Uncategorized

By Rodney A. Brooks – Monday, Jan. 8, 2024

It’s time for those annual New Year’s resolutions – the goals that almost no one sticks to after January.  But there are some easy-to reach financial resolutions that can help retirees make the most of precious post-retirement dollars. So, let’s get started with five easy-to-achieve financial resolutions for 2024.

Create a budget. It’s the most important thing anyone can do, says Michael Berkhahn, vice president at Graham Capital Wealth in Tampa, Florida. “You have the previous 12 months or 2023 and can get a true understanding of what that individual or that family is spending on a monthly basis,” he says. “I don’t think a lot of people realize what they’re actually spending on a monthly basis on average because maybe not all bills are paid out on an ongoing monthly basis.”

“I go back to Warren Buffett,” he says. “A while ago he said the first rule of investing is don’t lose money, and then he said the second rule is don’t forget the first rule. So, I say when it comes to your New Year’s resolution, when it comes to financial planning, the first rule is to create a detailed financial plan.”

Start an emergency fund. “I’d revisit the emergency fund and ensure there are 3-6 months’ worth of expenses for a rainy day,” says Mitch Katz, wealth manager advisor and partner at Capital Associates in Bethesda, Maryland. “For those without emergency funds, start building one.  Even if it’s just $50-$100 per month to start. Whatever they can contribute is better than doing nothing at all.”

Check your credit report. “Typically, people can check for free at freecreditreport.com/ and while checking, close any old credit cards or store cards with high interest rates,” says Katz.  “While they are at it; reassess all of the monthly subscriptions.  These dollars can be repurposed to the emergency fund.”

Don’t buy things you don’t need just because they’re on sale. “One on my financial New Year’s resolutions is to stop buying clothes and kitchen gadgets just because they’re “on sale,” says Jeanne Thompson, a retired Fidelity Investments executive who is now an author, speaker and podcaster (Fab Fridays Live w/ Jeanne and Martha). “It always seems like a great deal, one that I can’t pass up,” she says. “But often it’s not something I needed or wanted, and I only buy it because it’s “on sale.” It’s never part of my budget and often I don’t wear the clothes or use the kitchen gadget and end up giving it away. Therefore my 2024 resolution is to stick to my budget and not buy things just because they’re on sale!”

Pay off high interest debt. Today’s high interest rates make it imperative to pay off your credit cards or any other high interest debt obligations, says Berkhahn. “Because there’s no investment out there that someone can make that’s guaranteed to get to 20%,” he says. “And if you’re sitting there with $10,000 or $20,000 in credit card debt, and racking up at 20% or 25% APR, you’re much better off trying to pay that down as quickly as you can.”

Finally, says Katz, when people set New Year’s resolutions, most set them for the short term and only keep them for a few weeks or months at best. “To be in good shape, you need to resolve that you’re going to do these things for many years to ensure you meet your long-term financial goals.”

If you aren’t bothered by symptoms of low blood pressure, treatment is likely unnecessary. After all, a low BP on its own is not usually a problem. In fact, it’s often taken as a sign of good health.

But if it’s affecting your well-being, you need to take steps to address it. Low blood pressure is treated in the elderly by first determining the underlying cause. If your low BP is a result of your medication regimen, your doctor may be able to adjust your dosages or change your meds. (If you find it difficult to keep your meds organized, a pill dispenser for seniors could help.) If dehydration is the culprit, fluid replacement may solve the problem.

In some cases, you may require medication specifically for your low BP. Two of the most commonly prescribed medicines are fludrocortisone and midodrine. Fludrocortisone is a steroid that causes the body to retain sodium and fluid, thus increasing blood volume and raising blood pressure. Midodrine causes your blood vessels to resist expanding, thereby boosting blood pressure.

However, many people can manage their hypotension through diet and lifestyle changes rather than medical interventions. Here are some tips on how you can fix low blood pressure:

• Drink more water. Consuming additional fluids can boost blood volume and prevent dehydration. Having a glass of water before you stand up or at the end of a meal can sometimes help avoid sudden drops in blood pressure. Sport drinks containing electrolytes can also help but try to avoid ones with high amounts of sugar.
• Limit the booze. Alcohol is dehydrating and can drive your blood pressure even lower.
• Eat smaller meals more frequently. Going too long between meals can wreak havoc on your blood sugar levels. And indulging in heavy meals can cause a sudden drop in blood pressure as the blood moves from your brain to your intestines to help you digest your food. As a general guideline, it’s a good idea to eat small amounts five or six times a day.
• Choose your diet carefully. Cutting back on carbs (especially refined carbs such as white bread and pasta) may help keep you from feeling dizzy after you eat. Plus, foods that are high in folate and vitamin B-12 can help alleviate low blood pressure that is caused by anemia. Asparagus, legumes, leafy greens, eggs, and fortified cereals are good choices.
• Increase your salt intake. Salt causes your body to retain fluid, which raises your blood pressure. Your doctor may recommend taking salt tablets or adding a bit of salt to your meals. Carrots, beets, and olives are a few examples of foods that have naturally higher levels of sodium. But be aware that potassium-rich foods like apricots and bananas lower blood pressure by causing you to lose sodium through your urine.
• Make slower transitions. Change positions slowly and gradually. If you’re lying down, sit up and dangle your feet or march your feet gently for a couple minutes before you try to stand. Once you’re on your feet, stay still for a bit until you feel steady enough to walk.
• Wear compression stockings. They promote better circulation by compressing the leg veins. This keeps blood from pooling in your lower legs and shifts it toward other areas of the body. Styles for both men and women are available.
• Don’t overheat. High temperatures cause blood vessels to dilate, which lowers blood pressure. Plus, sweating out fluids can cause reduced blood volume and dehydration. So be careful to stay out of the sun and don’t do anything too strenuous when it’s warm. Avoid spending long periods of time in hot tubs or saunas. You might also want to keep a nonslip chair in the shower in case you feel dizzy.

Low blood pressure in elderly people has a wide variety of causes and effects. The information above can help you understand the danger signs and take appropriate steps to safeguard your well-being.

You may also have to revise your ideas about dieting if you and your healthcare provider determine that losing weight will help your overall health. That’s because many seniors find that weight loss gets more challenging as they get older. While slower weight loss can be frustrating, it’s also a natural part of the aging process. So, don’t blame yourself if you struggle to drop extra pounds. If a 60-year-old woman can’t lose weight, she might blame herself for not being disciplined enough. However, her body might just be responding in a way that’s appropriate for her age.

But that doesn’t mean that losing weight over 60 is impossible. Many people successfully lose weight at any age. You can lose weight as you get older by adapting your weight-loss strategies to your changing body.

The first step in understanding why weight loss rules can be different for seniors is to consider your basal metabolic rate. That’s the number of calories you burn just staying alive (i.e., the energy you expend breathing and digesting food). This rate is different than the calories you burn through exercise or everyday activities.

Your body composition impacts your basal metabolic rate. That’s because, in addition to its heavier weight, muscle burns more calories than fat. So, a person who has a lot of muscle mass should have a higher basal metabolic rate than someone who doesn’t.

However, starting in our 30s, we lose muscle mass unless we work to maintain it. Although we may not even notice this process when it starts, it has a large impact over time. One study published in Clinical Interventions in Aging found that, on average, we lose about 30 percent of muscle strength between age 50 and 70. And the rate of muscle loss is even faster after 70. Consequently, losing weight after 70 will be that much harder than it is for someone who is 30.

If you continue to eat the same number of calories and do the same amount of activity as you did in your younger days, you could be at risk of gaining weight because your basal metabolic rate is slowing down.

As a result, the number of calories you should eat in a day is about 100 calories lower with every decade you age. That’s not a huge amount (about the equivalent of one apple). But it does add up. So, for example, all other factors being equal, a 60-year-old woman should eat fewer calories in a day than a 40-year-old woman to lose weight.

Although it might seem unfair in today’s more sedentary world, this process makes sense from an evolutionary standpoint. Long ago, as we grew older and our hunting and gathering abilities slowed down, our bodies had to learn how to survive on less food. The result? Aging bodies want to hang onto any extra body weight (even if we no longer need – or want – them to).

As well, for many seniors, weight loss slows down because of additional factors that affect their metabolisms, including:

• Medications: Seniors are more likely to be taking medications that can contribute to weight gain and make it harder to lose weight. But the effects are often hard to predict. For example, some people find that the antidepressant Wellbutrin can help with weight loss, but others find that they gain weight while taking it. If you’re concerned about a medication’s impact on your weight, be sure to talk to your doctor.
• Gastrointestinal changes: Some seniors avoid fresh fruits and vegetables because they don’t want to upset their stomachs. If you’re experiencing digestive issues that interfere with a healthy diet, your doctor can help.
• Certain medical conditions: Some health issues that are common in seniors can slow weight loss. For example, when your thyroid doesn’t produce enough thyroid hormone, your metabolism can slow down. You can lose weight with an underactive thyroid by working with your doctor to restore your thyroid hormone levels.

Traditionally, old age marked the final stage in the human life cycle; you were old when you were approaching the end of your life. The problem with that old age definition is that no one knows for certain when they are going to die. And people are living much longer than they used to: When Social Security began in 1935, the average life expectancy in the U.S. was 61 years. Today, it’s closer to 79.

Increased longevity is not just an American phenomenon. A 2017 study in The Lancet found that life expectancy was projected to grow in every one of 35 developed countries, albeit at different rates. The study concluded that by 2030, women in South Korea will likely have an average life expectancy of over 90 years. Researchers believe the gains are largely attributable to medical advances that allow people to extend their lives, as opposed to decreases in child mortality.

So, if the definition of “old age” depends on the average length of people’s lives, what age is considered “elderly?” When does middle age end and old age begin?

Stanford economics professor John Shoven looked at mortality rates for different age groups through time and suggested that “middle-aged” adults are those whose chances of dying within the next 12 months are one percent or less. That would mean that American men today would be considered middle-aged until they reach about age 60 (up from around age 44 in 1920) and women wouldn’t leave middle age until 65 (considerably later than age 48 like in 1920).

Similarly, Shoven suggested that an elderly definition could include adults whose chances of dying within the next year are four percent or more. So how old is “elderly?” Shoven’s theory would define elderly men as those over age 76 and elderly women as those over age 80.

How old is “old?” As you can see, there’s no simple answer to that question. However, there are a few commonly accepted ways to define old age:

• By chronology: You become old when a certain number of years have elapsed since your birth. However, the precise number can vary dramatically in different contexts. For instance: Medicare benefits begin at age 65, many senior discounts are aimed at those aged 55 or 60, and AARP starts accepting members at age 50.
• By social role: You become old when your children become adults, or you become a grandparent, or you retire from the paid workforce. In some rural areas of sub-Saharan Africa, where a formal retirement age is meaningless, you are considered to have reached old age when you must stop performing physically strenuous tasks and instead take on more of a managerial role in the household.
• By physical or health status: You become old when you get grey hair, develop wrinkles, or start experiencing physical frailty or mental decline. (Hence the oft-repeated phrase, “You’re only as old as you feel.”) A report in Geriatrics and Gerontology International found that many Japanese people believe that the term “elderly” should be reserved for those who are dependent on others for their daily functioning.

Not surprisingly, everyone has different ideas about what elderly age is or when old age begins. A survey by Pew Research Center found that Americans aged 18 to 29 believed that a person becomes old when they turn 60, whereas those over 65 said a person doesn’t get old until his or her 74th birthday. (Notably, the same survey found that only 35 percent of people over age 75 said they felt old.) And a survey by PayingTooMuch.com of adults over 40 found that most of them believed old age began at 80.

The Health Care Cost Institute reports median per person healthcare spending has increased by 24% from 2017, but residents of some cities pay far more.

By Jacqueline LaPointe – REVCYCLE INTELLIGENCE – July 07, 2023

Healthcare spending is still on the rise, with median costs per person increasing to over $6,000 in 2021, according to a new analysis from the Health Care Cost Institute (HCCI).

Median per person healthcare spending increased by 24 percent from 2017 through 2021, HCCI’s latest Healthy Marketplace Index shows. But healthcare spending varied significantly depending on where people lived. For example, patients in metropolitan areas with the highest utilization rates paid nearly three times more for healthcare services that year compared to their neighbors in metropolitan areas with the lowest utilization rates.

Rising medical prices impacted healthcare spending, with overall spending growth reflecting a 9 percent increase in prices, on average, and 14 percent increase in service use, on average.

The American Medical Association (AMA) reports patients spent $433.2 billion, or 10.2 percent of total healthcare spending, in 2021, the same year of the HCCI analysis.

“High and growing health spending is forcing families, employers, and governments across the country to make difficult tradeoffs,” Katie Martin, HCCI’s president and CEO, said in a statement. “The Healthy Marketplace Index shows that health care costs depend a great deal on where you live, the result of market dynamics like prices, practice patterns, and competition. Therefore, we need a multi-dimensional approach to making [healthcare] more affordable.”

Market consolidation continues to impact medical prices and overall healthcare spending. The Healthy Marketplace Index shows that most hospital markets lacked competition in 2021 and two-thirds of the 183 metropolitan areas studied became less competitive over time.

A Health Affairs study from May 2022 found that vertical consolidation — for example, health systems buying physician practices — resulted in a 12 percent increase in primary care physician prices and a 6 percent increase in specialist prices. Research has also shown similar price increases when markets experience horizontal consolidation, which is when hospitals merge or acquire other hospitals.

Hospital markets tended to be less concentrated in larger metropolitan areas, such as San Francisco, New York City, and Philadelphia. Meanwhile, according to HCCI’s analysis, the most concentrated areas were metropolitan areas with populations of less than 350,000 in 2021. The most concentrated areas included Johnson City, Tennessee, Kingsport, Tennessee, and Wilmington, North Carolina.

HCCI notes that a potential factor in market consolidation is the degree to which patients from one metropolitan area seek care in a neighboring region.

Healthcare spending is only expected to rise, with the latest healthcare spending projections from federal actuaries estimating healthcare to account for nearly 20 percent of gross domestic product (GDP) by 2031.

HCCI’s Healthy Marketplace Index provides interactive reports in which readers can compare prices and hospital market concentration across metropolitan areas.