Planning For Retirement - Will Your Golden Years Be Golden?

Guest Blog Post by Baby Boomers Planning for Retirement

Time passes quickly by, and the day of your retirement is drawing near. Will you be prepared or will you still be thinking about planning for retirement? 

"According to Scottrade's fifth annual American Retirement Survey, 60 percent of Gen Y-ers saved nothing toward retirement last year and 40 percent plan to save nothing in 2011." Is this your situation? Not planning for retirement, is a recipe for disaster. You cannot count on Social Security providing for all your needs in your golden years. It was never intended that Social Security would be a retirement pension. It was designed to be a supplement to your savings.

Like a three legged stool, if one leg is missing, you do not have a stable seat. Savings is one very important leg of your retirement planning stool. The sooner you begin saving a minimum of 10% of your annual income, the larger your retirement income will be.

Time, saving money, and the power of compounding of interest will work miracles for your retirement years.

Consider this scenario. Who do you think would have more money saved for retirement? Person A saves a mere 5% of his gross salary of $40,000, or $2,000 for forty years and invests it for a return on investment of 10% annually. Or, person B who gets a late start and saves $5,500 annually for twenty years also at 10% R.O.I.? 

Person A would save and earn a grand total of $885,185.11. Person B would only accumulate $315,012.50 before taxes. Had Person A saved and invested a full 10% of his salary, he would have accumulated a grand total of $1,770,370.22! 

When planning for retirement, the sooner you start and consistently contribute to your savings and investment plan, the better off you will be in your retirement years. 

If you have a 401(K) Plan where you work, you should take full advantage of this plan. Often employers will also contribute a portion based on your contribution. This is an additional boost to your savings. 

If you do not have an employer 401(K) plan, you must start either a standard IRA or a Roth IRA. Your savings will grow tax free under the Roth IRA plan under current rules. 

In November 2008, there were articles that appeared that Democrats in the House of Representatives were conducting hearings on the proposals to confiscate all IRAs and 401(K)s. These accounts would be converted to accounts administered by the Social Security Administration. 

In light of the debt crisis, this Draconian measure cannot be ruled out by a cash strapped government. The wise investor will not put all of their investment eggs in one basket or account type. You might consider hiring an asset protection attorney to protect your IRA from government confiscation. 

Planning for retirement begins with a savings plan. All good investors are good savers. You should learn how to invest. Stansberry & Associates Investment Research offers excellent newsletters that will teach you the essentials of wise investing. I have found them to be a great asset. 

Once you have an investment plan in place, I would also recommend that you plan for your health issues for your latter years. Most people will need some assistance in their last years. One way to pay for assisted living care or a nursing home, is to purchase a Long Term Care insurance policy that covers these expenses. 

The average number of years a man needs assisted living is two years. A woman needs a minimum of three years. Remember, that is just an average. Some residents with dementia have been committed for as long as ten years. 

Planning for retirement early will help you have a comfortable and financially secured retirement under normal conditions. 

For more articles on Planning for Retirement consult

And to get an idea of your area's nursing home costs, take a look at  Caregiverlist's Nursing Home Star-Ratings and Costs.

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Senior Veteran Aid Organization Champions Patriot Flag Tour

As July 4 approaches, it is time to remember our senior veterans and those who gave (and continue to give) so much of themselves for our freedoms.

Caregiverlist friend and founder Debbie Burak is a great senior veteran advocate and part of the group sponsoring the Patriot Flag Tour. The massive 30 foot by 55 foot American Flag is dedicated to and honors those who died in the September 11, 2001 attacks and those who responded. The nationwide tour will end this Sept. 11, on the 10th anniversary of the attacks when the flag will be flown in New York City at Ground Zero, at the Pentagon and in the field where United flight 93 went down near Shanksville, Pa.

You can learn more about the tour and watch Debbie speak at the opening ceremony here.

Because senior programs and resources vary state to state, make sure you know your eligibility and entitlements by checking the resources available to you in your state.

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CaringBridge Caregiver Comfort Kit Giveaway

Caregivers for family and friends and for seniors sometimes have the challenge of keeping up with all the care issues when the care receiver is in the hospital or a rehab facility.  Caregiverlist recently partnered with CaringBridge, a nonprofit providing free websites to help patients and caregivers stay connected to their family and friends. CaringBridge websites offer a personal and private space to communicate and show support, saving time and emotional energy when health matters most.

How it Works
By following a few simple steps, a personalized website complete with privacy options can be started in just minutes. The author introduces the reason for the CaringBridge site in “My Story” and provides ongoing updates through entries in the “Journal.” Friends and family members can receive automatic updates when journal entries have been made, and can leave messages of love, support and encouragement in the “Guestbook.”

Benefits to Patients and Caregivers
Using CaringBridge to centralize communication during a health challenge saves time and energy and makes it easy for caregivers to keep loved ones updated. Everyone can stay in touch, regardless of time zones and area codes. CaringBridge provides a personal and private space for everyone to express their feelings and offer support.

Many authors also feel the therapeutic benefits of writing down their experience. “I know I said things in the journal I would not have said out loud because I don’t think I would have been able to say them in front of people without totally losing it,” said one CaringBridge author.

Healing Power of Connection
The power of connection and support often extends beyond the psychological to the physical; in a 2010 study of patients using a CaringBridge website to share health news, 91% of patients agreed that it helped make their health journey easier and 88% of patients agreed that it positively impacted their healing process.

“Without CaringBridge, I know that we would not have gone through our experience as well supported,” said a CaringBridge author.

CaringBridge has provided a comfort kit to giveaway to one lucky reader. It includes items like travel-size lotion and lip balm. To be entered to win, just leave a comment on this blog post about how you share health news and stay connected to your network of support.

And if you are looking for a professional career in caregiving, visit's Caregiving Career Center.

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Caregiver Empathy, Try the Mitten Test

Understanding how a senior's senses change as they age can help caregivers to relate better to when they may need to step in with a helping hand.

Guest Blog post by Charlotte Bishop of Creative Case Management.

The trees are budding and blooming, the bulbs have forced their way to the surface in beautiful blossoms and the birds are twittering and nesting.  Time to put away your winter coats, wool scarves and mittens, right? Well, partly right. Your winter mittens have another useful purpose that can help you make home an easier place for your older loved ones.

As our bodies age, certain of our nerve pathways begin to fail, and the human anatomy uncannily reroutes many of the circuits as they stop firing. But with age, more and more of those pathways may slow or fail for a variety of reasons, and it just makes it harder for older adults to do the simple manual tasks they used to do without even a thought. Turning a door knob, turning on a lamp or taking the lid off a jar become challenging, maybe even impossible. It is hard for those of you who may be in the prime of your lives to really get this, no matter how empathetic, so I recommend an easy exercise to help you experience what this erosion of manual dexterity and fine motor skills feels like. In doing so, you can also help identify challenging hardware or activities that can be more easily managed with a bit of creative help.
Caregivers for seniors can take a pair of mittens, walk through each of the rooms in your elder loved one's home and go through the normal activities of the person who lives in those rooms. As you enter a room, it is may be more challenging to flip a light switch or twist the switch on a lamp with your hands in mittens. These can be remedied by retrofitting wall switches with the larger rectangular switches that one merely presses on and off. Likewise, the lamp twist switches that are challenging with mittens can be replaced with wider winged grips. And even before you enter a room, the door knob may be your undoing if the knob is too small or too slippery. Handles may be an appropriate replacement.

You would find that mittens are effective barriers to everything from opening the ketchup bottle to a twisting the lid on a jar of apple sauce or beverage bottle and more. Some of the web sites and stores with helpful assistive devices can be found in the blog Safer Senior Living-The Kitchen. And if a key itself is hard for an older loved one to grip when opening a door, hardware stores have over-sized sheaths to make gripping easier.

With your mittens still on, try tying your shoe laces or buttoning a shirt or blouse. It may be time to get creative with Velcro-equipped shoes or other substitute hardware for buttons. And go through the motions of other self-grooming activities to determine what challenges are manageable and which are just out of reach. The number of what are called "assistive devices" will amaze you as you look to television remote controls, computer access and more. Check out the Department of Health and Human Services Assistive Technology site.

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management.

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Medicaid Redesign in New York

Guest Blog Post By David A. Cutner, Esq.

Last January, New York Governor Andrew Cuomo appointed a Medicaid Redesign Team and tasked it with reversing a decades-long crisis of overspending and waste in our Medicaid system. The Redesign Team made a variety of proposals, a couple of which would have been devastating to the elderly and their spouses, and to disabled children and their parents.

Fortunately, two of the most problematical proposals were not included in the State budget that was approved on March 30th, but there are some changes in the law that are significant for Medicaid planning.

Probably the most controversial proposal from the Redesign Team was to use the 5-year penalty period in connection with applications for community-based benefits, including Medicaid home care. Since February 2006, as required by Federal law, New York has applied the 5-year look back to Medicaid nursing home applications, and has penalized uncompensated transfers.

The purpose of the 5-year look back is to determine whether the Medicaid applicant has transferred assets that could have been used to pay for care. The penalty calculation involves dividing the amount or value of the transferred assets by the monthly regional rate of nursing home care, yielding a period of time in months during which the applicant is ineligible to receive benefits. For example, a $100,000 transfer divided by the current New York City regional rate of $10,579 yields a 9.5 month Medicaid penalty.

While superficially it might seem logical to apply the look back and penalty to community-based Medicaid, any attempt to do so would be extremely difficult to implement, and very detrimental to patient care in many cases. This is because home care patients have widely-varying needs, and Medicaid does not cover any living expenses. Happily, the Redesign Team's proposal was omitted from the budget.

Many people are unaware that, in New York, there is no look back or penalty for transferring assets when applying for Medicaid home care. This remains the law.

The other highly controversial proposal from the Redesign Team was the elimination of spousal refusal and parental refusal. By eliminating spousal refusal, many applicants would have been ineligible for Medicaid benefits until the couple had spent down virtually all of their savings (including the individual assets of the well spouse) and had contributed a substantial share of both spouses income. Similarly, parents would have been required to spend down all of their savings before their disabled child became eligible for benefits.

Fortunately, this proposal was not accepted either. Spouses and parents need not be forced into poverty in order to secure care for their loved ones. (However, they remain subject to claims by Medicaid for contribution if their resources or income exceed certain limits).

One of the Redesign Team's proposals that was enacted is a revised and expanded definition of an individual's estate for Medicaid purposes. The expanded definition is obviously aimed at giving Medicaid the ability to recover greater amounts from the estates of Medicaid recipients. The expanded definition includes interests that have traditionally never been a part of the probate estate of a deceased person. These include retained life estates, jointly held property, and interests in trusts.

The expanded definition is problematical in certain respects, and at odds with legal precedent. For example, a life estate is extinguished upon death, and the holder of the remainder interest automatically becomes the 100% owner. Similarly, if property is jointly owned with right of survivorship, the survivor automatically becomes the 100% owner. It will be interesting to see how the courts decide Medicaid's estate recovery claims when they collide with these long-established rules.

Until the courts provide clarity regarding the application of Medicaid's expanded definition of estate, Elder Law practitioners will want to carefully consider their use and choice of trusts in Medicaid planning. While grantor, income only, trusts have been extensively used in the past, it may be prudent to consider substituting a family trust where the grantor retains no rights in the trust whatsoever.

Budgetary constraints at the Federal and State levels are going to put continuing pressures on Medicaid benefits, making it increasingly important for seniors and their families to seek advice from an Elder Law attorney and plan ahead.  Understand the costs for senior care and plan for your care before you need it.

Contributed by New York Elder Law Attorney, David A. Cutner.

Remember, Medicaid rules and benefits change by state. Learn about your particular state services.

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Caregiving Jobs

Senior caregivers are able to be hired by senior home care agencies, assisted living communities, nursing homes and hospitals.  Both companion caregiver and certified nursing aide positions are available along with part-time and full-time schedules.

As senior care must sometimes be provided around-the-clock and facilities must staff day time and night time shifts for nursing aides, there are a wide variety of employment opportunities available.

Some positions require experience and other positions only require a caring personality.

You may learn about the caregiver job description, take a practice nursing aide exam, find training programs in your area, build your own resume and apply for a caregiving job near you to begin your career path in senior care.

CLASS Act Passes Senate: Natl. Long-term Care Insurance

The Senate passed the Community Living Assistance and Support Services (CLASS) Act on Friday, December 4th, making this act an approved portion of the healthcare reform bill.  The word on the street is the healthcare bill will pass, in some form, and this portion of the bill has now been approved.

What is it?

The CLASS Act allows Americans to contribute, through payroll deductions, to this long-term care insurance program.  After 5 years of paying into the program, benefits may be paid, if assistance is needed for a minimum of 2 Activities of Daily Living.

The purpose of the program is to provide an alternative to nursing home care for people with disabilities and seniors.  It will also allow family members to be able to continue to work and pay for a caregiver. 

Average policy premium?  About $50 per month.

Average amount of daily benefit?  About $75 per month.

How will the benefit be paid for? Through the insurance policy premiums - - this was fashioned to follow how private insurance is operated - which can be extremely profitable when managed well.  The government did have actuaries crunch the numbers for this insurance program (yep, there is a reason why Warren Buffett, one of the wealthiest guys in the U.S.A., likes to buy insurance companies - - many more people pay into premiums than collect on them and interest can be earned on the money in the meantime).  The premiums will be age-adjusted and contributions must be made for 5 years before someone can file a benefit claim.  And, the government can't "borrow" from this money to pay for other programs.

By delaying and preventing nursing home admissions, the CLASS Act will also decrease costs for Medicaid, which only provides for care in a nursing home. 

The risk?  It will be important for participation rates to be high.

Learn more about the CLASS Act and read the statement prepared for the Senate by Massachusett's Senator Kirk, who filled former Senator Edward Kennedy's seat - - Senator Kennedy had been a proponet of the CLASS Act as a way to allow seniors and the disabled to remain in their homes and afford at least part-time care.



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Healthcare Reform: Don't Forget Billions in Medicare Fraud

As the Senate debates healthcare reform and how the additional coverages would be provided, why aren't they talking about the $90 billion that has been given away for free through Medicare fraud?

A private company would close their doors if all of their earnings were being stolen by clients.  Why does the government create programs which make it possible for fraud to easily take place? 

Those of us in the healthcare industry are aware of the stories which circulate about medical equipment companies who are billing improperly to Medicare (even the Scooter Store, which advertises heavily on television with infomercials, settled a lawsuit with the federal government after an employee blew the whistle on improper claims).  Part of the problem stems from government programs which make some reimbursements a bit too large, as compared to the profitability a company would earn in the private sector - but shouldn't government pay the same as the private sector pays for products (or less, if they are guaranteeing bulk orders)?

From the government's news release on the Scooter Store fraud:

"By representing to physicians that their patients wanted and needed power wheelchairs, The SCOOTER Store obtained thousands of “Certificates of Medical Necessity” from physicians who did not know about the company’s fraudulent practices. The SCOOTER Store then billed government and private health care insurers for power wheelchairs, which were far more costly than power scooters, and collected millions of Medicare and Medicaid dollars.

The SCOOTER Store received $5,000 to $7,000 in reimbursement for each power wheelchair it sold, more than twice the amount for a scooter, which sold for around $1,500 to $2,000. Many beneficiaries had no idea what kind of equipment they were getting, until it was delivered by The SCOOTER Store.

The government’s lawsuit also alleged that The SCOOTER Store knowingly sold used power mobility equipment to beneficiaries and billed Medicare as if the equipment were new, in violation of Medicare regulations. In addition, the U.S. alleged that The SCOOTER Store charged Medicare millions for unnecessary power mobility accessories."

If seems if the government could just cut out the programs that have a bit too much frosting and whipped cream on top for certain industries, and created efficient systems for reimbursement, the billions in fraud that are saved would more than pay for additional healthcare benefits.

Check out this 60 Minutes story which aired on October 25, 2009, and profiles the billions being stolen from Medicare via fraudulent claims.  It seems it would not be that difficult to set up a better system for checking out claims to avoid this fraud, especially when people aren't just stealing a million or two million, but million after million after million without being caught. 

Medicare does not pay for long-term care and because of this, many seniors must hire their own senior caregiver and the additional cost of providing health insurance for senior caregivers is not always covered by small businesses or when a caregiver is hired directly (or when a family member must quit their job to provide for the care). 

Meanwhile, studies show the most important factor in senior care is one-on-one care services by a caregiver.  Even Medicaid-funded nursing homes often do not staff more than 1 Certified Nursing Aide for each 12 residents, which often means this nursing aide cannot adequately provide care to each senior. 

It seems eliminating the extremely high Medicare reimbursements for some medical equipment would be the first easy fix to help pay for more health insurace benefits for Americans, including benefits for senior caregivers.




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Caregiver Application

Interested in assisting seniors as a companion caregivers or nursing aid or home health aid?

Many positions are available for caregivers to work for senior home care agencies, assisted living companies and nursing communities as part-time or full-time caregivers.  Senior care companies provide benefits, including payroll tax contribution (this means you can retire someday and collect social security benefits yourself), worker's compensation insurance and usually health care benefits for full-time employees.

You may fill out a job application as a caregiver to reach professional senior care companies in your area, as new positions become available each day, as seniors are discharged from the nursing home, assisted living communities and hospitals.

You may also learn about pay, policies, certified nursing aide programs and view caregiver training videos.



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Caregivers Provide Added Safety for Seniors with Memory Loss

Seniors with memory loss, and especially seniors who have been diagnosed with Alzheimer's disease, can benefit from having a part-time or full-time caregiver.  Senior home care agencies provide training and ongoing support for caregivers who are caring for clients with memory loss.  As every day can be different for the seniro with memory loss, and because sometimes the caregiver is the first person to be blamed for anything impacted by the senior's memory loss, having the full agency team proves valuable.

In Georgia this weekend, an 87-year-old woman with Alzheimer's disease left her home alone before dawn.  Fortunately, she did have a caregiver present, who discovered her missing at 6:00 a.m. Saturday morning.  The state police and sheriff's department began a search and found her just before 9:00 a.m. This is a reminder that confusion about time and place can lead to a senior with Alzheimer's Disease placing themself in harmful situations.  Providing a caregiver can help keep their daily schedule on track, along with keeping meals and medications consistent.

The Georgia senior's wandering incident is a reminder of the realities of the challenges and needs of a senior with memory loss. 

If you are a caregiver, find out if the senior you are caring for has had a mini-mental exam given by their doctor.  This is an easy way to catch memory loss early.

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