How to Assess What You Need in a Walker
Dear Savvy Senior,
Can you give me some tips on choosing an appropriate walker for my elderly father? He has some balance issues along with arthritis in his hips and could use a little more help than a cane provides.
- Wobbly in Wisconsin
Dear Wobbly,
When it comes to choosing a walker, there are several styles and options to consider, but selecting the best one for your father will depend on his needs, as well as where he’ll be using it. Here are some tips that can help you choose.
Types of Walkers
There are three basic types of walkers on the market today. To help your dad choose, consider how much support he’ll need. Then, pay a visit to a medical equipment store or pharmacy (see Medicare.gov/medical-equipment-suppliers) that sells walkers so he can test-walk a few. Here are the different types he’ll have to choose from.
Standard walker: This is the most basic style of walker that has four legs with rubber-based feet (no wheels), is very lightweight (5 to 6 pounds) and typically costs between $30 and $100. This type of walker must be picked up and moved forward as you walk, so it’s best suited for people who need significant weight bearing support, or who are walking very short distances.
Two-wheeled walker: This has the same four-leg style as the standard walker except it has wheels on the two front legs that allow you to easily push the walker forward without lifting, while the back legs glide across the floor providing support while you step forward. These are best for people with balance issues and are priced at around $50 to $150.
Rollator: This is a rolling walker that has wheels on all (three or four) legs. Four-wheel rollators typically come with a built-in seat, basket and hand-breaks and are best suited for people who need assistance with balance or endurance inside or outside the home. Some rollators even come with pushdown brakes that engage with downward pressure and will lock if you sit on the seat. Or, if you dad needs to navigate tight spaces at home, three-wheel rollators, which don’t have a seat, are a nice option. Rollators typically run between $60 and $250.
Other Tips
After deciding on the type of walker, there a few additional things you need to know to ensure it meets your dad’s needs.
First, be sure the walker’s height is adjusted appropriately. To do this, have your dad stand with his arms relaxed at his sides. The handgrips of the walker should line up with the crease on the inside of his wrist.
If your dad is a large person, verify that the walker’s weight capacity will support him, and if he chooses a four-wheel rollator, that his body can fit between the handgrips when sitting. Heavy duty (bariatric) rollators with higher weight capacities, bigger wheels and wider seats are also an option.
Your dad also needs to test the handgrips to make sure they’re comfortable and be sure to purchase a walker that folds up (most do) for easier storage and transport.
There are also walker accessories that can be added for convenience such as food tray attachments, tote bags for carrying personal items, oxygen tank holders, and tennis ball walker glides that go over the feet of a standard walker to help it slide more easily across the floor.
For more tips on how to choose and use a walker, visit Mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/walker/art-20546805. It’s also a smart idea to work with your dad’s doctor or a physical therapist, and be sure to get a written prescription, as Medicare will cover 80 percent of the cost.
What Are the Early Signs and Symptoms of Diabetes?
Dear Savvy Senior,
What are the early signs and symptoms of diabetes? I’m 60 years old, and in pretty good shape, but was just diagnosed with type 2 diabetes. What did I miss?
- Diabetic Dan
Dear Dan,
The signs and symptoms of type 2 diabetes can be so mild that many people miss them. That’s why testing is so important. Here’s what you should know.
According to the Centers for Disease Control and Prevention more than 38 million Americans have diabetes today, and another 97 million have prediabetes, but many of them don’t even know they have it.
Type 2 diabetes is a disease that develops slowly over decades. Most people have prediabetes for a long time before the disease becomes full-blown diabetes, and even then, it progresses gradually.
Diabetes occurs when your blood glucose, also called blood sugar, is too high. This excess blood sugar damages blood vessels and affects circulation, putting you at risk for a host of ailments, from heart attack and stroke to blindness, kidney failure and nerve damage.
Signs and Symptoms
So how can you tell if you have diabetes? The earliest signs, which are usually subtle, including urinating more frequently (often at night), being thirster and hungrier than usual, weight loss without trying, feeling very tired, having dry itchy skin and blurry vision.
And the symptoms that can indicate advanced diabetes and long-term damage has occurred includes cuts or sores that heal slowly, having more infections than usual, and pain or numbness in your feet or legs.
Who Should Get Tested?
Because prediabetes typically causes no outward symptoms, and the signs of early type 2 diabetes can easily be missed, the only way to know for sure if you have it is to get a blood test.
Everyone age 45 years or older should consider getting tested for diabetes, especially if you are overweight with a body mass index (BMI) above 25. See CDC.gov/bmi to calculate your BMI.
If you are younger than 45 but are overweight, or have high blood pressure, a family history of diabetes, or belong to an ethnic group (Latino, Asian, African or Native American) at high risk for diabetes, you should get checked too.
To help you determine your risk for diabetes, the American Diabetes Association (ADA) has a quick, online risk test you can take for free at Diabetes.org/risk-test.
Diabetes Tests
There are three different tests your doctor can give you to diagnosis diabetes. The most common is the “fasting plasma glucose test,” which requires an eight-hour fast before you take it. There’s also the “oral glucose tolerance test” to see how your body processes sugar, and the “hemoglobin A1C test” that measures your average blood sugar over the past three months. It can be taken anytime regardless of when you ate.
Most private health insurance plans and Medicare cover diabetes tests, however, if you’re reluctant to visit your doctor to get tested, an alternative is to go to the drug store, buy a blood glucose meter and test yourself at home. They cost around $20.
If you find that you are prediabetic or diabetic, you need to see your doctor to develop a plan to get it under control. In many cases lifestyle changes like losing weight, exercising, eating a healthy diet and cutting back on carbohydrates may be all you need to do to get your diabetes under control. For others who need more help, many medications are available.
For more information on diabetes and prediabetes or to find help, join a lifestyle change program recognized by the CDC (CDC.gov/diabetes-prevention). These programs offer in-person and online classes in more than 1,500 locations throughout the U.S.
How to Find Legal Help When You Can’t Afford a Lawyer
Dear Savvy Senior,
Can you recommend any programs or organizations that provide free or low-cost legal services to seniors? I believe I need some professional legal help but have limited income and very little savings.
- Almost 70
Dear Almost,
Whether you need help drawing up a will or a contract, or you’re facing some sort of legal jeopardy or dilemma, hiring an attorney can be expensive. Most lawyers today charge anywhere between $100 and $300 an hour. Fortunately, there are a number of different programs and organizations that offer free legal advice and may help you find a free or low-cost attorney. Here’s where look for help in your area.
Legal Aid: Directed by the Legal Services Corporation, legal aid provides free legal assistance to low-income people of all ages. Each community program will differ slightly in the services they offer and income qualifications. Visit LSC.gov/find-legal-aid to locate a program near you.
LawHelp: Powered by Pro Bono Net, a national nonprofit organization, LawHelp.org is a terrific resource that will help you locate free legal aid near you, get answers to your legal questions and even fill out legal documents. These free services are for people with low to moderate incomes.
Free Legal Answers: This is an online program created by the American Bar Association that matches low-income clients with volunteer lawyers who agree to provide brief answers online for free. This service will not answer criminal law questions and it’s not available in every state. See ABAfreelegalanswers.org to look for a program in your state.
Senior Legal Hotlines: There are around 30 states that offer senior legal hotlines, where all seniors over age 60 have access to free legal advice over the telephone. To find out if this service is available in your state, go to ProSeniors.org and click on “Resources,” followed by “U.S. Senior Legal Hotline Directory.”
Senior Legal Services: Coordinated by the Administration on Aging, this service may offer free or low-cost legal advice, legal assistance or access to legal representation to people over the age of 60. Your Area Agency on Aging can tell you what’s available in your community. Call the Eldercare Locator at 800-677-1116 to get your local number.
Local Law Schools: More than 200 university law schools across the country have pro bono programs that offer free legal assistance provided by law students, who are supervised by their professors. See AmericanBar.org/groups/center-pro-bono – scroll down and click on “Directory of Law School Public Interest and Pro Bono Programs” to locate a program near you.
Pension Rights Center: This is a nonprofit consumer organization that provides free legal assistance for problems with pension, 401(k) or other retirement plans. Go to PensionRights.org/find-help to search for help in your state.
Stateside Legal: For military members, veterans, and their families, StatesideLegal.org provides access to free legal information and legal assistance in your area.
National Disability Rights Network: This is a nonprofit membership organization that provides legal assistance to people with disabilities through their Protection and Advocacy System and Client Assistance Program. If you are disabled, visit NDRN.org to find help in your state.
Other Options: If you can’t get help from one of these programs, or find that you aren’t eligible, another option is to contact your state or local bar association to see if there are any volunteer lawyer projects in your area or if they can refer you to a low-fee lawyer. To contact your state or local bar association, go to FindLegalHelp.org.
Health Insurance Options for Early Retirees
Dear Savvy Senior,
I’m going to retire in a few months and need to get some temporary health insurance until I can enroll in Medicare at age 65. What are my options?
- Early Retiree
Dear Early,
There are several places early retirees can find health insurance coverage before Medicare kicks in, but the best option for you will depend on your income level, your health care needs and how long you’ll need coverage for. Here’s where to look.
Affordable Care Act: For most early retirees who aren’t yet eligible for Medicare, the Affordable Care Act (ACA) health insurance marketplace, also know as Obamacare, is the best option for getting comprehensive health coverage. And you won’t be denied coverage or charged extra for preexisting health conditions.
And, if your income falls below the 400 percent poverty level after you retire – anything below $60,240 for a single or $81,760 for a couple in 2024 – you’ll also be eligible for a subsidy that will reduce your monthly premiums. The ACA also ensures that at least through 2025, households with incomes above that 400 percent poverty level will not have to pay more than 8.5 percent of their income for a benchmark policy.
To see how much subsidy you may be eligible for, use Kaiser Family Foundation subsidy calculator at KFF.org/interactive/subsidy-calculator.
To shop for ACA plans in your state, visit HealthCare.gov or call 800-318-2596. Or, if you want some extra help, contact a certified agent or broker at HealthCare.gov/find-assistance.
COBRA: Another temporary health insurance option you may be eligible for is the Consolidated Omnibus Budget Reconciliation Act (COBRA). Under this federal law, if you work for a company that has 20 or more employees, you can remain on your employer’s group health plan for at least 18 months – but could last up to 36 months. But be aware that COBRA isn’t cheap. You’ll pay the full monthly premium yourself, plus a 2 percent administrative fee.
To learn more, talk to your employer benefits administrator or contact the Employee Benefits Security Administration (Askebsa.dol.gov; 866-444-3272).
If, however, the company you work for has fewer than 20 employees, you may still be able to get continued coverage through your company if your state has “mini-COBRA.” Contact your state insurance department to see if this is available where you live.
Short-Term Health Insurance: If you can’t find an affordable ACA plan and COBRA is too expensive, another possible option is short-term health insurance. These plans, which are not available in every state, are cheaper, bare-bones health plans that provide coverage for up to 3 months with a one-month extension available. But be aware that short-term plans don’t comply with the ACA so they can deny sick people coverage, they don’t cover preexisting conditions and they can exclude coverage essentials like prescription drugs.
To find and compare short-term health plans, try sites like eHealthInsurance.com or PivotHealth.com.
Healthcare sharing ministries: If the previously listed options don’t work for you, another temporary solution could be healthcare sharing ministries (HCSM). These are cost-sharing health plans in which members – who typically share a religious belief – make monthly payments to cover expenses of other members, including themselves.
HCSM’s are cheaper than paying full out-of-pocket costs for traditional health insurance but be aware that HCSM’s are not health insurance. They don’t have to comply with the consumer protections of the ACA, and they can also reject or limit coverage for having pre-existing health issues and limit how much you’ll be reimbursed for your medical costs. Preventive care typically isn’t covered either.
To look for these plans, comparison shop at the three largest providers – Samaritan Ministries (SamaritanMinistries.org), Medi-Share (MyChristianCare.org), and Christian Healthcare Ministries (Chministries.org).
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.
