http://www.csa.us/email/spirit/ssarticles/0512SeniorSpotlight.html
At 102, Hedda Bolgar’s Therapy Practice is Still Thriving
“Extemporaneous” and “Eloquent” – two words that describe 102-year-old Hedda Bolgar. With an ever-thriving therapy practice, Bolgar was honored in Washington D.C. with one of two Outstanding Oldest Worker Awards. Read her story.
http://www.youngatheartchorus.com/film.php
Meet The Young @ Heart Chorus – A Senior Musical Extravaganza!
What started as a small sing-along group for seniors 30 years ago has grown into an extraordinary traveling musical extravaganza! These seniors surely know how to rock-to-the-beat to such artists as Bruce Springsteen, James Brown, and the Ramones. Check them out!
http://www.csa.us/email/spirit/ssarticles/0512Lifestyle.html
Seniors and Adult Children Under One Roof: How to Succeed With This New Trend
With crushing student loans and an economy that doesn’t offer enough job opportunities, college graduates and even older adult children are moving back home with mom and dad in record numbers. Click here to view article.
Money or investment advice from a family member or friend may be helpful and free, but it is not necessarily the best approach for solid financial planning. A financial advisor could be your most profitable investment. A financial advisor is a professional who receives compensation for providing individual clients with financial guidance, advice and services such as investment management, income tax preparation and estate planning.
Financial advisors can carry one or more designations. Each designation holds its own requirements, and the majority of certifications require candidates to put in many hours of study and meet high ethical and professional standards. The more common financial advisor designations are:
Understanding a financial advisor’s compensation
Financial advisors receive compensation and charge fees in a variety of ways. Each person’s financial situation is different, so not every method of paying a financial advisor makes sense for everyone. Before working with an advisor, be sure to ask for clarification about how fees are charged and what specific services are provided. Financial advisors may charge fees in any of the following ways:
A flat fee for a specific project – This fee is not tied to investments. It is a quoted and agreed upon rate and a clear description of what services are provided for that fee needs to be included.
A quarterly or annual retainer fee – This type of fee works well if the client has a complex financial situation. This may include a small business, rental properties or if regular income from investment is required. A written contract detailing all of the fees and services should accompany this arrangement.
A fee charged as a percentage of assets – The advisor charges a fee that is based on a percentage of your account value. The financial advisor’s compensation is directly correlated to your account value, so the advisor has the incentive to grow your account and to minimize losses. Typical fees range from 0.5 to 2 percent per year. The more assets a client has, the lower the fee percentage.
Commissions received when a client purchases financial or insurance products through the advisor – Commissions are paid on the front-end of a sale when a client purchases particular financial products. The client may ask the advisor how much the advisor is paid when investment or insurance products they recommend are bought.
A combination of fees and commissions.
Fee-only vs. fee-based
An advisor’s compensation is either fee-only or fee-based. Fee-only advisors can only receive compensation from the client, not a brokerage firm, mutual company or insurance company. This may be as an hourly rate, a flat fee, a retainer or as a percentage of the client’s assets.
On the other hand, fee-based advisors can receive compensation from the client and commissions paid by a brokerage firm, mutual company, insurance company or investment partnership.
Asking questions to find a good financial advisor
Dana Anspach, CFP, RMA is founder of Sensible Money, LLC and a contributor to the About.com Guide to Money Over 55 for investors over 55 years old. She recommends asking the following questions over the phone and prescreening a potential financial advisor, saving the face-to-face appointments for a couple of advisors you liked during the phone conversation.
1. Can you tell me about your ideal client? – Any good financial advisor will have an area of expertise. The ideal financial advisor is someone who has expertise in working with clients who fit your profile in terms of asset level, stage of life and age.
2. Ask a potential financial advisor to explain a concept to you. – By asking a question like one of the questions below, you are determining if you can understand the advisor’s explanation. The goal is to find someone who will be able to explain financial concepts in a language that makes sense to you. Consider asking:
3. What assumptions do you use when running retirement planning projections? – The advisor should be able to project a retirement plan for you. This helps you see how much money will be available to spend each year, taking into account life expectancy. The projection includes assumed rates of return for your assets, inflation rates, and personal spending needs and habits.
4. How are you compensated? – The financial advisor should be able to detail all fees and services. You should ask questions until you completely understand how the compensation is paid.
Fees paid to financial advisors can be complicated. It is important for you and your financial advisor to establish a good rapport and regular communication from the onset of the relationship. You should always feel comfortable approaching the financial advisor, otherwise the arrangement may need restructuring or termination. A financial advisor should clearly understand your goals and risk tolerance before making investment recommendations. At that point, the advisor can develop a customized long-term financial plan for you.
Acording to the American Diabetes Association, 25.8 million people in the United States have diabetes, which equals 8.3 percent of the population. Of the senior population of 65 and over, 10.9 million, or about 27 percent, have diabetes. With statistics such as these, two recent studies in the New England Journal of Medicine are bringing attention to surgeries that remove a portion of the stomach to control diabetes. These surgeries are the first of their kind, and while under some controversy, seem to have immediate positive results.
Diabetes – what is it?
Diabetes occurs when the body has a problem making or using insulin. The body needs insulin to move blood sugar, otherwise known as glucose, into the cells, which store the insulin and later use it for energy. Of the three types of diabetes, type 1, type 2 and gestational, type 2 diabetes is the most common. It is also known as “noninsulin-dependent diabetes” or “adult-onset diabetes.”
People with type 2 diabetes experience what is called insulin resistance where the cells in the body’s fat, liver and muscles don’t respond properly to insulin. The glucose does not get into the cells and therefore, cannot be stored for energy. The glucose then builds up in the blood resulting in hyperglycemia.
Most people who have type 2 diabetes are overweight when they are diagnosed because the body has a harder time using insulin correctly when it contains higher levels of fat. However, elderly people who are thin are at risk as well. Other risk factors include family history, low activity level and poor diet.
People with type 2 diabetes may not show symptoms for many years. The National Institute of Health lists the early symptoms of type 2 diabetes as:
A doctor can screen for and help a patient try to prevent the development of type 2 diabetes. However, if a person does find themself with type 2 diabetes, treatment with prescription drugs and advice to change to a healthier lifestyle and diet are usually the initial approach by physicians. Yet, many of the medicines prescribed to treat diabetes can actually cause weight gain and make the situation even worse for the patient.
How the surgery works
The gastrointestinal surgery for diabetics reduces the size of the stomach. Through a small incision in the abdomen, doctors can cut away part of the stomach and reconnect it to the small intestine. Gastric bypass is the most common of these surgeries. Initially used for patients with weight issues, gastric bypass surgery is now also an option for patients with diabetes.
The surgery appears to treat diabetes because food makes the stomach produce hormones that stimulate the production of insulin, and doctors believe that shrinking the size of the stomach may impact the rate at which the stomach produces hormones, thereby decreasing insulin production. The surgery costs approximately $15,000 to $25,000, and Medicare will often cover the costs for very obese people with diabetes.
The studies and their findings
The Cleveland Clinic’s Dr. Philip Schauer performed the first study about diabetes and gastrointestinal surgery. He studied 150 people who were given one of two kinds of surgery along with standard medicines and a third group who did not have surgery but were given only medicine. After a year of treatment, between 37 and 42 percent of the patients in the surgery groups had desirable blood-sugar levels, compared to 12 percent of the group given only medicine.
The second study was directed by Dr. Geltrude Mingrone at the Catholic University in Rome and Dr. Fancesco Rubino, New York Presbyterian Hospital/Weill Cornell Medical Center’s chief of diabetes surgery. Sixty patients received one of two types of surgery or solely medication. Two years after treatment, between 75 and95 percent of patients in the two surgery groups have maintained healthy blood-sugar levels with no additional medications. None of the people in the medicine-alone group were able to maintain healthy blood-sugar levels.
Rubino said that there were signs that the surgery itself – not just weight loss – helps reverse diabetes. Weight-loss surgery “has proven to be a very appropriate and excellent treatment for diabetes.”
The surgery results are considered dramatic. Generally, more patients reached normal blood-sugar levels through this type of surgery than by medicine alone. Some patients could stop taking their prescribed insulin within a week of the operation. The surgery also significantly improved cholesterol and other heart-risk indicators.
Even with all of the seemingly favorable outcomes to the surgery, doctors are not quick to claim that the surgery is a cure. They know that most patients in these studies were able to cease taking all diabetes drugs and the disease stayed in remission for at least two years, but there is still skepticism.
Not all experts agree
Doctors are still asking questions and expressing concerns about using gastric bypass surgery as treatment for diabetes. Mark Hyman, M.D. shares his thoughts in a Huffington Post article. “The researchers asked the wrong question. It should not have been, ’Does surgery work better than medication?’ but ’Does surgery work better than intensive lifestyle and diet change?’”
He is surprised that the researchers did not also investigate and determine if change of lifestyle and diet also had a profound effect on diabetes by including a treatment group that addressed this approach to combating the disease.
Hyman continues, “Lifestyle change and changes in diet work faster, better and more cheaply than any medication and are as effective as or more effective than gastric bypass without any side effects or long-term complications. These changes are not easy, but then neither is gastric bypass.”
Overall, doctors and researchers are hopeful that patients who chose to have the surgery will maintain healthy blood-sugar levels and not need to take medicine to control diabetes for the long-term. The results of the studies only show short-term gain at this point. Doctors would agree that a healthy lifestyle and diet are a less intrusive way to approach diabetes and reduce the chance of becoming diabetic in the first place.
Experts view the surgery as a viable option for patients with type 2 diabetes in the right situation; however, the surgery is not for everyone with type 2 diabetes. Consult with a physician to determine the best approach for you.