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Lifting Weights Can Help Seniors Stay Independent Longer

Thursday, February 10, 2011
Adults who begin lifting weights early in life may benefit from decreased age-related muscle loss and live independently longer, according to a report published this month by the American College of Sports Medicine.

The report, titled "Influence of Resistance Exercise on Lean Body Mass in Aging Adults: A Meta-Analysis," was published in Medicine & Science in Sports & Exercise®, the official scientific journal of the American College of Sports Medicine. A research team with the University of Michigan compiled data from 49 studies to assemble this report. They found that older adults gain an average of 2.42 pounds of lean body mass, primarily muscle, after strength training for approximately 20 weeks.

This 2.42-pound increase counteracts the 0.4 pounds of muscle lost each year by sedentary adults over age 50. The findings suggest that aging individuals should consider beginning a strength training regimen as early as possible to maximize results and delay sarcopenia, an age-related muscle deterioration that can lead to mobility disability and loss of independence for seniors.

"The findings of this analysis are significant, given the millions of U.S. adults affected by sarcopenia," said Mark Peterson, Ph.D., lead author of the study. "Because we have identified a robust link between resistance exercise and lean body mass, future generations of seniors who incorporate this modality may be less affected by age-related muscle loss and better able to preserve independence and quality of life."

In addition to beginning a strength training program early in life, researchers also recommend adults consider the volume, or number of sets, of their program. The analysis suggests progression models, with gradual changes in volume and load, are appropriate to accommodate long-term growth in muscle mass.

"Our report is the first comprehensive meta-analysis to confirm a significant association between strength training volume and lean body mass increases in aging men and women," said Dr. Peterson. "These findings suggest that, while effective for getting started, a single set of resistance exercises and/or fixed-volume programs may no longer be sufficient for individuals looking to achieve long-term changes in lean body mass."

Researchers screened more than 5,000 references for this analysis, and 49 studies with 81 cohorts were selected for inclusion based on several criteria. The selected studies had an average participant age of at least 50 years, incorporated supervised, whole-body resistance training programs, and lasted at least eight weeks in duration.

ACSM and the Physical Activity Guidelines for Americans recommend that adults get at least 150 minutes of moderately intense physical activity each week. For more information on exercise for older adults, see the ACSM Position Stand on "Exercise and Physical Activity for Older Adults."

Source: American College of Sports Medicine

Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Alzheimer's Scan Might Help Spot Disease

Wednesday, February 09, 2011

FRIDAY, Jan. 21 (HealthDay News) -- An advisory panel's recommendation that the U.S. Food and Drug Administration approve a new chemical that can highlight the telltale signs of Alzheimer's in brain scans may one day help doctors diagnose the neurodegenerative disease, experts said Friday.

On Thursday, the panel voted 16 to 0 to recommend approval of the imaging agent, known as Amyvid, with one critical caveat: Manufacturer Eli Lilly and Co. must demonstrate that standards for interpreting brain scans that show amyloid plaques illuminated by Amyvid can be made consistent enough to routinely guarantee an accurate diagnosis.

Amyvid (florbetapir) is injected into patients who then undergo a PET scan; a negative result can help rule out Alzheimer's, according to Lilly.

Experts agreed that the test could become a critical part of spotting Alzheimer's before symptoms have taken hold, but they noted that the clinical reality of that is far from imminent.

"It may well be that amyloid imaging will join colonoscopy, mammography, etc. as mid-life surveillance tests, and that anti-amyloid interventions are most effective in the pre-symptomatic stages of Alzheimer's disease," said Dr. Sam Gandy, the Mount Sinai Chair in Alzheimer's Disease Research in New York City. However, this possibility is years away, he added.

The value for research is clear, Gandy said. "Either a spinal fluid amyloid test or an amyloid scan will help weed out non-Alzheimer's dementias in clinical trials of anti-amyloid agents. The clinical value in the short-term is less obvious."

Current medications are most effective in the early stages of Alzheimer's, and amyloid scans might identify those patients for doctors who don't have access to neuropsychological testing, Gandy said.

"A confirmed diagnosis would enable planning for the future while patients are at an early enough stage to still participate in the discussion," he said. "In the symptomatic patient, the amyloid scan would portend the onset of dementia within the next five years."

However, because there is no cure for Alzheimer's disease yet, the test might be one that is not considered worth its cost, Gandy said.

Gandy noted that the "300-pound gorilla in the room" is whether Medicare/Medicaid will reimburse such a test, even if the FDA follows its expert panel's advice and approves Amyvid. (While the FDA doesn't have to follow a panel's advice, it usually does.) "Medicare may decide that the added value does not merit reimbursement without a meaningful intervention," he said.

Also, Grandy said he doesn't expect approval until there are methods in place to train doctors in how to read these scans.

Another expert, David Loewenstein, a professor of psychiatry and behavioral sciences and neurology at the University of Miami Miller School of Medicine, said that the approval of Amyvid "will allow physicians to come to an earlier diagnosis of Alzheimer's."

What is needed is consistency for evaluating scans using the agent, he said, so that physicians "can apply a single standard and there won't be gaps between hospitals because of different readers using different methods."

Loewenstein thinks use of this new diagnostic tool will help in several ways. First, it will help researchers find effective treatments by diagnosing the disease early, although having the plaques does not always mean the patient has Alzheimer's. Second, it will identify people who can take part in clinical trials of new Alzheimer's drugs.

"There is a whole new line of drugs being formulated that will help treat the earliest stages of the disease," Loewenstein said. "We need to know who are the appropriate people with the mildest cognitive problems to get into clinical trials."

In addition, the test has value even before treatments are available in terms of helping patients prepare for the course of the disease, Loewenstein noted. "I think many people would like an early diagnosis," he said.

More information

For more information on Alzheimer's disease, visit the Alzheimer's Association.

Aging With Dignity: Five Wishes

Wednesday, February 09, 2011
Five Wishes lets your family and doctors know:
  • Who you want to make health care decisions for you when you can't make them.
  • The kind of medical treatment you want or don't want.
  • How comfortable you want to be.
  • How you want people to treat you.
  • What you want your loved ones to know.

Five Wishes is changing the way America talks about and plans for care at the end of life. More than 14 million copies of Five Wishes are in circulation across the nation, distributed by more than 23,000 organizations. Five Wishes meets the legal requirements in 42 states and is useful in all 50.

Five Wishes has become America’s most popular living will because it is written in everyday language and helps start and structure important conversations about care in times of serious illness.

Five Wishes was introduced in 1997 and originally distributed with support from a grant by The Robert Wood Johnson Foundation, the nation's largest philanthropy devoted exclusively to health and health care. With assistance from the United Health Foundation, Five Wishes is now available in 26 languages.

Alzheimer's Treatments

Wednesday, February 09, 2011

Currently, there is no cure for Alzheimer's. But drug and non-drug treatments may help with both cognitive and behavioral symptoms.

Researchers are looking for new treatments to alter the course of the disease and improve the quality of life for people with dementia.

In this section:

What is Alzheimer's

Wednesday, February 09, 2011

alz.org offers valuable information about Alzehimers.

Alzheimer's is a brain disease that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.

The basics
Symptoms
Changes in the brain

Plaques & tangles
Research

The basics

  • Alzheimer's is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Alzheimer's disease accounts for 50 to 70 percent of dementia cases.
    Learn more: What We Know Today and Related Dementias.

Alzheimer's is not the only cause of memory loss.

Many people have trouble with memory — this does NOT mean they have Alzheimer's. In fact, most do not. There are many different causes of memory loss. If you or a loved one is experiencing symptoms, it is best to visit a doctor so the cause can be determined.

Learn more: Visiting Your Doctor
  • Alzheimer's is not a normal part of aging, although the greatest known risk factor is increasing age, and the majority of people with Alzheimer's are 65 and older. But Alzheimer's is not just a disease of old age. Up to 5 percent of people with the disease have early-onset Alzheimer's (also known as younger-onset), which often appears when someone is in their 40s or 50s.
    Learn more: Risk Factors
  • Alzheimer's worsens over time. Alzheimer's is a progressive disease, where symptoms gradually worsen over a number of years. In its early stages, memory loss is mild, but with late-stage Alzheimer's, individuals lose the ability to carry on a conversation and respond to their environment. Alzheimer's is the sixth leading cause of death in the United States. Those with Alzheimer's live an average of eight years after their symptoms become noticeable to others, but survival can range from three to 20 years, depending on age and other health conditions.
    Learn more: 10 Warning Signs and Stages of Alzheimer's Disease.
  • Alzheimer's has no current cure, but treatments for symptoms are available and research continues. Although current Alzheimer treatments cannot stop Alzheimer's from progressing, they can temporarily slow the worsening of symptoms and improve quality of life for those with Alzheimer's and their caregivers. Today, there is a worldwide effort under way to find better ways to treat the disease, delay its onset, and prevent it from developing.
    Learn more: Standard Treatments, Treatment Horizon, Prevention and Clinical Trials.

Help is available

If you or a loved one has been diagnosed with Alzheimer's, you are not alone. The Alzheimer's Association is the trusted resource for reliable information, education, referral and support to millions of people affected by the disease.

Call our 24/7 Helpline: 800.272.3900
Locate a chapter in your community



Symptoms

The most common early symptom of Alzheimer's is difficulty remembering newly learned information.

Just like the rest of our bodies, our brains change as we age . Most of us eventually notice some slowed thinking and occasional problems with remembering certain things. However, serious memory loss, confusion and other major changes in the way our minds work may be a sign that brain cells are failing.

The most common early symptom of Alzheimer's is difficulty remembering newly learned information because Alzheimer changes typically begin in the part of the brain that affects learning. As Alzheimer's advances through the brain it leads to increasingly severe symptoms, including disorientation, mood and behavior changes; deepening confusion about events, time and place; unfounded suspicions about family, friends and professional caregivers; more serious memory loss and behavior changes; and difficulty speaking, swallowing and walking.

There are many conditions can disrupt memory and mental function. Anyone experiencing significant memory problems should see a doctor as soon as possible. If you need assistance finding a doctor with experience evaluating memory problems, your local Alzheimer's Association chapter can help. Early diagnosis and intervention methods are improving dramatically, and treatment options and sources of support can improve quality of life.

RELATED INFORMATION



Alzheimer's and the brain

Microscopic changes in the brain begin long before the first signs of memory loss.

The brain has 100 billion nerve cells (neurons). Each nerve cell connects with many others to form communication networks. Groups of nerve cells have special jobs. Some are involved in thinking, learning and remembering. Others help us see, hear and smell.

To do their work, brain cells operate like tiny factories. They receive supplies, generate energy, construct equipment and get rid of waste. Cells also process and store information and communicate with other cells. Keeping everything running requires coordination as well as large amounts of fuel and oxygen.

Scientists believe Alzheimer's disease prevents parts of a cell's factory from running well. They are not sure where the trouble starts. But just like a real factory, backups and breakdowns in one system cause problems in other areas. As damage spreads, cells lose their ability to do their jobs and, eventually die, causing irreversible changes in the brain.

Learn more: Brain Tour

The role of plaques and tangles

Plaques and tangles tend to spread through the cortex as Alzheimer's progresses.

Take the Brain Tour

Two abnormal structures called plaques and tangles are prime suspects in damaging and killing nerve cells.

Plaques are deposits of a protein fragment called beta-amyloid (BAY-tuh AM-uh-loyd) that build up in the spaces between nerve cells.

Tangles are twisted fibers of another protein called tau (rhymes with “wow”) that build up inside cells.

Though most people develop some plaques and tangles as they age, those with Alzheimer's tend to develop far more. They also tend to develop them in a predictable pattern, beginning in areas important for memory before spreading to other regions.

Scientists do not know exactly what role plaques and tangles play in Alzheimer's disease. Most experts believe they somehow play a critical role in blocking communication among nerve cells and disrupting processes that cells need to survive.

It's the destruction and death of nerve cells that causes memory failure, personality changes, problems carrying out daily activities and other symptoms of Alzheimer's disease.



Research and progress

Today, Alzheimer's is at the forefront of biomedical research.

Ninety percent of what we know about Alzheimer's has been discovered in the last 15 years. Some of the most remarkable progress has shed light on how Alzheimer's affects the brain. The hope is this better understanding will lead to new treatments. Many potential approaches are currently under investigation worldwide.

Learn more: Alz.org Research Center

10 Signs of Alzheimer's

Wednesday, February 09, 2011
We think this article provides valuable information about alzheimers:

Memory loss that disrupts daily life is not a typical part of aging. It may be a symptom of Alzheimer's, a fatal brain disease that causes a slow decline in memory, thinking and reasoning skills. Every individual may experience one or more of these signs in different degrees. If you notice any of them, please see a doctor. Learn how Alzheimer's affects the brain and take the Brain Tour.

10 warning signs of Alzheimer's:

Memory loss that disrupts daily life
One of the most common signs of Alzheimer's is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.
What's a typical age-related change? Sometimes forgetting names or appointments, but remembering them later.

Challenges in planning or solving problems
Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.
What's a typical age-related change? Making occasional errors when balancing a checkbook.

Difficulty completing familiar tasks at home, at work or at leisure

People with Alzheimer's often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.

What's a typical age-related change? Occasionally needing help to use the settings on a microwave or to record a television show.

Confusion with time or place
People with Alzheimer's can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.
What's a typical age-related change? Getting confused about the day of the week but figuring it out later.

Trouble understanding visual images and spatial relationships

For some people, having vision problems is a sign of Alzheimer's. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not realize they are the person in the mirror.

What's a typical age-related change? Vision changes related to cataracts.

New problems with words in speaking or writing

People with Alzheimer's may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a "watch" a "hand-clock").

What's a typical age-related change? Sometimes having trouble finding the right word.

Misplacing things and losing the ability to retrace steps

A person with Alzheimer's disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.

What's a typical age-related change? Misplacing things from time to time, such as a pair of glasses or the remote control.

Decreased or poor judgment
People with Alzheimer's may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.
What's a typical age-related change? Making a bad decision once in a while.

Withdrawal from work or social activities
A person with Alzheimer's may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.
What's a typical age-related change? Sometimes feeling weary of work, family and social obligations.

Changes in mood and personality
The mood and personalities of people with Alzheimer's can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.
What's a typical age-related change? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

Reverse Mortgages - Get the Facts Before Cashing in on Your Home’s Equity

Wednesday, February 09, 2011

If you’re 62 or older – and looking for money to finance a home improvement, pay off your current mortgage, supplement your retirement income, or pay for healthcare expenses – you may be considering a reverse mortgage. It’s a product that allows you to convert part of the equity in your home into cash without having to sell your home or pay additional monthly bills.

The Federal Trade Commission (FTC), the nation’s consumer protection agency, wants you to understand how reverse mortgages work, the types of reverse mortgages available, and how to get the best deal.

In a “regular” mortgage, you make monthly payments to the lender. In a “reverse” mortgage, you receive money from the lender, and generally don’t have to pay it back for as long as you live in your home. The loan is repaid when you die, sell your home, or when your home is no longer your primary residence. The proceeds of a reverse mortgage generally are tax-free, and many reverse mortgages have no income restrictions.

Types of Reverse Mortgages

There are three types of reverse mortgages:

  • single-purpose reverse mortgages, offered by some state and local government agencies and nonprofit organizations
  • federally-insured reverse mortgages, known as Home Equity Conversion Mortgages (HECMs) and backed by the U. S. Department of Housing and Urban Development (HUD)
  • proprietary reverse mortgages, private loans that are backed by the companies that develop them

Single-purpose reverse mortgages are the least expensive option. They are not available everywhere and can be used for only one purpose, which is specified by the government or nonprofit lender. For example, the lender might say the loan may be used only to pay for home repairs, improvements, or property taxes. Most homeowners with low or moderate income can qualify for these loans.

HECMs and proprietary reverse mortgages are more expensive than traditional home loans, and the up-front costs can be high. That’s important to consider, especially if you plan to stay in your home for just a short time or borrow a small amount. HECM loans are widely available, have no income or medical requirements, and can be used for any purpose.

Before applying for a HECM, you must meet with a counselor from an independent government-approved housing counseling agency. Some lenders offering proprietary reverse mortgages also require counseling. The counselor is required to explain the loan’s costs and financial implications, and possible alternatives to a HECM, like government and nonprofit programs or a single-purpose or proprietary reverse mortgage. The counselor also should be able to help you compare the costs of different types of reverse mortgages and tell you how different payment options, fees, and other costs affect the total cost of the loan over time. To find a counselor, visit www.hud.gov or call 1-800-569-4287. Most counseling agencies charge around $125 for their services. The fee can be paid from the loan proceeds, but you cannot be turned away if you can’t afford the fee.

How much you can borrow with a HECM or proprietary reverse mortgage depends on several factors, including your age, the type of reverse mortgage you select, the appraised value of your home, and current interest rates. In general, the older you are, the more equity you have in your home, and the less you owe on it, the more money you can get.

The HECM lets you choose among several payment options. You can select:

  • a “term” option – fixed monthly cash advances for a specific time.
  • a “tenure” option – fixed monthly cash advances for as long as you live in your home.
  • a line of credit that lets you draw down the loan proceeds at any time in amounts you choose until you have used up the line of credit.
  • a combination of monthly payments and a line of credit.

You can change your payment option any time for about $20.

HECMs generally provide bigger loan advances at a lower total cost compared with proprietary loans. But if you own a higher-valued home, you may get a bigger loan advance from a proprietary reverse mortgage. So if your home has a higher appraised value and you have a small mortgage, you may qualify for more funds.

Loan Features

Reverse mortgage loan advances are not taxable, and generally don’t affect your Social Security or Medicare benefits. You retain the title to your home, and you don’t have to make monthly repayments. The loan must be repaid when the last surviving borrower dies, sells the home, or no longer lives in the home as a principal residence.

In the HECM program, a borrower can live in a nursing home or other medical facility for up to 12 consecutive months before the loan must be repaid.

If you’re considering a reverse mortgage, be aware that:

  • Lenders generally charge an origination fee, a mortgage insurance premium (for federally-insured HECMs), and other closing costs for a reverse mortgage. Lenders also may charge servicing fees during the term of the mortgage. The lender sometimes sets these fees and costs, although origination fees for HECM reverse mortgages currently are dictated by law.
  • The amount you owe on a reverse mortgage grows over time. Interest is charged on the outstanding balance and added to the amount you owe each month. That means your total debt increases as the loan funds are advanced to you and interest on the loan accrues.
  • Although some reverse mortgages have fixed rates, most have variable rates that are tied to a financial index: they are likely to change with market conditions.
  • Reverse mortgages can use up all or some of the equity in your home, and leave fewer assets for you and your heirs. Most reverse mortgages have a “nonrecourse” clause, which prevents you or your estate from owing more than the value of your home when the loan is repaid.
  • Because you retain title to your home, you are responsible for property taxes, insurance, utilities, fuel, maintenance, and other expenses. If you don’t pay property taxes, carry homeowner’s insurance, or maintain the condition of your home, your loan may become due and payable.
  • Interest on reverse mortgages is not deductible on income tax returns until the loan is paid off in part or whole.

Getting a Good Deal

If you’re considering a reverse mortgage, shop around. Compare your options and the terms various lenders offer. Learn as much as you can about reverse mortgages before you talk to a counselor or lender. That can help inform the questions you ask that could lead to a better deal.

  • If you want to make a home repair or improvement – or you need help paying your property taxes – find out if you qualify for any low-cost single-purpose loans in your area. Area Agencies on Aging (AAAs) generally know about these programs. To find the nearest agency, visit www.eldercare.gov or call 1-800-677-1116. Ask about “loan or grant programs for home repairs or improvements,” or “property tax deferral” or “property tax postponement” programs, and how to apply.
  • All HECM lenders must follow HUD rules. And while the mortgage insurance premium is the same from lender to lender, most loan costs, including the origination fee, interest rate, closing costs, and servicing fees vary among lenders.
  • If you live in a higher-valued home, you may be able to borrow more with a proprietary reverse mortgage, but the more you borrow, the higher your costs. The best way to see key differences between a HECM and a proprietary loan is to do a side-by-side comparison of costs and benefits. Many HECM counselors and lenders can give you this important information.
  • No matter what type of reverse mortgage you’re considering, understand all the conditions that could make the loan due and payable. Ask a counselor or lender to explain the Total Annual Loan Cost (TALC) rates: they show the projected annual average cost of a reverse mortgage, including all the itemized costs.

Be Wary of Sales Pitches

Some sellers may offer you goods or services, like home improvement services, and then suggest that a reverse mortgage would be an easy way to pay for them. If you decide you need what’s being offered, shop around before deciding on any particular seller. Keep in mind that the total cost of the product or service is the price the seller quotes plus the costs – and fees – tied to getting the reverse mortgage.

Some who offer reverse mortgages may pressure you to buy other financial products, like an annuity or long term care insurance. Resist that pressure. You don’t have to buy any products or services to get a reverse mortgage (except to maintain the adequate homeowners or hazard insurance that HUD and other lenders require). In fact, in some situations, it’s illegal to require you to buy other products to get a reverse mortgage.

The bottom line: If you don’t understand the cost or features of a reverse mortgage or any other product offered to you – or if there is pressure or urgency to complete the deal – walk away and take your business elsewhere. Consider seeking the advice of a family member, friend, or someone else you trust.

Your Right to Cancel

With most reverse mortgages, you have at least three business days after closing to cancel the deal for any reason, without penalty. To cancel, you must notify the lender in writing. Send your letter by certified mail, and ask for a return receipt. That will allow you to document what the lender received and when. Keep copies of your correspondence and any enclosures. After you cancel, the lender has 20 days to return any money you’ve paid up to then for the financing.

Reporting Possible Fraud

If you suspect that someone involved in the transaction may be violating the law, let the counselor, lender, or loan servicer know. Then, file a complaint with:

  • the Federal Trade Commission (FTC). You can do that online at ftc.gov or by phone at 1-877-FTC-HELP (1-877-382-4357).
  • your state Attorney General’s office or state banking regulatory agency.

Whether a reverse mortgage is right for you is a big question. Consider all your options. You may qualify for less costly alternatives. The following organizations have more information:

Reverse Mortgage Education Project
AARP Foundation
601 E Street, NW
Washington, DC 20049
www.aarp.org/revmort
1-800-209-8085

U. S. Department of Housing and Urban Development (HUD)
451 7th Street, SW
Washington, DC 20410
www.hud.gov
1-800-CALL-FHA (1-800-225-5342)

Federal Trade Commission
Consumer Response Center
600 Pennsylvania Avenue, NW
Washington, DC 20580
www.ftc.gov 
1-877-FTC-HELP (­1-877-382-4357)

The FTC works to prevent fraudulent, deceptive and unfair business practices in the marketplace and to provide information to help consumers spot, stop and avoid them. To file a complaint or get free information on consumer issues, visit ftc.gov or call toll-free, 1-877-FTC-HELP (1-877-382-4357); TTY: 1-866-653-4261. Watch a video, How to File a Complaint, at ftc.gov/video to learn more. The FTC enters consumer complaints into the Consumer Sentinel Network, a secure online database and investigative tool used by hundreds of civil and criminal law enforcement agencies in the U.S. and abroad.

VeteransAid.org Aid & Attendance Pension

Wednesday, February 09, 2011

THE AID & ATTENDANCE PENSION

The Aid and Attendance (A&A) Pension provides benefits for veterans and surviving spouses who require the regular attendance of another person to assist in eating, bathing, dressing and undressing or taking care of the needs of nature. It also includes individuals who are blind or a patient in a nursing home because of mental or physical incapacity. Assisted care in an assisting living facility also qualifies.

To qualify for A&A it needs to be established by your physician that you require daily assistance by others to dress, undress, bathing, cooking, eating, taking on or off of prosthetics, leave home etc. You DO NOT have to require assistance with all of these. There simply needs to be adequate medical evidence that you cannot function completely on your own.

The A&A Pension can provide up to $1,632 per month to a veteran, $1,055 per month to a surviving spouse, or $1,949 per month to a couple*.

Eligibility must be proven by filing the proper Veterans Application for Pension or Compensation. (Form 21-534 surviving spouse) (Form 21-526 Veteran.) This application will require a copy of DD-214 (see below for more information) or separation papers, Medical Evaluation from a physician, current medical issues, net worth limitations, and net income, along with out-of-pocket Medical Expenses.

A DD-214 is issued to military members upon separation from active service. DD-214s were issued to separated service members beginning in the 1950's. The term "DD-214" is often used generically to mean "separation papers" or "discharge papers", no matter what form number was used to document active duty military service. If the VA has a copy of a DD-214, it is usually because the veteran attached a copy (or sometimes, the original) to his or her application for disability or education benefits. If you've lost your original DD-214 or a copy and you are receiving (or applied for in the past) disability or education benefits from the VA, they may have a copy (or the original, if you gave it to them) on file. At the very least, if you are currently receiving benefits (or did in the past), they should be able to provide a Statement of Service, which can be used instead of a "DD-214".

To request a copy of a DD-214 visit www.vetrec.archives.gov.

For more general information about the Aid & Attendance Pension, please see our FAQ Section.

Tips From The National Institute on Aging

Saturday, February 05, 2011

There’s No Place Like Home—For Growing Old

 

We believe this site offers valuable tips and resources for keeping your loved ones in their homes.

 

“The stairs are getting so hard to climb.”
“Since my wife died, I just open a can of soup for dinner.”
“I’ve lived here 40 years. No other place will seem like home.”

These are common issues for older people. And, you may share the often-heard wish—“I want to stay in my own home!”  The good news is that with the right help you might be able to do just that.

As part of the Federal Government’s National Institutes of Health, the National Institute on Aging (NIA) funds and conducts research related to aging, including how older people can remain independent.  This NIA tip sheet introduces you to the kinds of help that you might want to consider so you can continue to live on your own.  Where possible, we give you suggestions for free or low cost help and include ways to identify benefits that might be available to you.  A list of groups to contact for more detailed information is included at the end of the tip sheet. You can share this tip sheet with others in your family, and you can use it to begin talking about your needs—now and in the future.

What do I do first?

Planning ahead is hard because you never know how your needs might change.  But, the first step is to think about the kinds of help you might want in the near future.  Maybe you live alone, so there is no one living in your home who is available to help you. Maybe you don’t need help right now, but you live with a husband or wife who does. Everyone has a different situation, but one way to begin planning is to look at any illnesses like diabetes or emphysema that you or your spouse might have. Talk to your doctor about how these health problems could make it hard for someone to get around or take care of him- or herself in the future. Help getting dressed in the morning, fixing a meal, or remembering to take medicine may be all you need to stay in your own home.

How can I help my older relatives stay independent?

As they grow older, some people start having trouble doing everyday activities like shopping, cooking, and taking care of their home or themselves. Is this happening to any of your relatives—your parents or an aunt or uncle, for example? If so, talk to them about getting help. Maybe you can offer to get information for them. Think about what you and others in the family can do to help. Talk to your friends whose relatives may be facing the same kinds of problems. Ask about the solutions they found. Then let your relatives know what you have learned. You might be able to help them develop a plan.
What kinds of help can I get?

You can get almost any type of help you want in your home—often for a cost. The following list includes some common things people need. You can get more information on many of these services from your local Area Agency on Aging, local and State offices on aging or social services, tribal organization, or nearby senior center.

Personal care. Is bathing, washing your hair, or dressing getting harder to do? Maybe a relative or friend could help. Or, you could hire a trained aide for a short time each day.

Homemaking. Do you need help with chores like housecleaning, yard work, grocery shopping, or laundry? Some grocery stores and drug stores will take your order over the phone and bring the items to your home. There are cleaning services you can hire, or maybe someone you know has a housekeeper to suggest. Some housekeepers will help with laundry. Some drycleaners will pick up and deliver your clothes.

Meals. Worried that you might not be eating nutritious meals or tired of eating alone?  Sometimes you could share cooking with a friend or have a potluck dinner with a group of friends. Find out if meals are served at a nearby senior center, church, or synagogue. Eating out may give you a chance to visit with others. Is it hard for you to get out? Ask someone to bring you a healthy meal a few times a week. Also, meal delivery programs bring hot meals into your home.

Money management. Do you worry about paying bills late or not at all?  Are health insurance claim forms confusing?  Maybe you can get help with these tasks.  Ask a trusted relative to lend a hand. Volunteers, financial counselors, or geriatric care managers can also help. Just make sure you get the referral from a trustworthy source, like your local Area Agency on Aging. If you are familiar with computers, you could pay your bills online. Check with someone at your bank about this option.  Some people have their regular bills, like utilities and rent or mortgage, paid automatically from their checking account.

Consider having your Federal Government benefits checks deposited directly to your bank account.  It’s safer than getting your check through the mail, and you can have your money sooner.  If you are interested, you can go to www.godirect.org (www.directoasucuenta.org for Spanish), call 1-800-333-1795 (toll-free), or stop by your bank, credit union, or Social Security Administration office to start the process.

You can have your Social Security or Supplemental Security Income benefit checks deposited to a prepaid debit card by using the Federal Government’s Direct Express program.  Go to www.usdirectexpress.com or call 1-877-212-9991 (toll-free) to learn more. 

Be careful to avoid money scams.  Never give your Social Security number, credit card account numbers, or bank account numbers to someone on the phone (unless you placed the call) or in response to an email you receive on your computer.  Always check all bills, including utilities, for charges you do not recognize.

Even though you might not need it now, think about giving someone you trust permission to discuss your bills with creditors or your Social Security or Medicare benefits with those agencies.  You could do this by phone with each office or agency or in a letter to each one.  Or, you could give overall permission to handle a variety of legal matters for you in the form of a durable power of attorney.  “Durable” means the permission remains in effect if you cannot make decisions yourself, but you can change the power of attorney or cancel it at any time.

Health care.  Do you forget to take your medicine? There are devices available to remind you when it is time for your next dose.  Special pill boxes allow you or someone else to set out your pills for an entire week.  Have you just gotten out of the hospital and still need nursing care at home for a short time? The hospital discharge planner can help you make arrangements, and Medicare might pay for a home health aide to come to your home. 

If you can’t remember what the doctor told you to do, try to have someone go to your doctor visits with you.  Ask them to write down everything you are supposed to do, or if you are by yourself, ask the doctor to put all recommendations in writing.

Be prepared for a medical emergency

If you were to suddenly become sick and unable to speak for yourself, you probably would want someone who knows you well to decide on your medical care.  To make sure this happens, think about giving someone you trust permission to discuss your health care with your doctor and make necessary decisions.  One way to do this is through a durable power of attorney for health care. A durable power of attorney for health care allows you to name a health care proxy—someone to make health care decisions for you any time you can’t. This is part of an advance directive.  Another part of an advance directive, called a living will, allows you to decide in advance how much or how little care you want near the end of life.

Products to make life easier. Is it getting harder to turn a door knob or put on your socks? Devices are available to make activities you do during the day easier. The Department of Education’s website, www.abledata.com, has information on more than 30,000 assistive-technology products designed to make it easier for people to do things for themselves.  If you can’t use a computer, you can call 1-800-227-0216 to learn more.

Getting around—at home and in town. Are you having trouble walking? Perhaps a walker would help.  If you need more, think about getting an electric chair or scooter. These are sometimes covered by Medicare. Do you need someone to go with you to the doctor or shopping? Volunteer escort services may be available. If you no longer drive a car, check if there are free or lower-priced public transportation and taxis in your area. Maybe a relative, friend, or neighbor would take you along when they go on errands or do yours for you.

Activities and friends. Are you bored staying at home? Your local senior center offers a variety of activities. You might see friends there and meet new people too. Is it hard for you to leave your home? Maybe you would enjoy visits from someone. Volunteers, called “Friendly Visitors,” “Senior Volunteers,” or “Senior Companions,” are sometimes available to stop by or call once a week. They can just keep you company, or you can talk about any problems you are having.  Call your local Area Agency on Aging to see if they are available near you.

Safety. Are you worried about crime in your neighborhood, physical abuse, or losing money as a result of a scam? Talk to the staff at your local Area Agency on Aging. Do you live alone and are you afraid of becoming sick with no one around to help? You might want to get an emergency alert system. You just push a special button that you wear, and emergency medical personnel are called. A monthly fee is charged.

Care away from home.

Do you need care but live with someone who can’t stay with you during the day? For example, maybe they work. Adult day care outside the home is sometimes available for older people who need help caring for themselves. The day care center can pick you up and bring you home. If your caretaker needs to get away overnight, there are places that will provide more extended temporary respite care.

Housing. Would a few changes make your home easier and safer to live in? Think about things like a ramp at the front door, grab bars in the tub or shower, nonskid floors, more comfortable handles on doors or faucets, and better insulation. Sound expensive? You might be able to get help paying for these changes. Check with your local or State Area Agency on Aging, State housing finance agency, welfare department, community development groups, or the Federal Government (see the resources in For More Information).

Where can I look for help?

Here are some resources to start with:

People you know. Family, friends, and neighbors are the biggest source of help for many older people. Talk with those close to you about the best way to get what you need. If you are physically able, think about trading services with a friend or neighbor. One could do the grocery shopping, and the other could cook dinner, for example.

Community and local government resources. Learn about the services found in your community. Healthcare providers and social workers may have suggestions. The local Area Agency on Aging, local and State offices on aging or social services, and your tribal organization may have lists of services. Look in the phone book under “Government.” If you belong to a religious group, talk to the clergy, or check with its local offices about any senior services they offer.

Geriatric care managers. These specially trained professionals can help find resources to make your daily life easier. They will work with you to form a long-term care plan and find the services you need. They will charge for this help, and their fees probably won’t be covered by any insurance plan. Geriatric care managers can be very helpful when family members live far apart. If asked, they will check in with you from time to time to make sure your needs haven’t changed.  See the resources in For More Information.

Federal Government sources. There are many resources from the Federal Government where you can start looking for information. Some are only available with a computer. If you don’t have a computer, you might be able to use one in your local library or senior center. Perhaps your son or daughter, grandchild, niece, nephew, or a friend or neighbor could look on the internet for you.

Eldercare Locator Program

Through the Eldercare Locator, the Administration on Aging provides information on many different services for older people. The Eldercare Locator can give you the number of your local Area Agency on Aging. To use this service call 1-800-677-1116, or go to www.eldercare.gov on the internet.

You can get long-term care suggestions tailored to your own needs from the Medicare website at www.medicare.gov. Clicking on “Long-Term Care Planning” in the “Resource Locator” takes you to the “Long-Term Care Planning Tool.” Type in information about yourself (age, sex, and whether or not you are married), as well as your health problems and other needs. Very quickly it will give the kind of help you should look for and general advice on how to find it and how to pay for it. You do not have to identify yourself—not even your name or Social Security number.

The National Library of Medicine’s website, www.medlineplus.gov, has a section “Home care services” containing links to useful information.

To search the National Institute on Aging’s (NIA) online list of health and aging organizations, go to to this link on the NIA web page, or call NIA at 1-800-222-2225 (toll-free) for help finding the resource you need. The NIA list has the names, addresses, phone numbers, and websites for more than 260 government agencies, professional associations, and public and private groups that have information or help for older people.

Once you have decided on the services you need and have chosen some providers for them, you might be able to get more information about those sources from www.medicare.gov. Medicare’s Home Health Compare section there, www.medicare.gov/HHCompare/, can tell you more about some of the home healthcare providers in your State. You can also check on whether the people receiving care are satisfied. No computer? Just call 1-800-MEDICARE (1-800-633-4227/toll-free) and ask for the same information.

How much will this cost?

An important part of planning is thinking about how you are going to pay for the help you need. Some things you want may cost a lot. Others may be free. Some might be covered by Medicare, private “Medigap” policies or other private health insurance, Medicaid, or long-term care insurance. Some may not. Check with your insurance provider(s). There is a chance that paying for just a few services out of pocket could cost less in the long run than moving into an independent living, assisted living, or long-term care facility. And you will have your wish of still living on your own.

Once you have thought about which services you need, you can find out about Federal, State, and local government benefits at www.govbenefits.gov. If you can’t get to a computer, call 1-800-FED-INFO (1-800-333-4636/toll-free) for the same kind of help.

Another website to search for benefits is www.benefitscheckup.org from the National Council on Aging. By typing in general information about yourself, you can see a list of possible benefits you might qualify for. You don’t have to give your name, address, or Social Security number in order to use this service.

Are you eligible for veterans benefits from the Department of Veterans Affairs? The VA sometimes provides medical care in your home. In some areas they also offer homemaker/home health aide services, adult day health care, and hospice. You can learn more by going to www.va.gov, calling the toll-free VA Health Care Benefits number, 1-877-222-8387 (toll-free), or contacting the VA medical center nearest you.

One family’s story

The house on Maple Street has been Ellen Pinkham’s home for more than 45 years.  It has changed over time—the twins’ bedroom is now Ellen’s sewing room. After Herb died, Ellen gave his mystery books to the local library.  But because staying on Maple Street is so important to Ellen, her family is making changes.  They call her daily to touch base.  They added grab bars in the tub and by the toilet, got rid of those loose rugs in the hall, and put her doctor’s phone number on speed dial.  A hot meal is delivered regularly, and Ellen’s granddaughter drives her to bingo and the grocery store.  As they look to the future, Ellen’s family knows they can call the local Area Agency on Aging if they need help finding home health aides or other assistance.  It looks like Ellen has a plan that is working.  She may be able to stay on Maple Street. 

For More Information

GENERAL GOVERNMENT:

Administration on Aging
Washington, DC 20201
1-202-619-0724
www.aoa.gov

Department of Veterans Affairs
Veterans Benefits Administration
Veterans Health Administration
810 Vermont Avenue, NW
Washington, DC 20420

VA benefits:
1-800-827-1000 (toll-free)
1-800-829-4833 (TDD/toll-free)

To speak with a healthcare benefits counselor:
1-877-222-8387 (toll-free)
www.va.gov

Eldercare Locator
1-800-677-1116 (toll-free)
www.eldercare.gov

Federal and State Government Benefit Information
1-800-FED-INFO
1-800-333-4636/toll-free)
www.govbenefits.gov

Medicare
Centers for Medicare and Medicaid Services
7500 Security Boulevard
Baltimore, MD  21244-1850
1-800-633-4227 (toll-free)
www.medicare.gov
www.medicare.gov/homehealthcompare/

USA.Gov for Seniors
www.usa.gov/Topics/Seniors.shtml

HOUSING INFORMATION:

Department of Housing and Urban Development
451 Seventh Street, SW
Washington, DC 20410
1-202-708-1112
1-202-708-1455 (TTY)
www.hud.gov

Low-Income Home Energy Assistance Program (LIHEAP)
National Energy Assistance Referral Hotline (NEAR)
1-866-674-6327 (toll-free)
1-866-367-6228 (TTY/toll-free)
www.liheap.ncat.org

National Resource Center on Supportive Housing and Home Modification
3715 McClintock Avenue
Los Angeles, CA 90089-0191
1-213-740-1364
www.homemods.org

Rebuilding Together
1899 L Street, NW
Suite 1000
Washington, DC 20036
1-800-473-4229 (toll-free)
www.rebuildingtogether.org

Senior Housing Associations
www.reversemortgagealert.org/housing-association-directory/

SERVICE PROVIDERS:

LeadingAge
2519 Connecticut Avenue, NW
Washington, DC 20008-1520
1-202-783-2242
www.leadingage.org

National Adult Day Services Association
85 South Washington Street
Suite 316
Seattle, WA  98104
1-877-745-1440 (toll-free)
www.nadsa.org

National Association of Professional Geriatric Care Managers
3275 West Ina Road
Suite 130
Tucson, AZ 85741-2198
1-520-881-8008
www.caremanager.org

For more information about health and aging, contact:

National Institute on Aging
Information Center

P.O. Box 8057
Gaithersburg, MD 20898-8057
1-800-222-2225 (toll-free)
1-800-222-4225 (TTY/toll-free)
www.nia.nih.gov
www.nia.nih.gov/Espanol

To order publications (in English or Spanish) or sign up for regular email alerts, go to: www.nia.nih.gov/HealthInformation.

Visit NIHSeniorHealth (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health information for older adults. Special features make it simple to use. For example, you can click on a button to have the text read out loud or to make the type larger.