How to Stay in Good Health When Times are Tough

 

With the economy in a tailspin, most of us are feeling the effects of the financial crisis. Amidst the daily struggle to hang onto jobs, pay our bills, and save for retirement, physical wellness can take a back seat to more immediate concerns.

But the stress of trying to cope in a tough economy makes it more important than ever to care for your most valuable asset – your health. Good health can make a tremendous difference in your ability to face the pressures of uncertain times.

Nutrition

A demanding schedule can make it tempting to eat on the run; with grocery prices soaring, you may skimp on more wholesome foods in favor of cheaper alternatives. But good nutrition is the cornerstone of good health, and it is possible to eat well without draining your wallet.

- Plan Ahead
Plan a weekly menu before you shop and purchase only the items you need – you will save a lot of money.
Keep the FDA food pyramid in mind, and skip the prepackaged meals. Use fresh produce and whole grains
whenever possible – farm stands are excellent sources of fresh and inexpensive seasonal items.

- Avoid Fast Food
Although it is cheap and convenient, fast food is calorie-laden and lacking in nutritional value. Carry healthy
snacks and ignore the lure of the drive-through.

- Dine In
Restaurants are expensive, and little attention is given to the nutritional quality of the food coming out of the
kitchen. Make cooking a family event, or invite your friends – everyone will benefit from good food and the
camaraderie of preparing a meal together.

Exercise

You’ve been working overtime to make ends meet. With the bills piling up, the gym membership is an expense you can’t justify. Sticking to an exercise routine seems impractical – you’ll get back into it when things get better.

Feeling this way is understandable, but physical activity is a vital to maintaining good health. Exercising is a great way to de-stress, keep your metabolism running, and sustain a healthy body weight.

If you can’t afford the snazzy gym, you can still work out without the expensive equipment and personal trainer. Why not rediscover the pleasures of the great (and free) outdoors? Take a walk with friends, your partner, or the dog. A bike ride is an excellent workout, even if you ride a $200 model instead of a sexy, top-of-the-line racing cycle.

Take a hike and enjoy the scenery, or go for a vigorous swim. If you live in a winter climate, even sledding with the kids can be great exercise – the trudge back up the hill is a workout in itself. However you choose to stay fit, you will feel refreshed and ready to deal with any challenge.

Stress Management

Medical experts agree that high stress levels have a tremendous impact on our health. Stress weakens the immune system and depletes the hormones that promote healthy body function and mental well-being; it is also a huge factor in illnesses such as heart disease.

Make time for yourself. Yoga, meditating, or simply listening to soothing music can help you to relax, reduce your stress level, and allow your body’s self-healing abilities to take over.

Risky Behaviors

Behaviors such as smoking, heavy drinking, and drug use are never good for you. Aside from the adverse health effects, these substances can dim your outlook, exacerbate stressful situations, and impair your ability to make good decisions.

Cutting back on drinking and smoking can only be beneficial, and you will find yourself feeling more energized and positive about your life.

Preventative Health Care

It is impossible to overemphasize the importance of preventative care. Scheduling a checkup or mammogram may be the furthest thing from your mind right now, but remember that early detection is critical in treating any disease.

- Lab tests (such as pap smears) can spot diseases which are easily treated in early stages, but become
much more complicated and dangerous if allowed to progress.

- Mammograms are recommended for women ages 40 and up. Don’t duck out of your checkup with the
excuse that you don’t have time – you could be saving your life.

- Cholesterol checks are vital for older adults. Maintaining a healthy cholesterol level can minimize your risk of
stroke or heart disease.

Don’t overlook your annual checkup. Even in difficult times, you will greatly improve the quality of your life if you practice good habits and maintain a healthy lifestyle.

 

Socialize for Better Memory and Mental Health

Does it make sense to be  more  involved and have a more active social life as we age?  Yes it does.  Being more engaged socially  appears to delay memory loss as we grow older, a new study has shown.

 

The finding, which appears in the July issue of The American Journal of Public Health, suggests that strong social interaction, through friends, family and community groups can enhance our brain health as we age and that social isolation may be an important risk factor for cognitive decline for old folks.

 

Researchers at the Harvard School of Public Health used data gathered from 1998 to 2004 from the Health And Retirement Study, a large, nationally representative population of American adults aged 50 and older.

 

In the study, participants took memory tests at two-year intervals during the period.  Testers read a list of 10 common nouns to survey respondents who were then asked to recall as many words as possible immediately.  They did so again after a five-minute delay.  The researchers also measured social integration based on marital status, volunteer activities and contact with parents, children and neighbors.

 

When the results were analyzed, it  showed that people in their 50s and 60s who were involved  in a lot of social activity also had the slowest rate of memory decline.  In fact, compared to those who were the least socially active, study subjects who had the highest social integration scores had less than half the rate of memory loss.  The researches looked at age, gender, race and health.

 

It was interesting that those who had the least number of  years of formal education appeared to have he most to gain from an active social life as they aged.  The study showed hat the protective effect of social integration was greatest among individuals with fewer than 12 years of education.

 

“The working hypothesis is that social engagement is what makes you mentally engaged,” said Dr Lisa F Berkman, the study’s lead researcher and director of the Harvard Center For Population And Development Studies.

 

“You can’t sit and withdraw if you’re constantly talking and working on things and figuring out problems in your daily life.  It’s not just completing a crossword puzzle, it’s living your life.”

 

Hopefully, the results will change the mindset of those who are put in a position to care for an elderly family member.  There are many people who erroneously believe that just being there to give moral support to an aged person is enough.  But people need to understand that aged people need to be more socially engaged to reap the rewards of good mental health.  Old folks need to be encouraged to get involved more socially and engaged at a level that is meaningful both for the individual and the group or community they are involved in.

 

Such involvement by aged people in a community or group can reap similar memory benefits as engaging in a memory training or using memory techniques to enhance learning and memory skills.  It is also definitely more meaningful and has an added side effects – contentment, greater self-esteem, optimism and overall greater self-confidence.

 

“A lot of people, when they think about the elderly, focus on social support … things like what can I do for my elderly mother,” Dr Berkman said, “But having someone to count on is not what we’re measuring.  It’s not about support it’s about being completely engaged and participating in our society.”

 

What was notable about he study is that participants didn’t have to be married to or surrounded by extensive family to receive the protective effect of social engagement.

 

“You don’t have to have friends if you have family.  If you don’t have family but you have friends, that’s good.  If you volunteer to civic organizations that can be a substitute,” Dr Berkman said.

 

“People don’t have to have all of these things.  They just have to have some breadth and diversity in the kinds of networks and ties they have in a community.”

Build Your Retirement Savings with Your Health Care Savings Account

Health Savings Accounts are an excellent way to build a second retirement account.  These tax-favored accounts, which have only been available since January of 2004, can be opened by anyone with a qualifying high-deductible health insurance plan.  Once you open an HSA account, you can place tax-deductible contributions into it, which grow tax-deferred like an IRA.  You may withdraw money tax-free to pay for medical expenses at any time.
The biggest reason more people don’t retire before age 65 is lack of health insurance, and many Americans reach age 65 woefully unprepared for the medical expenses they’ll face once they do retire.  One of the most important long-term reasons for establishing an HSA is to build up some money for medical expenses incurred during retirement.

Fidelity Investments reports that the average couple retiring in 2006 will need $190,000 to cover medical expenses during retirement.  This assumes life expectancies of 15 years for the husband and 20 years for the wife.

HSAs are, without exception, the best way to build up money to pay for medical expenses during retirement.  You should not contribute any money to your traditional IRA, 401 (k), or any other savings account until you have maximized your contribution to your HSA.  This is because only health savings accounts allow you to make withdrawals tax-free to pay for medical expenses.  You can take these distributions anytime before or after age 65.

Your HSA contributions won’t affect your IRA limits — $3,000 per year or $3,600 for those over 55.  It’s just another tax-deferred way to save for retirement, with the added advantage being that you can withdraw funds tax-free if they are used to pay for medical expenses.

For early retirees who are healthy, a health savings account can also be a smart option to help lower their health insurance costs while they wait for their Medicare coverage.  The older someone is, the more they can save with an HSA plan.  For many people in their 50’s and 60’s who are not yet eligible for Medicare, HSAs are by far the most affordable option.

Any money you deposit in your health savings account is 100% tax-deductible, and the money in the account grows tax-deferred like an IRA.  For 2006, the maximum contribution for a single person is the lesser amount of your deductible or $2,700.  In other words, if your deductible is $3,000, you can contribute a maximum of $2,700; if your deductible is $2,000, then that is the maximum.  For families, maximum is the lesser of $5,450 or the deductible.

If you’re 55 and older, you can put in an extra $700 catch-up contribution in 2006, $800 in 2007, $900 in 2008, and an additional $1,000 from 2009 onward.  The contribution limit is indexed to the Consumer Price Index (CPI), so it will increase at the rate of inflation each year.

How much you accumulate in your HSA will depend on how much you contribute each year, the number of years you contribute, the investment return you get, and how long you go before withdrawing money from the account.  If you regularly fund your HSA, and are fortunate enough to be healthy and not use a lot of medical care, a substantial amount of wealth can build up in your account.

Health savings accounts are self-directed, meaning that you have almost total control over where you invest your funds.  There are numerous banks that can act as your HSA administrator.  Some offer only savings accounts, while others offer mutual funds or access to a full-service brokerage where you may place your money in stocks, bonds, mutual funds, or any number of investment vehicles.  

One of the biggest advantages of retirement accounts like HSAs are that the funds are allowed to grow without being taxed each year.  This can dramatically increase your return.  For example, if you are in the 33% tax bracket, you would need a 15% return on a taxable investment to match a tax-deferred yield of only 10%.

As another example, if you are in a 33% tax bracket and were to invest $5,450 each year in a taxable investment that yielded a 15% return, you would have $312,149 after 20 years.  If you put that same money in a tax-deferred investment vehicle like an HSA, you would have $558,317 – over $240,000 more.

Because catch-up contributions are allowed only for people age 55 and older, if one or both of you are under age 55 you should establish your HSA in the older spouse’s name.  This will allow you to capitalize on the expanded HSA contribution limits for people in this age range and maximize your HSA contributions.  Once that person turns 65 and is no longer eligible to contribute to their HSA, you can open another health savings account in the younger spouse’s name.

Strategies to Maximize your HSA Account Growth

If your objective is to maximize the growth of your HSA in order to build up additional funds for your retirement, there are three important strategies you should implement.

Strategy #1: place your money in mutual funds or other investments that have growth potential.  Though this is riskier than placing your money in an FDIC-insured savings account, it is the only way to really take advantage of the tax-deferred growth opportunity that an HSA provides.

Strategy #2: delay withdrawals from your account as long as possible.  Though you may withdraw money from your HSA tax-free at any time to pay for qualified medical expenses, you do have the option of leaving the money in the HSA so that it continues to grow tax-free.  As long as you save your receipts, you can make medical withdrawals from your account tax-free at any future date to reimburse yourself for medical expenses incurred today.

As an example, let’s say a 45 year old couple places $5,450 per year in their HSA over a period of 20 years, they have $2,000 per year in qualified medical expenses, and they get a 12% return on their investments.  If they withdraw the $2,000 from their HSA each year, they’ll have a net contribution of $3,450 per year into their account, and they’ll have $248,581 in their account when they begin their retirement years.

If on the other hand they delay withdrawing that money, they will have $392,686 in their account at age 65.  If they choose they can withdraw the $40,000 to reimburse themselves tax-free for the medical expenses incurred during that 20 year period, and still have $352,686 in their account – over $100,000 more than if they had withdrawn the money each year.

Strategy #3: make the maximum allowable deposit to your HSA at the beginning of each year.  Even though you are allowed until April 15 of the following year to make deposits to your HSA, you should take advantage of the tax-free growth in your account by funding it as soon as possible.  The extra interest you can earn by contributing to your account on January 1 of each year rather than the next April 15 can amount to over $40,000 in a 20 year period, and over $100,000 in 30 years.

Using Your HSA to Pay for Medical Expenses during Retirement

When you enroll in Medicare, you can use your account to pay Medicare premiums, deductibles, copays, and coinsurance under any part of Medicare.  If you have retiree health benefits through your former employer, you can also use your account to pay for your share of retiree medical insurance premiums.  The one expense you cannot use your account for is to purchase a Medicare supplemental insurance or “Medigap” policy.

Though Medicare will pay for the majority of health expenses during retirement, there many be expenses that Medicare will not cover.  Nursing home expenses, un-conventional treatments for terminal illnesses, and proactive health screenings are all examples of medical expenses that will not be paid for by Medicare, but that you can pay for from your HSA.

Long-term care is assistance with the activities of daily living, such as dressing, bathing, or feeding yourself.  It can be provided in your home, a retirement community, or a nursing home.  Long-term care expenses can be paid for using funds from your HSA, and long-term care insurance can even be paid for from the HSA up to the following maximum annual amounts:

- Age 40 or under: $260
- Age 41 to 50: $490
- Age 51 to 60: $980
- Age 61 to 70: $2,600
- Age 71 or over: $3,250

To establish a health savings account, you must first own an HSA-qualified high deductible health insurance plan.  Compare HSA plans side by side to determine the best value to meet your needs.  Once you have your high deductible health insurance plan in place, you can open your Health Savings Account with the financial institution of your choice.

Lyme Disease: A National Health Crisis

“No pain, no gain!” is a grim, but popular maxim for the dressage competitor- indeed, for any competitive athlete. But especially for the dressage enthusiast who suffer not only muscle soreness and joint strain, but blisters and calluses on hands – and much worse!

Yes, we equestrians are all gluttons for punishment in our passionate pursuit for the elusive mastery of subtle aids and powerful performance.

“It’s not trail-riding!” quips Sue Jaccoma to students who dare to whine about the physical demands in following her directions. As a successful instructor and top national competitor herself, she leads by example and manages to inject humor into the gruesome reality of callused crotches, back problems and bruises of all shapes and sizes, never complaining (actually relishing) the challenge of riding 5 to 6 horses per day without complaint.

And yet it is this iron-will and blind determination that makes dressage riders so vulnerable to Lyme disease.

Lyme Disease is now thought to be the fastest growing infectious disease in the world having finally surpassed AIDS in the US (Source: International Lyme and Associated Diseases Society.)

According to a Harvard medical study, there are believed to be at least 200,000 new cases each year in the U.S, and some experts think that as many as one in every 15 Americans is currently infected (20 million persons).

The truly frightening aspect of this disease is that most victims never see the tick or the bulls-eye rash, and with an enormous capacity for pushing through pain, many dressage riders don’t recognize the onset of symptoms (which for many feels like a flu), and ignore the sporadic pain that occurs as the spirochetes burrow deeper and deeper into the tissue causing joint pain (especially neck and back), abdominal pain, fatigue and a whole host of other symptoms that can mimic everything from MS, fibromyalgia, chronic-fatigue syndrome, and rheumatoid arthritis just to name a few.

Lyme affects each person in a very unique way depending upon immune strength. Additionally, it can hide in a healthy person for years in a cystic form, and then become virulent at the first sign of weakness.

To make matters even worse, there is no reliable test available to determine the presence of Lyme in a person, you need a Lyme-literate doctors who can put the puzzling symptoms together with a full health history and a test for antibodies (the western blot) to determine the diagnosis and design a treatment protocol which varies greatly from person to person.

Johanna Husta lives in Ulster County, New York, where she has ridden her whole life. First competing in hunter-jumper, then eventing, she fell in love with dressage after a single lesson with Meri Straz (now sadly deceased). Before that, in 1996, Johanna (known as Jiffy) started feeling sick. She remembers, It felt like someone pulled the plug on my life-force.

It began with unusual fatigue and achiness, along with joint pain, migraines, depression and night sweats. Eventually, the symptoms became so troubling that Johanna went to the doctor. “I never go to the doctor maybe once a year for my annual physical but this was beginning to scare me.” Says Johanna of that long-ago visit.

“He (the doctor) attributed all of my symptoms to depression and sent me home with anti-depressants. To his credit he ordered a Lyme test, but it came back negative.”

Johanna’s Lyme test was the ELISA test which looks for your bodies antibodies to the infection. Unfortunately the test misses 40% 80% of the time (depending upon your source,) but it is especially ineffective once the bacteria has disseminated and invaded more deeply into the tissue.

For seven more years, Johanna went from doctor to doctor, diagnosed with depression, rheumatoid arthritis and fibromyalgia. Each year the ELISA test was repeated with negative results and Johanna, still riding several horses per day and working a full-time corporate job, continued to suffer.

Finally, in the spring of 2004, an allergist sent her to Dr. Horowitz, a premier Lyme-literate doctor who has been treating all forms of Lyme for over 20 years. At last she was given the western blot which showed positive results 8 years after her first symptoms.

Relieved and undaunted, Johanna took mega-doses of oral antibiotics for 18 months during which time she continued to ride, but had marginal improvement. Dr. Horowitz decided to treat her more aggressively and placed her on IV antibiotics for 6 months.

Another less dedicated rider might have canceled their ambitious Florida plans, but Johanna was determined. She had been rehabbing an older competitive horse, and was eager to spend the winter in Wellington, Florida training with Sue Jaccoma.

“I covered my IV-line with an arm-band, and most people didn’t even know I was sick. But Sue knew, and tried to accommodate my good day/bad day roller-coaster recovery. She was very understanding!” Johanna recalls,

“The excitement I felt as my riding improved actually helped me feel better faster.” And by the end of the season, Johanna was starting to feel some semblance of physical and mental normalcy.

Unfortunately, like so many others, Johanna had a full relapse six months later, and this time she had to cancel her Florida plans. But she isn’t bitter.

“Everything happens for a reason.” She says softly. “You’ve got to have faith.” And Johanna’s faith encompasses her plans to compete at the highest level.

Unlike Johanna, I started riding as an adult, taking my first dressage lesson in 1995. I spent 8 years at Training Level and then in 2003 – at age 42 – I purchased a school-master from gold-medalist Susanne Hamilton (CSF Imports), and began training with her in earnest.

Undaunted by the physical challenge of daily schooling and frequent showing, by the end of 2005 I had earned my bronze medal, and by May of 2006, I had earned my silver medal as well.

Looking back, I remember fighting incredible fatigue and a long list of aching muscles and joints that I ascribed to the physical cost of competitive dressage.

In September of 2006 – ignorant of any possible illness I loaded up my Holsteiner mare and 3 month old filly to Region 8 Championships in Saugerties, New York for the breed show, along with my Hanoverian schoolmaster and won 3rd place in Prix St. Georges (adult amateur class).

Ten days later I had to cancel my lesson with Sue Jaccoma due to a mysterious flu-like illness.

During the next several months, my health rapidly deteriorated with no evident cause. Specialists from Portland Maine to Boston, Mass performed every test imaginable (including a negative ELISA titer for Lyme Disease), and still no answers.

By this time my symptoms included severe neurological involvement and relentless abdominal pain which confined me to constant bed rest in a dark room which is an unimaginable nightmare for anyone but especially an active equestrian.

Finally, Sue put me in touch with Johanna, and after comparing symptoms, I felt certain I was suffering from Lyme Disease. Thanks to Johanna’s knowledge and encouragement it took only 2 more months for a diagnosis (most Lyme-literate doctors have waiting lists between 3 and 8 months due to the massive swell of new infection cases.)

Unfortunately, after months of mega-doses of 4 different antibiotics and penicillin shots three times per week, I was still not improving. Finally, my doctors put me on IV antibiotics, but when I still seemed to be worsening, the doctors ordered a CD-57 test.

The CD-57 test, a major medical break-through in the treatment and diagnosis of Lyme, which measures a subset of killer cells (also used for AIDS and other immune system related illnesses), and will show abnormally low results for Lyme Disease (The range is from 60 to 360 with most people maintaining a level around 200.

In fact, Dr. Burrascano, a Lyme Specialist who treated over 12 thousand Lyme cases before retiring, wanted to see the CD-57 over 200 before ending antibiotic treatment. He found that anything lower resulted in relapse of symptoms.)

When my test returned a 28, my specialist gently prepared me for the lengthy and difficult recovery plan I could expect over the next several years. I didn’t think it could get worse, but I think that may have been the lowest moment, realizing I wouldn’t be riding any time soon.

Over the next two months, my husband and I wrestled with the right course of action for our three horses.

My Grand Prix schoolmaster at 17 was not ready for retirement, but had been out of work during my illness, and I finally broke down and realized that it was selfish to keep such a wonderful teacher and friend out in a field, waiting for me, not understanding why he didn’t get the pampering and daily riding.

So, instead of riding FEI tests all summer and going to Florida in the winter, I have been isolated and bed-ridden for over 18 months, sometimes in a basement room with no windows, afraid of the pain generated by light and sound.

Daily infusions of IV antibiotics through a port installed in my chest, and a dozen supplements along with the multiple prescription medications finally stopped the downward spiral, but then began the long battle back to health.

It is still a major accomplishment to do a load of laundry, but the dream of getting back on my horses someday keeps my spirits up.

To avoid such a frightening disease common-sense protection for you and your animals cannot be under-stated. But the hardest thing for dressage riders is to re-train your mind to pay attention to every ache and pain, especially in the spring and fall when the ticks are most active.

Another helpful preventative according to Stephen Buhner, author of “Healing Lyme”, is taking 1000 mg of the herb Astragalus – 2 times per day, which is effective for resisting infection and/or lessening the disease impact.

Maintaining a strong immune system is also critical. A healthy diet and adequate rest are important, but equestrians need supplements just like our horses do.

Ticks are a part of the dressage rider’s life, and with the spread of the disease, it becomes increasingly likely that you too could contract Lyme disease.

It is critical to get medical attention at the first sign of Lyme symptoms (especially flu-like symptoms from early summer through the fall.) The infamous bulls-eye rash is a definitive symptom, however less than 305 ever see the tick or any rash.

If you do see the rash, a three to four week course of antibiotics will completely eradicate Lyme in most people. However, the frightening truth is that the longer you have Lyme disease the harder it is to get rid of.

Home Health Care v.s. Facility Placement : Options in Elder Care

It always makes me sad to hear the families of an elder say “Mom made me promise to never put her in a nursing home”. That is simply a promise that most families today cannot keep. If a caring son or daughter finds that they have to break that promise, they may feel guilty for the rest of their lives. Mom probably asked for that promise because the nursing homes she remembers were dark, institutional places which would be considered substandard in America today. Today’s family structure and the financial challenges of elder care, make facility living a very common choice. When an elder shows signs of not being able to perform the basic activities of daily living, families or concerned professionals must step in. It is actually against most state laws for a professional to be aware of an elder in trouble without taking some reasonable action to secure their safety. There are many indicators that an elder is no longer safe at home alone. The basic litmus test is to ask yourself is: “Could this person save him or herself if their home were on fire? Would they be able to call 911 and communicate their exact location? If left alone for any period of time are they at risk for physical abuse or financial exploitation? Do they have the skills and resources to meet their daily hygiene and nutritional needs? The answer is “NO” for many American elders who live home alone.

Independence vs. Isolation

Many of my elderly clients who were trying so hard to maintain their independence by living alone at home actually maintained nothing more than an isolated existence punctuated by the occasionally call or visit from friends and family. This type of isolation was also coupled with medication errors or abuse, self neglect and unsanitary housekeeping. A person living in this situation will often “bloom like a flower” in the right retirement facility environment. It is amazing what three hot meals a days, social interaction, clean sheets and regular administration of medications can do for a person’s mind, body and spirit. A person who lives alone is more likely to fall and lay alone on the floor for days without being found. A person, who lives alone may make poor choices such as keeping, (or worse,) spoiled food in the refrigerator. If a person lives alone, there are many signs of illness that no one will notice during sporadic short visits. Medical appointments may be missed and prescriptions left unfilled. Many people feel that they are honoring their aging loved one by letting them live alone, even though all the tell tale signs of self neglect are apparent. There is no honor or dignity in being found on the floor after one has laid in their own excrement for three days. Unfortunately, many families will wait for this type of incident before insisting on either home health care or facility placement. If an elder is physically or verbally abusive to family and care givers, they are much more likely to be left alone to make their own decisions, regardless of how dysfunctional their situation may be. Elders with difficult personalities are many times more likely to be abused by caregivers. They need more supervision, not less.

American Family Dynamics and the Pressures of Today’s World

I hear people say “Americans don’t take care of their elders like other countries do”. Well that is not my experience. The adult children who consult with Geriatric Care Manager or other eldercare professionals are very concerned about their parents. They love them and they want the best care their money can buy. That’s the clincher: what their money can buy. In America, caregivers, maids, etc,, are expensive. Perhaps in another country where slave labor is commonplace, people can afford plenty of care. But in this country it costs $12.00 per hour (or more) for a home health aide. At eight hours per day, that is $96.00 per day. That is $2,880 per month or $34,560 per year – more than the average working American earns per year. The average woman gets a social security check of less than $500.00 per month. Do the math and you will soon see that unless you are wealthy, many people cannot afford to keep their elders in their own home with a part time caregiver or even in their children’s home with a caregiver.

Now couple this financial problem with another very real problem. Most middle income women in their fifties, who are caring for their elderly parents, are also trying to hold down a job, help their young-adult children and maintain a marriage. If a middle income woman stops working to care for her parents, she and her husband either cannot pay their bills or they must significantly reduce their standard of living. I know a few husbands who are fifty-something and feel they have worked too hard and too long to have their dreams of retirement evaporate because someone else’s needs are suddenly more important than their own. Now that Americans have come to grips with the concept that it takes two incomes to live well in this country, they are more determined than ever to have a retirement. Paying $35,000 per year for a caregiver can take a huge chunk out of the retirement savings. Frankly, most people couldn’t afford to do it even if they wanted to. Because most Americans’ net worth is in the equity of their home, selling the family home is the most common way to finance elder care services. If the family home sells for $100,000.00 and the average cost of an Assisted Living Residence is $36,000.00 per year, an elder can afford to live in that Assisted Living for 2.7 years. Coincidently, the average amount of time a person lives in an Assisted Living before moving on to a nursing home is 2.5 years.

Many adult children, who do have the desire and financial means to bring their elders to live with them, still cannot. They cannot because the medical or psychological needs of the elder are beyond their capacity to manage. For example, if Grandma is sweet and docile by day, but “sundowns” or grows agitated as evening falls, this poses a difficult problem for the caring family. When some people experience dementia or other medical issues, they may stay awake all night. They sometimes wander out of doors or rummage through drawers and closets. This behavior will keep the whole family awake at night. If a working family cannot sleep at night, this situation will become intolerable very quickly. Some adult children have been raised by violent, aggressive parents who are now violent aggressive elders. Children who have been raised under these conditions need not feel obligated to bring their parents to live with them, despite the pressure they may get from outsiders who do not know the real story.

Elders and their families who are trying to make difficult choices about elder care benefit from a professional assessment from a geriatric specialist. Professional care managers can offer an objective opinion based on a clinical evaluation of the physical and cognitive status of the elder. Physicians, hospital case managers, facility admissions coordinators and social workers can also offer advice about appropriate placement of an elder or even suggest how to set up services in the home to best meet the elder’s needs.

Home Health Care – Stay Home without Being Alone

At the very least, any elder living alone should have a medical alert system. This is a necklace or wrist band with a panic button that can be pushed in case of emergency. If the button is pushed a dispatch center receives the signal and makes and attempt to communicate with the elder through a speaker placed in the home. If the elder needs help or does not respond to attempts to communicate, emergency services will be dispatched to the home. Many services will also contact friends and family to notify them that assistance is needed. A good candidate for this device is one WHO DOES NOT have memory loss as memory loss makes it difficult to learn to operate new appliances.

There are two basic types of home health care services: Medicare and Private Duty:

Medicare Home Health is free but can only be accessed if ordered a physician. Medicare will only authorize the free home health services if specific events have happened such as a recent hospitalization lasting three or more days, or a recent change in health status, etc. Medicare will send a Registered Nurse to evaluate the elder and that nurse decides if other professionals such as physical therapists, social workers, dieticians, etc. should perform evaluations. Each professional will determine what services they will render and for how long. Medicare services are temporary in nature and are not offered on a full time basis. The average visit by the nurse, aide and therapist is less than one hour each. Even Medicare home health aides only stay long enough to bathe and dress the patient.

Private Duty Home Health can be arranged on a full time, part time or live- in basis. Many Long Term Care Insurance policies will pay for home health care. The amount of care one can get and the duration of the services varies depending upon which policy they purchased. If someone does not have insurance, they must pay out of pocket (or private pay) for any services. Typically a private home care agency will offer services at a minimum of four hours per day. Typical eight hour shifts are 7am-3pm, 3pm-11pm and 11pm – 7am. Many elders complain that an agency sends them a different caregiver each day. In order to avoid having the same aide, that as much as possible, order care every day for at least eight hours. This will allow the agency to schedule the same person for all your shifts. Because labor laws do apply and the agency would have to pay overtime for time which exceeds 40 hours per week, you will most likely have at least two to three caregivers on a full time case. The average hourly rate is $14.00 per hour. A live-in will cost about $150.00 per day. A live-in lives in your home and drives your car (or theirs for a mileage fee) and you are expected to feed them as well, even if you go out to dinner. By law, a live- in is entitled to two hours per day of free time. They can do what ever they like, including leaving the house during their break. If this arrangement will not work for your situation, consider hiring an aide around the clock. Around the clock care is typically delivered in two twelve hour shifts which are done by two different caregivers.

One aide comes to the home from 8am until 8pm and is relieved by the second caregiver at 8pm until 8am. Around the clock care can be delivered in many schedule formats. A live- in is expected to have their own private bedroom and bathroom although many agencies are flexible on this issue. The live- in is expected to be awake all day and have at least 7 hours of sleep at night. If the elder does not sleep at night, a live- in arrangement will not work. One option is to have the live in ($150/day) plus hire a caregiver to come to the house and stay up all night with the elder ($14.00. hour for eight nighttime hours). This costs $112 + $150= $262.00 per day. The only other alternative is to have around- the- clock care which will cost $14.00/hr X 24 hr=$336/day. Adding the eight hour night shift to the live in, saves about $3,000 per month. The Veterans Aid and Attendance Pension is available to qualified veterans who need a caregiver in their home on a regular basis.

Types of Adult Housing and Facilities:

Independent Living Facilities usually offer small apartments with some meals included in the price. A person who lives in an Independent Living Facility is expected to manage their daily care needs on their own, but the staff would readily recognize if needs increased and assist the resident in obtaining the needed help. Some facilities have extra care services available for additional charge to help the resident “age in place.” Others may ask a resident to move out if their needs exceed the scope of that particular facility. Limited transportation is usually provided although many residents are still driving when they enter an Independent Living Facility. These facilities may cost anywhere from less than $1,000 per month to over $5,000 per month depending upon the luxury amenities and location.

Assisted Living Facilities usually offer hotel size rooms with the option to share a room or pay extra for a private room. Three meals and snacks are usually provided as part of the price. Residents are expected to need some assistance with their daily care needs. Medication administration is strictly supervised. The State laws dictate who can live in an Assisted Living. The State does not want Assisted Living facilities to house nursing home candidates or Nursing Homes to admit people who could function just as well in an Assisted Living Facility. Assisted Living residents must be able to walk and transfer ( from bed to chair or chair to standing) with the assistance of only one other person. An Assisted Living resident can be left alone in their room for two hours or more. Nurses aides are on duty around the clock. Registered nurses or Licensed Practical Nurses are on duty at least during the daytime. Many medical services may make rounds and visit residents at least monthly. It is not uncommon for an Assisted Living resident to never have to leave the building for a medical or beauty appointment. Prices may range from under $1200/month to over $8,000/ month, once again depending upon the amenities. Medicaid has a program called the Medicaid Waiver which can pay part of the cost of the Assisted Living. However, funds have been historically limited and waiting lists can be long. The Veteran Aide and Attendance Pension is designed to financially assist qualified veterans who need the services of an Assisted Living facility

Dementia Specific Facilities are designed especially for the memory impaired resident. The building, floorplan, furnishings, décor, activity program and even the lighting have been scientifically engineered to enhance the lifestyle of residents with dementia. Many Assisted Living Facilities and Nursing Homes offer a dementia program or dementia unit, but there are entire facilities which specialize in this unique population. Dementia Specific Facilities can be either Assisted Living Facilities or Nursing Homes. They are secure in order to prevent residents from wandering off the property and getting hurt or lost. The price for this extra level of care is usually about $1,000 to $2,000 more per month than a non-specialty building.

Nursing Homes are State regulated and are inspected at least annually. A person who needs a nursing home generally cannot live safely in an Assisted Living environment. A typical resident is either wheelchair bound or bed bound. Those who can walk around freely may need the nursing home environment because they need constant medical supervision. The medical component of this environment is similar to a hospital or hospice setting. The emphasis is on rehabilitation or custodial care rather than socialization and activities. The ICP Medicaid Program (institutional care program) will pay for the room, board and medical costs of those residents who meet the financial and medical criteria. It is possible to plan in advance to help an elder meet these strict criterion.

Financial Realities

Keeping an elder at home with a caregiver can be the most expensive option of all. Many families feel keeping their loved one in the comfort of their own home is priceless. If a paid caregiver cost $14.00/hour, eight hours per day is equal to $2,880.00 per month. Around the clock care exceeds $10,000 per month. Independent Living Facilities cost an average of $2,300.00/ month and provide no personal assistance. Assisted Living Facilities range from about $2,500/month to $5,000/month and provide limited care. A Nursing Home (without ICP Medicaid assistance) can cost from 5,000.00 to $7,000.00 per month and will provide total care.

Anyone considering hiring home health or moving an elder into a care facility of any type should have their elder’s current needs assessed by a qualified professional who can ascertain the elder’s current medical/psychological and financial needs and anticipate future needs/solutions. With careful, realistic planning, caring for an elder does not have to be a financial or emotional nightmare. Making the right choices for you and the elder you care about is easier when you enlist the help of people who know the eldercare community and all that it has to offer.

Better Sleep in May: Improving Senior Health Care

Elected “Better Sleep Month” by the Better Sleep Council, this May is the official month to improve all areas of our sleeping lives. Though many don’t realize it, getting a good night’s sleep is vital to our ability to function properly throughout the day. Lack of sleep or interrupted sleep can eventually lead to deterioration of the body and mind. Children, teenagers, adults, and seniors can all suffer the consequences of a poor sleeping pattern. Therefore, it’s important to assess your sleep on a regular basis, and take the right steps toward consistently obtaining better rest.

As we grow older our schedules change and our sleep patterns modify along with them. Because of this reason, seniors are very susceptible to sleep disorders. Since May is “Better Sleep Month”, many senior service groups are promoting senior health care and better sleep by doing their part to inform seniors about the intrinsic risks of deprived sleep, and how to develop an effective sleep plan.

Improving on Sleep

Sleep deprivation can be detrimental to your general health. Fortunately, there are a variety of options that can help you improve your sleeping habits. Good health, a satisfactory environment, consistent schedule, and many other factors can contribute to a great night of sleep. Below are a few suggestions to help you achieve better, more consistent sleep:

Ø Purchase a New Mattress – Though it is often ignored, purchasing a new mattress can do wonders for a good night of sleep. Old mattresses with sags, tears, and other general maladies can interrupt an otherwise comfortable night of sleep. Senior health care professionals agree that, as our bodies grow older and lose the ability to handle stress, it is good practice to purchase a new mattress every 5-7 years.

Ø Schedule – Do not underestimate the benefits that a regular sleeping schedule will have on your body. Try performing a similar routine before you go to bed every night. This routine will alert your body to begin producing the proper chemicals that prepare the mind and body for sleep.

Ø General Health – As one of the most important aspects of daily life, general health is also vital for sleep, too. Proper diet and exercise, as well as finding ways to reduce stress on a daily basis, can help your sleep cycle tremendously.

Ø Environment – Your sleeping environment should be as simple as possible. Dark environments with a comfortable temperature are best for sleeping. Even the tiniest bit of light may interrupt your sleep cycle, so don’t use your bedroom for work or other activities that might produce light and disrupt your sleep.

Ø Stimulants – Before bedtime, steer clear of stimulants such as cigarettes, caffeine, or alcohol. These can upset your sleep cycle, and cause sleep disorders.

The Inherent Risks of Sleep Deprivation

At first glance, the only consequence of a meager night’s sleep would be feeling drowsy the following day, which you might combat with a cup of strong coffee. However, the consequences of a consistently deprived sleep schedule are much more serious. Some of these consequences include:

Ø Mood Disorders

Ø High Stress Levels

Ø Memory Loss

Ø Irritability

Ø High Blood Pressure

Ø Heart Disease

Ø Diabetes

Senior Health Care and Sleep Disorders

Sleep disorders are common among Senior Citizens. If you’re feeling tired during the day then it’s very possible that you may have one. While specially designed sleep clinics and other senior services will help monitor sleeping patterns to diagnose a particular disorder, there are signs and symptoms you should be aware of:

Ø Sleep Apnea – Sleep apnea is an inherently dangerous sleeping disorder. Pauses in breathing occur throughout the night with sleep apnea, causing you to wake up periodically and diminish the quest for a good night sleep. Frequent awakening and louder than normal snoring are signs that you may have sleep apnea.

Ø Insomnia – Insomnia is very frequent in adults who are 60 and above, making it a major concern for many nursing homes and other senior health care service providers. Consult your doctor if you have trouble staying asleep or going to sleep since both are signs of insomnia.

Sleep and Alzheimer’s disease – Nursing homes and other senior health care services have begun focusing on the sleeping habits of those with Alzheimer’s disease and how to improve their rest and safety at night. Many who suffer from Alzheimer’s have erratic sleeping schedules and, often times, disorders which include insomnia, sleep walking, and other similar disorders.

Sleep disorders and other forms of sleep deprivation can become a serious health concern for people of all ages. Assess your sleep on a regular basis and make sure you’re getting proper rest at night.

Can our Economy and Health Care System Survive Aging Baby Boomers?

There have been improvements in the Social Security system that includes the introduction of Medicare that has had important effects on the economic well-being of senior citizens in the United States. Today, the percentage of senior citizens with incomes below the poverty line is about 10%. These gains have not been shared by all senior citizens. Poverty rates are higher among certain groups of senior citizens that include:

•Black Americans

•Hispanic Americans

•People who never finished high school

•People living alone

•People 85 and older

•People living in central cites

•People living in rural areas

Level of education among US senior citizens in the future is one of the most dramatic changes. By the year 2030, 83% of seniors will have completed high school. Senior citizens with a bachelor degree or more will have increased to 24%. These changes are significant for health and social service systems because education is closely related to lifetime income, and people with more education generally are in better health and at lower risk of disability. However, the better-educated seniors are expected to be more demanding health care consumers.

Widowhood is much more common among senior citizens due to the fact that women generally live longer than men. Senior citizens who live alone after losing a spouse usually prefer to remain independent and continue living alone as long as health and finances allow it. Even though many of this group of senior citizens have families or friends nearby they are still more likely than those who live with others to feel lonelier and more isolated.

Average life expectancy in the United States is currently highest for white women, followed by black women, white men, and black men. As an average, women who live until age 65 can expect to live to age 84. Those who live to age 85 can expect live to age 92. The number of people living to age 100 in the United States is certainly growing.

Disability and diseases are much more common in senior citizens than in people younger than 65. Common chronic conditions among senior citizens include:

•Arthritis

•High blood pressure

•Heart disease

•Diabetes

•Lung disease

•Stroke

•Cancer

•Hip fractures

•Parkinson’s Disease

•Alzheimer’s disease

•Dementia

An increase in the senior citizen population means more health care expense, and the likelihood of having more than one disease among senior citizens also increases. Among people age 65 and older, 30% have three or more chronic diseases. Having more than one disease complicates care. Sudden change or illness in one body system may stress another body system and make it difficult to interpret symptoms for a definitive diagnosis. Sometimes the symptoms one disease may hide the symptoms of another disease. For example, a person with arthritis may never be physically active enough to show symptoms of heart disease, which makes making the heart disease difficult to recognize.

Senior citizens who need assistance with routine ADLs rely first on family. The use of paid helpers, however, is consistently higher among older adults living alone and increases with age.

On the average, senior citizens go to the doctor more often than younger adults. Senior citizens are also hospitalized more frequently than younger people.

Senior citizens utilize the services of home health care that includes medical treatment, physical therapy and homemaker services more than the younger population. Prescription drugs are a major part of medical treatment. At least 80% of senior citizens take one or more prescribed medicines.

One of the most important, unanswered questions is whether or not our increased lifespan will be filled with good days and years. It is not likely one answer can be applied to all senior citizens because of the great variations in health and functioning from one senior citizen to the next.

Other unanswered questions can only be answered by the passage of time. These questions include:

•Will the increasing numbers of senior citizens with more education and longer lives contribute productively to the larger society?

•Can the health care system handle the greater number of senior citizens?

Some analysts fear the great increase in the numbers of senior citizens from the baby boomer generation of people born between the years of 1940 and 1960 may place a strain on the medical care system and the public programs that finance health care and retirement to the breaking point. What we have on our side is:

•Improvements in health behavior

•Medical breakthroughs

•Financial prosperity

These three may help diminish the threats from the increased senior citizens from the baby boomer generation of people born between the years of 1940 and 1960.

Source: Foundation for Health in Aging

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. The information in this article is not intended to diagnose, treat, cure or prevent any disease. All health concerns should be addressed by a qualified health care professional.

This article is FREE to publish with the resource box.

© 2007 Connie Limon All Rights Reserved

By: Connie Limon -

Seniors Beware, Health And Fitness Equals Great Sex

Having a great sex life by adults over 60 is largely dependent on health and lifestyle. Their children and grandchildren are having a hard time getting used to the facts of life, that their aging parents or grandparents might still be enjoying sex. The baby boomers that are actually the original ‘flower children’ started the sexual revolution over 40 years ago. For a lot of them who are over 60, the revolution is still goin’ strong ‘though it is an undeniable fact more than a few of them are experiencing problems in getting the va-va-vroom back in the old engine.

Sexual arousal doesn’t die when a person gets older. Aging is simply a period in life. It does not mean that a person becomes physically or sexually unappealing nor does it mean you become less interested in sex as you age.

According to a recent study, the number of seniors in their 70’s who are sexually active – and are bragging about it being great sex – is increasing. Also, older women are indicating being satisfied with their sex lives. There’s an increase in the number of these women who are reporting having an orgasm during sex and a decrease in the number who report not having an orgasm. There also is a general increase in the number of women who are reporting high sexual satisfaction. Though not as many women are reporting low satisfaction with their sex lives, it is a different situation for men – there has been an increase in the number of men who are reporting not being satisfied. Probably, this is due to the new idea of men accepting responsibility for sexual failure instead of blaming the opposite sex, according to the authors.

The coverage by the media of retired baby-boomers and their older cousins paint a picture of seniors that are a homogeneous group who jump into bed and ‘hook-up’ with great abandon. Sex is now a Fountain of Youth. In fact, the diversity in sexual interest and activity in the over 65 crowds is as diverse as the individuals who are part of that group. It is evident that the later years can be a time of relief since there are no children hiding in nearby bedrooms, and you don’t have to worry about jumping up early in the A.M. to head for work. For many of us, this is a time we are free to explore sexual expression in ways never before realized. A time to cast away the societal expectations of earlier years. For others, they no longer worry about sexual performance, and seek other forms of companionship and sharing.

Regarding health, one fascinating recent study found that older men having more than two orgasms per week have a lower mortality rate. Of course, these numbers demonstrate a correlation between sex and longevity; the numbers do not show that sex prolongs life. More than likely, the answer is that older people who are well enough to engage in sexual activity are more than likely also healthier in general. But I believe that sexual activity can be and is physically, intellectually, and even spiritually fulfilling. Also, it’s considered a good form of exercise, and it can stimulate the brain and promote good mental function.

Today’s older adults are active, on the go and still doing many of the things they enjoyed in their younger years, a healthy sexual relationship can positively affect all aspects of your life, including your physical health and self-esteem.

You might get the idea from movies and TV that sex is only for younger adults, but that’s not true. Man’s need for intimacy is ageless. Humans never outgrow the need for affection, emotional closeness and intimate love and they never will. People still have their sexual fantasies and desires into their 80s and 90s.

It’s true that sex in the 70’s and 80’s is not the same as in the 20s, but it can be as fulfilling and as enjoyable. Understanding the changes your bodies are going through will help you prepare for the challenges you’ll face. These changes can affect sexual relationships. The physical changes are the most often discussed, but psychological issues must also be considered. Testosterone regulates the sex drive in both men and women. The good news is, most aging men and women produce the testosterone levels required to maintain their interest in sex. Some changes that occur in your body may make some aspects of sex more difficult; with these changes you will have a reason to try new positions and techniques.

Here’s news you can use! A study at the University of Michigan in Ann Arbor has found that caffeine may hold the secret to a better sex life for seniors. They found that among married men, 59% that didn’t drink coffee had trouble getting it up when needed while only 36% of the same group who did drink coffee reported similar problems. Of course, this correlation between coffee and sex might just be a statistic. The group that chooses to drink coffee might just be healthier overall.

It is a known fact, better health translates into better sex lives, healthy people are more likely to engage in sex and not just sex, but good sex, and to actually express an interest in more sex. So, lets make sure we do all we can to live healthy and enjoy our later years fully.

Using Your Health Savings Account to Build Retirement Savings

Health Savings Accounts are an excellent way to build a second retirement account. These tax-favored accounts, which have only been available since January of 2004, can be opened by anyone with a qualifying high-deductible health insurance plan. Once you open an HSA account, you can place tax-deductible contributions into it, which grow tax-deferred like an IRA. You may withdraw money tax-free to pay for medical expenses at any time.

The biggest reason more people don’t retire before age 65 is lack of health insurance, and many Americans reach age 65 woefully unprepared for the medical expenses they’ll face once they do retire. One of the most important long-term reasons for establishing an HSA is to build up some money for medical expenses incurred during retirement.

Fidelity Investments reports that the average couple retiring in 2006 will need $190,000 to cover medical expenses during retirement. This assumes life expectancies of 15 years for the husband and 20 years for the wife.

HSAs are, without exception, the best way to build up money to pay for medical expenses during retirement. You should not contribute any money to your traditional IRA, 401 (k), or any other savings account until you have maximized your contribution to your HSA. This is because only health savings accounts allow you to make withdrawals tax-free to pay for medical expenses. You can take these distributions anytime before or after age 65.

Your HSA contributions won’t affect your IRA limits — $3,000 per year or $3,600 for those over 55. It’s just another tax-deferred way to save for retirement, with the added advantage being that you can withdraw funds tax-free if they are used to pay for medical expenses.

For early retirees who are healthy, a health-savings account can also be a smart option to help lower their health insurance costs while they wait for their Medicare coverage. The older someone is, the more they can save with an HSA plan. For many people in their 50’s and 60’s who are not yet eligible for Medicare, HSAs are by far the most affordable option.

Any money you deposit in your health savings account is 100% tax-deductible, and the money in the account grows tax-deferred like an IRA. For 2006, the maximum contribution for a single person is the lesser amount of your deductible or $2,700. In other words, if your deductible is $3,000, you can contribute a maximum of $2,700; if your deductible is $2,000, then that is the maximum. For families, maximum is the lesser of $5,450 or the deductible.

If you’re 55 and older, you can put in an extra $700 catch-up contribution in 2006, $800 in 2007, $900 in 2008, and an additional $1,000 from 2009 onward. The contribution limit is indexed to the Consumer Price Index (CPI), so it will increase at the rate of inflation each year.

How much you accumulate in your HSA will depend on how much you contribute each year, the number of years you contribute, the investment return you get, and how long you go before withdrawing money from the account. If you regularly fund your HSA, and are fortunate enough to be healthy and not use a lot of medical care, a substantial amount of wealth can build up in your account.

Health savings accounts are self-directed, meaning that you have almost total control over where you invest your funds. There are numerous banks that can act as your HSA administrator. Some offer only savings accounts, while others offer mutual funds or access to a full-service brokerage where you may place your money in stocks, bonds, mutual funds, or any number of investment vehicles.

One of the biggest advantages of retirement accounts like HSAs are that the funds are allowed to grow without being taxed each year. This can dramatically increase your return. For example, if you are in the 33% tax bracket, you would need a 15% return on a taxable investment to match a tax-deferred yield of only 10%.

As another example, if you are in a 33% tax bracket and were to invest $5,450 each year in a taxable investment that yielded a 15% return, you would have $312,149 after 20 years. If you put that same money in a tax-deferred investment vehicle like an HSA, you would have $558,317 – over $240,000 more.

Because catch-up contributions are allowed only for people age 55 and older, if one or both of you are under age 55 you should establish your HSA in the older spouse’s name. This will allow you to capitalize on the expanded HSA contribution limits for people in this age range and maximize your HSA contributions. Once that person turns 65 and is no longer eligible to contribute to their HSA, you can open another health savings account in the younger spouse’s name.

Strategies to Maximize your HSA Account Growth

If your objective is to maximize the growth of your HSA in order to build up additional funds for your retirement, there are three important strategies you should implement.

Strategy #1: place your money in mutual funds or other investments that have growth potential. Though this is riskier than placing your money in an FDIC-insured savings account, it is the only way to really take advantage of the tax-deferred growth opportunity that an HSA provides.

Strategy #2: delay withdrawals from your account as long as possible. Though you may withdraw money from your HSA tax-free at any time to pay for qualified medical expenses, you do have the option of leaving the money in the HSA so that it continues to grow tax-free. As long as you save your receipts, you can make medical withdrawals from your account tax-free at any future date to reimburse yourself for medical expenses incurred today.

As an example, let’s say a 45 year old couple places $5,450 per year in their HSA over a period of 20 years, they have $2,000 per year in qualified medical expenses, and they get a 12% return on their investments. If they withdraw the $2,000 from their HSA each year, they’ll have a net contribution of $3,450 per year into their account, and they’ll have $248,581 in their account when they begin their retirement years.

If on the other hand they delay withdrawing that money, they will have $392,686 in their account at age 65. If they choose they can withdraw the $40,000 to reimburse themselves tax-free for the medical expenses incurred during that 20 year period, and still have $352,686 in their account – over $100,000 more than if they had withdrawn the money each year.

Strategy #3: make the maximum allowable deposit to your HSA at the beginning of each year. Even though you are allowed until April 15 of the following year to make deposits to your HSA, you should take advantage of the tax-free growth in your account by funding it as soon as possible. The extra interest you can earn by contributing to your account on January 1 of each year rather than the next April 15 can amount to over $40,000 in a 20 year period, and over $100,000 in 30 years.

Using Your HSA to Pay for Medical Expenses during Retirement

When you enroll in Medicare, you can use your account to pay Medicare premiums, deductibles, copays, and coinsurance under any part of Medicare. If you have retiree health benefits through your former employer, you can also use your account to pay for your share of retiree medical insurance premiums. The one expense you cannot use your account for is to purchase a Medicare supplemental insurance or “Medigap” policy.

Though Medicare will pay for the majority of health expenses during retirement, there many be expenses that Medicare will not cover. Nursing home expenses, un-conventional treatments for terminal illnesses, and proactive health screenings are all examples of medical expenses that will not be paid for by Medicare, but that you can pay for from your HSA.

Long-term care is assistance with the activities of daily living, such as dressing, bathing, or feeding yourself. It can be provided in your home, a retirement community, or a nursing home. Long-term care expenses can be paid for using funds from your HSA, and long-term care insurance can even be paid for from the HSA up to the following maximum annual amounts:

Age 40 or under: $260

Age 41 to 50: $490

Age 51 to 60: $980

Age 61 to 70: $2,600

Age 71 or over: $3,250

To establish a health savings account, you must first own an HSA-qualified high deductible health insurance plan. Compare HSA plans side by side to determine the best value to meet your needs. Once you have your high deductible health insurance plan in place, you can open your Health Savings Account with the financial institution of your choice.

Planning for Retirement With Poor Health

It is what many of us have planned for throughout our working, adult years. We envision it to be a time of relaxation and reflection, a time for us to attempt things we’ve always wanted but didn’t have the chance to at earlier points in our lives. We hope that by now that our children are independent and no longer need us to support them. Retirement is a time when we can pay more attention to fulfilling our dreams.

Although the majority of us will rejoice at the fact we now have time on our hands, in some circumstances health can be a major issue among the retirement community. Perhaps you were made to retire early due for health reasons but it is true for many that their health is not comparable to what it was like in their youth.

For many, health was the main concern that led to them deciding on retirement and it can be the same for you. One has to deal with the prospect of getting smaller pensions than expected when compelled to retire. This can pose a problem for many. With lesser disposable income, paying the bills can become a headache. However, if you are prepared for your retirement you will have an easier time supporting yourself during your golden years.

If health issues were your main reason for early retirement taking on a part time job might not be a feasible option for you. However, if you are healthy enough you always have the option of working in a different field, maybe a less stressful one or one that only requires you to work a few hours a day as opposed to working an eight hour day. Another option that you might want to consider is freelancing. This is a great way for you to work only the hours you want to work. Freelance writing online can be among the best ways to bring in a little extra money without having to stress yourself out.

Regardless of your decision to go back to work or not to, it should depend on how successfully you planned ahead for your retirement days. Also, your health should always be the top priority in any situation. Never over do your work in order to make ends meet. You must make the decision to quit the new job and find something more suitable or quit working completely if your health suffers.

Another reason many retirees go back to work is because they are often forced to make a decision between buying food, medication or fuel. In some cases this is because they were forced into early retirement which caused them to be penalized by their pension plan. It could be a result of proper planning for retirement or bad management. When one is made to retire early due to health issues, facing financial difficulties is a common situation.

In some cases if you are retired and find that you are having serious financial problems as well as your health problems you should contact your local elderly service agency. You can also seek help from federal funding to aid ou in special needs. For instance, it aids with transportation, medical and electricity costs for heating and cooling. If they cannot be of assistance to you they might be able to help direct you to someone that can help you.

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