Planning to “retire” from driving

Did you know that we usually outlive our ability to drive safely by six to ten years? As we age, we naturally modify how we drive to address physical changes: Stiff joints, poor vision, slow reflexes. But a time will come when it’s simply unwise to continue behind the wheel.

We do plenty of planning and preparation before retiring from work. Similarly, it’s smart to take a moment and consider the probability that you may not be driving your last few years. How can you retire from driving without giving up an active life?

Most people find it works best to have more than one driving alternative. Check these out:

  • Family and friends. This is by far the most common strategy.
  • Ride-sharing apps. Services such as Lyft and Uber can be extremely helpful (and not that expensive when you factor in the costs of a vehicle, gas, insurance, etc., that you are being spared). Both services are exploring senior options with door-to-door assistance. No smartphone? Consider a phone service such as GoGoGrandparent.com.
  • Local transportation programs. Many churches and senior centers have volunteer driver programs that are free or low cost. These are ideal for errands or doctor appointments. Think about “paying it forward” by serving as a volunteer driver now.
  • Public transportation. Standard buses are an option. Some have a “buddy program or a “senior training day” to help you get oriented. Many public transit companies also provide “paratransit” services. This is a low-cost, door-to-door service available for those who meet disability criteria. Rides must be scheduled a day or two in advance.
  • Special service vans. Senior centers often put together ride packages to cultural events. Leave the driving and the parking to someone else! Medical or cancer treatment centers may offer transportation. Take shuttle services to the airport.
  • Self-driving cars. Wonderful to anticipate, but they are some time off as yet.
  • Online services. Spare the trip! Order online and take advantage of delivery services. Arrange for appointments to be done by video chat when possible.

Considering a move or downsizing? Factor in driving retirement. Would your new abode allow for easy walking to where you want to go? To public transportation? For assisted living, is there van service to doctors or shopping?

Find out now what’s available. Check out ridesinsight.org or call 855-607-4337 (toll-free, nationwide) to find local driving alternatives.

Learning how to age in your own style?
Give us a call at 916-524-5151
.

Age-friendly exteriors

When imagining an age-friendly house, many people think of ramps for wheelchairs and walkers. Indeed, ramps are essential—if and when they are needed. There are, however, modifications for the outside of a home that simply make daily life and basic maintenance easier. They help prevent falls by addressing the common conditions of arthritis, poor eyesight, or limited balance.

Some safety suggestions also deter thieves.

Lighting. To reduce shadows, point lights down rather than across. And use frosted glass fixtures or bulbs to reduce glare (a notable hindrance to seeing well as we age). Consider adding lights that come on automatically in low-light conditions or when motion is detected. Put them along all pathways and stairs, and at the corners of your house. Also install them at common destinations, such as all entry doors, the mailbox, a trash enclosure, and the garage door. Abundant light illuminates hazards while also discouraging burglars!

Stairs. Several modifications can make a stairway safer. Handrails, ideally on both sides, that are at least 1½ inches in diameter so they are easier to grip. And a textured or nonskid surface on the tread of each stair. Also take care to repair any broken steps so they are level and soundly anchored. Even out the rise of each step so they are all the same height. To make it easier on knees and hips, plan for the rise of each step to be no more than 7 inches and no less than 4 inches. The tread—space allotted for the length of your foot—should be no less than 11 inches. If you are reinstalling a staircase, plan for a landing for every 12 feet of vertical rise.

The entryway. Many activities occur at entryways: Opening a locked door, bringing in groceries, greeting visitors, retrieving delivered packages. In addition to good lighting and nonskid surfaces, consider elements that might facilitate these daily tasks. A lever doorknob is easier for arthritic hands. A keyless lock avoids the need to juggle groceries while finding the key. Perhaps a bench where you might set groceries down. A hinged chest/seat would enable delivery people to safely hide your packages. You might also consider a video doorbell to easily view who is there before opening the door. Video can also dissuade thieves—or at least get a recording if someone steals a package left on the doorstep.

Simplifying home maintenance. Add gutter covers to minimize the frequency of cleaning out leaves. (After a certain age, ladders are not your friend! Bones are too brittle if you fall.) Change to brick or vinyl siding to reduce the need for ladder-based maintenance of a wooden exterior. Similarly, resin-based decking will save hours of on-your-knees upkeep.

Looking to age in place?
We are the experts! Give us a call at 916-524-5151.

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Splitting the pie fairly

Splitting the pie fairly

If you have more than one child, deciding how to distribute your assets among them may prompt some angst: If and how should your will or trust reflect your understanding of their different needs? According to a Merrill Lynch study, two-thirds of parents over age 55 are open to the idea of unequal bequests.

“Fair” does not necessarily mean “equal.” If one child has invested considerable time caring for you during health challenges—perhaps giving up valuable income-earning years—should that be reflected in their inheritance? Again, two-thirds of parents think it should. (Not all children agree.) If one child is in a lucrative profession and the others are not so well paid, should you bequeath equally or according to need? Should a health-challenged child get more? What if some of your kids have children and others do not? Should the nonparents get less?

Money does not equal love. This is a self-evident truth. But as a culture, we tend to view money as a proxy for affection. Differing amounts can bring up old resentments. “Dad loved you best …” These feelings may even play out in a court battle. (Sigh)

There are myriad ways to divide the pie. Here are three common scenarios:

  • Equal parts in the will, but gifts as needed before you go. What you give to your children in the normal course of life need not be up for family discussion. It’s between you and each individual child.
  • Acknowledge prior financial help given as a “draw down” on the inheritance. Some children may have needed more help (a down payment for a house, rehab for substance abuse, assistance due to the pandemic). Deducting your past financial support from that child’s “fair share” may quell resentment from other siblings.
  • Unequal bequests with a description of your reasoning. Leave a note with your will or trust that affirms your equal love and explains your logic.

Talk with your kids ahead of time. It’s advisable to discuss your plans with your children individually. (You could learn that the prosperous child prefers that more be given to a less financially stable sibling because it reduces the chance of their being tapped for aid later.) You might then review your plans with everyone in a family meeting. If these conversations seem daunting, let’s talk. We can serve as an objective sounding board to help clarify your thoughts, prepare for the discussions, and perhaps even facilitate your family conversation.

Work with an estate planning attorney. There may be options you hadn’t thought of and details you need to include. You will need an attorney to draw up the final documents.

Are family dynamics a source of worry for you?
We are experts in the needs of aging families. Give us a call: 916-524-5151.

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The Cancer You Can See – Skin Cancer

by Hannah

Skin cancer is very common. In fact, one in every three cancers diagnosed are classified as skin cancer. But what is skin cancer? The Epidermis (skin) is made up of four different types of cells Merkel, Langerhans, Keratinocytes, and Melanocytes. Skin cancer occurs when irregular skin cells form to create a malignant or benign lesion. Malignant lesions are more aggressive and considered cancerous. Benign lesions are considered non-cancerous. These irregularities within the cells are a DNA mutation caused by ultraviolet light.

Skin cancer is most commonly a result of sun exposure. There are steps you can take to safeguard yourself from developing the disease. First and foremost, anytime you are going to be exposed to sun you should be wearing sunscreen. When selecting sunscreen, make sure you choose broad spectrum with an SPF of 30 or higher. When you have outdoor activities planned make sure you are covering up or enjoying your time in shaded areas. Avoid tanning beds. Although it may be tempting to achieve that summer glow from a tanning bed, it is not worth it. When you use a tanning bed, you are exposing your skin to direct ultraviolet light, the very thing that causes skin cancer.

Even after taking precautions, skin cancer can still develop. It is important to note, although skin cancer is most commonly caused by sun exposure, it can develop in areas of the body that are not exposed to sun. That is why it is important to know what to look for and to search your body thoroughly. You should be examining your skin every month and visiting a dermatologist each year for a full examination. You should see your dermatologist right away if you spot any notable skin issues.

Where should you be looking and what are you looking for?

Typically, skin cancer forms on sun exposed skin. Primarily affected areas are scalp, lips, chest, arms, hands, face, and ears. When you perform your examination remember you ABCDE’s:

A – Asymmetry, lopsided or uneven.
B – Border, irregular edges like a puzzle piece or blurred edges.
C – Color, red, white, blue, or pink.
D – Diameter, size of the growth.
E – Evolution, changes noted to the growths size, color, edges, etc.

Monitoring your skin for these changes is a helpful habit to create. Early detection is key in treating skin cancer. If caught in the early stages surgical excision is often the only treatment necessary.

When visiting your dermatologist, they will perform a full body scan to check for growths. If your dermatologist notes any irregularities, they will mark them and discuss a biopsy with you. A biopsy involves removing the lesion and sending it to a lab for review. The lab will take the lesion and perform a microscopic examination to look for cells that tell them what type of lesion was excised.

There are 3 main types of skin cancers; Basal Cell Carcinoma, Squamous Cell Carcinoma, and Melanoma.

Basal Cell Carcinoma is most commonly found on the face and neck. They can be described as a flat flesh color or brown scar like bump. Usually they bleed and scab but will return each time.

Squamous Cell Carcinoma is typically found on the neck, face, ears, and hands. Manifesting in a firm red nodule or a flat lesion.

Melanoma, the most dangerous, appear as a large brown spot with irregular borders. They can also have a red, pink, white, or blue color at the borders. They change each day as they grow. They also cause pain and an itching or burning sensation.

Once your dermatologist receives results back from the lab, they will review them with you. Excision may be the only treatment necessary, however, there may be more treatment steps involving further surgery or radiation treatment. Your dermatologist will advise you on what steps to take.

Remember to keep in mind that skin cancer is the cancer you can see and the cancer that you can take precautions to prevent. Being mindful of sun exposure and taking the proper precautions to protect yourself in addition to regular skin screenings you can protect yourself and those you love from skin cancer .

How do Shingles Affect the Elderly and the Immunocompromised?

by Hannah Turk

Simply put, Shingles is an attack on the body’s immune system. Shingles, also known as herpes zoster, is a viral infection that causes a painful skin rash which often include blisters. The blisters most commonly appear in a stripe like pattern, entering at the roots of nerves and follows them to the skin. Shingles is caused by a reactivation of the varicella zoster virus, also known as chicken pox. The chicken pox virus lies dormant for years, sometimes even decades, waiting to be reactivated.

Approximately one in three Americans will experience Shingles in their lifetime. Typically, Shingles affect the elderly and the immunocompromised. As we age, our immune system’s ability to fight off various illnesses naturally diminishes. Others who are fighting autoimmune disorders, being treated for cancer, or that have HIV are also at risk for developing the virus. Although rare, low risk healthy adults can develop shingles. Fortunately, they usually have an easier time recovering from the effects of the virus. Those who are elderly or have other complications have a difficult time recovering from Shingles. The virus can be fairly serious but is rarely deadly.

People afflicted with shingles note a multitude of symptoms, including but not limited to burning, tingling, itching, skin sensitivity, rash, blisters, chills, etc. Shingles also can cause long term side effects like nerve pain, scarring, and neuropathy. The scarring occurs where the blisters appeared on the skin during the viral attack. The scarring is usually caused when the person affected picks or scratches at the blisters. Post-Herpetic Neuralgia (PHN) is a condition developed after Shingles categorized by ongoing nerve pain. Usually, the older you are the more likely you are to develop PHN. Pain from PHN can cause depression, anxiety, weight loss, sleeplessness, etc. It has been known to make it difficult for the afflicted to perform their basic activities of daily living. Symptoms of PHN can last anywhere from a few months to years.

Fortunately, unlike its predecessor Chicken Pox, Shingles cannot be passed from person to person. However, a person with Shingles can spread the virus to another person who has not had chickenpox. That person could develop chicken pox but not shingles. The duration of illness is only about 7-10 days in most cases. Most people only get shingles one time, but it is possible to get it multiple times. There are a large variety of things someone dealing with Shingles can do to get relief. Most importantly getting adequate amounts of rest while affected. Other methods of relief include stretching, walking, cool compress, wearing loose fitted clothing, calamine lotion, and oatmeal baths. It is also helpful to use reading, tv, or hobbies to distract from the itching. If symptoms are severe enough contacting a physician to prescribe anti-viral medication can be helpful. Unfortunately, when dealing with a viral infection there is not a perfect medication available to manage all the symptoms.

Thankfully, due to advances in modern medicine, Shingles can be prevented. If you have had chicken pox in the past and are 50 years or older, talk to your doctor about getting vaccinated. Receiving a Shingles vaccine can reduce your chances of getting Shingles.

Mild cognitive impairment (MCI) and what you can do

Mild cognitive impairment (MCI) and what you can do

Mild cognitive impairment (MCI) is the medical name for memory problems that exceed the “normal forgetfulness of aging” but are less than associated with an Alzheimer’s diagnosis. If you have received a diagnosis of MCI, you are at risk for continued significant cognitive decline. Each year about 10–15% of persons with MCI receive an Alzheimer’s diagnosis, as compared to 1–3% of all older adults.

That said, many people with MCI do not experience further decline. And some people even improve–if their memory loss was caused by something fixable like a medication reaction or untreated depression. For all these reasons, it is important to have symptoms reassessed every 6–12 months to monitor changes.

There are things you can do. While there is no medical treatment as yet for MCI, some everyday activities can help prevent or slow its progression. The goal is to increase blood flow and oxygen to your brain, and keep your mind active.

  • Manage your blood pressure. Keeping blood pressure within the normal range has a profound effect on delaying memory problems.
  • Practice healthy habits. Get regular aerobic exercise, such as brisk walking. Aim for eight hours of sleep. Eat a diet low in processed foods and high in fruits and vegetables. Limit alcohol. Quit smoking. Manage other conditions (e.g., diabetes, depression).
  • Wear your hearing aids. A loss in hearing means a loss of stimulation to the brain. Studies now connect this loss with a decline in brain function. (Plus, some things you are “forgetting” may in fact be from conversations you didn’t fully hear.)
  • Participate in social activities. Even if you don’t talk much, the stimulation of spending time with others is beneficial.
  • Learn a new skill. Make your brain exercise! Try something you’ve never done. Brush your teeth with the “opposite” hand. Or have some fun: Ping-pong? Drumming?
  • Engage your mind with puzzles. This is brain calisthenics. Keep your neurons firing with activities that make you think.

Memory aids. Accept that you are forgetful and support yourself for success. Make ample use of to-do lists, big calendars, and notes or alarms on your phone. Leverage the power of routines. Put your keys and glasses, purse/wallet in the same place every time. Set yourself up for environmental cueing, consciously putting things where you will see them when needed, such as leaving your morning pills by the coffee maker.

Worried about MCI?
Give us a call. We can help. 916-524-5151

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What is “elder law”?

Elder law focuses on the special rights, needs, and challenges that arise in the context of simply growing older and planning for possible care needs.

Attorneys specializing in elder law take a holistic perspective.

They acknowledge the interplay of health, family, disability, and housing, as well as emotional and financial issues. Consider a consultation for:

  • Estate planning. Within elder law, estate and trust attorneys advise on the best strategy for organizing and managing your assets now that also ensures ease of transfer upon your death. This may involve a will. Or a living trust. There are pros and cons to each. And, if you have a dependent adult in your life, an attorney can draw up a special needs trust to provide for care when you are no longer alive.
  • Decision-making plans. With advancing age, many of us lose the ability to manage our finances or make complex healthcare decisions. Especially if you do not have relatives to step in, you will need legal assistance to locate and contract with trustworthy professionals to fill these roles.
  • Paying for care. An elder law attorney knows about the many programs designed to assist with the cost of care. You may, for instance, be considering a reverse mortgage, but there are significant “gotchas” with this arrangement. If Medicaid is your fallback should you need a nursing home long term, you will want to work with an attorney to be sure your spouse is not left without resources when you die. Long-term care insurance is another payment option worthy of an attorney’s review.
  • Housing contracts. Before moving into an assisted living or continuing care retirement community (sometimes called a “life care” community) or a nursing home, have an elder law attorney review the paperwork. They can clarify tax implications and advise you regarding your rights and how or when you can cancel a housing contract.
  • Claims and appeals. You may have disagreements with Social Security, Medicare, your pension fund, or other insurance or benefit programs. An elder law attorney can help you navigate the appeals process and increase your chance of a successful resolution.
  • Grandparent visitation rights. Whether the schism is due to a divorce, the death of your child, or estrangement from your son or daughter, you do have rights to see your grandchildren. An elder law attorney can help you stay connected.
  • Age discrimination in employment. Have you been turned down from a job, a promotion, or fired because of your age? An elder law attorney can help you rectify the situation.

Looking for an attorney specializing in elder law?
We network with the best. Give us a call at 916-524-5151.

Learn more about our services to help you age well.

“Can we hug yet?”

Yes, if you are fully vaccinated!

It’s a different world in many ways:
Gathering indoors

  • People nearby whom your loved one knows are vaccinated can now visit together indoors. No need for masks or social distancing. Have a few friends over and celebrate!
  • One household of unvaccinated people can even visit with those in a vaccinated household. No precautions needed. Hug those grandchildren!
  • The only exception concerns people at high risk and their housemates. If an unvaccinated person is over age 85, overweight, diabetic, or a smoker and/or has a heart, lung, or kidney disorder or cancer, then everyone at the gathering should observe the usual precautions: Masks, social distancing, washing hands, and meeting in well ventilated spaces.
  • This applies even if the high-risk individual is not visiting, but someone in their household is.

Gathering outside the home, continue with precautions

In a crowd, one never knows for sure who is and isn’t vaccinated. For the protection of all of
us, everyone needs to follow precautions in public, including the fully vaccinated.

  • It is best to avoid medium and large gatherings, indoors or out. That includes trains, planes, and public transport.

Caring after the hospital

Hooray! Your loved one has been discharged from the hospital. While extreme cause for concern may be over, recovery from COVID and its intensive treatment simply
will take time.

Here are things you can do to help:
Physical concerns

Trouble breathing. Use the breathing exercise devices given to you by the hospital. You can also ask for home visits from a physical therapist or
occupational therapist.
Circulatory problems. So much time in bed is not good for the heart and body. Encourage your loved one to get up and walk around as much as possible.
Weakness. Time in the hospital saps stamina. Pace tasks so there are rest periods in between. A cane or walker may help your relative get around without becoming too tired.
Fatigue. To get a good night’s sleep, support your loved one to go to bed at the same time each night, limit caffeine, and avoid naps after 3:00 pm.

Mental and emotional concerns. Many people who were hospitalized experience PTSD symptoms much like soldiers returning from war.

Depression. Sadness, certainly, but also disinterest in activities that used to be fun. Feelings of guilt or worthlessness may arise. Also, irritability.
Anxiety. Worry, restlessness, and difficulty sleeping.
• “Brain fog.” From short-term memory problems to
difficulty concentrating or making decisions. Sometimes familiar tasks feel challenging, like following a recipe or paying the bills.
Nightmares. Especially common among those who were in the ICU (Intensive Care Unit).

If your relative has these symptoms, talk with the doctor. There are medications and counseling services to help your loved one return to a healthy state

Anniversaries can be painful

For every individual who was lost to COVID, there are on
average nine survivors. As a nation, that means close to 5
million Americans will be coming up on the anniversary of a
loved one’s passing this year.


Many families were not able to be at the bedside when their
relative died. Hospitals couldn’t allow visitors. Travel was
restricted. The result has been crushing feelings of guilt,
even though their absence couldn’t be helped.


Funerals have been kept to a minimum. Grief has been
processed in isolation, without the hugs and community
gathering that ease the pain of a loved one’s death.
If you are coming up on such an anniversary, be aware that
you may have strong feelings arise, even mental and
physical reactions. It’s not unusual to experience

• sadness, anger, and anxiety
• confused thinking
• trouble with sleep (too much or too little)

You may find yourself reliving the events leading up to your
loved one’s illness and death. And you may find yourself
drawn to alcohol or other substances to ease the distress.
Children may also have problems at the anniversary. Some
withdraw. Others may become aggressive or act out.


Everyone—adults and children alike—should expect that
there may be a dip in “normal functioning” around the time
of the anniversary. It’s wise to be prepared for a slowdown
and allow the mind, body, and spirit to process the loss.
If you have a friend struggling with an anniversary, the best
thing you can do is listen. Let them share memories of their


loved one. Talking helps. Grief has no timetable. There’s no
such thing as “getting over it.” Only getting used to it.


These are tender times. Be gentle with yourself. If grief
seems to get in the way of normal functioning for two weeks
or more, then it may be wise to talk with a grief counselor.

Contact us at 916-524-5151

Age-friendly bathroom remodels

Activities that are easy now may become more difficult in the future: Going up and down stairs, standing up from sitting, getting in and out of the tub, catching your balance if you start to slip. . . . As you consider aging in place, it is wise to keep these issues in mind, particularly about the bathroom.

Structural considerations. To eliminate the need to climb stairs, the ideal is a full bathroom on the main level of the house. In addition, as we age, the likelihood of needing support increases. Whether a wheelchair or walker, or a spouse or paid caregiver is providing assistance, a spacious room is best.

Did you know the bathroom is the most dangerous room in the house? Eighty percent of falls occur in the bathroom on hard, sometimes slippery surfaces. Most falls occur in the process of sitting down on or getting up from the toilet, or getting in/out of the bath/shower.

Bathtub or shower? The most versatile design involves a water-friendly, nonslip floor with a drain, and no hard curb around the shower area. This allows for rolling a wheelchair into the shower and provides room for a helper. Even without such a radical makeover, it’s easy to install a handheld showerhead and a built-in or portable bench in an existing bathroom to create a seated shower option.

If you need to soak—great for achy arthritic joints—consider a walk-in tub. These tubs have a watertight seal on a side door that allows you to walk in, sit on a bench, and then fill the tub to the desired height. Or have a dip cut into the side of an existing tub to lower the height for ease of stepping in and out.

Toilets and bidets. Purchasing a high toilet or adding an extender that raises the sitting surface greatly reduces the physical challenges of sitting down and getting up. Many people find a bidet adds to convenience and cleanliness. (Twisting to wipe our nether regions becomes more difficult with age.) Rather than ask for help, cleaning with water can improve hygiene while preserving dignity.

Other fall prevention strategies. You don’t need a full remodel to improve safety. Installing grab bars beside the toilet and within and outside the bathing area is an easy and effective modification. Grab bars must be attached securely to the studs of the wall and be able to support 250–300 pounds. Installing nonslip flooring or applying antislip floor coatings for higher traction is also wise. Increased lighting will help visibility and reduce falls. In addition, lights installed on the wall instead of on the ceiling reduce the need to get on a ladder, and possibly fall, when changing a bulb.

How age friendly is your bathroom?
Give us a call at 916-524-5151.

Social Security and the newly single

Life has a way of throwing us curveballs.

The unexpected death of a spouse—or a divorce—can certainly wreak havoc on your emotions. It can also throw a wrench in your finances.

If you are age 62 or older, here are some Social Security basics to bear in mind as you regain your financial footing or make contingency plans.

Survivor benefits. If you find yourself widowed after at least one year of marriage, then you are eligible to receive monthly survivor payments.

Did you also work outside the home? If so, you can choose the higher of the two benefits: yours personally; or as a surviving spouse.

Before deciding, confirm the amount for each one for three points in time: collecting now; waiting until age 70; or at your designated retirement age (as determined by Social Security). While you cannot receive both benefits at the same time, you can strategically claim the highest one now and then switch to the one that becomes higher later.

Spousal benefits. A divorce does not erase the contribution you made to the household. As a formerly married spouse, you are eligible for Social Security benefits based on the earnings of your breadwinning partner. As long as you were married for 10 years or more, you have earned spousal benefits.

Receiving spousal benefits does not affect what your ex will receive from Social Security. What’s more, your ex does not need to know, give permission, or sign any papers. All you need to provide is the marriage certificate, divorce papers, and your ex’s full name.

If you were also employed and are eligible for your own Social Security benefits, investigate which benefit will pay more: now; when you turn 70; or at your designated retirement age. Unlike survivor benefits, you cannot switch benefits at a later date. Decide when is the best time to apply, and choose the larger amount.

It’s important to make a fact-based decision. The difference in monthly payments, added up over many years, could mean there are thousands of dollars at stake. There are many more details than we can cover here, including information about benefits in same-sex marriages. Consider working with a certified financial planner who can run the various calculations for you and suggest the wisest strategy. There’s too much to lose to depend on Social Security staff for detailed guidance.

Find yourself suddenly single?
Let us help you get reoriented. Give us a call: 916-524-5151.


Learn more about our services for aging well.