Movies for Older Adults
While most movies today are aimed at a much younger population, we suggest several that reflect seniors’ concerns. Click here to read more.

You don’t have to spend a lot of time watching TV’s current crop of movies to realize that the majority of films these days are aimed at younger people. Yet the need remains for older adults to be able to view movies that portray their concerns and situations. We compiled a list from several Internet sites, which offers a starting point for movies that reflect an older, or should we say, more mature, point of view.

About Schmidt (2002): Upon retirement and the death of his wife, a man embarks on a journey to his estranged daughter’s wedding only to discover more about himself and life than he ever expected. (Director Alexander Payne, starring Jack Nicholson, Hope Davis, Dermot Mulroney and Kathy Bates)

The Best Exotic Marigold Hotel (2011): British retirees travel to India to take up residence in what they believe is a newly restored hotel. (Director John Madden, starring Judi Dench, Bill Nighy, Maggie Smith and Tom Wilkinson)

The Bucket List (2007): Two terminally ill men escape from a cancer ward and head off on a road trip with a wish list of to-dos before they die. (Director Rob Reiner, starring Jack Nicholson and Morgan Freeman)

Cocoon (1985): Residents in a senior community encounter aliens, who offer them the gift of eternal life in this thoughtful film about the resilience of the human spirit. (Director Ron Howard, starring Don Ameche, Wilford Brimley, Hume Cronyn and Brian Dennehy)

Driving Miss Daisy (1989): An elderly Jewish woman and her African-American chauffeur in the American South have a relationship that grows and improves over the years. (Director Bruce Beresford, starring Morgan Freeman, Jessica Tandy, Dan Aykroyd and Patti LuPone)

Gran Torino (2008): Disgruntled Korean War vet Walt Kowalski sets out to reform his neighbor, a young Hmong teenager, who tried to steal Kowalski’s prized possession: his 1972 Gran Torino. (Director Clint Eastwood, starring Clint Eastwood and Bee Vang)

The Straight Story (1999): An elderly man makes a long journey by tractor to mend his relationship with an ill brother. (Director David Lynch, starring Richard Farnsworth and Sissy Spacek)

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Sometimes It Takes a Senior Village

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Using volunteers within and outside the community, a new movement offers simple services that help older adults stay in their homes. The village movement also fosters a sense of community. Click here to view article.

Louise, a widow, doesn’t want to move out of the home where she and her husband raised four children, but she’s not able to drive as well as she once did and is having a hard time doing small chores around the house. Fortunately, she belongs to a “village” community, where a fellow member can drive her to the doctor or climb a ladder to change a light bulb.

A 2010 report by AARP found that 90 percent of adults want to remain in their own homes as they get older. One of the big problems is lack of help with simple tasks. Offering assistance to older adults living at home, a new movement relies on volunteers and bargains for other services, such as plumbing, at cheaper rates. To fund the services they need, village members pay annual dues, which typically cover the cost of a staff person (or persons) who coordinates services. In addition to dues, some villages receive grants, donations and other funding.

The village concept began in Boston’s Beacon Hill in 2001 when a group of neighbors came together to develop services that would enable them to remain in their homes and community. Since then, 89 villages are operating across the United States, Canada, Australia and the Netherlands, with another 123 villages in development, according to Village to Village Network, which offers resources for village communities across the country.

At its most basic, the village movement fills the gap between totally independent seniors and those who need some form of assisted living but not in an institutional setting. Older adults may need assistance for simple tasks, such as cleaning out gutters or shoveling a driveway, although the biggest request isfor transportation.

On a deeper level, the village movement provides a sense of community, as members join together to set up the village and help each other. In some villages, volunteers are solicited from the community, thus providing interaction with younger adults.

Villages Around the Country

In Chicago’s Lincoln Park Village, seniors call the village for whatever they need. The two-year-old nonprofit serves 230 members in 165 households. Lincoln Park members pay an annual fee: $540 for individuals and $780 for a household of two. Those with incomes below $50,000, a fifth of members, pay a reduced rate, as low as $100 annually, and receive a credit toward any expense. (New York Times)

With its dues, Lincoln Park Village was able to hire two staffers who, with many volunteers, provide referrals to approved services—home care agencies, handymen, lawyers, financial managers—that often offer member discounts. The village also partners with Rush University Medical Center, where members can schedule appointments with specialists or receive counseling.

Members and student volunteers also contribute time. One member drives others to doctors’ appointments, a university student helps a 68-year-old with her paperwork and a 50-year-old member and librarian visits a retired librarian in her 70s.

In Madison, Wis., one program enlists university pharmacy students to make sure seniors aren’t overmedicated. Results showed that nearly 80 percent of the seniors checked were having adverse drug reactions. (US News Money)

In Pittsburgh, the Mount Lebanon Village program works with volunteers and schools to provide intergenerational activities, including a day of light sporting events and a personal history project, where seniors are paired with students who learn about an older person’s life story. (US News Money)

In Washington, D.C., Capitol Hill Village, founded in 2007, now has 350 members. The village has student-senior mentoring programs and a network of young professional volunteers in the Washington area who are separated from families and looking to connect with older adults. (US News Money)

California, the Bay Area in particular, is one of the fastest-growing regions for villages. (San Francisco Chronicle) In February, the San Francisco Board of Supervisors gave $50,000 each to two San Franciscan villages—San Francisco Village, with more than 220 members, and Next Village San Francisco, which has just over 60 members. “In this city, 40 percent of the residents will be 60 years of age or older in 17 years,” explained board president Jonee Levy about the need to plan for the future.

The first village in California, Avenidas Village in Palo Alto, started operating in 2004, helped by its affiliation with an existing nonprofit senior center. It now has more than 350 members and has established alliances with healthcare organizations, including the Palo Alto Medical Foundation, El Camino Hospital, Stanford and Kaiser Permanente.

Some California villages have received grants and other support from nonprofits, including the Archstone Foundation, a Long Beach grant-making group focused on meeting the needs of the aging population.

Challenges for the Movement

While some villages acquire monies from outside sources, funding is always a problem, especially for low-income groups. Most villages charge an annual fee of $400 to $700, according to the national Village to Village Network. That can be a high a cost for low-income people, who are often the most in need of such services. To remedy this problem, at least one village has a different model. ElderHelp of San Diego is supported largely by philanthropy that provides intensive support services to a largely lower-income group of seniors. The goal is to use the village model to demonstrate cost-effective solutions that much more expensive government programs traditionally provided. (US News Money)

However, the private sector is not always a dependable source, so village leaders around the country are looking toward the Affordable Care Act’s provisions to fund wellness and long-term care programs.

Although the annual fees might seem like a lot of money to an individual, the costs are small compared to the price of a nursing home or home health care. The annual average cost of a private room in an Ohio nursing home, for example, was $81,213 last year, according to the insurance and financial company Genworth. An assisted-living facility cost an average of $44,550, while home health care cost $43,197. (Columbus Dispatch)

It’s projected that 45 percent of American households will be headed by someone who’s at least 55 years old by 2020. As the country grapples with the challenge of paying for higher Medicaid and Medicare costs, and as older adults try to figure out how to make ends meet on sometimes shrinking budgets, the village movement offers a low-cost alternative while creating a sense of community and offering seniors the option of staying in their homes.

Challenges of Starting a Village

The job of creating a village—incorporating as a nonprofit organization and drafting bylaws, and business and financial plans—can be difficult. At a recent Washington, D.C.-based conference sponsored by Beacon Hill Village, AARP and NCB Capital Impact, an Arlington, Va. nonprofit, speakers provided advice about the real work it takes to start a village:

• Time: It takes time to launch a village. Make sure timetables are realistic.
• Founders: The founders—often a core group of six to eight people—need to be passionate and have a shared vision for creating their village. Ideally, they should have skills that the village needs, including business management, fundraising and membership development experience.
• Organization: Have a business plan before you begin, not after. Become a 501(c)(3) nonprofit. Make sure you have liability insurance for village directors and volunteers.
• Funding: Explore founders’ grants (tax deductible once the village achieves nonprofit status) to raise early funds.
• Affiliation: Being affiliated with an area institution can jump-start a village, provide credibility, grant access to free or inexpensive resources and offer the comfort that you have a partner.
• Internet: Build a website early in the process. The site can help market the village and act as an invaluable and cost-effective communications tool to support village operations.
• Management: Choose an executive director who is passionate about the job, because salaries tend to be low. And because money is always tight, the director needs to be effective at acquiring resources for little or no money.

Source: Adapted from US News Money

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Annuities a Complex and Thorny Investment

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As a tax-deferred tool for retirement, annuities might be the appropriate investment, but they come with a lot of issues. Make sure you know what you’re getting into before purchasing one. Click here to view article.

When it comes to buying annuities, the terminology and choices can be overwhelming as well as word-twisting: single premium annuity, multiple premium annuity, immediate annuity, deferred annuity, fixed annuity, variable annuity, equity-indexed annuity—and that’s just a few. No wonder so many investors give up before they start or buy annuities that might not be appropriate for them.

In its basic form, an annuity is a tax-deferred investment vehicle from an insurance company or other financial institution. They are attractive because you can choose regular payouts, which provide a steady source of income, and you can defer taxes until retirement. When you later make withdrawals, the amount you contributed to the annuity is not taxed, but your earnings are taxed at your regular income tax rate. In some cases, payouts will last as long as you live, so you can’t “outlive your money.”

Because annuities can have high annual expenses, many financial advisors recommend using them only after reaching contributions limits to an IRA or 401(k), because annuities do not have such restrictions. Annuities are helpful for those nearing retirement who might need to sock away more money for when regular paychecks stop. With so many factors to consider, investors need to carefully examine annuities’ advantages and disadvantages before purchasing them.

Types of Annuities

There are two basic types of annuities:

• Deferred annuity: Your money is invested over a period of time until you are ready to begin taking withdrawals, typically in retirement, at which point you hopefully have accumulated interest on your principal. This annuity often is used by those who are several years from retirement and want to accumulate a retirement income.
• Immediate annuity: After you invest your money you can immediately start taking payments. This might be used by those who are already retired or soon to be and want the income now.

Once you decide on the type of annuity, choose from these two options for investing the funds:

• Fixed annuities: The insurance company determines the interest rate, which guarantees principal and earnings, so you can be confident about your investment. However, the guaranteed rate is often relatively low.
• Variable annuities: More choices are available with this type of annuity, including stock, bond, real estate and other investments, meaning that your rate of return will fluctuate with the financial markets.

Options for Payouts

The next decision you need to make is how you want your eventual payouts to be calculated:

• Life annuity: The insurer pays an income for as long as you live. However, there are no survivor benefits, which means all payments cease upon your death.
• Period certain annuity: You are guaranteed a specific payment amount for a set period of time. If you die before the end of the period, your beneficiary will receive the remainder of the payments for the guaranteed period.
• Life annuity with period certain: The insurer will pay you an income for as long as you live, but if you die before the certain period that you have chosen, the income will be paid to a survivor (beneficiary) you designate until the end of that period.
• Joint and survivor annuity: The insurer will pay an income to you during your life, and after your death will pay a percentage of that income (50 or 75 percent, for example) to a survivor you designate for his or her life.

Pitfalls of Annuities

Annuities pose numerous drawbacks:

Maintenance fees: Perhaps the biggest downside is the high annual fees for variable annuities, including an annual insurance charge and investment management fee, plus fees for various insurance riders. These charges can add up to 2 to 3 percent of the annuity. In comparison, a non-annuity mutual fund charges an average of 1.5 percent annually, and unmanaged index funds often charge less than 0.50 percent a year. (Some investment companies sell annuities, called direct-sold annuities, without charging a sales commission or a surrender charge.) Because of these fees, make sure that the tax benefits outweigh the higher costs for variable annuities.

Penalties for early surrender: Most annuities come with a surrender charge: If you decide after a few years that the annuity wasn’t a good investment, you will have to pay a surrender charge, typically about 7 percent of your account value in the first year, with the charge decreasing to zero after a certain number of years.

Also, the IRS will hit you with an early withdrawal penalty of 10 percent if you take out funds from your annuity before you reach 59½.

Commissions: Because the commissions can be high and are generally charged at the beginning—as much as 10 percent—salespeople can be aggressive and not give you the whole story. Because of the inherent complexity of annuities and the potential to either buy an annuity you don’t need or want, or the wrong type, several agencies offer guidelines especially directed toward seniors. Reputable organizations include the U.S. Securities and Exchange Commission, the National Association of Insurance Commissioners, the Arizona Department of Insurance and the California Department of Insurance. In fact, California requires individual annuity contracts for seniors to contain a disclosure regarding the surrender charge period.

As with any big financial decision, consult a professional tax advisor to discuss your individual tax situation. Annuities are complex contracts, and it is easy to misunderstand or be misled about the benefits and risks. Evaluate carefully before buying an annuity (see sidebar).

Evaluating an Annuity

For some, an annuity can be an appropriate part of an overall financial plan. For others, an annuity can be totally unsuitable. Think about what your goals are, as well as how much risk you are willing to take. Consider the following before buying an annuity, and beware of unscrupulous sellers.

• Determine how much retirement income you will need in addition to what you will get from Social Security and/or a pension plan. Will you need that additional income only for yourself, or for yourself and others?
• Calculate if you will have enough money to cover your expenses if you put your money into an annuity.
• Learn how long you can leave funds in the annuity and if you can take out money when you need it.
• Find out how long the surrender charge period lasts.
• For a fixed annuity, know what the initial interest rate is and how long it is guaranteed.
• Ask if you can get a partial withdrawal without paying surrender and/or other charges.
• How much of a partial withdrawal can you take without being penalized?
• Find out the kind of benefits for survivors.
• Ask for an explanation of anything you don’t understand.
• Ask for a complete listing of fees and commissions before buying any investment product.
• Understand contract restrictions such as surrender penalties.
• Compare similar products from several companies before you sign.
• Take notes and get key information in writing. Keep copies of all documents, correspondence, notices, special offers and payment receipts.
• Read the contract promptly upon receipt; if dissatisfied, use your 30-day free look period to obtain a refund.
• Be alert for deceptive sales practices.
• Steer clear of repeated or unsolicited contacts from particular groups or agents that make you feel pressured or uncomfortable. A licensed agent or producer should willingly verify his or her credentials. If it seems too good to be true, it probably is!

Sources: “What Seniors Need To Know About Annuities,” California Department of Insurance and “Tips for Protecting Yourself”, Arizona Department of Insurance

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Hearing Aids Use New Technology

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It’s estimated that only 15 percent of those who need hearing aids actually have them. One reason people are hesitant to use hearing aids is because they can pick up too much background noise, but new digital technology can overcome this and other problems.Click here to view article.

Arnold gets annoyed when his children and wife don’t speak loudly enough for him to hear them. But they become frustrated when he’s constantly yelling “What?” Although Arnold has a hearing aid, he won’t use it, because “it doesn’t work,” he says.

Hearing aids that don’t “work” for whatever reason is a common complaint for many older adults with hearing loss and one of the reasons that many who need hearing aids don’t buy them.

Hearing loss is not a minor issue. One-third of Americans 65 to 74 years of age and 47 percent of those 75 and older suffer from hearing loss. Among seniors, hearing loss is the third most common treatable health issue behind arthritis and hypertension. Nor are its effects to be taken lightly. Evidence is showing that people with hearing loss suffer from mental issues, perhaps from feeling isolated from others and their activities, and have problems with memory and thinking.

A survey by the National Council on Aging of 2,300 hearing-impaired adults age 50 and older found that those with untreated hearing loss were more likely to report depression, anxiety and paranoia, and were less likely to participate in organized social activities, compared to those who wear hearing aids. Perhaps not surprising, the study also found that those who used hearing aids significantly improved their relationships at home and felt more independent.

Another study led by a John Hopkins professor found that men and women with hearing loss showed declines in memory and thinking 30 to 40 percent faster than those with normal hearing. People with more serious hearing loss had steeper declines in mental function (Web MD).

Reasons for Hearing Loss

Generally, hearing loss comes with age, developing over a period of 25 to 30 years. A lifetime of loud noises, such as from lawnmowers, snow blowers or blaring concerts, can damage either the auditory nerve that controls hearing or the hair cells in the ear that help transmit sound. Heredity is also a factor, and viruses, bacteria, heart conditions, strokes, brain injuries or tumors can affect hearing.

Less common is conductive hearing loss, caused by earwax buildup, fluid buildup from an ear infection or a punctured eardrum.

With hearing loss, sometimes high-pitched sounds and consonants such as s, f, and z may be indistinguishable from one another. In this situation, the person may hear you but not be able to understand you.

The National Institute on Aging provides several questions to determine if you have hearing loss:

• Have trouble hearing over the telephone
• Find it hard to follow conversations when two or more people are talking
• Often ask people to repeat what they are saying
• Need to turn up the TV volume so loud that others complain
• Have a problem hearing because of background noise
• Think that others seem to mumble
• Can’t understand when women and children speak to you

How Hearing Aids Work

While conventional hearing aids in the past were analog, which make certain sounds louder and others softer, the standard today is digital, which gives you some choice over which sounds you want to amplify. Digital aids deal with the number one complaint of hearing aid users— background noise. In fact, many digital hearing aids contain a directional microphone, which is aligned to pick up sounds coming from in front of you and reduce noise coming from behind or beside you. By controlling ambient sound, you may hear conversations more easily. Today, less than 10 percent of people use conventional hearing aids.

With digital technology, a computer chip converts the incoming sound into digital code, then analyzes and adjusts the sound based on your hearing loss, listening needs and the level of the sounds around you. The device then converts the signals back into sound waves and delivers them to your ears. The result is sound that’s more finely tuned to your hearing loss. Hearing aids can automatically alternate among programs, or can be manually adjusted for a noisy restaurant, for example, or a quiet conversation with your spouse.

Today’s hearing aids come in various styles, from small, almost-invisible devices that mold to fit completely inside your ear canal, to larger gadgets that sit behind the ear. Each design has advantages and disadvantages, so you can choose the option that works best for your budget, hearing needs and style preferences.

New Technology

Digital technology is creating huge advances in hearing aids. For example, certain hearing aids can transmit sound from Bluetooth devices such as Bluetooth cell phones. They require an interface that wirelessly picks up the Bluetooth signal from Bluetooth-compatible devices and transmits it to the hearing aid. Other devices have a remote control that can adjust the volume and change other settings such as activating the directional microphone or increasing the noise reduction.

“The Best New Technology in Hearing Aids: 2013” reports that “The best of the new hearing aid designs incorporate a sleek design with power and clarity. Several hearing aids now offer water resistance, and one hearing aid is actually waterproof . . . and may be worn while swimming!” The articles reports that “rechargeable batteries, ‘invisible’ hearing aids and hearing aids which stream music and sound from computers, cell phones and MP3 players, are commonplace in today’s hearing aid market. Receiver-in-the-canal options allow hearing aids to remain small, even for severe hearing losses.”

High Cost of Hearing Aids

Despite the touted benefits of hearing aids, one study estimates that only about 15 percent of those who need hearing aids actually have them. Problems are denial (“my hearing is not that bad”), bad experiences (“my hearing aid is not working”), social issues (“I don’t want to appear old”) and cost (“I can’t afford them”). About one-half of hearing-loss patients cite the expense of hearing aids, which average $3,000.

Medicare and most insurance companies do not cover the cost of hearing aids, so most people have to pay out of pocket. (Depending on eligibility, military veterans might be able to get hearing aids for free.) The high price tag is a result of new technology plus the cost of the middleman—either the retailer or the audiologist.

Cheaper hearing aids are available online, but if you need an adjustment, you’ll have to mail the device back, perhaps several times if the adjustment needs fine tuning. Moreover, website personnel aren’t going to understand your problem as well as a local audiologist.

Because of the high demand for hearing aids, especially less expensive ones, Costco, the giant wholesale chain, is getting into the hearing aid business. Costco’s devices range from $900 to $1,400, and unlike Internet retailers, the chain does offer custom service.

However, before you buy a hearing aid, take the necessary steps to ensure you need one and that you’re getting the right product (see sidebar).

Sources

“Hearing Loss and Seniors,” A Place for Mom

“Untreated Hearing Loss Linked to Depression, Social Isolation in Seniors,” American Academy of Audiology

“Hearing Loss Linked to Mental Decline in Elderly,” WebMD Health News

“Hearing Aids – Too Expensive? Paying Through the Nose for a Necessity,”About.com

“The Hunt for an Affordble Hearing Aid, “New York Times blogs

“Hearing aids: How to choose the right one” Mayo Clinic

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Planning should be a driving force behind taking away the car keys

Driving demands quick reaction time and fast decision making — because of this, a person with Alzheimer’s will eventually become unable to drive. Families should talk openly about driving soon after an individual receives a diagnosis so everyone is prepared.
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A Supportive Conversation: Frank has early stage Alzheimer’s and the doctor said it’s no longer safe for him to drive. His wife doesn’t drive, but knows it’s time to discuss finding alternative transportation. Full Screen

Having the conversation

Losing the independence driving provides can be upsetting. It is important to acknowledge a person’s feelings and preserve his or her independence, while ensuring the person’s safety and the safety of others.
Starting the conversation

• Initiate a dialogue to express your concerns. Stress the positive and offer alternatives.
• Address resistance while reaffirming your unconditional love and support.
• Appeal to the person’s sense of responsibility.
• Reinforce medical diagnoses and directives. Ask the physician to write a letter stating that the person must not drive. Or ask the physician to write a prescription that says, “No driving.” You can then use the letter or prescription to reinforce the conversation.
• Consider an evaluation by an objective third party.
• Understand that this may be the first of many conversations about driving

When the conversation does not go well
Some people give up driving easily, but for others this transition can be very difficult. Be prepared for the person to become angry with you, due to the memory and insight issues that are part of Alzheimer’s.

• Be patient and firm. Demonstrate understanding and empathy.
• Acknowledge the pain of this change and appeal to the person’s desire to act responsibly.
• Ask a respected family authority figure or your attorney to reinforce the message about not driving.
• If the conversation does not go well, do not blame yourself. The disease can impair insight and judgment, making it difficult for people to understand that their driving is no longer safe. Also the disease can cause mood and personality changes that make reactions more pronounced.
• As a last resort, take away the car keys, disable the car or remove the car completely. When you do any of these things, be sure to provide safe, reliable alternative transportation.

Planning ahead

For people in the early stages of Alzheimer’s, it is never too soon to plan ahead for how you will get around when you can no longer drive. Putting a plan in place can be an empowering way to make your voice heard.

Tips for planning ahead

• Remember that each situation is unique. What works for one person may be different from what works for another. You can get the information and support you need from the Alzheimer’s Association at 800.272.3900.
• Involve family and close friends in the plan.
• Confront resistance. Empathize with those who are uncomfortable having the conversation and stress the importance of preparing for the future.
• Develop an agreement for all to share that includes practical safety steps, such as a periodic driving assessment, a GPS monitoring system for the car, and alternate transportation options.

Transportation options

Sign a driving contract.

A driving contract allows you to share directions for what you would like to happen when you can no longer drive.
Learn more:
Contract (PDF)

Driving is not the only transportation option available. There are many options people can explore that will allow them to continue to travel independently and remain in control of their mobility.

• Transition driving responsibilities to others. Arrange for family members and friends to provide transportation.
• Arrange a taxi service.
• Use special transportation services for older adults. Access local resources using the Eldercare Locator at www.eldercare.gov or use our Community Resource Finder to search for transportation services.
• Reduce the need to drive by having prescription medicines, groceries or meals delivered.

Signs of unsafe driving

Determining when someone can no longer safely drive requires careful observation by family and caregivers. The following list provides warning signs that it’s time to stop driving:

• Forgetting how to locate familiar places
• Failing to observe traffic signs
• Making slow or poor decisions in traffic
• Driving at an inappropriate speed
• Becoming angry or confused while driving
• Hitting curbs
• Using poor lane control
• Making errors at intersections
• Confusing the brake and gas pedals
• Returning from a routine drive later than usual
• Forgetting the destination you are driving to during the trip

Driving evaluation

At the earliest stages, a person with Alzheimer’s disease may begin to have difficulty with complex tasks such as driving. Although family and caregivers can watch for signs of unsafe driving, a proactive strategy would be to get a comprehensive driving evaluation by an occupational therapy driving rehabilitation specialist. The evaluation provides a more objective understanding of the current impact of the disease on driving capacity and results in a plan of options. The goal is always to retain the highest level of independence and mobility in the community. Initial recommendations may include strategies to reduce driving risk during the early part of the disease. The occupational therapist can offer strategies specific to the individual’s goals and needs. The American Occupational Therapy Association website includes a national database of driving specialists as well as a wealth of resources for both persons with Alzheimer’s disease and their families.  

LEARN MORE:
Find a Driving Specialist

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