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Do our bodies simply wear out after too much usage? Or is the schedule of our aging programmed into our DNA? The research on these questions is active and ongoing. Whether the answer is wear ‘n tear, or DNA, or probably a little of both, the reality is that the aging process may be prolonged, but is inexorable. Sooner or later, we all must face it.

Aging is a normal process, and we can observe the effects of aging as its progression impacts all of our various bodily systems. Specifically -

• The Nervous System - The synapses fire at a slower rate which results in reduced balance and coordination. In the brain itself, memory and quick decision-making become less efficient.
• The Musculoskeletal System - These effects are typically noticed first, i.e.
  • Loss of muscle tone and mass throughout your body, including the heart muscle and those affecting the bladder,
  • Loss of bone density, which often is viewed as a woman’s issue, but does affect older men as well, and
  • Reduced flexibility and range of movement as joints wear and tendons loose elasticity.
• The Gastrointestinal System - With aging, metabolism slows down and the digestive process becomes less efficient. Although fewer calories are needed, the system’s ability to extract nutritional value out of the calories that are ingested is diminished.
• The Cardiovascular System - Plaque builds up in the blood vessels, requiring the weakening heart muscle to pump harder. The blood pressure rises while the ability of the blood to absorb oxygen diminishes.
• The Respiratory System - The reduced efficiency of the lungs to supply oxygen starts being felt while climbing stairs or being involved in any energetic activity.
• The Immune System - With the changes to our biochemistry, hormone production diminishes and the immune system begins to atrophy.

However, there are a number of actions that can be taken to delay these changes and diminish their impact on our lives. They are further specified in -

• wikiSenior Basics and
• wikiSenior Medical Information.

Also, for an interesting diversion and a lot more facts, look at 50 Fascinating Aging Facts for a number of helpful links.

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Personal Financial Planners offer one answer to the nagging question, “What do I do with my money?” Like any group of service providers, they come in a variety of flavors. They segment themselves by –

• The amount of money per account they accept under their management,
• The range of services they provide to those accounts,
• Whether they are independent or company/franchise operators,
• How they charge for their services, and
• The professional organizations in which they participate (are certified).

As in any services sector, planners also segment themselves into poor, average, good, better, and best. As you might expect, that classification can be quite difficult to discern.

By and large, Personal Financial Planning was a spin off of the insurance industry. Good insurance brokers have always needed to understand their client’s financial picture, and adding financial products to their product portfolio was a natural. Then some stock brokers saw the opportunity and jumped aboard. Today, it has become an established, self-regulated sector.

1.  To begin your search for a planner, start with the organizations, i.e.

• Financial Planning Association (FPA),
• The National Association of Personal Financial Advisors (NAPFA),
• Certified Financial Planner (CFP), and
• National Association of Insurance and Financial Advisors (NAIFA).

2.  Visit the web sites of a few planners listed in your area. You will find –

• Nearly all listings will specify the financial tiers, e.g. from $100,000 to $5million, for which they will accept clients.
• Many planners will specify certain financial sectors in which they specialize as well as the range of services they provide.
• Whether the planner is part of an independent firm or a larger company/franchise is often not highlighted, but the information can be researched or requested.
• The NAPFA members have fee-based services while the FPA members typically offer free initial consultations with a combination of fee and commission-based services thereafter.
• CFA members have passed certain tests to become certified. They will appear throughout the listings of the other organization.
• NAIFA members are closely wedded to the insurance industry and often stress annuities as their primary financial offering.

3.  Ask your friends and neighbors. Although people often don’t discuss it, most will readily give you the name of their planner if they have one. Whether they will give you an accurate evaluation of their performance is another question entirely. If you target your inquiries toward people whose judgment you trust, however, you might find a name that keeps popping up.

4.  In any case, interview a few planners to discover how comfortable you are with them. Ideally, this relationship should last for a few years. You have no need to pay for a personality clash no matter what rate of return they profess to achieve.

Once you have taken all of these steps, you should have discovered someone with a few more tools, interest, and motivation to achieve better financial results than you could effect on your own. In this crazy market, that can’t hurt.

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Just like real estate and insurance, the rules for Assisted Living and Nursing Homes vary by state. The comments and concerns mentioned here pertain to the State of Washington. Your state may be different. But the issues raised are real and are a concern to everyone. If someone you love is in a care facility, you need to be aware of the issues.

These comments are merely reactions to a series of investigative articles that appeared in the Seattle Times under the name of “Seniors for Sale”. Just the title can scare you, but the details are even more arresting.

For example –

• Because of the Baby Boomers, Senior Care is seen as a growth industry.
• Referral services now exist that can route candidates for nursing care to homes that are enrolled but never monitored.
• Homes pay about one-month of their caregiving charge (c. $3,500) for each successful referral.
• Homes can be established by nearly anyone.
• There is very little oversight. No specific staffing levels are required.
• Homeowners are not required to have adequate training.
• Although abuses can be, and are, reported by the Department of Social and Health Services, these are after-the-fact.

It must be extremely frustrating for the careful, loving, well-established homes to be accused by implication in this scandal. These are the homes that don’t want or need referral services. These are the ones whose relationship with their clients is as personal as it is financial.

The question is, “How do you find these good places?”

The obvious answer is, “It takes effort.”

• Research, research, research. – Start early before the need is immediate.
• Learn about and observe – cleanliness, staffing levels, training certifications, scheduled activities, and references.
• Visit and observe at both scheduled and unscheduled times.
• Perform internet and local inquiries about any report of abuses.
• Talk to the employees. Are they happy?

Although the best home is absolutely your own, any of us could become candidates for another “Home.” The natural inclination is to ignore or delay the thought of it. But our own network of friends and acquaintances may be the best place to start our research. People talk, and it is wise to listen. If you do some of the legwork now, it will give your family a place to start if that day actually arrives.

Don’t wind up “For Sale.”

Everyone who has entered the realms of retirement has to answer a question, “What do I do about money?” An annuity is often a simple answer, but not necessarily the best.

If you happened to buy a fixed annuity in 2006, you are feeling pretty good right now. With 2010 interest rates almost non-existent, a 6% fixed annuity can make you feel both relieved and smug at the moment. You should feel good, because you have a great deal . . . at least for the moment.

In principle, annuities should be a simple investment. Their basic purpose is to give you a monthly flow of income after you hand over to the company (typically an insurance company) a large chunk of your money. Insurance companies are professional investors. They are sufficiently confident in their management of money to offer either -

• fixed annuities, which pay a set amount per month, or
• variable annuities, whose payments can vary within a set of parameters.

The downside for annuities is twofold.

1. Your money is committed and no longer accessible to you, and
2. The rates of return for annuities are invariably lower, over time, than other investments available at the time of purchase.

As a result, you should be very careful when investing in annuities.

• They are usually a good deal for the salespeople who befriend the senior to whom that are selling, but often may not be a good deal for the senior.
• Annuities can be sold with some very complicated features. If it is too complicated, back off. Especially be wary of any fees that can be added.
• Do not put all your savings into annuities. At most, they should only be one component of your savings.
• If you are considering any annuity from any company, have at least one objective, knowledgeable person look it over carefully.
• Consider other alternatives. Typically, you can set this up yourself by investing the money in a safe fund and pulling a set amount out every month. Usually, this approach will allow you to control your own money and typically cost you less.

For further information, try -

• New Retirement.com
• CSMonitor.com
• Money Magazine

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Ever since the passage of the Health Care Reform Act on April 23rd, I’ve been looking for a good summary of its components. Of course, any legislation with that many pages will be difficult to summarize, but someone had to take a swing at it. I guess no one will be surprised that it was the AARP that took up the challenge.

At the link, AARP User’s Guide to Health Care Reform, you will find a summary that doesn’t take that long to read. It does, however, have a sufficient sweep and level of detail, that you can develop a sense of the legislation.

Three things to note -

1. Medicare will finally start to cover its most foolish lack, i.e. some preventative services. Catching conditions sooner rather than later should always reduce the cost of their care.
2. The Part-D Donut Hole will be phased out over the next decade.
3. The overpayments for Medicare Advantage Plans will be phased out.

Every senior should read this summary. Thanks AARP, you did a good job!

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Don’t you just love all of the “Best Places” listings. It’s like a reality show about geography. The “Best Here” and the “Best There” always seem to be someplace else other than where you are at. (Since our own little burg was recently listed within the Top Ten by one national magazine, I’ve really started to wonder. It can be nice, but . . . Top Ten?)

There doesn’t seem to be any listing that incorporates and prioritizes all the criteria that you would like to see. However, what they do show can be interesting. Take a sampling of the many listings, and you will invariably learn something new. For example, look at -

• Money Magazine Best to Retire
• Money Magazine Best to Live
• US News & World Report
• AARP Best Destination Choices
• Forbes Magazine
• Wikipedia Best in World
• Sperling’s Best Places
• Business Week Best for Kids
• Kiplinger Best for Taxes
• Weather Statistics

The criteria used by any of these listings seem to be those that appeal to their editors. For example, weather and climate patterns, population size and growth, recreation opportunities, arts and culture organizations, cost of living comparisons, housing costs, job opportunities, colleges and universities, health care facilities, crime statistics, and libraries. But every senior considering a change of location must evaluate these criteria in the light of “How will you spend your time?” From that perspective, the various criteria can be organized into an order that best fits each person’s needs and aspirations. Your “best place” make not make anyone’s else Top Ten List except your own, but that is the only one that matters.

To find your own Best Place -

1. Really decide how you want to spend your time.
2. Reorder the various ranking criteria into a priority list that makes sense to you.
3. Using that list, reevaluate locations based upon your personal aims.
4. If your can, visit your top one or two location choices to get a reality check on how your criteria selection actually feels to you.
5. Once you have decided upon an area, rent there for a year to validate your choice and learn more about the nuances of the location.

The conclusion of all this research may well be that your Best Nest is located right were you are sitting. But “just looking”, never hurts, and you might be surprised at what you find.

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The vast majority of retirees spend their ‘golden’ years not only in the same town, but often in the same house. My wife and I, who spent practically all of our adult lives within seagull distance of the Atlantic, now find ourselves watching seagulls from the Pacific. We’ve not only changed houses; we’ve changed oceans.

Our first choice for our retiree home was a house on the East Coast that we thought would act as a magnetic and encourage visits from our three children. Unfortunately, the magnet had the wrong polarity. All three of our children landed in Seattle. Rather than live with phones and planes, we chose to pick up and engage the experience of West Coast living. After nearly five years of building a new nest and settling in, we still exchange glances at odd moments that say, “We did the right thing.”

What have we learned in the process?

1. The most important question every retiree must answer is not “Where will you be?” Instead, the real question is “How will you spend your time?” Activities of your choosing will define how live the rest of your life. Any destination you consider should be particularly suited to supporting how you want to spend your time. If alpine skiing tops your list of things you want to do, it is unlikely that Florida would be a good choice for you.
2. Location is the second most important choice for a retiree since it can enable or delimit so many other opportunities you will have. Make certain you are both comfortable with your reasons for changing your location. You both don’t have to have the same reasons, but you should understand what each other is expecting from the move.
3. Communication is key to this decision process. Some of you may be thirsting to try something new or to pursue a passion that has long festered. Others may want to get to, or return to, remote family or friends. You may find that some reasons may surprise you. But the only way to discover them is to talk a lot about it.
4. Once your general objectives for activities are clear, use them to build a balanced set of criteria for your new destination. Even if you already know the general area of your new location, you also have to decide on what are you looking for in any new home. Evaluating destinations seems to work best as an iterative process. Expect a few cycles of reevaluation before you start to feel comfortable with the ideas of both your choices. Obviously, there is no perfect home or place, but careful planning and discussion can increase your odds for success.
5. If possible, visit the new area a few times and talk to as many locals as you can. You want to find a place where people are quite willing to share their positive views. Each slice of geography and neighborhood has its own particular quirks. Use the time you have to learn as much as you can before you put the house on the market.
6. Once you are both comfortable with your decision, you must face the ugly realities of listing, selling, packing, and moving out. Home Buying and Selling can vary by market location, and the financial factors involved may influence some of your other choices. The only good thing about this process is that ultimately it has an end. The other side benefit is that you do get rid of a lot of ‘stuff’ that you have been meaning to discard for a long, long time.
7. The best advise we received for a major move was to rent for awhile before you buy any real estate. We thought we would avoid this step, but did not. In hindsight, we learned an awful lot during our rental period and made different purchase decisions as a consequence. For example, one of the first challenges in any new location is to [[find doctors, services]], and other resources to replace the familiar ones left behind. However, that search process can reveal a lot of subtleties about your new location that are impossible to detect otherwise.
8. Finding new friends can be the toughest challenge for seniors in any new setting. Since the kids have long flown the nest, the common meeting places of schools and youth activities no longer act as the common infrastructure for meeting and sharing with new friends. But friends are a critical component to any new location. Give yourself time, but fight any natural tendency you may have toward shyness. Prior to your move, research any local chapters of organizations or groups that you have belonged to in the past.
9. After you have learned the area and know what kind of home you are looking for, start your search and take your time. This may be your last nest, so make sure it has the features that are most important to you. Once you find it, you will both ‘know’, and the final stage of your relocation, ‘moving in’, can begin.

Some additional insights on relocation by seniors can be found in the Ohio State Senior Series.

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Most senior citizens simply stay put right where they are when they retire. They cherish the friendships they have established, the history they have lived, and their familiar grocers, doctors, druggists, etc. However, staying in the same town doesn’t necessarily mean staying in the same house. Downsizing is one trend that many active seniors embrace as a way of simplifying their lives and prolonging their independence.

The ties of family and grandchildren may pull others to unfamiliar locations where their children have become entrenched. Selecting new doctors, finding new dentists, and coping with this change can be a stiff challenge for any senior.

Others, especially those who have had to face frequent moves during their working lives, like the idea of a new place to retire. They are enticed by the latest “Best Places to Retire” article and the challenge of a new adventure.

On any “Now that I’ve Retired List”, location is placed first because it influences so many other choices. For example, telephones, taxes, insurance, legal, and caregiving all have rules that vary by state.

What’s a person to do??

Whichever you choose, re-evaluating your location is a healthy exercise . . . even if it is the old homestead. Your location can determine -

• to which hospital a call to 911 will deliver you,
• the range of community support services that are available to you,
• the types of activities that are readily available to you as well as,
• the amount of snow that will have to be shoveled to get you out of the house.

Some people make this choice quickly. Others spend time and consider the wide range of choices available, i.e.

1. Staying Put Keeping the same, familiar roof, where the pencil marks of the children’s heights on the door jam still mark the progress of their growth. Here, the support of old friends, the history with known doctors, and the connections developed over the years provide a personalized support network that is impossible to duplicate elsewhere.
2. Moving locally - Changing to another nest and neighborhood within the same community might offer a better fit for the needs of your newly evolving senior lifestyle while maintaining your lifelong network of friends and community around you.
3. Downsizing - Simplifying your life and reducing the demands required for the upkeep and care of your nest, a move to a smaller structure can prolong your ability to stay there as the clock keeps ticking.
4. Relocating farther away - Making a move to another community, state, ocean, or country is for the brave of heart. You can’t wait too long to make this move since the effort involved can be taxing. Evaluating destinations, together with its weather patterns, safety concerns, theater offerings, and recreation, can become a major project in and of itself. Once you decide on a place, those with wisdom advise renting for a year while you discover the innuendoes of the locale and its neighborhoods. During that time, you can address the challenges of a new place, e.g. to Find doctors, services as well as Finding new friends.
5. Retirement communities - For those that prefer the amenities of a planned community, developments designed for the 55+ crowd offer an alternative that many people find very attractive. It’s like moving into a neighborhood with an established network. Many people make this choice because the want to follow friends who are already there.
6. Active/Assisted living facilities - If one member of a couple has an emerging health issue, these facilities with built-in medical services can provide a support structure that tiers the living accommodations to the health of the individuals,where care is provided with housing
7. Living abroad - This move can scratch a lifelong itch of an adventurous soul. However, if adaptability is your strong suit, there are many locations in the world where you can stretch your dollar.

Of course, once you make your decision, then the financial issues, Renting versus Home Buying and Selling, must be considered. These are quickly followed by the practical issues of Moving and Home Maintenance.

For further reading, try the AARP Article on Housing Choices.

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Although some individuals are still covered by company and union health plans once they start Turning Age 65, fewer and fewer people have that opportunity. By far, Most US citizens discover that they have come under the Medicare umbrella. Whatever other insurance they may consider, it is all influenced by Medicare. Or, if your income level provides that alternative, Medicaid. (A few qualify for both.)

What do these choices mean?

Original Medicare Part-A provides hospitalization coverage for no charge. It doesn’t cover everything, but it does cover a lot. The key words for coverage are “medically necessary” procedures, i.e. those required to keep you alive and functioning. Once you get in to “elective” or “experimental” procedures, you are no longer covered. For example, it does not cover private rooms, private nurses, or even TV and phones in the room because they are not “medically necessary”. Basically, during each year it covers hospital stays for -

• days 1 - 60 after $1,068 deductible,
• days 61 - 90 at $267/day,
• days over 90 at $534/day, which are deducted from a 60-day pool of “lifetime reserve days”, and
• days beyond the pool of “lifetime reserve days” at full coverage.
• Charges for blood as well as home, hospice, of skilled nursing facility care are determined separately.

Original Medicare Part-B provides coverage for doctors, lab work and other medical services. There is a monthly charge for this coverage which amounts to $96.40 during 2010. The coverage is limited to the Medicare-approved amount for the Medicare-approved services. For example, a colonoscopy is limited to once every ten years, or two years for high-risk patients. Basically, after an annual deductible of $135, Part-B covers -

• 80% of doctors services and medical devices,
• 100% of clinical lab and home health services, and
• other “medically necessary” services after a co-pay or co-insurance deductible.

Original Medicare Supplement policies, Medigap fill in some of the gaps left by deductibles and co-pays. The coverage offered by these policies is strictly formulated by Medicare and specified by the letters A through N. (Plans E, H, I, and J are being phased out.) Until now, F has been the most popular. Although the coverage of each lettered plan is specific, the companies and charges vary by state.

Medicare Advantage, i.e. Part C plans, are privately run HMO alternatives to Original Medicare. Your care is generally restricted to the doctors and facilities that are members of that organization. Essentially, the government pays your Medicare allocation directly to these plans. The plans then set up their own internal rules for coverage as well as any additional charges that may apply. These plans vary on a state-by-state basis, and must be reviewed in that context.

Medicare Part-D Drug Plans, which also vary state-by-state, provide coverage for prescription drugs. Unless you have other drug insurance, you must sign up for one of these plans within four months of turning 65 to avoid being charged a late penalty.

Medicaid programs offer more extensive coverage to people with limited income and resources. This program is jointly funded by both federal and state governments, so it also varies state-by-state.

Go to the government’s Medicare Web Site for more information and for links to individual state programs.

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Recently, one member of our family had a Zero Birthday. The family all gathered, and we had a wonderful evening to celebrate this special event. It wasn’t just another birthday, it was a Zero Birthday. It deserved special treatment.

We all seem to measure our lives by Zero Birthdays.

• At One and Zero, you’ve made it to the fifth grade and you’re not a baby anymore. You’ve become more confident of your likes and dislikes. You have friends, and you have fun. You’re doing more important chores that really help at home. Sometimes, the stories you imagine yourself are better than to ones you see on TV. You’re starting to learn that you are better at some things and worse at others.

• At Two and Zero, you’re not quite legal, but almost. The trauma of teenage years seem a distant memory, and you’ve developed a much better sense of yourself. You’ve moved away from home and consider yourself independent. You’re starting to realize that you might not have all the answers. You’ve just noticed that your parents suddenly seem to be getting a lot smarter.

• At Three and Zero, you know you’re a real adult, whatever that is. You’ve faced, made, and are making a number of life-defining choices, e.g. marriage, parenthood, education, career, location, and friends. You’ve got more choices to make, but you are comfortable making them. You know that there are people that really count on you. Life is very engaging, but can be very frenetic.

• At Four and Zero, you wonder if you’re starting to get ‘old’ because you’re no longer thirty-something. You’ve gotten to know yourself pretty well and are becoming comfortable with that picture. If you have teenagers, you are learning what wallpaper feels like, ever present but ignored. Your career is now defined, and you have achieved a few distinctions and bruises in the process. You are making more than you had planned, but you wonder if you are peaking. You measure yourself, probably too harshly, and wished you had attained more. Some friends always seem to be able to be doing more. Other friends have fallen away, but you know a select few will hang with you forever.

• At Five and Zero, the wrinkles in the mirror are sending you the message that the clock keeps ticking. You really don’t feel ‘old’, but you know that the jump in your step isn’t quite as bouncy. You’ve felt the sting of college tuitions, and the shock that your former teenagers are talking to, rather than at, you and are listening for your answer. Your kids act like they are adults, even though you picture them at age ten, or two. You’re ‘established’ in your community and have felt the joys of many achievements. You are reaping the fruits of your career, both positive and negative.

• At Six and Zero, you’re worried about this looming specter called retirement. Have you saved enough, and more importantly, what will you DO? You’re very engaged in a number of activities, and your daily schedule has many facets to it. You can’t imagine loosing that diversity, so you push it out of your mind. Your greatest delight is the arrival of grandchildren. You notice that the wrinkles have become deeper, and a couple of gray hairs have appeared in your eyebrows. You’ve decided to ignore the latest technical gizmo and have dismissed it as trivial. You’re learning the first names of a few new doctors.

• At Seven and Zero, you assume you’ll be offered the senior discount without asking for it. You’re not an ‘elder’, but you’re definitely a ‘senior’. You’ve begun to notice that younger people dismiss you, with kindness, or simply ignore you. You’re starting to think more and more about the big questions of life and living, and suddenly the questions seem to have become simpler, the answers more obvious. You know you are now officially ‘old’, and you know that your bones get stiff and creak where they never did. Your memory skills may not have ebbed, but you treat them as if they did. You hear the clock ticking more loudly in your mind.

• At Eight and Zero, you celebrate having made this milestone. Haven’t had the experience, so only conjecture is possible, but you must start hearing the word ‘elderly’ more and more. If you’re not committed to a certain amount of regular physical exercise, you’ll start overhearing the word, ‘frail’, when others nearby are conversing. Time for health maintenance activities has to take up more of your day.

• At Nine and Zero, ????

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