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Listening to their favorite music may help people with dementia

Nursing home residents with dementia had fewer behavior problems and were able to cut back on antipsychotic and antianxiety drugs when they listened often to their favorite music, according to a recent study.

Researchers at Brown University in Providence, RI studied over 25,000 residents in 196 nursing homes around the country. They used a program called Music & Memory which provides Alzheimer’s and dementia patients with individualized music playlists.

In a national campaign led by Medicare, gerontology experts and patient advocates are seeking non-pharmacologic interventions to reduce the use of antipsychotic and anti-anxiety medications.

In nursing homes that used the program, residents with dementia were more likely to discontinue antipsychotic and anti-anxiety medications, and engaged in fewer disruptive behaviors, than in homes where the music was not used. However, the study did not show a significant improvement in mood.06_ALIVE-INSIDE_Photo-Courtesy-of-BOND360

Caregivers and family members in a documentary called “Alive Inside,” say that personalized music helps even patients with highly advanced dementia. They observe that patients look more at ease after listening to their favorite music.

The researchers studied residents who had dementia and cognitive impairment, but were not in hospice care or comatose.

The rate of discontinuation of antipsychotics rose to 20.1 percent in 2013 compared to 17.6 percent in a similar period before. The discontinuation rate of anti-anxiety meds rose to 24.4 percent compared to 23.5 percent before. In the studied nursing homes that did not use the music program, the rates did not improve.

Behavioral improvement increased to 56.5 percent in program homes from 50.9 percent before the program. Improvement in the behavior of residents helps the treated patients, but also enhances the quality of life for residents around them. Also, improvement in patients’ behavior raises the morale of nursing home staff, and may reduce staff turnover.

The study was published in the American Journal of Geriatric Psychiatry. To improve their evaluation, Baier, Thomas and their colleagues plan to conduct a second study. 

Nursing home or memory care can be costly. Long term care insurance provides not only money for care but a support system for both those needing care and their families. For more about long term care and insurance visit GuideToLongTermCare

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Sources of Help for Seniors

There are many government-supported benefits for seniors, including some programs that are not widely known. Seniors and their caregivers can find services through some helpful online resources listed below.

The National Association for Home Care & Hospice has a Home Care and Hospice Agency Locator and a Caring Store with workbooks and manuals for caregivers.

The Visiting Nurse Associations of America has a Find-a-Provider website.

The website contains a searchable database of resources that are available at the state and community level. For example, there are connections for legal services, elder abuse prevention, health insurance assistance, home health care, and long term care. Users can enter their data to search for specific programs to meet their individual needs.

The National Council on Aging provides a website called on programs for the elderly, which it says can help some seniors save thousands of dollars on the basic costs of living.

The Older Americans Act of 1965 (OAA) established a national network of federal, state, and local agencies that help older adults live independently, called the National Aging Network. Anyone 60 or older is eligible for services under the OAA; those most in need get priority. The network includes 56 State Agencies on Aging, 622 Area Agencies on Aging, and more than 260 Title VI Native American aging programs. Its programs are supported by tens of thousands of service providers and volunteers. A few examples of the many programs in the network are:

EyeCare America provides access to free medical eye care and annual eye exams;

Program of All-inclusive Care for the Elderly (PACE), which provides stay-at-home alternatives to living in a nursing home;

Chronic Disease Self-Management Program (CDSMP), which gives workshops that help people manage health conditions such as arthritis, asthma, emphysema, bronchitis, cancer, depression, anxiety, diabetes, heart disease, high blood pressure, stroke, osteoporosis, and HIV/AIDS.

For information on Long Term Care Insurance, see the Guide To Long Term Care

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Tips for Buyers: LTC Insurance Health Assessment

Insurance companies will request a health assessment (interview) to be done either by phone or in-person. Insurance companies outsource the testing to paramedical companies.

When you are called to set your appointment they will identify themselves and the insurance company and they will let you know if it is a phone interview or a face-to-face interview.

Schedule the meeting for a time that is convenient and when you will not be too tired or too distracted.

The interview is an important part of the health underwriting/approval process. It is important to remember to be calm and focused. Also turn off your phone so not to be interrupted and only answer the questions asked.

More LTC insurers are requiring in-person or telephone interviews as well as physical exams, according to Joe Sperling, J.D. He said he reminds clients that the interviewers work for the insurer, which means applicants should be honest but stick to the point when answering interview questions. It’s the same advice an attorney would give a client who is about to testify in court: answer the question, don’t go beyond it, don’t volunteer, he said.

“The examiner is not their high school buddy,” Sperling said. “The examiner is there to ask questions about your medical history. You want to answer the questions, be succinct and not elaborate. A natural tendency is to get a little bit too verbose. Rein that in. The danger is getting into the embellishment because there’s nothing good to happen there.” 

Do not intentionally exclude information that is related to your health. The underwriter will be reviewing your medical record and will compare that to the application and health assessment. If you do remember something later that you had not disclosed during the exam contact your insurance agent.

Massage Therapy for Alzheimer’s Patients

According to the Alzheimer’s Association, 5.3 million people have Alzheimer’s disease in 2015, and the disease is the seventh leading cause of death in adults. With the population aging, some estimate that 16 million people will have Alzheimer’s by 2050. It is estimated that in 25 years, in the United States, everyone will either have Alzheimer’s or be caring for someone with it.

Alzheimer’s disease is a gradual onset, progressive, degenerative disease that attacks the brain and results in impaired memory, thinking and behavior, and reduces the ability to perform activities of daily living. Symptoms of Alzheimer’s and dementia include memory loss, confusion, difficulty communicating, disorientation in time and place, mood swings, restlessness, sleeplessness, behavioral disturbances, personality changes and perceptual motor problems. There is no known cause or cure.

Alzheimer’s patients are usually prescribed drugs, but the drugs have limited benefits, and side effects are a major concern. Some patients are benefiting from alternative approaches, including massage therapy. An increasing number of assisted living facilities and clinics provide massage therapy for Alzheimer’s and dementia patients.

Touch in itself is soothing, reduces feelings of isolation and loneliness, and provides a feeling of caring and security. Studies show that senior citizens who are touched on a regular basis are healthier and less likely to develop Alzheimer’s and dementia.

Massage therapy increases body awareness and alertness, and reduces confusion and anxiety. Healing touch builds a sense of closeness and trust, and helps to calm and relax patients. Sometimes even patients who rarely speak will remark on how good the massage feels, or give a smile.

Studies show that massage therapy reduces stress, and that therapeutic touch reduces the level of cortisol, “the stress hormone”, in people with Alzheimer’s disease. A slow stroking massage reduced physical expressions of agitation in one study. Another study found that therapeutic touch produced a noticeable decrease in agitated behavior such as restlessness and disruptive vocalization. These benefits are significant because agitated behavior is difficult for both patients and caregivers, and often results in nursing home placement.

As life expectancy increases, so does the rate of those afflicted: 1 of 10 have Alzheimer’s by age 65, 1 of 2 by age 85. In addition to the huge national cost of care, there is the personal cost for both patient and caregiver. Long term care insurance has been important in providing care for those with Alzheimer’s or other dementias.

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Boomers Look for Peace of Mind But Most Won’t Have It

The last of the Baby Boomers celebrate their 50th birthday this year and may spend one third of their lifetime in retirement. The dream of life after work is becoming a nightmare reality.

Boomers are not taking the steps necessary to assure they achieve the one thing most are looking for in retirement: peace of mind. Financially they are in a mid-life crisis. “Will I have enough income when I retire?” Peace of mind will elude most boomers, not for lack of desire, but for lack of planning.

When we are in our 30s and even 40s we usually do not have much experience with the world of care needing and care giving. It seems in the last 5 years incidences of long term care are showing up more in the Boomers life. Relatives, friends, even spouses may be the next one being diagnosed with a condition, many that will require care later (Parkinsons, Alzheimer’s, etc). Unfortunately just the diagnosis is enough to disqualify them from purchasing care insurance.

When the care is needed it is usually first paid for with income. Then if more money is needed to pay for care the next to go are savings and investments.

Without long term care planning most Boomers will find their nest egg empty having spent it on long term care. Many who could buy insurance delay the purchase only to find out later that they can no longer afford the premium because the cost is higher the older you are when you buy a policy.

One way many could have protected their nest egg was by using the interest on their investment to pay the insurance premium. $100,000 x 5% = $5000 – taxes ($5000-$750=$4250). The average LTC premium for a couple is $3600. Spending $3600 a year to save the $100,000. Kiplinger Financial predicts the cost of care to be $250,000 a year in 17 years and as much as $600,00 total spent on care. (link).

But what tends to happen more often is health changes, now uninsurable and without peace of mind.



Are Grains Bad For Your Brain?

A Mayo Clinic study published earlier this year in the Journal of Alzheimer’s Disease found that people 70 and older with a high-carbohydrate diet face a risk of developing mild cognitive impairment 3.6 times higher than those who follow low-carb regimens. Those with the diets highest in sugar did not fare much better. However, subjects with the diets highest in fat were 42% less likely to face cognitive impairment than the participants whose diets were lowest in fat.

Further research published in the New England Journal of Medicine in August showed that people with even mildly elevated levels of blood sugar — too low to register as a Type 2 diabetes risk — still had a significantly higher risk of developing dementia.




Long term care insurance rate of return.

The cost of Long Term Care varies by location and where services are provided. Below are national averages. It will cost more for care in NYC than Omaha.

Cost of care
In Home Care: Average 5 hour day/$21 per hour = $105 per day or $3,150 per month or $113,400 over a 3 yr period
Assisted Living: $5,000-$6000 per month $216,000 over a 3 yr period
Nursing Home: $7,000-$9,000 per month $324,000 over a 3 yr period

Care payment options
Self Funding: You will pay out of pocket with after tax dollars or are forced to liquidate assets
Medicaid: You will be financial destroyed and the Government takes over but in a skilled nursing home only
Medicare: There is very little benefit for skilled nursing home care only under this program
Health Insurance: No benefit is paid by a health insurance carrier for custodial care
LTC Insurance: This is the best option for funding a long term care event

Transfer the Risk – 60 yr old couple plan example
• $5000/mo benefit
• 90 day elimination period
• 2 year benefit period (4 year shared pool)
• 3% Compound Inflation Rider
• $240,000 shared pool

Do the math
• $4,000 annual premium for both for 20 years
• $80,000 investment by age 80 for both
• $433,449 pool of money by age 80 for both

• Americans have a 70% chance of needing long term care – US Dept. of Health & Human Services
• 90% of estates are spent on paying for long term care – Jonathan Pond, award-winning financial advisor

There is no investment on earth that can guarantee this rate of return. A proper long term care plan can be the difference between financial preservation or ruin. Wouldn’t you agree that some insurance is better than none? Get a quote.

How much will you need out of pocket for long term care expenses?


As insurance brokers we hear this all the time “I’ll invest the money instead of paying premiums for insurance.” 

For every $1,000 of monthly retirement income you want to generate from your own savings, you will need about $230,000 in assets, according to the Schwab Center for Investment Research. For example, if you want $3,000 a month, or $36,000 a year, you would need savings of $690,000. That’s a conservative estimate, assuming that you earn 5.2% on your investments and live off the earnings without dipping into the principal.

A $3,000 a month benefit policy might cost $1,000-$3,000 a year for the premium, depending on age, health and other benefit options chosen. The $3,000 a month benfit policy would include inflation protection that would increase the monthly benefit to $4,000 a month ($48,000/yr) in ten years. — link

Where Do You Want Your Estate To Go?
Jonathan Pond, award winning financial planner, says that 90% of estates are spent this way:
1) nursing home
2) IRS
3) children
4) grandchildren
5) charity.

More people are worried about the IRS taking their money than about having to spend it on a nursing home. If you’re thinking about Medicaid planning, it’s a Federal offense to try to hide assets. There is a 5-year look-back period from the time you apply for Medicaid. The Partnership program is designed to protect assets from Medicaid’s draconian spend-down requirements. 

30 States have Filial Laws that put your children at risk of having to pay for your care. That’s something that most everyone would not want to have happen.