Many seniors have enjoyed substantial appreciation in the value of their homes. The question today is: What are we going to do with the equity that has built up in our house over time?  If you think about it for just a few minutes, you will discover there are several attractive options for how an older person can take advantage of her/his cash equity in their house. For example, one option is to sell the old family homestead and move into a smaller more accessible house, apartment or rental housing in a neighborhood of your choice, and then invest the extra cash from the sale in secure investments.

 Or, if you are happy with your present house and want to stay there, another option is to apply for a federally insured reverse mortgage and use the cash to significantly increase your quality of life and ensure a more satisfying and secure old age.  The cash available from a reverse mortgage can be used to repair and renovate your house or organize and modify the several rooms where you spend the most time so they are appropriate for aging in place. Depending on your health and circumstances, you might prefer to use the extra cash to hire help around the house such as a housekeeping service, someone to care for the lawn and garden or a handyman who will repair leaky faucets, running toilets and squeaky doors.  Paying to have more fun is another option where cash from a reverse mortgage would be useful.  It is never too late to sign up for dance classes, taking a foreign language course or planning a trip with your grandchildren. The possibilities are endless, especially if you desire to maintain an interest in living a fulfilling life.

 Federally Insured Reverse Mortgages

 Most of the public is vaguely aware that a “reverse” mortgage is a loan against your existing home.  But the public is only slowly beginning to understand that a federally insured reverse mortgage is a new and very useful financial instrument for older homeowners.  With a reverse mortgage, you can turn the value of your home into cash without having to move or to repay the loan each month.  And perhaps most important, you do not have to pay back a reverse mortgage for as long as you live in the house.  The cash you obtain from a reverse mortgage can be paid to you in several ways:

·      All at once, in a single lump sum of cash

·      As a regular monthly cash advance

·      As a “line of credit” account that lets you decide when and how much of your available cash is paid to you or

·      As a combination of these payment methods.

 Federally insured reverse mortgages are available regardless of your current income or assets The amount a person can borrow depends on their age, the current interest rate, and the appraised value of their home. Generally, the more valuable your home is, the older you are, and the lower the interest, the more you can borrow. The money you receive from a reverse mortgage can be used in any way you wish:

 • To pay off bills or credit card debt

• To make home repairs

• Maintain your independence

• Travel and learn

 Some Essential Facts

 The best and most secure reverse mortgage is the Home Equity Conversion Mortgage (HECM). The Federal Housing Administration (FHA), a part of the U.S. Department of Housing and Urban Development (HUD), insures HECM loans. The FHA tells lenders how much they can lend you, based on your age and your home’s value. The HECM program limits your loan costs, and the FHA guarantees that lenders will meet their obligations. HECM loans generally provide the largest loan advances of any reverse mortgage. HECMs also give you the most choices in how the loan is paid to you, and you can use the money for any purpose. Although they can be costly, HECMs are generally less expensive than privately insured reverse mortgages. Other reverse mortgages may have smaller fees, but they generally have higher interest rates. On the whole, HECMs are likely to cost less in most cases.

 Unlike ordinary home equity loans, an FHA reverse mortgage does not require repayment as long as the home is the borrower’s principal residence. Lenders recover their principal, plus interest, when the home is sold. If any home equity remains after sale, the remaining value of the home goes to the homeowner, estate or heirs. You can never owe more than your home’s value.

 To be eligible for a FHA insured reverse mortgage :

 • You and any other current owners of your home must be aged 62 or over,and live in your home as a principal residence.

• Your home must be a single-family residence in a 1- to 4-unit dwelling, a condominium, or part of a planned unit development (PUD).

• Your home must meet HUD’s minimum property standards, but you can use the HECM to pay for repairs that may be required.

•You must discuss the program with a counselor from a HUD-approved counseling agency.

For more information, contact:

 AARP: www.aarp.org/money/revmort

U.S. Department of Housing and Urban Development: http://www.hud.gov/buying/rvrsmort.cfm

Falls are among the most serious health concerns facing older persons. From 30 to 40 percent of adults older than 65 years fall each year.  Rates are higher in nursing home residents and hospitalized patients. The incidence of falls rises steadily from middle age and peaks in persons older than 80 years.  Between 20 and 30 percent of older persons who fall suffer serious injuries such as hip fractures and head trauma. The National Safety Council estimates that persons over the age of 65 have the highest mortality rate (death rate) from injuries. Among older adults, injuries cause more deaths than either pneumonia or diabetes. Falls account for about one-half of the deaths due to injury in the elderly.

For the older, sick elderly, falls are often associated with dizziness and syncope (brief loss of consciousness; “passing out”), cardiac and neurologic disease, poor health status and functional disability.  Recovery from falls often is complicated by poor quality of life caused by restricted mobility, functional decline, and increased risk for nursing home placement.  Self-imposed functional limitations due to the fear of falling may cause post-fall anxiety syndrome. This can lead to depression, feelings of helplessness, and social isolation.

·      Among 65 year-old women nearly one in three (30 percent) will fall; after age 85, over half of women will suffer a fall.

·      For men, the proportion who fall increases from 13 percent in the 65 to 69 age group to a peak of 31 percent in the 80- to 84-year age group. For those over the age of 85 there is a slight decrease.

·      It appears that for the elderly living at home one-third to one-half tend to fall or do fall.

·      Those who are more aged, female, single, divorced or widowed have an increased rate of falling.

·      In the younger, healthier elderly, environmental factors are more important, with stairs and floor obstacles being common causes of falls.

·    Among people 65 to 69, one out of every 200 falls results in a hip fracture, and among those 85 or over, one fall in 10 results in a hip fracture.

·     One-fourth of those who fracture a hip die within six months of the injury.

·      The most profound effect of falling is the loss of independent functioning.

·      Twenty-five percent of those who fracture a hip require life-long nursing care.

·      About 50 percent of the elderly who sustain a fall-related injury will be discharged to a nursing home rather than return home.

Causes and Risk Factors of Falls

The causes of falls are known as “risk factors.” Although no single risk factor causes all falls, the greater the number of risk factors to which an individual is exposed, the greater the probability of a fall and the more likely the results of the fall will threaten the person’s independence.  Many of these risk factors are preventable. As obvious as it may sound, a lack of knowledge about risk factors and how to prevent them contributes to many falls.

Some people believe that falls are a normal part of aging, and as such are not preventable. Lack of knowledge leads to lack of preventive action, resulting in falls. Research reveals:

·   The risk of falling increases with age and is greater for women than for men.

·   Two-thirds of those who experience a fall will fall again within six months.

·   A decrease in bone density contributes to falls and resultant injuries.

·   Failure to exercise regularly results in poor muscle tone, decreased strength, and loss of bone mass and flexibility.

 •  At least one-third of all falls in the elderly involve environmental hazards in the  home.

A good laugh and a long sleep are the best cures in the doctor’s book.  — Irish Proverb

 A good nights rest is an invaluable asset. It leads to a more productive and happier life. Watch for signs of insomnia, and keep track of behaviors that may lead you to a less restful sleep. Write down tasks that are on your mind early in the evening so they don’t preoccupy your thoughts at bedtime, limit caffeine and alcohol consumption, and be sure to get in your daily dose of exercise. You will be glad you did!

Getting that restful night’s sleep, however, can be a challenge for many older adults. More than 50% of older adults suffer with some form of insomnia.  Many older adults have trouble falling asleep, staying asleep throughout the night, or not feeling fully rested after a night’s sleep. Difficulties with sleep and sleep patterns can contribute to daytime confusion, inability to concentrate, memory loss, increase risk of falling, increased risk of automobile accidents, and decreased quality of life.

There are many possible causes of sleep disorders ranging from medication side effects to chronic medical conditions to changes in circadian rhythms (altered sleep – wake cycle). Chronic health conditions include heart and lung disease as well as arthritis, cancer,  and other muscular skeletal pain. Conditions such as restless leg syndrome and sleep apnea are also contributing factors.

Source: Susan Forman, RPh, Silver Nation, LLC

Anyone interested in successful aging, or helping an elderly relative or friend move to a new home or apartment, would be wise to learn more about the growing network of senior move managers.  With the ever expanding number of older persons downsizing their living arrangements, or moving into assisted living facilities, a new senior service market has developed for “professionals” willing and able to help an elderly person with their move, handling tasks as diverse as organizing closets, decorating, arranging and mounting photographs, disposing of clutter as well as selling treasured furniture and books.

I first learned about the value of a senior move manager eight years ago when my oldest son and I helped a colleague of mine go through and assess the books and papers of her recently deceased husband, a pioneer social worker and policy analyst in health care issues.  My colleague wanted my help in deciding which books and papers would be appropriate to donate to a school of social work before she moved from their condo into a continuing care retirement community (CCRC).  When I asked my colleague if we could help her with other aspects of her planned move, she informed me she had already hired a senior move manager.  Later, when I visited her in the CCRC, she proudly showed me her new apartment, all the time speaking highly about the help and assistance she had received from the senior move manager. 

Subsequently, I learned many senior move managers have backgrounds in social work, health care, nursing and project management.  In 2002, the National Association of Senior Move Managers (NASMM)  was created.  It is a nonprofit professional association of local senior move managers (or senior relocation specialists) assisting older adults and families with the physical and emotional demands of downsizing, relocating, or modifying their homes.  Today, the association has nearly 500 members nationwide. For more information contact: 

National Association of Senior Move Managers

PO Box 209, Hinsdale, IL 60522 — Telephone: 877.606.2766 

Life Expectancy and Mortality

 Life expectancy at birth hit a new record high in 2006 of 78.1 years, a 0.3 increase from 2005. Record high life expectancy was recorded for both white males and black males (76 years and 70 years, respectively) as well as for white females and black females (81 years and 76.9 years).

 Between 2005 and 2006, the largest decline in age-adjusted death rates occurred for influenza and pneumonia, with a 12.8 percent decline. Other declines were observed for chronic lower respiratory diseases (6.5 percent), stroke (6.4 percent), heart disease (5.5 percent), diabetes (5.3 percent), hypertension (5 percent), chronic liver disease and cirrhosis (3.3 percent), suicide (2.8 percent), septicemia or blood poisoning (2.7 percent), cancer (1.6 percent) and accidents (1.5 percent).

 Source: National Center for Health Statistics

The Digital Television (DTV) Transition and Public Safety Act of 2005 will require the nation’s TV viewers to switch from over-the-air analog to digital broadcasting beginning February 17, 2009. An estimated 20 million households rely on antennas to receive over-the-air signals for their TVs. The Government Accountability Office (GAO) reported that of those OTA households, about 48 percent have incomes under $30,000. Moreover, approximately 8 million – or 40% — of these households include at least one person over the age of 50. (Source: Nielsen Media Research TV Household Estimates, 2003-2004.)

In order to keep watching TV after the transition, consumers using analog TVs will need to: 1) buy and install a converter box; 2) buy a digital TV; or, 3) subscribe to cable or satellite service. Without proper education and hands-on assistance throughout the conversion to digital TV, a large proportion of older adults will likely find that their televisions will not function after February 17, 2009. Exacerbating this mandated conversion process to digital TV is the fact that many elderly persons with analog TVs have limited incomes, limited mobility/transportation resources, and/or limited physical and mental capabilities.

To facilitate the successful transition to digital TV, the U.S. Department of Commerce’s National Telecommunications and Information Administration (NTIA) has funded an array of “educational” initiatives to alert and inform the general public about: 1) the transition from analog to digital TV; 2) the availability of converter boxes; and 3) how individuals can apply for up to two $40 coupons to help defray the cost of a converter box, estimated to cost between $40 – $70 at large retail electronic stores, (e.g., Wal-mart, Best Buy). Every buyer of a converter box is expected to read the instructions and install his or her own converter box and make their TV operational. Until several weeks ago, it has been assumed that all elderly persons, like the general public, will be able to handle the transition to digital TV successfully, relying on family, friends and neighbors for assistance when needed.

Less than two months before the nation will switch from over-the-air analog to digital broadcasting, the National Telecommunications and Information Administration (NTIA) awarded a $2.7 million cooperative agreement to the National Association of Area Agencies on Aging (n4a) and a coalition of aging network partners including the Asociacion Nacional Pro Personas Mayores, Meals on Wheels of America, National Association of Nutrition and Aging Service Programs, National Association of State Units on Aging, National Caucus on Black Aged, National Council on Aging, National Pacific Center on Aging, and AARP. The coalition plans to provide outreach/education and one-to-one assistance to 250,000 older persons. Utilizing the aging network to communicate information and offer services to the poor and vulnerable elderly living in the community is an excellent strategy. Led by n4a, the aging network is a comprehensive system that includes 650 area agencies on aging (AAAs), 29,000 local service provider organizations and hundreds of thousands of volunteers who interact with seniors on a regular basis in communities throughout our nation. There is no more effective coalition of national organizations with “feet on the ground” to reach out and communicate information and offer services to the vulnerable elderly in their own homes or apartments.

The only question now is: Is it too little too late? We should begin to see and hear the results on February 18, unless Congress extends the deadline for the transition.

The costs of family caregiving to US employers are substantial – including absenteeism, tardiness, and lowered productivity. There are also health implications: family caregivers report increased strain, anxiety, fatigue and have higher medical bills.

The cost to U.S. business from the lost productivity of working caregivers is more than $33 billion per year, according to the MetLife “Caregiving Cost Study: Productivity Losses to U.S. Business.” The average caregiver costs an employer $2,110 per year. The findings in the 2006 study represent an increase of about $4 billion in both categories from 1997, when the study was first conducted.

Working family caregivers tend to make informal adjustments, such as being late to work or leaving early, making incoming and outgoing telephone calls, and writing e-mails to arrange and monitor care and take unexpected days off. Employees who are caregivers are most likely to be middle-aged and older workers who have accumulated the most expertise, skills and institutional memory, and are consequently the most expensive to replace. 

 The growth of the number of caregivers in the workforce is a trend that will not go away soon. The companies that will thrive in the future will adapt to this reality by implementing or strengthening their Human Resources policies and practices to recognize the burden of family caregiving. 

 Caring for an older family member has become a way of life for millions of working Americans. Today, it is estimated 15.6 million Americans are trying to balance employment and care giving responsibilities. Nearly half of the caregivers are employed full-time. Another 11% are employed part-time. Not surprisingly, employed caregivers are often exhausted, burdened, and stressed.

 As employers have become more aware of the employee-caregiver problem, their responses have been varied and unsystematic. The lack of a clear and well-defined corporate response to this issue is because employee-care giving is a relatively new phenomenon.  It has evolved gradually from the coalescing of three powerful but independent factors:

 • Improved medical care and prevention efforts have contributed to dramatic increases in life expectancy. The growth in the number and proportion of very old adults is unprecedented in the history of the United States. Concurrently, there has been a major shift in the leading causes of death from infectious diseases and acute illnesses to chronic diseases and degenerative illnesses.

 • The trend toward smaller and more diverse families.  Since 1970 the percentage of households containing five or more people has fallen by half. Meanwhile, the “modern family” (i.e., consisting of a breadwinner and a homemaker) is giving way to a collection of diverse, often fragile domestic arrangements that comprise the “postmodern family” — single mothers, blended families, cohabiting couples, lesbian and gay partners and two-wage earner families.

 • Growth in the proportion of “dispersed families.” It is no longer unusual for adult children to be living in a geographically different location than their parents.

 Add it all up and the result is: There are fewer family members at home to help adult children care for aging parents or relatives with chronic illness. And this employee-eldercare problem will continue to grow as an issue for employers.

A guardian is a person appointed by the court to make personal, financial and medical decisions on behalf of a person who is unable to manage his or her own affairs. Guardians for adults may be appointed for people who are unable to care for themselves by reason of mental illness, mental retardation, and those who become unable to make or communicate informed decisions because of illness or injury. However a guardian’s duties depend on the court’s order and on a state’s law.

Basic information regarding guardianship is surprisingly scarce. Nationally, no one knows how many people are under guardianship or who is serving them. And although several states have taken active steps to improve guardianship laws, few use computers to track actual cases.

Between 1 and 2 million Americans age 65 or older have been injured, exploited, or otherwise mistreated by someone on whom they depended for care or protection. (Elder Mistreatment: Abuse, Neglect and Exploitation in an Aging America. 2003. Washington, DC: National Research Council Panel to Review Risk and Prevalence of Elder Abuse and Neglect.)

To learn more about guardianship, visit the National Guardianship Association (www.guardianship.org/) or the Stop Guardian Abuse organization (www.StopGuardianAbuse.org/)

To report suspected abuse or neglect of an older person, contact your state’s Adult Protective Service.