Family inHome Caregiving Blog
Consumers have done a good job trying to avoid trans fat after a number of research projects have linked them to higher risk of heart disease, strokes and other serious health problems. However, researchers have found that labeling on a lot of commonly used products may be misleading. A study which was published in the Journal Preventing Chronic Disease looked at 4,340 packaged foods and found that of the nearly 400 products that listed in the ingredients “partially hydrogenated oils,” the main dietary source of trans fat, only 15% reported that there was trans fat in the product on their labels. The other 84% of products listed zero grams of trans fat on the label. Current guidelines from the Food & Drug Administration allow food producers to list zero grams of trans fat on the label if the product contains less than 0.5 grams per serving. Therefore, you need to be suspicious of any products that list partially hydrogenated oils on the label.
We all know that fish is a healthy food to eat. But a new study, which was published in The American Journal of Clinical Nutrition, found that there is an additional benefit: it could help prevent hearing loss. Researchers studied records from more than 65K female nurses over an 18 year period. They found that, compared with women wo ate fish less than once per month, those eating fish at least twice per week had a 20 percent lower risk of hearing loss, even after accounting for the fact that women who eat more fish may have healthier diets and lifestyles. All fish, even canned tuna and shellfish, helped the women have a lower risk of hearing loss. Researchers believe that the omega-3 fatty acids in fish may improve blood flow within the ear, just like they do in other parts of the body.
A class of drugs called PD-1 inhibitors are showing extreme promise in fighting Hodgkin’s Disease, a debilitating condition that strikes almost 10,000 people per year. The drugs free the body’s immune system to fight cancer and have shown that they shrink cancer in over half of the patients on the drugs, and these are people that have exhausted many other treatment options. What’s exciting about this new class of drugs is that researchers believe they may also work on lung, kidney and some other types of cancers. Although the trials thus far have been small, at the annual meeting of the American Society of Hematology, participants were excited about the potential for this class of drugs. About 30% of those treated for Hodgkin’s disease either do not respond to current treatments or do initially but then relapse.
A Federal judge yesterday issued a ruling blocking drug company Actavis from halting sales of the old version of Alzheimer’s drug Namenda so that it could make more money from a new version of the drug which has a longer patent life. It’s become common practice for companies to come out with a slightly tweaked version of a drug so that it can keep its name-brand drug on the market when new generic versions are allowed to be manufactured by competitors. For instance, the owner of the patent on the popular sleeping pill Ambien came out with a time-released version (Ambien-CR) in order to create new life for the Ambien brand. But Actavis took this strategy even one step further. It introduced Namenda XR, which is taken once per day rather than the old version of Namenda which was taken twice per day. By taking Namenda off the market and introducing Namenda XR before generic Namenda came to market, it would get patients switched to what was essentially a new drug which couldn’t be substituted for a generic by the pharmacist. “Our lawsuit against Actavis sends a clear message: Drug companies cannot illegally prioritize profits over patients,” New York attorney general Eric Schneiderman said.
The latest issue of Kiplinger's Retirement Report brought up an important issue: Those with public pensions face reduced Social Security benefits. The article interviewed Jim Knight, a 68 year old man who filed for benefits at age 66. He started receiving payments of $1,000 per month. However, a year later when he started getting his teacher’s pension check, his monthly Social Security check dropped to $600 per month. “It’s unfair. That money is mine,” he told a reporter. Unfortunately, it is legal under the so-called “windfall elimination provision” or WEP which penalizes those who worked in the private and public sectors unless they have 30 years or more of substantial earnings or have a military pension. Sadly, some people get hit twice. If you are a public pensioner who applies for a spousal or survivor benefit, that too will be cut by two-thirds of the amount of the public pension.
There has been quite a bit of focus recently on improving awareness of planning for end-of-life care (often referred to as hospice) which includes things like signing a Physicians Order for Life-Sustaining Treatment (also known as a POLST). This form outlines how you want physicians to treat you should you become incapacitated and unable to communicate your wishes. We also recommend that you meet with friends, family, and anyone you have given power-of-attorney to or made a potential trustee on a living trust. Talk to them frankly about what you would want to happen if you were put on life support or were in another medical emergency. Unfortunately, experts are saying that many people signing these forms don’t fully understand what they mean. There is a lot of medical jargon such as a “DNR” or do not resuscitate order which people need to fully understand before signing such forms. In contrast to a POLST form, which spells out your wishes in certain circumstances, a DNR directs medical providers not to try to revive you if you have no pulse or aren’t breathing, however it doesn’t address other things like withdrawing or withholding care. A number of studies have shown that even doctors are confused about the meaning of instructions in living wills and DNR orders. Some doctors even mistakenly thought a living trust was the same as a DNR while others believe a DNR means that they should not provide any treatment at all. This is quite frightening. “The risk is that you don’t receive the necessary and standard-of-care treatment for a critical illness such as a heart attack, which could lead to death or permanent disability, whereas the standard-of-care treatment could save your life,” Dr. Ferdinando Mirarchi, lead investigator of what are called the TRIAD studies which found all of this confusion among doctors. The bottom line is that you should have a POLST and appoint someone as your medical representative, fully explaining to them exactly what your wishes are in various medical scenarios so that there is no confusion.
Many baby boomers have grand plans for retirement while others have no idea how they will spend their time after they stop working. A new study which was published in the Journal of Financial Planning might give you some ideas. The survey of middle to high income seniors (at least 50, retired and having a household income of $60,000 or more) found many enjoyed eating out more, preparing meals, reading and gardening. Full-time workers spend only 13 minutes per week reading for personal pleasure versus 48 minutes for retirees.
Top Weekday Activities*
TV & Movies 223
Eating and drinking 89
Reading for personal interest 48
Washing, dressing and grooming 39
Socializing and communicating 34
Food and drink preparation 34
Lawn, garden and houseplant care 30
Interior cleaning 24
Shopping, except groceries, food & gas 23
*In average minutes per day for retirees surveyed. Sources: Bureau of Labor Statistics data via "How Retirees Spend Their Time: Helping Clients Set Realistic Income Goals," Charlene M. Kalemkoski and Eakamon Oumtrakool
Most activities are fairly inexpensive. "I don’t want to tell people not to worry," Charlene Kalenkoski, co-author of the study, told The Wall Street Journal. However, she said that if the research holds true, retirement "isn't going to be as expensive as people might think," she said.
Walgreens has partnered with Telehealth to develop a web site and mobile App called MDLive which it claims will transform retail digital healthcare delivery. The App will provide access to doctors 24 hours a day 7 days a week. Walgreens already offers access to its pharmacists 24/7. The Virtual Medical Office platform will allow patients, healthcare professionals and insurance companies to collaborate via secure voice, video, email and mobile devices. You could, for instance, consult with your physician who could then immediately email a prescription to Walgreens. CVS is testing tele-health in 28 locations while Rite Aid is partnering with a company called HealthSpot to test private in-store kiosks which connect customers to physicians. Other drug store chains will likely jump on the bandwagon.
With the recent volatility in the stock market, many seniors are wondering if they should pull all of their money out of the market and go completely into cash. Although investment advisers stress the fact that you need to invest more conservatively as you get older, you might be surprised that many still advise some stock exposure even for an 80-year old. Many use the age-in-bonds formula which reduces your equity exposure by one percentage point per year. A 25 year old would hold 25% in bonds and 75% in stocks while an 80 year old should have 20% in stocks and 80% in bonds. One important thing to keep in mind is that you need to create a portfolio where you won't run out of money and you will still have enough available for living expenses. One way to get a steady stream of income is to buy an inflation-adjusted annuity with payouts that match projected spending. Another is creating a so-called TIPS ladder, which is a collection of Treasury inflation-protected maturities to provide a steady stream of principal and income to support spending during your retirement. The latter, however, is tough in this low-interest rate environment so consult a financial adviser to analyze your investment portfolio and tell you how likely it is to hold up during your retirement.
The Wall Street Journal recently ran a great article entitled, “Why Everything You Know About Aging Is Probably Wrong.” A lot of the article was positive, stating that as people get older friendships, creativity and satisfaction with life all can flourish. Many people, however, are extremely anxious about retirement. Among those surveyed that are 18-64, 57% expect memory loss although it impacts only 25% of those over 65. About 14% of seniors aren’t able to drive and yet about 45% of those 18-64 believe they won’t be able to. The list goes on and on. While most of the articles we read about seniors tend to focus on the negative, this one was great, aiming to dispel common myths such as depression being prevalent with the elderly. Research actually indicates that emotional well-being continues to improve until the 70’s, at which point it levels off. Even centenarians report overall high levels of well-being according to a 2014 study done by a number of researchers including Laura Cartensen, the director of Stanford University’s Center on Longevity. It’s a long article but I would encourage you to give it a read, it synthesizes a lot of recent research which has been done on the elderly.