Social Security

 
Linda asked, "When should I take my Social Security? I will turn 57 this year and have a strong earnings history, having paid into Social Security for nearly 35 years. Given the year I was born, my 'regular' retirement age for purposes of Social Security will be age 67 but I can take 'early' benefits starting at age 62 or even wait until age 70. Which is better for me?"

Social Security Benefits


The average American retires and receives Social Security to cover part of his or her retirement expenses. A typical Social Security payment replaces approximately 40% of your pre-retirement income. To qualify for Social Security, you need to have contributed to the fund for 40 quarters or 10 years. Your Social Security payout will be dependent on your highest earning years.

Full Payments at Age 67


In the 1980s, Congress decided to slowly increase the age for full Social Security benefits from 65 to 67. For anyone born after 1960, the full Social Security retirement benefit is available at age 67.

Based on the tables, at age 67 Linda would qualify for $2,451 per month (in current dollars). If she waits until that age to start payouts, she receives a larger amount than if she selects an early payout at age 62 and it will be adjusted for inflation.

The favorable news for Linda is that she would receive this larger amount plus cost-of-living increases for her lifetime. In addition, if she works after age 67, there's no reduction in her Social Security payment. She can continue to receive the full income of her work and the Social Security benefit. Of course, because both she and her employer are contributing to the Social Security system while she is working, her actual Social Security benefit is significantly reduced. Her Social Security payout will be taxed and her net after-tax benefit will be reduced.

Because Linda is still working, she is contributing about $600 per month of after-tax income to Social Security. Her employer is also contributing a similar sum. The net Social Security benefit to her, after payment of income taxes on her contribution and the contribution by her employer from her salary, is now approximately $300 to $600 of added after-tax monthly income.

Early Payout at Age 62


Linda could join many Americans and start taking payments when she is age 62. Based on the current Social Security tables, her maximum payment would be 30% lower than the full benefits she would receive at age 67.

This amount will be adjusted every year based on the Social Security cost-of-living increase. While her benefit is adjusted for inflation, the actual value or purchasing power of this amount will not change. Linda's mother is still living and her grandmother lived to be 96, so she may be wise to plan for a fairly long retirement.

There is one other challenge for Linda. If she continues to work, and many individuals do work until their late 60s, she will lose part of her Social Security payment. For every $3 in income (over an indexed limit) she earns between age 62 and her full retirement age, she loses $1 in Social Security benefits. By taking her payment at age 62, she receives both a lower payout for her lifetime and reduced payments for the years until her full retirement age.

Delaying Payments to Age 70


If Linda continues with her present employment and does not need her Social Security income, she can receive an increased benefit by delaying the start of payments to age 70. The benefit starting at age 70 for Linda is currently 24% higher than what she would receive at age 67. With inflation adjustments, Linda's benefit could be even higher by the time she reaches age 70.

This represents a significant increase over her normal retirement amount. The amount increases by about 8% per year because the government has held her funds longer and she has a shorter period of time before beginning to receive her payments.

If Linda lives to her mid-80s, then she will have received a greater total Social Security benefit. If she joins her long-lived relatives who have survived to their mid-90s, her net economic benefit from Social Security by delaying the first payouts to age 70 is dramatically greater than her total payouts starting at age 62 or 67.

Tax-free Social Security Payouts


Individuals with lower incomes do not pay any federal tax on Social Security. Generally, single people with incomes under $25,000 per year do not pay tax.

50% of Social Security Taxable


For many Social Security recipients, their income is in the middle range and 50% is taxable. For example, a single person with taxable income of approximately $25,000 to $34,000 would pay tax on half of his or her Social Security. The taxable income is called the modified adjusted gross income and includes adjustments for some types of tax-free income.

Because Linda has a substantial IRA, she expects to have a higher level of income.

85% of Social Security Taxable


With other pension income and IRA income, Linda anticipates a modified adjusted gross income of over $36,000 per year. As a result, 85% of her Social Security is taxable.

Linda is not very pleased with this plan. Because she already paid tax on her half of the Social Security, she feels that this is a very substantial tax. However, with the increasing need to fund Social Security in the future, the high probability is that Linda will pay tax on 85% of her Social Security during her lifetime.

Social Security for Spouses


A spouse may have different options for receiving Social Security. First, if he or she qualifies based on employment, then the best choice may be to take his or her normal benefit at the selected retirement age.

However, a surviving spouse can receive a reduced spousal benefit starting at age 60. At a later date they may transition to a full benefit under their own qualification.

Is There an Age Limit for Organ Donation?

I never thought about becoming an organ donor until my brother died of kidney failure last year. But at age 78, I would like to know if I am too old to be a donor. I am also curious if they would even use my organs if I were to die from COVID-19. What can you tell me?

There is no cutoff age for being an organ donor. Anyone, regardless of age or medical history, can sign up. In fact, there are many people well into their 80's that donate. The decision to use your organs is based on health of the organ, not age. So, do not disqualify yourself prematurely. Let the doctors decide at the time of your passing whether your organs and tissues are suitable for transplantation.

Regarding the COVID-19 part of your question, as of right now, the Organ Procurement and Transplantation Network (OPTN) does not recommend transplantation of organs from donors known to have the virus. If you were to contract coronavirus and pass away, your organs would probably not be used. However, this may change as treatments are developed.

Here is what else you should know about becoming a donor.

Donating Facts


In the United States, more than 112,000 people are on the waiting list for organ transplants. Because the demand is so much greater than the supply, those on the list routinely wait three to seven years for an organ, and more than 7,000 pass away waiting for a transplant each year.

Organs that can be donated include the kidneys, liver, lungs, heart, pancreas and intestines. Tissue is also needed to replace bone, tendons and ligaments. Corneas are needed to restore sight. Skin grafts help burn patients heal and often mean the difference between life and death. Heart valves repair cardiac defects and damage.

By donating your organs after you pass away, you can save or improve as many as 50 lives. The United Network for Organ Sharing maintains the OPTN, a national computer registry that matches donors with waiting recipients.

Some other things you should know about being an organ donor are that it does not in any way compromise the medical care you would receive in a hospital if you are sick or injured, nor does it interfere with having an open-casket funeral if you want that option. Also, most major religions in the United States support organ donation and consider it a final act of love and generosity toward others.

How to Donate


If you would like to become a donor, there are several steps you should take to ensure your wishes are carried out, including:

Registering: Add your name to your state or regional organ and tissue donor registry. You can do this online at either OrganDonor.gov or DonateLife.net. If you do not have internet access, call Donate Life America at 804-377-3580 to sign up over the phone.

Identify yourself: Designate your decision to become an organ donor on your driver's license, which you can do when you go in to renew it. If you do not drive anymore or if your renewal is not due for a while, consider getting a state ID card, which also lets you indicate you want to be a donor. You can get an ID card for a few dollars at your nearby driver's license office.

Tell your family: Even if you are a registered donor, in many states, family members have the ultimate say whether your organs may be donated after you die. So, clarify your wishes to family. Also, tell your doctors and indicate your wishes in your advance directives. These are legal documents that spell out your wishes regarding your end-of-life medical treatment when you can no longer make decisions for yourself. If you do not have an advance directive, go to MyDirectives.com to create one for free.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

 

Published September 18, 2020

What is a Reverse Mortgage?

What can you tell me about reverse mortgages? The damage to my retirement account from the coronavirus has me considering it but want to make sure I know what I am getting into.

Massive job losses, a volatile stock market and low interest rates caused by the coronavirus pandemic have caused many cash-strapped retirees to consider a reverse mortgage. But there are many things to consider to be sure it is a good option for you now.

A reverse mortgage is a unique type of loan that allows older homeowners to borrow money against the equity in their house (or condo). To be eligible for a reverse mortgage, you must be 62 years of age or older, own your own home (or owe only a small balance) and currently be living there.

The loan does not have to be repaid until the homeowner dies, sells the house or moves out for at least 12 months. At that point, you or your heirs will have to pay back the loan plus accrued interest and fees.

It is also important to understand that you, not the bank, owns the house. You are still required to pay the property taxes and homeowners insurance. If you do not pay, you may face a foreclosure.

You will need to undergo a financial assessment to determine whether you can afford to continue paying your property taxes and insurance. Depending on your financial situation, you may be required to put part of your loan into an escrow account to pay future bills. You will likely be denied a reverse mortgage if the financial assessment finds that you cannot pay your insurance and taxes and have enough cash left to live on.

Loan Details


Around 95% of all reverse mortgages offered are Home Equity Conversion Mortgages (HECM), which are FHA insured and offered through private mortgage lenders and banks. HECMs have home value limits that vary by county, but cannot exceed $765,600 in 2020.

The loan amount you can receive through a reverse mortgage depends on your age (the older you are the more you can get), your home's value and the prevailing interest rates. Generally, most people can borrow somewhere between 50% and 60% of the home's value. To estimate how much you may be able to borrow, you can use an online reverse mortgage calculator. The loan amount can be paid as a lump sum, a line of credit, regular monthly checks or a combination of these.

Beware! Reverse mortgages are not cheap. HECM loans require a 2% upfront mortgage insurance payment, plus an additional 0.5% annual charge, in addition to origination costs and lenders' fees. Any amount you borrow, including these fees and insurance, accrues interest, meaning your debt grows over time.

To learn more, read the National Council on Aging's online booklet "Use Your Home to Stay at Home" at NCOA.org/home-equity.

Also note that because reverse mortgages are complex loans, all borrowers are required to get counseling through a HUD approved independent counseling agency before taking one out. Most agencies charge between $125 and $250 for the counseling. To locate one near you, visit Go.usa.gov/v2H, or call 800-569-4287.

Other Options


If you have a short-term need for cash, there are other options you may want to pursue. For example, many low-income seniors do not realize they qualify for the Earned Income Tax Credit, a refundable tax break that can put cash in your pocket. You also could use BenefitsCheckUp.org to search for financial assistant programs you may be eligible for.

A charitable alternative to a reverse mortgage is combining a life estate reserved with a charitable gift annuity. You would receive an immediate charitable income tax deduction and charitable gift annuity payments for the rest of your life at an attractive fixed rate.

To create a charitable gift annuity using your home, you would deed your home to a charitable organization as a remainder interest and retain a life estate. The life estate deed would provide you the right to use your home for the rest of your life. You will be required to maintain the property in good condition and pay the property taxes and homeowners insurance with this option as well. When you pass away, the home would belong to the charitable organization and will benefit the charitable mission of that organization.

Another possibility is a regular home equity loan or line of credit. This type of borrowing requires you to make regular payments. Lenders can freeze or lower limits on lines of credit, but the borrowing costs are much lower.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

Convenient IRA Gift in 2020

The Coronavirus Aid, Relief, and Economic Security (CARES) Act waived the requirement to take a required minimum distribution (RMD) in 2020. This closely followed the SECURE Act, which recently changed the age for RMDs from 70½ to 72.

The required minimum distribution (RMD) applies to most retirement plan owners over age 72. Because the 2020 RMD was calculated based on the December 31, 2019 value when the markets were at a high level, Congress decided RMDs should be waived for 2020. The 2020 RMD waiver also applies to inherited IRAs. The RMD for IRA owners over age 72 will resume in 2021.

Fortunately, the IRA charitable rollover is still available for IRA owners over age 70½. While it does not fulfill the 2020 RMD because of the waiver, there are reasons many loyal donors will make IRA charitable rollovers, also known as qualified charitable distributions (QCDs) in 2020.

An IRA charitable rollover is a convenient way to make a gift in 2020. Many friends of nonprofits have IRA balances that have recovered from the March downturn. By fall 2020, these IRA balances may be an attractive source for loyal donors to use for charitable gifts. IRA owners may contact their IRA custodians to arrange a transfer directly to a favorite nonprofit.

Each IRA owner over age 70½ may give up to $100,000 per year in QCD gifts. The gifts are made to public charities for the general fund or a designated purpose. They may not be made to a donor advised fund, supporting organization or life income plan.

The QCD is not included in taxable income so there is no charitable deduction. It is simply a convenient way to support a favorite nonprofit. Many donors have made QCD gifts in past years and will choose to make the same IRA gift this year. In a year when the nation needs all of the services of the nonprofit community to help those in need, an IRA charitable rollover gift is an excellent way to help.

How to Prevent Falls During a Pandemic

My 80-year-old mother, who lives alone and is self-isolating during the coronavirus pandemic, has fallen several times. Are there any extra precautions you recommend that can help prevent this?

Falls are a common concern for many elderly adults and their families, especially during the coronavirus pandemic when many seniors are sheltering at home alone.

Each year, more than 1 out of 4 older Americans fall, making it the leading cause of both fatal and nonfatal injuries for those age 65 and older. Many falls can be prevented. Here are some different tips that can help prevent it.

Encourage exercise: Weak leg muscles and poor balance are two of the biggest risk factors that contribute to falls. Walking, strength training and tai chi are all good for improving balance and strength. There are a number of balance exercises your mom can do any time, such as standing on one foot for 30 seconds then switching to the other foot and walking heel-to-toe across the room. She should consult with her physician prior to undertaking any new exercise regimen.

Review her medications: Does your mom take any medicine, or combination of medicines, that may make her dizzy, sleepy or lightheaded? If so, make a list or gather up all the drugs she takes – prescriptions and over the counter – and contact her doctor or pharmacist for a drug review and potential adjustment.

Get a vision test: Poor vision can be another contributor to falls. Your mom should get her eyes checked once a year and update her eyeglasses when needed. Also be aware that wearing bifocals or progressive lenses can increase the risk of falling, especially when walking outside or going down steps. These lenses can affect depth perception, so she may want to get a pair of glasses with only her distance prescription for outdoor activities.

If your mom is concerned about a visit to her eye doctor during the pandemic, she can get her vision tested online. Put a call in to her eye doctor about this option, or consider some online vision testing sites.

Fall-proof her home: There are a number of simple household modifications you can do to make your mom's living area safer. Start by helping her arrange or move the furniture so there are clear pathways to walk through. Also, pick up items on the floor that could cause her to trip, such as newspapers, shoes, clothes and electrical or phone cords.

If she has throw rugs, remove them or use double-sided tape to secure them.

In the bathroom, use non-skid rugs for the floors and a rubber suction-grip mat or adhesive non-skid tape for the floor of the tub or shower. Install grab bars in and around the tub or shower for support.

Also, make sure the house is well lit. Inexpensive plug-in nightlights for the bathrooms and hallways can help with lighting. If she has stairs, ensure handrails are installed on both sides.

For more tips, see the NIA "fall-proofing your home" web page at NIA.NIH.gov/health/fall-proofing-your-home.

Choose safe footwear: Going barefoot or wearing slippers or socks at home can also increase the risk falls, as can wearing backless shoes, high heels and shoes with smooth leather soles. The safest option for your mom is rubber-sole, low-heel shoes.

Purchase some helpful aids: If your mom needs some additional help getting around, a cane or walker may help. Also, to help ensure your mom's safety and provide you some peace of mind, consider getting her a medical alert device that comes with a wearable emergency button that would allow her to call for help if she were to fall or need assistance.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

An Executor's Guide to Settling A Loved One's Estate

My aunt recently asked me to be the executor of her will when she passes away. I am flattered that she asked, but I am not sure what exactly the job entails. What can you tell me about this?

Serving as the executor of your aunt's estate may seem like an honor, but it can also be quite a bit of work. Here is what you should know to help you prepare for this job.

As the executor of your aunt's will, you will essentially be responsible for winding up her affairs after she dies. While this may sound simple enough, you need to be aware that the job can be time consuming and difficult depending on the complexity of her financial and family situation. Some of the duties required include:
  • Filing court papers to start the probate process (this is generally required by law to determine the will's validity).
  • Taking an inventory of everything in her estate.
  • Using her estate's funds to pay bills, including taxes, funeral costs, etc.
  • Handling details like terminating her credit cards and notifying banks and government agencies, such as Social Security and the post office of her death.
  • Preparing and filing her final income tax returns.
  • Distributing assets to the beneficiaries named in her will.
Be aware that each state has specific laws and timetables on an executor's responsibilities. Your state or local bar association may have an online law library that details the rules and requirements. The American Bar Association website also offers guidance on how to settle an estate. Go to AmericanBar.org and type in "guidelines for individual executors and trustees" in the search bar to find it.

Get Organized


If you agree to take on the responsibility as executor of your aunt's estate, your first steps are to make sure she has an updated will and find out where she keeps all her important documents and financial information. Being able to quickly locate deeds, brokerage statements and insurance policies after she passes away will save you a lot of time and hassle. These are great conversations and questions to ask your aunt.

If she has a complex estate, you may want to hire an attorney or tax accountant to guide you through the process. The costs to hire an attorney or tax accountant may be paid from your aunt's estate. If you need help locating a professional, the National Association of Estate Planners and Councils (naepc.org) and the National Academy of Elder Law Attorneys (naela.org) are good resources that provide directories on their websites to help you hire someone.

Avoid Conflicts


Find out if there are any conflicts between the beneficiaries of your aunt's estate. If there are some potential problems, your job as executor can be much easier if everyone knows in advance who is getting what, and why. It may be a good idea to ask your aunt to tell her beneficiaries what they can expect from her estate. This includes personal items because wills often leave it up to the executor to distribute heirlooms. If there is no distribution plan for personal property, suggest she draft one.

Executor Fees


As the executor, you are entitled to a fee paid from the estate. In most states, executors are entitled to take a percentage of the estate's value, which often ranges anywhere from 1 to 5% depending on the size of the estate. However, if you are also a beneficiary, it may make sense for you to forgo the fee. Executor fees are taxable, but most states do not tax income from an inheritance.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

How Medicare Can Help Smokers Kick the Habit

I understand that COVID-19 hits smokers a lot harder than nonsmokers but quitting at my age is very difficult. Does Medicare offer any coverage that helps beneficiaries quit smoking?

Smokers and individuals who vape have a higher risk of severe COVID-19 complications because the coronavirus attacks the lungs. That is why quitting now is more important than ever before.

If you are a Medicare beneficiary, you will be happy to know that Medicare Part B covers up to eight face-to-face counseling sessions a year to help you quit smoking. If you have a Medicare Part D prescription drug plan, certain smoking-cessation medications are covered too. Here are some other tips that can help you kick the habit.

It Is Never Too Late


According to the Centers of Disease Control and Prevention (CDC), 12.5% of Medicare beneficiaries smoke. Many older smokers indicate that they would like to quit, but because of an addiction to nicotine, it is very difficult to do.

Tobacco use is the leading cause of preventable illness, responsible for an estimated one-fifth of deaths in the United States each year. Research shows that quitting, even after age 65, greatly reduces your risk of heart disease, stroke, cancer, osteoporosis and many other complications from diseases including COVID-19. Quitting also helps you breathe easier, smell and taste food better and saves you quite a bit of money. A $6 pack-a-day smoker, for example, saves about $180 after one month without cigarettes and nearly $2,200 after one year.

How to Quit


The first step is to set a "quit date," but give yourself a few weeks to get ready. During that time, you may want to start by reducing the number or the strength of cigarettes you smoke to begin weaning yourself.

Also check out over-the-counter nicotine replacement products – patches, gum or lozenges – to help curb your cravings (these are not covered by Medicare). Just prior to your quit day get rid of all cigarettes and ashtrays in your home, car and place of work. Try to clean up and even spray air freshener. The smell of smoke can be a powerful trigger.

Get Help


Studies have shown that you have a much better chance of quitting if you have help. So, tell your friends, family and coworkers about your plan to quit. Others knowing can be a helpful reminder and motivator.

Counseling can also be an important part of the process. Do not go at it alone. Start by contacting your doctor about smoking cessation counseling covered by Medicare and find out about prescription antismoking drugs that can help reduce your nicotine cravings.

You can also get free one-on-one telephone counseling and referrals to local smoking cessation programs through your state quitline at 800-QUIT-NOW. Or, call the National Cancer Institute free smoking quitline at 877-44U-QUIT.

It is important to identify and write down the times and situations you are most likely to smoke and make a list of things you can do to replace it or distract yourself. Some helpful suggestions when the smoking urge arises are to call a friend or one of the free quit lines, keep your mouth occupied with some sugar-free gum, sunflower seeds, carrots, fruit or hard candy, go for a walk, read a magazine, listen to music or take a hot bath.

The intense urge to smoke lasts about three to five minutes, so do what you can to wait it out. It is also wise to avoid drinking alcohol and steer clear of other smokers while you are trying to quit. Both can trigger powerful urges to smoke.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

 

Published August 21, 2020

 County School Corporations Receive $50,000 for COVID Technology Upgrades

Washington County Community Foundation, with a grant from the Indiana Association of United Ways has issued a $50,000 grant to our county school corporations.  The funds, awarded based on enrollment population, are being used to enhance technology within all three school corporations to provide and disperse instruction during the pandemic by providing WiFi/MiFi hotspots to students without Internet, bus WiFi, and access points on school buildings. 

Representatives from the corporations discussed common needs and the best ways to distribute the funds and agreed that all three corporations could utilize the funds to provide technology for student use especially with more students opting for virtual learning and in case the schools would close for an indefinite time period.

West Washington School Corporation will be applying their $10,000 portion of the grant for Verizon Mi-Fi Hotspots. 

Salem Community Schools will be applying their $22,000 portion of the grant for Mi-Fi Hotspots, bus Wi-Fi to provide access to areas without internet access, and access points at Bradie Shrum Elementary to make it 1:1 ready at the K-3 level.

East Washington will be applying their $18,000 appropriation for student Mi-Fi Hotspots to allow students accessibility to curriculum while off campus.

Washington County Community Foundation is a nonprofit public charity established in 1993 to serve donors, award grants, and provide leadership to improve Washington County forever

End

Chronic Illness - Care of Your Person

 
If you have a chronic illness, your personal planning will need to involve careful consideration of your condition. Many Americans experience ALS disease, Alzheimer's, Huntington's disease, Parkinson's disease, multiple sclerosis (MS) or other types of chronic diseases.

If you or a loved one has one of these conditions, it is important to communicate with your attorney and other advisors about your condition. There are specific planning options both during life and for your testamentary plan that should be considered.

ALS (Lou Gehrig's disease) is a disease that progressively affects a person's ability to control muscle movement. Symptoms include muscle twitching and cramping. Most ALS victims will eventually need a ventilator for breathing, but often will be quite clear-headed during their lifetime.

Alzheimer's is a disease with a progressive reduction in mental capacity. Mild Alzheimer's may be identified by memory lapse and forgetfulness. As Alzheimer's progresses, the individual begins to lose speech facility, forgets to follow normal personal cleanliness habits and loses control. Often, the Alzheimer's sufferer eventually loses the ability to recognize family members and other loved ones.

Huntington's disease is an inherited disorder. The person with Huntington's disease may have great difficulty with coordination and eventually will suffer from dementia and require full-time care.

Parkinson's disease is a disorder of the nervous system. It can lead to progressive deterioration of both the physical body and mental capabilities. Because there is great variation with the disease, some individuals with treatment are able to live reasonably long lives.

Multiple sclerosis (MS) is also a disorder of the nervous system. There is progressive damage to nerve fibers that leads to physical and mental disability. MS may be fairly moderate at first but tends to lead to attacks that can cause progressive deterioration. MS may range from fairly mild to quite severe and very debilitating.

These five and other chronic diseases are all unique and different. Some afflict the body and others reduce the capabilities of the mind. For example, Alzheimer's has greater impact on mental ability, while ALS victims are often suffering in body but may be quite clear in mind.

Your attorney and other advisors need to understand the conditions sufficiently well so that your documents and plans reflect your particular circumstance.

The principal documents for any chronic illness are a durable power of attorney for healthcare, a living will and a HIPAA release. In many states, the durable power of attorney for healthcare and living will are combined into one document described as an advance directive.

Durable Power of Attorney for Healthcare


If you have a chronic illness, particularly one that leads to loss of mental capacity, it is very important to have a designated person who can make medical decisions for you. In the event that you are unable to reason or communicate, your designated advisor must discuss your medical care with doctors and hospital staff.

A durable power of attorney for healthcare allows you to designate a trusted person to speak to the doctors on your behalf. This power in some states is a separate document. In others, it is the first portion of an advance directive. Many states refer to the person holding the durable power of attorney as your "healthcare proxy."

Regardless of the form of the document or the name of your agent, this person is qualified to make your medical decisions if required.

Whom Should You Appoint?


For a person with a chronic illness, this can be a challenging decision. You would like to select someone who understands your medical condition and your preferences about care. This could be a family member or friend.

Adult children are often selected, but may experience great emotional trauma in making an end-of-life decision. A friend may be a good choice if you do not have a child who feels willing or emotionally capable of making those decisions.

Generally, you will select a healthcare proxy agent and a successor. It is usually best not to select two persons as your proxy agent—they might disagree at a critical time while you are in need of an immediate decision.

Living Will


A person with chronic illness needs both a healthcare proxy agent and a living will. Your healthcare proxy agent can make decisions regarding your care, even if you are not near death. The function of the living will is to describe your preferences for care if you are potentially in your last weeks or days of life.

The advance of medical science has enabled doctors to keep people alive for extended periods of time, even if there is virtually no possibility of recovery. If you are in this circumstance, your living will provides guidance to your doctors.

For example, the living will can discuss whether or not heroic measures will be taken to sustain your life. If you have an irreversible condition with no chance of recovery, the living will also specifies whether nutrition and hydration will be maintained.

If you suffer from one of the chronic illnesses that affects mental capacity, it may be important for you to sign your living will before your mental health deterioration. Many Alzheimer's patients and other individuals with great mental deterioration are no longer capable of signing a living will.

Health Insurance Portability and Accountability Act (HIPAA)


In 1996, Congress passed the Health Insurance Portability and Accountability Act. HIPAA was designed to protect your rights to medical information. Your doctor and other medical providers will frequently acquire extensive background information and treatment information for your chronic illness. Under the HIPAA rules, there are safeguards to protect your personal medical information. A doctor, medical center or other provider may not disclose this information, particularly to someone who will use it for marketing or similar purposes.

However, you may wish to have your medical information released to your professional advisors so they can make appropriate decisions for you. In order to receive this information, your healthcare proxy must have a formal release from you.

The HIPAA release, which will be in writing, should describe the type of health information that may be released to the person. It may provide a general list of medical centers or providers or could have an open-ended release for any hospital or medical provider and may include a termination date. After you sign your HIPAA release, you can always revoke that release and sign a new one.

Many states have specific forms for advance directives, living wills or durable powers of attorney for healthcare. You will want to be certain that you have signed the correct form for your state.

How to Keep a Watchful Eye on an Aging Parent

Can you recommend any services or technology to help me monitor my elderly mother who lives alone? Since the coronavirus pandemic started, my sister and I have noticed that my mom's health has slipped a bit. We would like to find something that helps us keep tabs on her when we are not around.

Depending on how closely you want to monitor your mother and what she is comfortable with, there are check-in call services along with some new monitoring technology devices you can turn to for help. Here are several to consider.

Check-In Calls


If you just want a simple check-in to make sure your mom is okay every day, consider signing her up with a daily check-in call service program. There are telephone reassurance programs run by police or sheriff's departments in hundreds of counties across the country. These are usually provided free of charge.

This is how they work. A computer automated phone system would call your mom at a designated time each day to check-in. If she answers, the system assumes everything is okay. If she does not pick up or if the call goes to voicemail after repeated tries, you (or her other designee) would get a notification call. If you are not reachable, calls are then made to backup designees who have agreed to check on your mom, if necessary. If no one can be reached, the police or other emergency services personnel will be dispatched to her home.

To find out if this service is available in your mom's community, call her local police department's nonemergency number. If it is not offered, there are other organizations or companies you can turn to that provide similar services.

One completely free service is Mon Ami (monami.io, 650-267-2474), which offers a volunteer phone bank that provides phone or video calls daily, weekly or anything in between. The volunteer will connect with your mom, provide companionship, make sure everything is okay and will let you know if they detect a problem.

Monitoring Technology


Technology also offers a variety of new ways to help you keep an eye on your mom when you cannot be there.

Some retailers offer a wearable wrist device that provides activity monitoring, a 24/7 emergency help button, medication reminders or a GPS locator to determine your mom's whereabouts when she is away from her home.

These may be linked to a family caregiver smartphone or tablet application to keep you and other loved ones in the loop. Many of these retailers offer the devices for free, but require a monthly subscription fee. The subscription fee is dependent on the level of monitoring desired.

If your mom is primarily homebound, another option to consider is a sensor-monitoring system. This uses small sensors (not cameras) placed in key areas of your mom's home to track her activities – everything from whether she used the coffee pot to how much she is watching TV. This will let you know if something out of the ordinary is happening. For instance, if she went to the bathroom and did not return, it could indicate a fall or other emergency.

Many of these sensor monitoring systems allow you to check up on her patterns anytime through a corresponding website or smartphone or tablet application. They also offer additional protections, such as emergency call buttons that can be placed around the house.

Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.

Published August 14, 2020

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