- How to Hire a Caregiver for In-Home Help
- How to Prevent and Treat Age-Related Macular Degeneration
- Kitchen Ideas for Aging-in-Place
- How Extreme Heat Affects Seniors: Tips to Stay Safe
Dear Savvy Senior,
My wife and I had our estate plan – including a will, power of attorney and advance directive – drawn up about 10 years ago but have recently read that our plan should include a digital will too. What can you tell us about this?
- Almost 80
Dear Almost,
If you or your wife spend much time online, adding a separate digital will document to your estate plan that provides a list of your digital assets would be extremely helpful to your loved ones when you die, not to mention it will help protect your privacy. Here’s what you should know.
Do You Have Digital Asset?
The term “digital assets” refers to personal information that is stored electronically on either a computer or an online cloud server account that belongs to an individual. Anyone who uses email, has a PIN code protected cell phone, makes online purchases, or pays bills online has digital assets.
Digital assets generally require a username, a password, or a PIN to access and can be difficult if not impossible to retrieve if someone is incapacitated or passes away.
Creating a digital will (also known as a digital estate plan) will help your loved ones access your electronic devices and online accounts more easily so they can manage your electronic affairs, according to your wishes, after you’re gone. This in turn will also protect your digital assets from hackers or fraud, which can happen to dormant accounts after you die.
How to Write a Digital Will
Your first step in creating a digital will is to make an inventory list of your digital assets, which includes everything from hardware to email accounts. Here are a few categories to help kick-start your list:
- Electronic devices (computer, smartphone, tablet, external hard drive).
- Digital files (for photos, videos or documents)
- Financial accounts (like bank and brokerage accounts, credit cards, cryptocurrency).
- Bill paying accounts (utilities, mortgage accounts)
- Social media accounts (like Facebook, Instagram, Twitter, LinkedIn).
- Email accounts (Gmail, Yahoo, Outlook, etc.).
- Cloud-storage accounts (like Google Cloud, iCloud, Dropbox, Microsoft OneDrive)
- Movie or music streaming services (like Netflix, Hulu, Spotify, Apple Music)
- Online purchasing accounts (like Venmo or PayPal)
- Subscription services (magazines, newspapers, Amazon Prime, etc.).
- Reward programs (travel, stores, etc.).
- Membership organizations (AARP, AAA, etc.).
When making your list, you’ll need to include usernames, passwords, PINS, account numbers or security questions for accessing each account. And provide instructions on how you want your assets managed after your death. For example: Do you want certain accounts closed, archived or transferred? Do you want specific files or photos to be deleted or shared with loved ones? Do you want your social media profiles memorialized or deleted? Be clear and specific about your wishes.
You’ll also need to appoint a digital executor that you trust to execute your wishes after you die.
From a legal perspective, you should know that most states have enacted the Revised Uniform Fiduciary Access to Digital Assets Act (RUFADAA), which legally recognizes digital estates. This law gives your personal representative or executor legally protected access to your online accounts.
Once your digital will is written, store it with your other estate plan documents either in a fireproof safe or file cabinet at home, on your computer hard drive, with your estate planning attorney or online at a reputable digital estate planning service like Everplans.com or Clocr.com. But make sure your executor knows where it is and has access to it.
Also remember to keep your digital will updated regularly when you create any new digital accounts or change passwords.
1.How to Hire a Caregiver for In-Home Help
Dear Savvy Senior,
I need to hire a good in-home caregiver to help my elderly father who lives alone. What’s the best way to do this?
- Searching Sarah
Dear Sarah,
Finding a good in-home caregiver for an elderly parent is not always easy. How can you find one that’s reliable and trustworthy, as well as someone your parent likes and is comfortable with? Here are some tips that can help.
Know His Needs
Before you start the task of looking for an in-home caregiver, your first step is to determine the level of care your dad needs.
For example, if he only needs help with daily living tasks like shopping, cooking, doing laundry, bathing or dressing, a “homemaker” or “personal care aide” will do. But if he needs health care services, there are “home health aides” that may do all the things a homemaker does, plus they also have training in administering medications, changing wound dressings and other medically related duties. Home health aides often work under a nurse’s supervision.
Once you settle on a level of care, you then need to decide how many hours of assistance he’ll need. For example, does your dad need someone to come in just a few mornings a week to cook, clean, run errands or perhaps help him with a bath? Or does he need more continuous care that requires daily visits?
After you determine his needs, there are two ways in which you can go about hiring someone. Either through an agency, or you can hire someone directly on your own.
Hiring Through an Agency
Hiring a personal care or home health aide through an agency is the safest and easiest option, but it’s more expensive. Costs typically run anywhere between $15 and $30 an hour depending on where you live and the qualification of the aide.
How it works is you pay the agency, and they handle everything including an assessment of your mom’s needs, assigning appropriately trained and pre-screened staff to care for her, and finding a fill-in on days her aide cannot come.
Some of the drawbacks, however, are that you may not have much input into the selection of the caregiver, and the caregivers may change or alternate, which can cause a disruption.
To find a home care agency in your dad’s area use search engines like Google or Bing and type in “home health care” or “non-medical home care” followed by the city and state your dad lives in. You can also use Medicare’s search tool at Medicare.gov/care-compare – click on “home health services.” Most home health agencies offer some form of non-medical home care services too.
You also need to know that original Medicare does not cover in-home caregiving services unless your dad is receiving doctor ordered skilled nursing or therapy services at home too. But, if your dad is in a certain Medicare Advantage plan, or is low-income and qualifies for Medicaid, he may be eligible for some coverage.
Hiring Directly
Hiring an independent caregiver on your own is the other option, and it’s less expensive. Costs typically range between $12 and $25 per hour. Hiring directly also gives you more control over who you hire so you can choose someone who you feel is right for your dad.
But be aware that if you do hire someone on your own, you become the employer so there’s no agency support to fall back on if a problem occurs or if the aide doesn’t show up. You’re also responsible for paying payroll taxes and any worker-related injuries that may happen. If you choose this option, make sure you check the aide’s references thoroughly and do a criminal background check at companies like eNannySource.com.
To find someone use an elder-care matching service like Care.com or CareLinx.com, which both provide basic background checks.
Savvy Senior
2.How to Prevent and Treat Age-Related Macular Degeneration
Dear Savvy Senior,
Is macular degeneration hereditary? My mother lost much of her vision from it before she died, and now at age 65, I’m concerned I may get it too. What can you tell me?
Brown Eyed Betty
Dear Betty,
Unfortunately, having a parent or sibling with macular degeneration does indeed increase your risk of getting it by three to four times. But the good news is there are things you can do to protect your eyesight, and a number of treatments that are available if you do happen to get it. Here’s what you should know.
What is AMD?
Macular degeneration, also known as age-related macular degeneration (or AMD) is the most common cause of severe vision loss in people over age 60, affecting an estimated 20 million Americans.
AMD is a progressive eye disease that damages the macula, the part of the eye that allows us to see objects clearly, causing vision loss in the center of your vision. This affects the ability to read, drive, watch television and do routine daily tasks, but it does not cause total blindness.
There are two types of AMD – dry and wet. Dry AMD, which affects about 85 to 90 percent of all people that have it, progresses slowly and painlessly over a period of years.
While wet AMD is much more aggressive and can cause severe vision loss in a matter of weeks or months.
Factors that can increase your risk of getting AMD include age (60 and older); smoking; excessive exposure to sunlight especially if you have light-colored eyes; certain genetic components; a family history of AMD; high blood pressure; obesity; and being Caucasian.
What You Can Do
For anyone over the age of 65, it’s a smart idea to get your eyes examined by an ophthalmologist every year. They can spot early signs of AMD before vision loss occurs. Early signs, however, may include shadowy areas in your central vision or unusually fuzzy or distorted vision.
The Amsler grid is also an excellent tool to check your eyes for AMD at home. Visit Macular.org, and search “amsler chart” to test your sight.
While there’s currently no cure for AMD there are things you can do if you’re high risk, including: eating antioxidant-rich foods such as dark green, leafy vegetables, and cold-water fish for their omega-3 fatty acids; protecting your eyes from the sun by wearing UV protective sunglasses; controlling high blood pressure; exercising regularly; and if you smoke, quit.
Dry AMD Treatments
If you do happen to get AMD, your doctor may recommend you start taking a daily dose of antioxidant vitamins and minerals known as AREDS or AREDS2. Studies by the National Eye Institute have shown that while taking these supplements cannot prevent you from getting AMD, they can reduce your risk of progression from intermediate to advanced AMD by about 25 percent.
You can purchase AREDS supplements – made by Bausch and Lomb and sold as PreserVision – over the counter in many drugstores and online for around $30 a bottle.
There are also two new medications (Syfovre and Izervay) that were approved by the FDA last year to treat a late-stage form of AMD called geographic atrophy or GA. These treatments, which are given either monthly or every other month in the form of an injection into the eye, can slow the progression of GA.
Wet AMD Treatments
For wet AMD, there are several anti-VEGF medications like Avastin, Lucentis and Eylea that can stop vision loss and may even restore it. These medications, which have been around for more than a decade, are also given by injection into the eye and repeated every month or two.
Newer anti-VEGF drugs, like Vabysmo and Eyla HD, are also highly effective but don’t require monthly treatments. Most patients on these medications can go three to four months between injections.
3.Kitchen Ideas for Aging-in-Place
Dear Savvy Senior,
My 77-year-old mother, who loves to cook has had several kitchen-related accidents over the past year. What tips can you recommend for making a kitchen safer and more practical for seniors, without doing a big expensive remodel.
Inquiring Daughter
Dear Inquiring,
There are a number of small improvements and simple modifications you can do that can make a big difference in making your mom’s kitchen safer and easier to maneuver. Depending on her needs, here are some tips for different aspects of her kitchen.
Lights: If the lighting in your mom’s kitchen needs improvement, replace the old overhead fixture with a bright new ceiling light, and add LED lighting under upper kitchen cabinets to brighten up her kitchen countertops.
Floors: If she has kitchen throw rugs, to reduce tripping or slipping, replace them with non-skid floor mats or consider gel mats, which are cushiony and more comfortable to stand on for long periods. GelPro.com and WellnessMats.comoffer a nice selection.
Cabinets and drawers: To reduce bending or reaching, organize your mom’s kitchen cabinets and drawers so that the items she most frequently uses are within comfortable reach. You can also make her lower cabinets and pantry easier to access by installing pullout shelves or lazy susans. And, by installing pull-down shelves in her upper cabinets (see Rev-a-shelf.com) so she doesn’t have to get on a stool to reach things on high shelves. I also recommend replacing her cabinet and drawer knobs with “D” or “C” shaped pull-handles because they’re more comfortable for arthritic hands to grasp than knobs.
Faucet: If your mom has a twist-handle kitchen faucet, replace it with an ADA compliant single handle faucet, or with a touch, motion or digital smart faucet. They’re easier to operate, especially if she has hand arthritis or gripping problems. And, for safety purposes, set her hot water tank at 120 degrees to prevent possible water burns.
Microwave and cooktop safety: If your mom’s microwave is mounted above her stove, consider moving it, or get her a small microwave for the countertop so she doesn’t have to reach over a cooktop to insert or remove food. And if you’re worried about your mom forgetting to turn off the stove there are automatic shut-off devices you can purchase and install to prevent a fire. iGuardStove (iGuardFire.com) makes one of the best smart shutoff devices for gas and electric stoves. And to guard against microwave fires, there’s the SmartMicro microwave shutoff made by Pioneering Technology (PioneeringTech.com).
Shopping for Appliances
If you’re looking to upgrade some of your mom’s appliances, here are some different features to keep in mind.
Refrigerator: French-door refrigerators that open in the middle are great for seniors because it makes it easier to see and reach what’s inside. Pullout adjustable height shelves and a water/ice dispenser on the outside of the door are also very convenient.
Stove or cooktop: Look for one with controls in the front so your mom won’t have to reach over hot burners to turn it off, and make sure the controls are easy to see. Flat surface electric or induction burners, or continuous grates on gas stoves are also great for sliding heavy pots and pans from one burner to the next. And ask about automatic shut off burners.
Oven: Self-cleaning ovens are a plus and consider a side-swing door model. They’re easier to get into because you don’t have to lean over a hot swing-down door. Also consider a wall-mounted oven, installed at your mom’s preferred height to eliminate bending.
Dishwasher: Consider a drawer-style dishwasher that slides in and out for easier access and, if possible, have it installed on a raised platform 12 to 24 inches above floor level so it can be loaded and unloaded without bending over.
Washer and dryer: Front-load washers and dryers with pedestals that raise the height around 24 inches are also back-savers and easier to access.
4.How Extreme Heat Affects Seniors: Tips to Stay Safe
Dear Savvy Senior,
I work for a county health department and every summer we’re seeing more and more seniors get sick and even die from heat-related illiness. Can you write an awarness piece on the affects extreme heat has on older adults, and what they can do to guard against this summertime risk. Thanks for helping keep seniors safe!
Health Advocate
Dear Advocate,
Happy to oblige! Most people don’t realize that each year, extreme summertime heat kills more people in the U.S. than hurricanes, floods and tornadoes combined. While extreme heat can be deadly for anyone, older adults are uniquely vulnerable because of three key factors: biological changes that occur with age; higher rates of age-related diseases; and greater use of medications that can alter the body’s response to heat.
Here’s how to gauge the risk for a heat-related illness for you or an older loved one and how to stay safe.
How Heat Affects Seniors
The human body has two main mechanisms to cool itself: sweating and increasing blood flow to the skin. In older adults, both of those processes are compromised. Seniors sweat less and they have poor circulation compared with younger people.
Chronic health conditions that are more common in old age, most notably cardiovascular disease and diabetes, can also exacerbate these issues. A diseased heart isn’t able to pump as much blood, further reducing blood flow to the skin. And if the nerves become affected in people with diabetes, the body might not receive the message that it needs to start sweating.
As people age, they also stop feeling as thirsty and so they tend to drink less. In hot conditions, that can cause them to become dehydrated faster.
In addition, some older adults, particularly if they have some form of dementia or cognitive decline, may not perceive temperature changes as well. As a result, they won’t respond appropriately to heat, both biologically (through sweating) and behaviorally (by moving to someplace cool).
Finally, certain medications many seniors take like diuretics and other high blood pressure drugs can affect people’s hydration, blood flow and even the sweat response, so be sure to ask your doctor about any medications you’re taking.
How to Stay Safe
On hot days, older adults and people with serious health conditions should limit outdoor activities like walking and gardening to the cooler mornings and evenings, take frequent breaks and drink plenty of water even if you aren’t thirsty. Listen to your body. If the activity starts to feel harder than normal, that’s a signal to stop and find a place to cool down.
Signs of dehydration or heat exhaustion include dizziness, lightheadedness, headache, flushed face, a racing heart or feeling lethargic. Low energy is especially important to watch out for in people with cognitive impairment, who may not realize how hot they are or be able to express it.
If heat exhaustion worsens to a heatstroke, it becomes a life-threatening emergency.
While older adults face unique challenges when it comes to heat, the ways to cool down are the same for any age. If you or a loved one start to experience any of the above symptoms, the best thing you can do is to go somewhere that has air-conditioning. If AC isn’t available in the home, check if there’s a local cooling center.
In the absence of air-conditioning, water is extremely helpful in reducing the risk for heat-related injury. Rubbing an ice cube or cold compress over your skin, spraying yourself with cool water or taking a cool shower or bath can also help.
For more heat related safety tips, visit the Center for Disease Control and Prevention website at CDC.gov/extreme-heat.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
