00 pm Wednesday Worship 7:30 am Wednesday Dinner 5:15 pm w/Contemporary Worship with Healing 6:00 pm Saturday Worship 5:15 pm Holy Communion is offered at all Worship Services Handicap accessible entrance from rear parking lot Visit our website at www.stpaulcarlisle.com
NON-DENOMINATIONAL • CHRISTIAN LIFE COMMUNITY CHURCH
“ A Christian Fellowship” 3151 Ritner Highway, Newville, PA, Phone: 776-6511 Senior Pastor: Rev. Steve Gibb Staff Pastor: Rev. Karren Hamm Our weekly Services: Sunday 10:00 am Worship/Word Service Sunday 10:00 am Children’s Sunday School Sunday 10:00 am Torchbearers (ages 8-12) Every other Wednesday Evening 7:00 pm Ladies Bible Study, Men’s Promise Keepers, Youth Group and Kid’s Club Monthly Praise and Ministry Services and Corporate Prayer Times - call church office for details An Elim - Fellowship Affiliated Church
• CARLISLE CHURCH OF CHRIST
971 Walnut Bottom Road, Carlisle (Across from Manor Care Nursing Home) 249-3267 Minister Tony Tarole www.carlislecofc.org Sunday Bible Study 9:30 am (classes for all ages) Sunday Morning Worship 10:30 am Sunday Evening Worship 6:00 pm Wednesday Evening Bible Study 7:00 pm (classes for all ages) Free Correspondence Course Daily in-home Bible Studies Handicapped Accessible
PRESBYTERIAN • MECHANICSBURG PRESBYTERIAN CHURCH
Pastor Kathryn Z. Johnston 300 E. Simpson Street, Mechanicsburg 717-697-0351 8:15 am & 11: 00 am – Sunday Worship 9:35 am – Sunday School
UNITED METHODIST • ALLISON UNITED METHODIST CHURCH
99 Mooreland Avenue (On the Dickinson College Campus) 243-5962 • www.allisonumc.org Bishop Neil Irons, Pastor Bishop D. Frederick Wertz, Pastor Emeritus 8:15 and 11:00 am Worship Services 9:30 am Sunday School for All Ages Nursery Care Provided 7:00 pm Wednesdays Youth Group All Are Welcome
• GOOD SHEPHERD COMMUNITY UNITED METHODIST CHURCH Pastor Scott Hocker 2135 Ritner Hwy., Carlisle 717-249-6879 9:00 am – Sunday Worship 10:30 am – Sunday School
• MT. HOLLY SPRINGS UNITED METHODIST
202 West Butler St. Rev. Ed B. Alwine (Butler is midway between traffic lights) Sunday Worship 8:00 & 10:30 am with Nursery Sunday School for all ages 9:15 am Church Office 486-4883, Tues. - Fri. 9:00 am - 3:00 pm Senior Choir Adult Bible Study Youth Fellowship meets weekly Wee Little Lambs Day Care Center (486-8728) Follow Me Pre School (486-8439) Sept.-May Mother’s Morning Out, Thurs-Fri 9 am - 1 pm Sept.-June www.mthollyspringsumc.org mthollyspringsumc@embarqmail.com
• OTTERBEIN UNITED METHODIST CHURCH
647 Forge Road, Carlisle Phone 717-258-6704 www.gbgm-umc.org/otterbeinumc info@otterbeinumccarlisle.org Rev. Daniel Dennis, Pastor Sunday Morning: Sanctuary Worship 9:00 and 11:15 am The Gathering Contemporary Service 9:00 am Sunday Church School for all ages at 10:10 am Sunday Evening: Jr. & Sr. High Youth Group Handicap Accessible Little Friends Nursery School
• WAGGONERS UNITED METHODIST CHURCH
1271 Longs Gap Road, Carlisle 243-2261 Mailing Address - 1055 Longs Gap Road, Carlisle Pastor Tim Funk Sunday Bridge Cafe 8:00am Sunday Worship 9:00am Sunday School for all ages 10:15am Bible Study Monday 7:00pm & Tuesday 9:00am Visit our web site at www.waggonersumc.com
UNITARIAN UNIVERSALISTS • UNITARIAN UNIVERSALISTS OF THE CUMBERLAND VALLEY
Boiling Springs, 249-8944, www.uucv.net Rev. Roy Reynolds, Interim Minister Service 10:30 am Children’s Religious Education “Our mission as an enduring liberal religious community in the Unitarian Universalist tradition is to transform lives and care for the world.”
WESLEYAN • CHURCH OF THE CROSS
430 B Street, Carlisle Rev. Daniel R. Mikesell, Pastor Sunday Worship 8:15 am and 10:30 am Sunday School 9:30 am Bible Study & Prayer, Wednesday 11:00 am Awana Clubs (September-April), Wednesday 6:30 pm (Ages 2 – Grade 6) Nursery Care Provided For more information, call 243-5145
Annual
G6 • The Sentinel
Pet health • Continued from G5
and people food should be avoided because of its high fat and caloric content. Packaged dog food and cat food is formulated so that the animal can maintain a proper weight. Also, certain human foods can be lethal to dogs.
Preparing for problems From day one, pet owners
should either set up a savings account or subscribe to pet insurance to help offset the costs of unexpected illnesses or injuries. “There are now a wide variety of carriers,” Albin said. “You n e e d to c h e c k c l o s e ly with each one as to what the package would cover.” Banks even offer low-interest loans for pet care. He also urges pet own-
ers to use caution when ordering pet medications online. “Many of these pharmacies do not get their meds directly from the manufacturers. Therefore, the drugs and guarantees are not supported by the manufacturer. We encourage people to buy products directly from a vet because we know wh e re t h o s e p ro d u c ts
Sunday, March 3, 2013
come from.” As much as you love your pet, there will come a time when a difficult decision needs to be made. All too often, pet owners delay the inevitable when they should consider the welfare of the animal. “I look at the pet first,” Knisely said. “Am I keeping him for my own sake? Is the pet suffering? Is he
in pain?” Quality of life is an important consideration in deciding whether to euthanize a pet, Albin said. “Are they eating or drinking? Do they enjoy the activity and attention that they are used to?” Knisely recommended the person wait for a time before setting out to find a new pet. One thing to re-
member is that every pet is an individual. The key is to find a good fit, not to expect the new animal to completely replace the deceased animal. Pet memorials is fast becoming a big business, Knisely added. There are even products available where pet owners can engrave a picture of the pet on the headstone.
“Pets are good at hiding illnesses.” Dr. Dwayne Albin
Gettysburg Road Animal Hospital
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Carlisle Crossing 214A Westminster Dr. 243-2215
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Hanover Street 14 N. Hanover St. 249-1331
Ritner Highway 1901 Ritner Hwy. 960-1400
Boiling Springs 3 East First St. 241-4131
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SHIPPENSBURG OFFICE 430 East king Street Shippensburg, PA 17257
Annual
Sunday, March 3, 2013
The Sentinel • G7
Their Future
Plan but don’t worry, experts agree BY JOSEPH CRESS THE SENTINEL
jcress@cumberlink.com
Old age and infirmity are as inevitable as death and taxes and just as scary to the unprepared among us. “A lot of people are so busy with their lives keeping their fingers crossed,” said John Bowen, director of social services at Bethany Village in Mechanicsburg. As he sees it, the choice is clear — continue to cruise in denial, hoping that things work out, or take on the challenge of preparing for future health care costs with both eyes open. “There are some people who are just carefree,” Bowen said. “If it happens, somebody will pay for it like the government or my kids, but this limits your choices. You are not going to get into a nice skilled nursing facility.” In fact, lack of preparation could make obtaining
the desired level of care all the more taxing on the family. Attorney David Nesbit of Keystone Elder Law in Mechanicsburg has seen the consequences of waiting out
the inevitable. It can be a hard sell at times to get people to realize that planning for the future is something that needs to be done, Nesbit said. For
many, just thinking about old age and extended care is painful and frightening. Part of his job is to gently guide clients to the realization that a financial plan
nursing can run as high as $9,000 per month. Depending on the age of the client, it may be more important just to seek advice than to implement specific steps in the planning process, Nesbit said. He was not alone in urging caution. “I need to differentiate between worrying about getting older and planning on getting older,” Bowen said. “There needs to be a balance. You don’t want to be too anxious about it and overreact.” Bowen suggested a twotiered approach to planning. One is to take advantage of every opportunity to learn about the aging process. The other is to take a wholeperson approach to wellness and prevention by investing time and resources towards keeping the mind, body and should be in place to cover spirit active and engaged. future costs. Nesbit menBethany Village, for extioned how the current rate ample, has a vocational for in-home care averages about $20 an hour while • See Finances, G8 the current cost of skilled
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1000 Claremont Road • Carlisle, PA • 717-240-1963 • www.ccpa.net/cnrc Serving Our Community Since 1913
The Carlisle Chamber of Commerce is proudly celebrating 100 years of service to the greater Carlisle area. Look for more information in the coming months as we reveal events and celebrations that commemorate this milestone. We offer: • Area Restaurant Information • Points of Interest • Things to Do • Tourist Information
visit our
showroom
MEMBERSHIP DIRECTORY 2012-2013
• Relocation Information
The Greater Carlisle Area Chamber of Commerce has put together a package of materials that we hope will familiarize you with the Carlisle area and our diverse cultural, business, and recreational opportunities. Our relocation packet is FREE, so stop in today if you or someone you know would find this information helpful. 212 N. Hanover St. Monday through Friday, 8:30am – 4:30pm
DON'T MISS SAVOR THE FLAVOR A TASTE OF CARLISLE 2013 13th
Sunday, March 10th 11:30 AM to 2:30 PM Dickinson College Holland Union Building For more information, visit CarlisleChamber.org Do you have your Keycard? Use it to get discounts at Chamber Member businesses all throughout the Greater Carlisle Area. For more information, call the Chamber today! A Special Thank You to Carlisle Regional Medical Center for being our Keycard Sponsor!
212 N. Hanover Street, Carlisle, PA 17013 • (717) 243-4515
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Annual
G8 • The Sentinel
Sunday, March 3, 2013
Finances • Continued from G7
component to its programs that encourages residents to volunteer. This helps to ward off depression by helping the individual feel productive, Bowen said. He added, from a financial standpoint, it is more cost-effective in the long-term to invest in wellness and prevention in the near-term. Sandy Gurreri is an aging care manager supervisors with the Cumberland County Agency on Aging. Her advice to seniors is to educate themselves on what programs are available. While the agency does not offer cash subsidies, staff members can provide information and screen seniors
for eligibility. Nesbit recommends a comprehensive approach to extended care planning. “A lawyer is not enough,” he said. “It has to be somebody who understands the law, how government agencies work, how caseworkers think and move files and how care facilities operate.” What people don’t understand is the current system consists of parts that are not coordinated or designed to be complimentary to one another, said John Reese, an elder care coordinator with Keystone Elder Law. “It is not a well thoughtout system,” Reese said. “It has been likened to a puzzle or a maze.” For example, an elderly
couple decides they want to give their two children some money. They consult with an accountant who advises them that IRS rules allow each spouse to give each child a gift of $14,000 for a total of $56,000. However, something happens that requires one of the spouses to seek out care in a skilled nursing facility. Under Medicaid rules, the spouse exceeded the monthly limit for a monetary gift jeopardizing their eligibility for medical assistance. While the gift was perfectly legal and sound advice from a qualified
• See Finances, G9
“There are some people who are just carefree. If it happens, somebody will pay for it like the government or my kids, but this limits your choices. You are not going to get into a nice skilled nursing facility.” John Bowen
Director of social services at Bethany Village in Mechanicsburg
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The Sentinel • G9
Their Future
Signs your loved ones need help BY JOSEPH CRESS THE SENTINEL
jcress@cumberlink.com
Being an outsider looking in can often be the best prescription for the long-term health and safety of an aging parent or spouse. “Sometimes you need that external person to be the voice of reason or insight,” said John Bowen, director of social services at Bethany Village in Mechanicsburg. “It is not always denial that prevents us from acting,” he added. “Not everyone has the insight to notice the changes going
on within yourself.” The challenge is how to be diligent, but not overbearing in your approach to helping the loved one juggle their finances and health care. It starts with a frank conversation the majority of us try to avoid, but need to make at some point while the parent or spouse is healthy and competent. This can be especially difficult for parents, said Sandy Gurreri, an aging care manager supervisor with the Cumberland County Agency on Aging. “They don’t want to give up that control,” she ex-
plained. “They don’t want to share that information. They don’t want their caregiver or children to know because they are afraid of the consequences.” Yet their refusal to discuss their finances may be the very first sign of a lapse
in memory or cognition that could lead to problems in keeping their bills up-todate. Some warning signs to watch out for include poor hygiene and weight loss, Gurreri said. There are important questions to ask
Finances
• Continued from G8
accountant, it failed to take into account other rules in play for seniors. “This is one of the confusing things about being an older person,” Reese said. Ne s b i t re co m m e n d s
that people between 55 and 70 consider purchasing long-term health care insurance. He explained how every dollar spent on premiums can multiply itself by six times by the time the insurance is needed.
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G10 • The Sentinel
Sunday, March 3, 2013
Their Future
“It’s an uncomfortable situation to talk about. It brings your own mortality to the surface.” Karen DeWoody
Claremont Nursing & Rehabilitation Center
Aging
• Continued from G9
damp, that could be a sign the person is not taking good care of themselves. The key is to approach the person is a life-affirming, non-threatening way before paranoia sets in where they question your motives, Gurreri said. She recommends the child or caregiver be persistent and try to reassure the person that you want their money to last and be used to help them meet their needs. “You have to be upbeat,” Gurreri said. “We want to help you with the process.” Karen DeWoody is administrator of the Claremont Nursing & Rehabilitation Center in Middlesex Township. She suggested holding this conversation long before a crisis is imminent. DeWoody recommended bringing it up at a family gathering so everyone is in on the discussion
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on the person’s wishes. “It’s kind of in all of us as to what we want,” DeWoody said. “It’s an uncomfortable situation to talk about. It brings your own mortality to the surface.” An important item of discussion should be disclosure of medical information, Gurreri said. Under the American Health Insurance Portability and Accountability Act, each individual has the right to designate who they want to have access to their medical information. Helen Schultz is the admissions coordinator at Claremont. She suggested starting a computer file on the loved one to document their current list of medications and past medical history. This could help the family track trends in changing needs and bring relatives from out of town up to speed on the current status of the loved one.
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Talking with your older parents about money The National Institutes of Health website says an estimated 5.1 million Americans already are struggling with Alzheimer’s disease.
to handle their finances. Medical documentation of dementia, Alzheimer’s or mental incompetence also would be required. A guardianship grants control over aspects beyond the financial aspects of the parable to handle her affairs No matter how old you ent such as treatment deciby age 82. Another option are, this is a difficult consions, handling of property would have been a springversation. and living arrangements. ing power of attorney that Some parents are comBy establishing the duratakes effect only when a fortable when it comes to ble power of attorney at the qualified physician consharing all their informasame time she set up her firms that person’s mental tion; what preparations will, Mom’s cost were unMary Brunski incompetence. they have made and what der $500 in 2000. (She also By having the power-ofthey want to have happen in • What is their medical set up her Advanced Direcattorney documents estheir winter years. history, names of doctors, tives at the same time; we tablished before we needed current treatments, preSome parents however knew what care she wanted them, handling her finances scriptions and what is the are not so open. Here is when the time came.) and care was easy — from why you should have the medigap insurance and Part Had it been necessary that standpoint. conversation now, rather D policies? to hire an attorney and go To help your parents, you than later. • Who is their CPA, attor- through the courts to gain a will need to know — or find ney, and financial advisor The National Institutes conservator and/or guard— the following informaof Health website says an Had the power of atianship, the costs would estimated 5.1 million Amer- tion: torney not already been in have been much more, not • What are their sources icans already are struggling place, when Mom began to mention additional time of income — Social Secuwith Alzheimer’s disease. having difficulty underand stress for everyone. rity, pension, IRAs, and/or The number of individuals standing her bills and When Mom entered into 401K? with Alzheimer’s (or other handling daily living activi- an assisted living facility, we • Where are their wills, forms of dementia) is exties, we would have had a were able easily coordinate deeds and any trust docupected to double for every more difficult time getting and pay for her care from ments? five-year interval beyond services for her. We would her accounts. Medicare will age 65. My mother’s jour• Who are the designated have had to file with the only pay if the patient has ney began around age 79. beneficiaries for the pencourts to become her conbeen hospitalized for three When she moved in with sion, IRA or 401K accounts servator or her guardian. or more days and cannot us at age 80, she went to an and insurance policies To become conservareturn home. attorney to set up a will in tor means going to pro• Critical information Then, they pay 100 perPennsylvania (she moved bate court with a family such as Social Security cent for the first 20 days, 80 law attorney so that you from Ohio). numbers, checking and percent after that (usually may handle the financial At that time she estabsavings accounts, invest“medigap” policies will lished a Durable Power of ment accounts, insurances aspects. You need to proAttorney which was helpful policies and personal iden- vide documentation that • See Parents, G11 the parent is no longer able when she was no longer tification numbers.
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Sunday, March 3, 2013
The Sentinel • G11
Parents
• Continued from G10
a final-expenses policy with a local funeral home and even ordered the stone. When she passed at age 92, help with the remaining 20 percent) for the next 80 days — or until everything had been taken care of and required payments of less than the patient is no longer progressing $400 to handle the final details. therapeutically. If that occurs on What if no one in the family wants Day 60, Medicare will cut off at that to handle all these details or take on point, and it will be a private-pay case if the parent still cannot be safe the responsibility? There are some firms that may offer to help with bill at home. paying, filing medical claims and Mom was in assisted living care other recurring tasks. for four and one-half years before One option is the local nonprofit, a hospital trip required her to be Marantha-Carlisle. They assist in moved into a skilled nursing care ensuring timely payment of bills facility. The majority of her care in and budgeting. Find out more about assisted living was on a private-pay them at http://maranatha-carlisle. basis and we had to find a nursing org. home that would be willing to acAnother option is Daily Money cept Medicaid or had an endowment Managers. Their services generally fund for when her funds ran out. include: When her funds begin to run low, • Bill-paying, including calls to the nursing home helped us file the paperwork for her to receive Medic- payees regarding incorrect bills and aid. It was about a three-month pro- preparation of checks for clients to cess before we received the determi- sign. • Balancing checkbooks and nation of when Medicaid would start maintaining organization of bank to assist with her care. records. At that point, with the power• Preparing and delivering bank of-attorney papers in hand. and deposits. knowing her final wishes, we set up
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The Sentinel • H1
Sunday, March 3, 2013
Their Future • March 3, 2013 • Section H
2013
Annual Report Dollars & Sense
How to maximize your budget and plan for your future
Their Future
Keeping informed of elder care options
ing the elderly and their families. jcress@cumberlink.com An aging parent, fearing the worst, pleads with a child There are certain promises not to be placed in a nursno one should keep with ab- ing home. The child agrees, solute certainty. out of guilt or obligation, but John Bowen has seen the does not realize the challenge scenario play out time and again in his 20 years of help• See Care, H2 BY JOSEPH CRESS THE SENTINEL
Michael Bupp/The Sentinel
Volunteer Bea Waggoner organizes cards in the gift shop at Bethany Village East in Mechanicsburg. Right: Judy Trissler participates in an water aerobics class at Bethany Village.
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H2 • The Sentinel
Sunday, March 3, 2013
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Above: Luych Vu, left, Robert Swoyer, center, and Ann Keiper-Smith, right, listen to stretching instructions from Jesse Swoyer at the Center for Independent Living of Central Pennsylvania. Michael Bupp/The Sentinel
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that lies ahead. Taking this approach can set up the child and parent for failure and hard feelings. Instead, what is needed is a healthy dose of reality to ease the anxiety of a loved one who dreads the final stage in the continuum of elder care options, said Bowen, director of social services at Bethany Village in Upper Allen Township.
His advice to the child involved is to reassure the parent that efforts will be made to avoid placing him or her in a nursing home as long as possible, but it may be something the parent needs in the future.
Staying at home Elder care starts at home with independent living and usually ends with intensive care at a skilled nursing facility, Bowen said. There are
advantages and trade-offs with every step along the way. While some retirees buy into a retirement community with a continuum of care, the vast majority of seniors live in their homes in towns and villages, Bowen said. The key to successful independent living is to keep pace with the level of need. “You don’t have to rip somebody out of their home just because they have been
diagnosed with something,” Bowen said. “You can brainstorm and problem solve in a way where can still allow them to stay at home as long as possible. Once you know what you are dealing with, you can fit the environment to meet the person’s needs.” For example, a caregiver can have grab bars installed so their aging parent or
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Sunday, March 3, 2013
The Sentinel • H3
Care
• Continued from H2
spouse can get in and out of the shower. A lift chair that costs about $600 can be a worthwhile investment that could add months or even years to the ability of a person to stay at home, Bowen said. He said that if the senior or his family has the money, they could hire a geriatric case manager or social worker to advise them on how to navigate the health care system and seek out resources in the community.
Care for the caregiver
In the case of a married couple, the more healthy spouse often takes on the role of caregiver for their frail or sickly partner. But this can present a problem if the caregiver becomes so focused on caring for the loved one that they lose touch with their own health. “A lot of times we see the caregiver pass on before the person who is diagnosed with an illness,” Bowen said. “They get burned out. If you just plow forward with blinders on and ignore everything else that is when the health of the caregiver declines.” Bowen recommends that to avoid this, the caregiver find a way to take a break, have some fun and relax every so often without having to feel guilty. Respite programs are available to give caregivers a much-needed time out for a recharge. Unless the caregiver has training as a nurse, he or she may be ill-prepared for the role beyond providing basic needs. Instead of giving up, Bowen suggests getting involved in a caregiver support group to learn as much as possible. “Not everybody is into searching the web or reading books, but if you go the group meeting, you will get an earful from people who are walking in your shoes,” Bowen said. “Sometimes the information sticks with you better.” While it is more cost-effective for an individual to remain in independent living, there has to be an adequate level of support to maintain that care, said Sandy Gurreri, an aging care manager supervisor with the Cumberland County Agency on Aging. In the end, the length of time a senior can remain at independent living depends on each individual case, Bowen said. “As long as you are safe and healthy, you can remain where you are.” The next step in the continuum is an assisted living or personal care home. At this stage, the senior goes from living at home to living in an apartment or cottage with a varying amount of assistance being provided for daily tasks. Bowen describes this step as being similar to college dorm living where seniors pay for room and board,
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utilities, three meals a day an individual to a more reand the services of profes- strictive living space, Bowen sional caregivers. One thing said. to watch for are signs of Scouting options stress and depression that go along with downsizing The experts recommend
Jason Malmont/The Sentinel
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Care
• Continued from H3
into a panic mode that may be a red flag, Gurreri said. It could also be a sign that a medical emergency is underway in one of the wards or that a licensing agency is on premises to conduct a periodic inspection. “You have to be realistic,” she said. As you tour a facility, ask yourself questions. How do the residents appear? Are they groomed and welldressed? Do they appear content? Are they involved in activities? How are staff members interacting with them? “It is always good to go in and visit during an offtime,” said Karen DeWoody, administrator of the Claremont Nursing & Rehabilitation Center in Middlesex Township. She suggested that families tour and compare a number of facilities to see what amenities each has to offer. Both Gurreri and DeWoody recommend req u e s t i n g a to u r ove r a scheduled meal to see how the facility handles food service. Though structured tours are available, unannounced tours may offer better insight into what is really happening in the facility, DeWoody said. Aside from tours, visitors must have access to the annual inspection reports prepared by state licensing agencies. “You can ask for it at the front desk or lobby,” Gurreri said. “They are not
the easiest things to read.” Things to watch out for include cases of dehydration, skin problems, accidents and injuries. These reports are also available online at the Pennsylvania Department of Health and the Pennsylvania Department of Public Welfare web sites. Gurreri also recommends families make use of county ombudsmen who serve as advocates for elder care clients. Even when a family exercises due diligence, the situation may be depend on where a bed is available. “Nine times out of ten when a person needs a nursing home they are not planning ahead,” Gurreri said. “They are coming right from a hospital with a fractured hip, a stroke or a heart attack. Their first entrance into the nursing home is through the rehab unit.” Helen Schultz is admissions coordinator at Claremont. She recommends that families should review their health insurance poliMichael Bupp/The Sentinel cies to determine how coverage exists for long-term Bethany Village wellness professional Sarah Snyder, right, helps Angelo Gallo with his workout. skilled nursing care. “You can not believe how many come in here shocked there is either limited coverage or no coverage,” Schultz said. T iming is important, Bowen said. Depending on the circumstance, there may be a benefit with placing a loved one in the next level of care sooner than later. “If you look ahead, understand there is going to be a proSandy Gurreri gression,” Bowen said. Cumberland County Agency on Aging
“Nine times out of 10 when a person needs a nursing home they are not planning ahead. They are coming right from a hospital with a fractured hip, a stroke or a heart attack. Their first entrance into the nursing home is through the rehab unit.”
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Sunday, March 3, 2013
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Sunday, March 3, 2013
The Sentinel • H5
Their Future
Power of attorney is essential “The will is less important because it only deals with property after you are dead. The power of attorney is what helps you while you are living.� David Nesbit
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Often, families end up paying expenses out of their own pocket because they lack a power of attorney to access the aging individual’s bank accounts. â–
BY JOSEPH CRESS THE SENTINEL
jcress@cumberlink.com
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said David Nesbit, a lawyer with Keystone Elder Law of Mechanicsburg. “The power of attorney is what helps you while you are living.� It is vital to have a power of attorney in place sooner than later while the person the document is for is competent enough to authorize
• See Elder law, H6
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Annual
H6 • The Sentinel
Sunday, March 3, 2013
Elder law • Continued from H5
it, said John Bowen, director of social services with Bethany Village in Mechanicsburg.
Time of the Essence
“If you wait too long, the document is not going to serve its purpose,” Bowen explained. “You can’t give a power of attorney to someone else if you are not using the right judgment or have the right cognitive ability to sign that over to somebody.” While every case is different, statistics show that for people 65 and older, the risk of dementia or cognitive loss doubles every five years of your life, Bowen said. “One in eight people at 65 has dementia. Once you reach 70, it is two in eight or three-quarters of your colleagues. At 75, it is half of your friends.” Bowen is not saying that every person in their 80s or 90s has dementia. “I have many examples of people who seem pretty ‘with it.’ It’s just that as we get older, there is going to be some kind of cognitive impairment or loss. It’s just the nature of the beast.” John Reese is an elder care coordinator with Keystone Elder Law. He has seen how family members agonize over how they are going to pay the bills of an incapacitated loved one. Often, they end up paying expenses out of their own pocket because they lack a power of attorney to access the aging individual’s bank accounts. Lack of foresight can have other consequences. All too often, families have to go through the expense, has-
sle and humiliation of having an aging family member declared incompetent by a court just so they can obtain a legal guardianship to pay that person’s bills, Nesbit said.
A matter of trust The most important step in preparing a power of attorney is to designate someone you can trust to manage
Jessica Fisher, also an attorney with Keystone Elder Law, recommends designating one primary agent along with an alternate to serve as a back-up. “You don’t want to have multiple agents working together,” she said. “If they don’t agree, you end up in court basically.”
your affairs and follow your guidelines. There are many things to consider. “You should ask them ahead of time ‘Are you OK with this?’” Bowen said. “‘Are you willing to take on this role?’ If they say ‘Yes,’ explain to them what your wishes are and then put it on paper and make sure they have a copy of it in a safe place.”
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Annual
Sunday, March 3, 2013
The Sentinel • H7
Elder law • Continued from H6
Also, married couples should have a power of attorney even if it is understood among the spouses that they will be taking care of the other person’s financial and health care needs, said Sandy Gurreri, an aging care manager supervisor with the Cumberland County Agency on Aging. Part of it goes back to the cognitive ability of each individual as they age. There is also the question of what happens when both the husband and wife are incapacitated after being in a traffic accident for example. Normally when there is no written power of attorney, next-of-kin decisions on medical procedures falls first on the spouse and then on the children, but the experts agree it is better to have something in writing.
Seeking advice
Keystone Elder Law routinely recommends that its clients draw up advance directives, a living will and a durable health care power of attorney at the same time they prepare a Durable Financial Power of Attorney. A few hundred dollars spent on legal fees today can save people money and headaches down the road, Bowen said. He said many of these documents use standard “boilerplate” language that only requires the insertion of names and addresses.
Nesbit recommends that people exercise caution when using an online source to download a standard document. While this may be better than nothing at all, it may not hold up under scrutiny if the loved one tries to sell real estate or goes to the bank or an insurance company, Nesbit said. Consulting an attorney is especially important in cases of a second marriage or a blended family, Bowen said. Gurreri said a legal expert can be useful in helping individuals protect their assets and quali-
fy for medical assistance. Next to Durable Financial POA, the second most important legal document is the Health Care Power of Attorney, Nesbit said. His firm uses a standard form recommended by the state Department of Health that should be familiar to most every medical professional and facility in Pennsylvania. “When there is an urgent medical issue, we would rather not have to consult a hospital lawyer or the ethics committee to determine what the document means,” Nesbit said.
End-of-life philosophy Fisher said the state form includes a checklist of medical procedures available along with space for the client to write in specific goals they want health care providers to consider when making decisions for them. For example, if an individual’s religious beliefs do not allow them to have a blood transfusion, such a restriction would be important to note in the “goals” section of the state form. Nesbit cited another example where the person listed as a goal his willingness to
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is only part of appointing a power of attorney. Equally important is sitting down with that person while you are competent to talk about your wishes. That way, your agent is more aware of what your philosophy or beliefs are when it comes to intensive or invasive medical procedures. Fisher explained how you can require your agent to follow directives to the letter or allow them the flexibility to bring their own experiences into the decision-making process. As for wills, a key decision is to name an executor who can act as your personal representative in issues involving the settlement of the estate, Fisher said. “People often think that ‘We are married so I would receive everything,’ but that is not true under Pennsylvania Law.” For one thing, the surviving spouse may not have access to bank accounts or property that are solely under the name of the deceased, Fisher said. She added it is not always prudent to designate the oldest child the executor. “It has to be somebody you can trust who is good about opening the mail and handling finances,” Fisher said.
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The Sentinel • I1
Sunday, March 3, 2013
Their Future • March 3, 2013 • Section I
2013
Annual Report Dollars & Sense
How to maximize your budget and plan for your future
End-of-life decisions: Individual attitudes matter BY JOSEPH CRESS THE SENTINEL
jcress@cumberlink.com
Experts agree that how a life ends often might come down to options best discussed sooner than later. Whether it involves an aged parent or relative, or an individual facing a terminal disease, the questions often are: Would that person want to stay alert and awake — grimacing in pain each time they try to interact with a friend or family member? Or should that person be given comfort measures and pain medication strong enough to gradually ease them out of a life cut short and numbered in days? John Bowen, director of social services at Bethany Village, says the attitude of individuals involved toward hospice should be part of any conversation dealing with the health care wishes of an aging parent or spouse.
• See End of life, I2
King Street Addition SummitHea lth . org/N ewWi n g
Annual
I2 • The Sentinel
End of life • Continued from I1
“There are a lot of people in good health who have said ‘I don’t want to live any longer than I have to,’” Bowen explained. “It is not that they are depressed or have a death wish. They have led a good happy life. They have seen their friends suffer with diseases. They just don’t want that.” Hospice is a way for the health care system to embrace this philosophy and allow such people to die free of the pain that so often accompanies terminal illness, Bowen said.
Dying with dignity
Sandy Gurreri is an agingcare supervisor with the Cumberland County Agency on Aging. She wants to clear up a misconception. “Some believe hospice is just giving up,” Gurreri said. “That is unfortunate. Hospice is an excellent choice for folks who are near the end of life. It is a way to die with dignity and support. It is when you realize you don’t want to take on any major surgery or aggressive treatment that might ruin your quality of life. It is about making a conscious decision. This is how I want my life to end. I want it in comfort.” T h e co nve rsa t i o n o n
whether to seek hospice care can take place anywhere within the continuum of health care options available to the elderly or seriously ill, Bowen said. “You don’t have to wait until you have gone all the way up the ladder. You are eligible for hospice even in your home. That is where most of the services are provided.” What is needed is a diagnosis from a physician that a disease is terminal and that the loved one has less than six months to live, Bowen said. What can happen is a difference of opinion or outright resistance from a medical professional. Since hospice care requires an order from a physician, it is important for the doctor, the patient and the family to be on the same page, Bowen said. “It you have a doctor that is not willing to do that than you need to find a different doctor.”
Heading off a crisis As with other issues related to health care for the aging, the key is to talk to the loved one before it becomes a crisis so that their wishes are carried out properly without placing undue stress on family members. Under hospice care, a doctor takes on the role of team leader with nurses, chaplains, social workers and volunteers providing sup-
port. Experience is more important than credentials when selecting a hospice service, Bowen said. A quality hospice service provides a spiritual component to end-of-life care, Gurreri said. “It is involv-
Sunday, March 3, 2013
ing the whole family. It is helping the family through the process.” Facilities such as Claremont Nursing and Rehabilitation Center provides hospice care as an ancillary service in addition to
skilled nursing care, administrator Karen DeWoody said. She explained when an individual goes into hospice, a different of Medicare takes over requiring that person to sign paper-
work agreeing they are no longer seeking a cure for their ailment. Once that occurs, the person can only be admitted into a hospital from hospice for a condition unrelated to a terminal illness, DeWoody said.
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The Sentinel • I3 Their Future
7 little-known Social Security benefits By Jennie L. Phipps Bankrate.com
In the first season of “Friends,” Rachel Green looks at her first paycheck as a waitress and asks, “Who’s this FICA guy, and why is he getting all my money?” That’s one hard lesson about Social Security. Another is that when it’s time to claim, you can’t depend on the Social Security Administration to be your personal adviser. In an effort to save time and cut costs, Social Se-
Their Future
How to benefit from Social Security By Barbara Whelehan Bankrate.com
The Social Security program is mired in controversy, with proponents saying we need to shore up the system and detractors demanding that we end the “Ponzi scheme.” But there’s no question that for many generations, it has accomplished what it
set out to do. Enacted under the Franklin D. Roosevelt administration, the Social Security Act of 1935 was designed to “provide for the general welfare by establishing a system of Federal old-age benefits.” It has provided a floor of income that has prevented millions of Americans from experiencing poverty in their retirement years.
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Most people depend on this important monthly stipend in retirement. Currently, 35.8 million retired workers are getting monthly benefits of nearly $44 billion per month, collectively, with the average monthly payout amounting to $1,230.50. It’s funded by payroll taxes, interest on investments and income taxes imposed on some So-
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cial Security benefits. But when it comes to claiming benefits, it’s easy to make mistakes. For instance, too many people sign up at their first opportunity — age 62. Their benefits could be higher if they wait until full retirement age, which for
• See Social Security, I4
• See Benefits, I4
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Social Security • Continued from I3
most people is 66. And they could get a substantially higher monthly check if they could let their retirement credits build up until age 70 before making a claim. If you’re married, there are ways to let your own retirement credits build up while collecting spousal benefits. But the decision about when and how to claim is complicated and depends on each
Benefits
• Continued from I3
a request that is not the most common choice, you’ll need to go to the Social Security office and make the request in person, he says. There are many ways a married couple can decide to take their Social Security benefits, according to Alicia Munnell, director of the Center for Retirement Research at Boston College. You can’t ask Social Security to list them all, so what’s the right choice? Munnell says it’s hard to beat waiting until you’re 70 to begin benefits because the monthly payment is 76 percent higher than it would be if you had started to take benefits at 62 and 32 percent higher than it would be if you claimed at age 66. On the other hand, some people advocate drawing Social Security benefits at the first opportunity. Doug Carey, who founded the financial planning software firm WealthTrace, says Social Security doesn’t see itself as an odds maker, but it does require you to bet on your longevity. He offers this chart as proof. It graphs the break-even point for a person who earned the inflation-adjusted equivalent of $70,000 per year for 35 years. If this person waits until 70 to claim Social Security and lives until at least age 90, he’ll accumulate almost $162,000 more in benefits than he would if he had claimed at 62. But there’s a possibility of losing the bet and getting nothing. Retired law professor and Social Security expert Merton Bernstein says the longevity bet odds are bad, so
“A widow can begin drawing a survivor benefit on her late husband’s Social Security when she is as young as 60, but only at a reduced rate.”
individual’s circumstances. Bankrate’s package on Social Security presents nine stories to help readers navigate the labyrinthine rules and regulations of the government program. It’s important to be armed with as much information as possible as you wind down from your earning years and approach your golden years, so you can make smart decisions about how to manage your money.
claim early. “You never know when the bell will ring. I subscribe to the Woody Allen principal: ‘Take the money and run.’” If you’re not happy in your marriage after nine and a half years, hold off before hiring a divorce attorney. “Stay married for at least 10 years,” says San Francisco-based Bank of America personal banker Raphael Gilbert. Why? That’s what it takes to stake a claim to your exspouse’s Social Security benefits. If you terminate the marriage after nine years and 11 months, you’re out of luck. If you make it for 10 years, you can collect a Social Security benefit based on up to half of your ex’s earnings or on the basis of your own earnings — whichever is higher. And we have another dirty little secret for you. If you haven’t remarried, chances are your ex-spouse is worth more to you dead than alive
Sunday, March 3, 2013
Graph courtesy of Bankrate.com
— especially if he or she was a high earner. Once an exspouse passes away, you’ll be treated just like a widow or widower. If you are at least 60, you’ll be able to collect your late-spouse’s benefit and allow your own benefit to grow unclaimed until you reach age 70, when you can switch if your own is higher, according to Carol Thomas, who worked for the Social Security Administration for 28 years and answers questions about Social Security at RetirementCommunity. com. Assuming your ex will dwell on Planet Earth to a ripe old age, the longer your ex-spouse delays claiming Social Security, the better it is for you. So, if you get a chance, encourage your ex to work until age 70. Then, when it’s all over, you’ll get to claim half of his or her maximum Social Security. Or once you and your exspouse reach full retirement age — usually 66 — you can claim half your ex’s benefit
and let your own grow untouched until you’re 70, says Thomas. Consider it payback. Social Security does a good job of explaining widow and widower benefits, but Dan Keady, director of financial planning for TIAA-CREF Financial Services, says it doesn’t clearly spell out a key difference between widow/widower benefits and spousal benefits. A widow/widower can begin benefits based on his or her own earnings record and later switch to survivors benefits or begin with survivors benefits and later switch to benefits based on his or her own record — even if the surviving spouse is filing before full retirement age. You can’t do that with spousal benefits. In other words, a widow can begin drawing a survivor benefit on her late husband’s Social Security when she is as young as 60, but only at a reduced rate. Then she can choose to leave her own So-
take that frequently results in denial of a claim. The Social Security website offers an explanation of how your benefits are calculated, but it’s a little hard to follow. You can find a simpler explanation at myretirementpaycheck.org, a website sponsored by the National Endowment for Financial Education. Your Social Security payment is figured using a complex calculation based on a 35-year average of your covered wages. Each year’s wages are adjusted for inflation before being averaged. If you worked longer than 35 years, the government will use the highest 35 years. If you worked for less than 35 years, they’ll average in zeros for the years you are lacking. You don’t have to be a math genius to figure out the impact of that — it drags down your average. If you can avoid zeros by working a couple of years longer, you’ll increase your Social Security payment.
cial Security alone, allowing it to grow in value until her full retirement age — or even age 70. This works for widowers, too. When you apply for disability insurance, Social Security doesn’t tell you that your first step ought to be hire a lawyer or other expert adviser. Allsup, a private firm that advises people about how to get SSDI, says Social Security doesn’t even make it clear that an applicant can have representation from the very beginning of the application process. As a result, lots of people don’t get help until they’ve been initially denied, and that slows down the process unnecessarily, according to Allsup spokeswoman Mary Jung. Jung also warns SSDI applicants to be accurate and precise on the application. Small mistakes can make a big difference. Minimizing how much exertion was required to perform the person’s job is a common mis-
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The Sentinel • I5
Their Future
Assistive technology for seniors at home
New PERS models not only trigger an automatic response, they also can detect the difference between a fall and someone stooping down to pick something up. ■
By Sonya Stinson Bankrate.com
Technology to help seniors age in place has gone far beyond grab bars and fall-alert buttons worn around the neck. Today, there’s a host of sophisticated products on the market, from medication dispensers that can report to a family member when their loved one forgets to take a pill to shoes embedded with GPS trackers to find cognitively impaired wanderers. The best choices for seniors who want to stay at home depend on their medical condition, budget and personal preferences, says Marnie Renda, an occupational therapist and certified aging-in-place specialist in Cincinnati. The goal should be to make the technology fit the lifestyle, not the other way around. “You find out what their daily routines are and what their preferences are, and
put technology in to support what they’re already doing,” Renda says.
4 products to consider Personal emergency response systems, or PERS: The old models featuring a button attached to a pendant or connected to a telephone for summoning help aren’t much help if the user is too forgetful or incapacitated to press the button. “What companies have seen over time with the basic push-button phone or pendant is that people often feel uncomfortable calling,” says Susan Garland, editor of Kiplinger’s Retirement Report, which ran an article about assistive technologies in its July 2012 issue. New PERS models not only trigger an automatic response, they also can detect the difference between a fall and someone stooping down to pick something up, Garland says. As Renda
pendence. “Some research shows that 20 (percent) to 30 percent of people who end up in nursing homes do so because they couldn’t manage their medication,” Renda says. One of the latest medication management tools is a countertop dispenser that’s about the size of a blender, Garland says. A caregiver loads in several days’ worth of medicine and provides the manufacturer of the dispenser with the patient’s medication schedule, and the machine is coded to deliver the right amount at the right time. Monthly
describes them, these new devices are worn as chest straps under clothing, similar to a heart monitor. Monthly subscriptions for basic PERS devices start at around $30, according to Julie Menack, a care manager and certified aging-in-place specialist in Oakland, Calif., who also sells assistive technology. The Kiplinger article features a model with an automatic alert that costs $49 a month. Medication dispensers: Taking prescribed medicine in a timely manner goes a long way toward helping seniors maintain their inde-
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habits to set up a baseline of what his or her style of living is, so the computers on the sensor know when that refrigerator door should open for breakfast or lunch,” Garland says. These types of monitors generally run from about $200 to several thousand dollars to purchase, plus a monthly fee of $70 to upward of $200, Menack says. Enhanced telephones: Te l e p h o n e s w i t h ve r y large buttons and room to
rental and monitoring fees run from $59 to $75, according to Garland. So m e m o d e l s c a n b e locked to prevent someone with dementia or simple forgetfulness from taking the wrong medicine, and some notify a caregiver by phone, email or text if a dosage is missed, Renda says. Motion sensors: Motiondetection monitoring systems are especially handy for remote caregivers, Garland says. These systems rely on floor mats and bed mats wired to pick up changes in the user’s normal activity. “You use the person’s
• See Technology, I6
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Their Future
Does bankruptcy in retirement make sense? ing with a bankruptcy filing. Federal law protects Social Security money from garnishment, whether seniors file for bankruptcy protection or not. But debt-plagued seniors who choose not to file still need to protect their Social Security money, according to Fort Lauderdale, Fla., attorney Teisha Powell. “Remember, at the time a creditor obtains a judgment, they will just garnish the bank account,” says Powell. “This means the creditor will have no way of figuring out that the Social Security income has been deposited in the bank account and exempted.” According to Powell, seniors should keep Social Security money in a separate account, and they should notify creditors in writing that the account contains only Social Security money. In addition, a new rule effective in May 2011 is designed to help prevent financial
By Michael Estrin Bankrate.com
Retirement is supposed to mean financial stability for seniors. But increasingly, Americans over the age of 65 are getting into trouble with debt and turning to the bankruptcy courts for relief. In 2007, seniors represented 7 percent of all bankruptcy filers. More than a decade earlier, only 2 percent of those filing for bankruptcy were aged 65 or older. According to a 2010 report by University of Michigan Law School professor John Pottow, seniors are the fastest growing demographic of bankruptcy filers. But bankruptcy — whether it’s a Chapter 7 liquidation or a Chapter 13 plan to renegotiate and repay debts — poses some special issues for seniors who, unlike other filers, tend to have more equity in their homes and less of a chance of increasing their income so late in life. Seniors in debt should consider these six questions before proceed-
• See Bankruptcy, I7
Senior checking not always good deal By Claes Bell Bankrate.com
Like the senior discount at Denny’s or your local movie theater, senior checking accounts are pitched as a benefit to help older people stay within their sometimes limited budgets. But senior checking accounts aren’t always a better deal, according to a study by the Pew Research Center. Last week, I wrote about a Pew study that examined student checking accounts and found them to be, on average, pretty good. Senior checking accounts, though, didn’t fair nearly as well. The study found that senior checking accounts basically fall into one of three categories: •Simple senior checking accounts: They offer a few minor freebies along with a basic checking account. •Low-cost/low-fee accounts: These give seniors more substantial benefits in the form of lower monthly maintenance fees and low balance
requirements to avoid those fees. •Senior added-benefit accounts: There are higher balance requirements in exchange for benefits such as earning interest and waiving certain fees. The first two categories of accounts offer real — if minor — benefits. But the last category can end up costing seniors big if they don’t meet higher balance requirements, according to the report: These accounts waive five fees that range from $1 to $10, some of which are for less common items like a ministatement at an ATM. These charges may not be incurred frequently enough by the typical customer to account for substantial savings. Essentially, accounts of this type are a luxury account tailored for seniors, not necessarily an improvement on the basic checking package. The upshot is that senior accounts are a mixed bag, and those looking to take advantage of any senior benefits need to read the fine print carefully before committing.
Technology • Continued from I5
display photographs of contacts on speed dial can be lifesavers for people with visual and cognitive impairment, Menack says. Special phones with enhanced sound help those with hearing loss. Menack notes that some cellphones on the market enable callers to access an operator instead of dialing the num-
bers themselves. Prices for picture phones start at about $80, while the cost of an amplified land line can range from $30 to $300, according to Menack. Cellphones with enhanced sound and special services are in the $50 to $300 range. She notes that some state agencies may offer free enhanced phones to those with a doctor’s prescription.
The learning curve Proper installation and training are essential to making assistive technology easy to use, Menack says. “Every product has a learning curve,” she says. “If the person the product is meant for isn’t that techsavvy, there has to be someone who is going to see it through and make sure that it’s working.” Adds Renda: “The key
ance plan or public program pays for all types of assistive technology. Medicare Part B pays for up to 80 percent of the cost of what it calls “durable medical equipment” — or devices needed for recovery from an injury or illness — but not for products meant for long-term use. The Department of Veterans AfHelp with financing fairs offers more extensive No single private insur- financial assistance for
to getting people to accept technology is making sure you have the right product. You have to make sure their vision is appropriate so that they can actually see the product and can use it. If the technology demands too much from them, they’re not going to be able to use it.”
veterans needing assistive technology. M o s t s t a te s p ro v i d e Medicaid Waiver reimbursement for personal emergency response systems, while a smaller number cover medication management and health monitoring systems, according to a 2011 study by the LeadingAge Center for Aging Services Technologies.
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The Sentinel • I7
Bankruptcy • Continued from I6
from just handing over account money to creditors. L i ke So c i a l Se c u r i ty, most retirement vehicles such as 401(k)s and pensions are exempted under federal bankruptcy law. That means creditors can’t touch those assets in a bankruptcy, says attorney Melissa Herman in Woodstock, Ga. Seniors with particularly hefty pensions, however, may not be eligible for Chapter 7 liquidation, and instead may be forced to file a Chapter 13 repayment plan, which can be tricky because seniors often lack the disposable income needed to make repayment work. Put another way, some seniors may have too much income to qualify for Chapter 7, but not enough cash flow to pay off their debt and take care of living expenses. Seniors who have IRAs are treated a little differently in bankruptcy. Federal law exempts IRAs up to $1,095,000. But seniors filing in states with a higher exemption can use their state’s statute to increase their exemption. Thankfully, most state exemptions are “large enough to cover most, if not all of a person’s specific retirement accounts,” says Herman. However, each state varies, so it’s best to check
“The best alternative for a senior with high equity and a low homestead exemption is to file for a Chapter 13.” with a local bankruptcy attorney. Generally, a debtor’s home equity is exempt from creditors in bankruptcy. But, says attorney Stuart Pack of Nagle Law Group in Phoenix, it’s important to remember that the amount of the exemption varies by state. In Florida, where there’s no limit to the homestead exemption, seniors filing for bankruptcy can protect their equity and keep the home, even in a Chapter 7 filing, which liquidates all nonexempt assets to pay off creditors. But seniors in states with low homestead exemptions don’t fare as well. “Suppose a senior citizen has $100,000 in equity and a (homestead) exemption of $20,000,” says Powell. “In that case, it would be foolish to move forward on a Chapter 7.” According to Powell, the best alternative for a senior with high equity and a low homestead exemption is to file for a Chapter 13. That means the senior will keep paying the mort-
gage (although possibly at a lower rate). If the senior has no mortgage, a Chapter 13 can force the senior to take out a loan to pay off the restructured debt. However, many seniors are at a particular disadvantage in this situation, says Powell, because they don’t have disposable income to pay off the loan and they’re unlikely to be able to go back to work. High medical bills are the leading cause of bankruptcy filings among seniors and those under age 65. But typically, those bills, which are classified as unsecured debt, are discharged in full at the conclusion of a Chapter 7 bankruptcy. But if the senior is not eligible for a liquidation bankruptcy, or they choose a Chapter 13 repayment plan, those bills may not go away. “In a Chapter 13 case, depending on the net monthly income and the amount of secured versus unsecured debts, a debtor may be required to pay a portion of the medical bills and other unsecured debt,” says Gallagher.
I t ’s a l s o p o s s i b l e — though rare — that the senior might have medical bills that are considered secured debt. “In some rare instances after a medical provider has obtained a judgment against a debtor, the debt would be considered a secured debt, which means that the provider has a judicial lien against all of the debtor’s property.” At its core, bankruptcy is about providing the debtor with a fresh start. Debts are forgiven and the debtor is allowed breathing room to get back on track. But
with seniors, bankruptcy raises some unique questions, says John Mlnarik, an attorney in Santa Clara, Calif. “Anyone who files for bankruptcy should have so m e t h i n g to p ro te c t , whether it is income, an asset or interest in some other exempt property,” Mlnarik says. “An individual who is ‘judgment proof’ does not need to file for bankruptcy, so long as they are relatively certain they will remain that way for the remainder of their life (not get a new job, inherit anything or win the
lottery). Seniors simply can determine with a greater amount of certainty that they will remain judgment-proof. And creditors, because of a person’s age, are more likely to believe them.” Whether filing for bankruptcy protection is worth it for a senior varies with each individual case. Seniors with assets to protect can expect to pay around $1,500 for legal help, says Powell. And even when the filer doesn’t have much in the way of assets, some seniors file simply to put an end to calls from creditors.
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I8 • The Sentinel
Sunday, March 3, 2013
Their Future
Cars don’t fit seniors’ needs By Tara Baukus Mello Bankrate.com
Almost 90 percent of senior drivers are driving cars that don’t meet their needs for health, safety and comfort, according to a new report by AAA. The study found that drivers older than 65 commonly have decreased flexibility and muscle strength, limited range of upper-body motion and diminished vision, and that while many cars have features that can help senior drivers compensate for these issues, they aren’t driving them. AAA has issued a variety of recommendations in its “Smart Features for Older Drivers” guide including: Seat heights that are higher off the car’s floor or can be adjusted so they are at least as high as the driver’s mid-thigh when standing for easier entry and exit in the car.
Power seats that adjust six ways or more to help with hip, knee or leg problems or decreased leg strength. Keyless entry and push-button start as well as thicker steering wheels for drivers with reduced grip strength in their hands. Power mirrors and dashboard controls with buttons for drivers who have trouble with twisting or turning motions with their hands. Larger displays with contrasting text for those with diminished vision. Many of today’s cars come standard with these features and don’t require purchasing a higher-priced car, which is helpful for those who are taking on an auto loan. By looking for a car equipped with features such as these, it can lengthen the amount of time senior drivers can maintain their freedom safely and comfortably.
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