Brain aging, end-of-life care in assisted living, brain games, and dementia


My favorite professor has a post out about how the brain ages.  Check it out.  He’s a great writer and scientist.

End-of-life care in assisted living isn’t the same as a hospital or a nursing home.

Brain games won’t do much to make you a memory champ, but doing something that is mentally stimulating helps.

This might be an interesting read: “I will Never Forget” is about a mother’s descent into dementia.

Photo courtesy of IsaacMao on Flickr.


You know what makes a great Christmas present?

The book: Continuing Care Retirement Communities: An Insider Tells All.  


Continuing care retirement communities (called “CCRCs” by industry insiders) are retirement communities that offer multiple living options (independent living, assisted living, and nursing). In exchange for an entrance fee and ongoing monthly fees, CCRC’s agree to care for residents for the rest of their lives.

Written by a former senior housing consultant, “Continuing Care Retirement Communities: An Insider Tells All” is a sweeping overview of the popular senior housing product. The book shows you:

  • What services are offered for seniors
  • How to find communities in your area
  • What to look for during your visit
  • How to read the contracts and disclosure statements
  • Why some communities go bankrupt
  • Some warning signs for potential residents of CCRC’s

You deserve the best coach when searching for the community of your dreams! “Continuing Care Retirement Communities: An Insider Tells All” shows you the good and the bad in the industry and offers advice on how to make the most of your move into senior housing.

Buy it on Amazon now!

Depression in women, curing Alzheimer’s, top 25 places to retire, and 401(k) plans


About one in five women over the age of 65 are depressed.

If there’s no cure for Alzheimer’s, then why ask for a diagnosis? (We’re doing much better detecting Alzheimer’s than we are in treating it.)

CNN just published a list of the top 25 places to retire.

Yahoo has a list of 10 things that 401(k) plans don’t tell you.

Photo courtesy of mrkumm on Flickr.

Tips to Demystify Medicare Open Enrollment

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Alexis Abramson, PhD


Lately I’ve spoken with SO many people who are extremely confused about their Medicare benefits – especially Part D (prescriptions)!  So I thought I would try to provide some information to help you manage your way through the Medicare maze…..

Close to 50 million Americans are enrolled in Medicare, and that number will continue to increase as more baby boomers turn 65.  Healthcare needs and financial situations may change from year to year and now is the time to make sure your coverage is adequate.  Navigating the offerings and coverage rules to find the right plan can be hard, but there are many resources at the federal and local level to help make the right choice.

Medicare’s Open Enrollment Period is when people who are currently enrolled in Medicare can make certain changes to their plan benefits. The Open Enrollment Period started on Oct. 15 and runs through Dec. 7.  Changes that are made during this period become effective Jan. 1, 2013.

Below is a list of changes that can be made during the Open Enrollment Period:

  • Switch from Medicare Parts A and B to a Medicare Advantage Plan (Part C)
  • Switch from a Medicare Advantage plan back to Medicare Part A and B
  • Switch from one Medicare Advantage Plan to another Medicare Advantage plan
  • Make changes in your Medicare Prescription drug plan – Part D (i.e. start a drug plan, drop coverage or move from one drug plan to another)

What are some of the new Medicare services being offered in 2013?

The new preventive services available next year include:

  • Alcohol misuse counseling
  • Cardiovascular disease counseling
  • Depression screening
  • Obesity screening and counseling
  • Sexually transmitted infections screening and counseling

Another important area for change in 2013 is that if you reach the ‘donut hole’ in your Medicare Part D prescription drug plan, you only have to pay 47.5% for covered brand-name drugs and 79% of the costs for generic drugs until you reach the end of the coverage gap.

With so many options based on where you live and what prescriptions you need, selecting a Medicare Part D Plan can be complicated and time consuming. However, every American 65 and older who wishes to enroll must sign up for a 2013 plan no later than Dec. 7, 2012.

Below are five simple tips to guide you through the process of registering for a Medicare Part D Plan for yourself – or a loved one.

1. Sign up for Medicare Part D – no matter what.

Even if you currently don’t take any prescription medications, you should still consider signing up for a Medicare Part D Plan. If you enroll late or when you are in need of drug coverage, you could face a penalty and be forced to pay much higher premiums. The only exceptions to this rule are seniors with equivalent or creditable drug coverage from an employer’s health care plan, a retiree health plan or from the U.S. Department of Veterans Affairs.

2. You can get Part D two ways, but PDPs are a more affordable option.

Your first option is to buy Part D coverage as part of a private Prescription Drug Plan (PDP) that is based on the drugs you take. Your second option is to sign up for Medicare Advantage, a Medicare HMO (Health Maintenance Organization) that also includes Medicare Part A and Part B (hospital and medical). According to the Kaiser Family Foundation, a majority of Medicare Part D enrollees opt for private PDPs.

3. Plans change annually, so take your time to research.

Assessing all your options isn’t easy. You must weigh short-term savings in monthly premiums against long-term costs from co-payments or limited overall benefits. Consider your developing health concerns and how easily a plan will allow you access to your favorite doctor or specialist and medications you may be taking.

4. Preferred pharmacies matter.

Once you’ve found a plan that fits your budget and medication needs, don’t forget about convenience when filling your prescriptions. A pharmacy accepted as “preferred” by a Medicare Part D Plan is a network pharmacy that offers covered drugs to plan members at lower out-of-pocket costs than what the member would pay at a non-preferred network pharmacy. For example, Walmart is a preferred pharmacy on multiple plans including the Humana Walmart-Preferred Rx Plan. (Incidentally, people who have high blood pressure or who are concerned about heart health should also know that Humana and Walmart just announced that members of the Humana Walmart-Preferred Rx Plan will have access to 10 hypertension drugs for a penny each when filled at one of the 4,400 Walmart or Sam’s Club pharmacy locations). 

5. Medicare plan finders are your friend.

There are so many options out there, so it can be hard to keep them all straight. Try one of the simple online search tools that source the most cost-effective plan for you. You can consult the website for great information and resources at your fingertips. is also easy to use and compares all available plans for you based on your zip code and the medications you take.

ALEXIS ABRAMSON, Ph.D. is cited as America’s leading, impassioned champion for the dignity and independence of those over 50. Abramson is the author of two
highly acclaimed books — The Caregivers 
Survival Handbook and Home Safety for Seniors.  For more information go to


Understanding CCRC debt


Almost all CCRCs have some debt.  It’s very rare that I encountered a community that hadn’t taken a loan out to complete some project on campus.  Interest rates are very low right now, so it’s especially tempting for providers to take on big projects and then pay them off over several years.

While there are no hard and fast rules for how much debt a community can have before it gets into trouble, there are a few things that you can do to understand the community’s debt level and how to relates to daily operations.

  • Read your copy of the disclosure statement.  In most states, communities are required to give these to residents prior to signing the resident contract. Take your time, and read through all of the document.  Ask questions if you don’t understand.  Try to figure out why the community took on the debt and whether or not the new amenities improved the community’s occupancy or income.
  • Ask for your financial planner to take a look.  While financial planners don’t spend all of their time looking at company financials, they should have some ability to read through financials and look for important bits of information.
  • Finally, if you’re on of those folks who needs to get their hands dirty and enjoys a little recreational math, I’d suggest that you look into some financial ratios like debt service coverage ratio, the debt ratio, and days cash on hand.  Knowing these three numbers can help you understand how hard it is for the community to make all of its debt payments. A little online research goes a long way to understanding these ratios.

Again, almost all retirement communities carry some form of debt.  In today’s environment of low interest rates, debt will likely become a more popular alternative to simply paying cash.  Some debt is normal and a part of doing business.  Large amounts of debt aren’t normal and can cause the community to go bankrupt if it encounters a rough patch.  So, be careful when you’re considering a retirement community.  Make sure that you understand how much debt your community has and whether or not it can continue to make its payments.

Photo courtesy of Philip Taylor PT on Flickr.

Top states for retirement, postponing retirement, brain injuries & dementia, and a new CCRC bankruptcy


Yahoo has a list of the top ten states for retirement.  I’m not sure that I agree with their methodology, but Hawaii is #1.  Who can argue with that?

News that you probably already knew: Boomers are postponing retirement due to the recession.

A 65-year-old talks about a brain injury in his 40’s that caused early-onset dementia

South Franklin Circle, a CCRC in Ohio, has filed for bankruptcy.

Photo courtesy of C.G.P. Grey on Flickr or

Help! I don’t like my caregivers!

I’ve been thinking a lot lately about how to help seniors who are currently in a CCRC and aren’t happy with the service.  Retirement communities get a decent portion of their revenue from word of mouth, so they have an incentive to provide good care to their residents.  But, occasionally service starts to slip, and residents don’t get the care that they deserve.  As a resident or an adult child who has a parent in that situation, there are several things that you can do:
  1. Start documenting everything. While simply requesting new service personnel might be enough, you might need the written record of wrongdoing.  Start early so that you don’t have to scramble in the event of a disagreement.  If there is any photographic evidence of poor care, take pictures to document the event.
  2. Formally request new caregivers.  Sometimes it’s as simple as finding a new nurse, so don’t overlook sending an email to the community’s executive director and the head of nursing.  Make sure to copy yourself on the email so that you have a record of the request.
  3. If the request doesn’t work, then it’s time to up the ante.  This is where the documentation comes in handy.  The more information you have, the better.  If your complaint has to do with quality of care (as opposed to a personality clash), your best bet is to file a complaint with the appropriate regulatory agency.  In most states, it’s the department of aging or the department of health.  Assisted living and nursing are almost always regulated through these agencies, but you can also try contacting the state ombudsman office.  They can almost always help you find the correct department or even file a complaint of your behalf.
  4. Finally, if there is abuse, please remove the patient from the situation!  Handle the documentation later.  Your first responsibility is to keep the loved one safe.

Hopefully, you never have to worry about the quality of your caregivers.  Most communities that I’ve visited work very hard to treat residents with the respect that they deserve.  But, if you’ve found yourself in this situation, documenting poor care is the best that you can do for yourself or your loved one.

Photo courtesy of xersti on Flickr.

Flu shots, memory loss, saving for retirement, and working longer


Maybe you don’t need the flu shot after all.  Some new studies show that if you’re over 65 and have gotten the shot before, getting a new shot doesn’t make much difference. 

What’s normal memory loss and what isn’t?  (How not to panic when you forget someone’s name.)

Americans aren’t saving enough for retirement

Is 75 the new 65?  People are working longer.  I’m not sure that’s a good thing. 

Photo courtesy of William Brawley on Flickr.

Having your license revoked, hospital visits, exercise, and Medicare paying for home care


Physicians can, and do, rescind drivers licenses if the patient no longer has the ability to drive.

Top 10 items to bring to your hospital visit

Another benefit of exercise: It makes your brain bigger later in life.

Good news: Medicare is going to start paying for more for home care services.

Photo courtesy of khawkins04 on Flickr.