"I DON'T WANT TO GET OLD"

A friend recently read this blog and made the above comment.

Here is my response:  "YOU ARE!"  Can't help it.  Gonna happen.  So, don't panic.  Embrace it.  Plan for it.  Have fun with it.

Well, OK, you may not have fun, but at least work to get the most out of it.  It can be (I say this with as yet limited personal experience) an interesting process.  Frustrating, messy, frightening, rewarding, peaceful,  exhilarating, did I mention frightening and rewarding.  As compensation, you get great discounts through AARP, people call you "sir" and "mam", sometimes you will be given a seat on a crowded train.  (Deleted text:  Sometimes you write things you wish you hadn't.)

Michael

Memory and Habits

I mentioned earlier that I am searching for some evidence that we can train ourselves now to resist certain behaviors in the future when our faculties have become impaired.  That we can somehow continue to be watchful against things like scams and bad ideas when they are presented to us.  We have all heard stories about elders being victims of the call in the night from the "grandchild" stranded in a foreign train station in need of some money or a credit card number fast.  See "Getting Scammed" posted 3/4/12.

I have found some hope on this topic in a book titled "Habit", by Charles Duhigg.  I have not finished the book yet, but thought I would report on some of its points.

The book includes a description of how habits are formed, how they can be changed, and how new, good habits can be learned.  It describes the neurology of habit formation - what goes on in the brain and where it goes on.  The key structure seems to be the basal ganglia.  Using brain probes in rats, activity in this structure has been seen to increases when habit forming or habit performing activities occur.  Even when other parts of the brain have been impaired, such as memory centers, habit behaviors continue.  In other words, habits are remembered even when memory is gone.  "Habits never really disappear."

So I wonder if we can develop certain habits, such as reacting with skepticism to people asking for money, bank numbers, SS numbers, etc., and have these habits not be over-ridden by our elderhoodedness (I am going to trademark some of these words!).  The above seems to indicate that the answer could be "yes."  But the bad news is that "people whose basal ganglia are damaged by injury or desease often become mentally paralyzed."  They are no longer able to perform habitual tasks like opening doors, making dinner.  They become overwhelmed by details that would normally be ignored because they are not needed to perform a habitual activity.  Too many doors to choose from, too much noise to recognize a familiar voice, too much cognitive dissonance, etc.

This almost sounds like a description of dementia.  So, I have a question:  What happens to our basal ganglia as we age?  Does it typically deteriorate with age?  If so, how rapidly?  Can other parts of the brain be reprogramed to take over its functionality? Does learning a language or doing crossword puzzles help keep the basal ganglia healthy?

OK, that is more than "a" question.  Kinda wish I had paid more attention in Psych 101.  My neurologist
(yes, I have one) suggested I check out a PBS series called "The Aging Brain" for some possible answers.  You can find it on-line by googling (I'm sorry, Googling) the title.  Let me know if you see anything interesting.  I'll watch it later, but right now I have to find the door to the kitchen.

Michael

The Cruise Ship as Retirement Home

Urban legend or kernel of truth?

Well, maybe a little of both.  It could be a real option.  Bea Muller was a resident of the QE2 for at least 5 years.  Claire Macbeth lived on a Cunnard ship for 14 years!

In 2005 a Northwestern University geriatrician calculated the costs of living on a cruise ship vis a vis a retirement home, and did not find what I would call a significant difference.  Prices have no doubt changed since then, but I would expect the relative difference to not have changed a lot.  Would be interesting to get an update.

Not for me, though.  I would not be willing to accept the significant drawbacks - isolation from friends and family, no access to skilled nursing care, possibility of getting the Norovirus, claustrophobic  accommodations,  no place to charge my portable drill.  Could be a viable substitute for an independent living retirement community if you like that sort of thing, but not a substitute for assisted living facility.  Remember the hierarchy of facilities as we age:

Living at home
Independent living retirement home
Assisted living facility
Nursing home

A ship could suffice for the first two levels, with limitations, but not the latter two where skilled care would be required.

There is a good piece on this at snopes (see attached url).  Go to this link and read on.

http://www.snopes.com/travel/trap/retire.asp

Here is another link on the same subject.

http://www.silverplanet.com/lifestyles/retirement-living/cruise-ships-different-way-retire/46559


Michael

Update on LTC Insurance

Remember a while back I described how Long Term Care Insurance works?  Remember how I said to plan on paying your premiums on time for a very long time - like forever?  Here is a comment from a DR (Dear Reader) (Wow, I actually have one!) about a recent WSJ piece announcing that Prudential will no longer sell individual LTC policies.

"Today's (3/8/2012) Wall Street Journal had an interesting piece  headed Prudential Pares Long-Term Care.  Prudential is no longer selling long-term care insurance, but I love this.  It "would honor existing policies and contract terms so long as premiums are paid on time."   Italics and underscore mine.   My thoughts--when you're old, that's one of the things that gets forgotten--bill paying can be less precise.  I saw that with my mom, with XXX's mom.  So pay those bills on time or put them on autopay or something. And don't get hospitalized so your bill-paying is delayed.  Or that policy will be useless.  After the announcement Prudential stock rose $1.03."

Michael

Getting Scammed

Another worrisome subject (and a too-long post - sorry).  You must all think I am paranoid, given all the things I seem to worry about.  But I am NOT paranoid.  Really.  A paranoid is someone who thinks everyone is out to get them.  But after reading a news story in today's Providence Journal about elders getting scammed, I understand that everyone IS out to get not just me, but all of us elders-in-training.

There are two sure-fire ways to protect ourselves from scammers.  First:  Don't get old.  Stop the clock.  Pull the plug.  This subject has been written about elsewhere, and will not be covered in this blog.

Second:  Enter elderhood with no assets that any scammer would covet. If you don't got it, they won't come after it.  "I would LOVE to send several thousand dollars to Ethiopia to bail out my long lost great great great second cousin's father's grandson from being stranded in a dangerous situation, but all I have is my phone, this stale tuna sandwich and a paper bag with a change of underwear.  Really."  Executing this plan is easy;  just liquidate all your lucre and with the proceeds send a cashier's check payable to me.  I promise you, I will keep it safe by investing it in large boats and old wine.  And maybe a ruby or two.

But I have another idea.  A "third way", if you will.  This might also be a good idea for those of you who DO have adult children to take care of you.

Think of elderhood as a business venture.  Strategic in nature, involving sources and uses of funds, fixed costs, discretionary spending, risk management, annual operating plans.  And at the end, as with any private equity investment, a planned liquidity event.  Or if you prefer, think of it as a family business with, in our case, no projeny to take over the business.

Businesses with strong corporate governance practices tend to be more successful than those run with less discipline.  A key feature of strong corporate governance is the oversight of a Board of Directors or Advisors.  This applies to public, private, not-for-profit and family businesses.

Lets consider establishing a Board of Advisors for ourselves.  I am going to make an assumption that my readers have at least a few trusted friends and/or independent advisors (lawyer, accountant, investment advisor, clergy, doctor, geriatric care coordinator, bartender).   It is risky to assign exclusive fiduciary responsibility to just one person (remember what happened to Brooke Astor!  Her son, of all people, ripped her off.  Or Mickey Rooney, featured in today's ProJo story).  But, with an advisory board, no one person will be able to act alone.  Decisions would require consensus.  A variety of opinions would be expressed.  Outcomes would be monitored.

So how would this work?  The Board's role would need to be clearly defined and agreed to.  Maybe in writing, with the help of a lawyer.  Dear Readers, give me some ideas.

Here is one possible scenario:

My Board agrees that I am not to spend any money over a certain amount, purchase any fixed asset above a certain limit, make any long term commitments, or (and this is important) make any charitable, medical, loans or advances of ANY amount, without getting Board consensus.

Then I get a phone call from the Acme Senior Science Holistic Medicine Company (ASSHOL MEDCO) telling me that I have been selected for a clinical trial and will receive a year's supply of a new pill that will prevent all forms of senility, GUARANTEED.  All I have to do is promise to fill out a survey at the end of the trial period.  And give them proof that I am a responsible elderperson by giving them my social security number, my bank account number and credit card number.  Just for verification purposes, of course.  But I must act now, because they need to select the trial participants, now, in order to secure government authorization to send me the pills.  Now.

"Hey, honey, this sounds like a great deal, we are so lucky to have been selected, the guy on the phone even said I could share the pills with you.  Quick, get me the check book!"  "Honey, I've got Darrell on the other line, you agreed we can't do anything without talking to him first."  "Hey, Darrell, you won't believe how lucky we are.  We just learned.......(yada yada yada)"  "Mike, you f-----g idiot.  That is not in your business plan.  Step away from the other phone."

That is the board's job.  To tell you that you are a f-----g idiot.  Actually, if you told the ASSHOL MEDCO guy that you needed to get authorization from your Board of Advisors, your phone line would probably go dead.  Now.

So, DR's, are there more ideas on how to prevent the Cons from hitting their Marks?  Remember, I am looking for ideas from the perspective of Elders without Youngsters.

What do you think?

Michael

 

 

Continuing Care Retirement Communities - CCRC's

Here is a piece from AARP on CCRC's that does a pretty good job of describing them.  Where-ever you see the term "your loved one", think "me, I or we".

These facilities are popping up everywhere, and obviously work best for those with the means to pay.  Long Term Care Insurance will cover these costs, but remember, there are annual and life-time limitations, so think about this carefully.  Also, if you need to take cash out of your IRA or 401(k) to make the up-front payments, you will have to pay taxes on the withdrawal.

(There are some embedded links in the following.  I have not used this feature before, so am not sure how they will work.  If the links do not survive on the posting, I will list the url's in a separate post.)

As always, what do you think?

Continuing Care Retirement Communities: What They Are and How They Work

from: AARP

When your parent or loved one decides they’re ready to move from the family home, Continuing Care Retirement Communities (CCRCs) may be worth considering. Offering a variety of services within one community, CCRCs guarantee lifetime housing, social activities and increased levels of care as needs change. These features, however, do come with a price. Learn more about CCRCs to decide whether they’re right for your loved one.

See also: Retirement communities bring in the kids.

Related

• What to Ask and Observe When Visiting Continuing Care Retirement Communities. Read

• Independent Living: Starting a Dialogue. Read

• Assessing Housing Options.Read

• How to Assess Your Loved One’s Situation. Watch

What CCRCs Are
Part independent living, part assisted living and part skilled nursing home, CCRCs offer a tiered approach to the aging process, accommodating residents’ changing needs. Upon entering, healthy adults can reside independently in single-family homes, apartments or condominiums. When assistance with everyday activities becomes necessary, they can move into assisted living or nursing care facilities. These communities give older adults the option to live in one location for the duration of their life, with much of their future care already figured out. This can provide a great level of comfort to both your parents and you and take much of the stress out of the caregiving relationship.

What CCRCs Cost
The most expensive of all long-term-care options, CCRCs require a hefty entrance fee as well as monthly charges. Entrance fees can range from $100,000 to $1 million — an upfront sum to prepay for care as well as to provide the facility money to operate. Monthly charges can range from $3,000 to $5,000, but may increase as needs change. These fees are dependent on a variety of factors including the health of your loved one(s), the type of housing they choose, whether they rent or buy, the number of residents living in the facility and the type of service contract. Additional fees may be incurred for other options including housekeeping, meal service, transportation and social activities.

Types of Contracts
There are three basic types of contracts for CCRCs:

• Life Care or Extended Contract: This is the most expensive option, but offers unlimited assisted living, medical treatment and skilled nursing care without additional charges.
• Modified Contract: This contract offers a set of services provided for a set length of time. When that time is expired, other services can be obtained, but for higher monthly fees.
• Fee-for-Service Contract: The initial enrollment fee may be lower, but assisted living and skilled nursing will be paid for at their market rates.

It is very important to review with your loved one each option as well as the long-term financial plan to support them. Often, charges above and beyond the entrance cost and monthly fees arise. Ensure that everyone understands just how much money will be needed to support this housing option.

Also, make sure the facility they are considering will be financially viable over the long term. Get assurance that 10 to 15 years down the road your loved one’s CCRC will still be operating and able to provide them with the care they’ve already paid for.

Where to Begin
Help your loved ones research CCRCs in their area and offer to accompany them on visits. While there, investigate thoroughly and meet with a representative who can walk them through the different housing options, cost structures and contract choices. Here is a checklist of things to look out for and ask while you’re visiting.

If your loved one decides on a CCRC, suggest that they request a weekend or week-long stay at the facility to ensure it’s the right choice for them. Once they are ready to commit, run the contract by an attorney to be sure everything is spelled out as it was agreed upon with the facility.

Other Tips

• If your parents are considering a CCRC as a couple, be sure they understand what will happen if one of them needs a higher level of care or dies, or if their circumstances dramatically change. Investigate whether there are circumstances where they can get a refund or leave any of their entrance fee to their estate should a change be necessary.

• When visiting, spend ample time visiting each part of the facility, regardless of whether your parent or loved one is in perfect health. Chances are they will need assisted living or nursing care at some point.

• Make sure they see all financial reports, licensing and inspection reports and any complaint investigations.