Seniors & Aging

Your turn! I said, and then you said….

I’m always imploring you to retaliate. Some columnists equate inviting feedback with masochism, but it’s treasured here. So is the opportunity to share some of your gems with everyone:

About improving our estate plans to be insightfully thought out and truly adequate: Reader and cheerleader B, who assiduously enhances my understatements, implores us to review and update our plans regularly and whenever a significant event occurs. Right again, B! Let’s discover and check all the insurance, employee benefits, and financial and retirement accounts, including old forgotten ones or ones that beneficiaries or fiduciaries don’t know about, too.

Reader K’s wordcraft embracing the wisdom of giving oneself permission to grieve is most heartwarming: “It feels good to be validated that this is ‘normal’ and to be expected….I need to quit beating up on myself about this, just let it be, and keep talking about it in a safe and supportive environment.”

The consumer fraud series is prompting more revelations. Reader G laments the many charitable foundations who desecrate their tax-free non-profit status and scam our good-faith billion-plus-dollar-a-day benevolence, allocating only token percentages of our contributions to actual benefits. Also, many honest charities, some even nationally and globally recognized and universally respected, function alarmingly inefficiently and are disturbingly hyper-generous to their executives and fund-raisers.

Www.charitynavigator.org takes us to a widely commended nonprofit public-interest foundation that objectively and professionally analyzes, performance-rates, and publishes the real facts about hundreds of charities. Some disturbing surprises might await you there — For example, some major foundations currently spotlighted in the news media score 80 and below on its quality scale of 100.

Some others, including a de-listed one that’s headline news as I write this, are so deceptive that Charity Navigator even declines to classify them as ratable charities.

While we’re agonizing about consumer fraud: See Lauren Zumbach’s article in the May 22 The Sun News, alerting us to the emerging ATM scam? Brainiac fraudsters plant mini-cameras on the machines, to snatch our credit and debit card data. The advice is to use ATM’s only at our banks’ offices, and to sleuth carefully even there for signs of tampering.

Mr. and Mrs. S describe themselves as being “among the vast majority of good middle-class folks of modest means and little financial knowledge. We can’t afford consultants, and don’t meet wealth managers’ net worth thresholds. We question the objectivity of those seminar presenters and article-writers who really are selling investments or newsletter subscriptions. We disregard know-it-all relatives, friends, and neighbors who really don’t know any better than we do. Where can we turn for really sound free or low-cost financial guidance?”

S’s, I suggest SimplySeniors.com’s March 29, 2016 Internet posting, “Finding Free Financial Advice For Seniors”, at: http//simplyseniors.com/Financial/estate_planning_free_advice_for_seniors.

Summarizing its points: Your bank’s or credit union’s counselors, incidentally sales-commissioned, but ethics-bound and corporate policy-bound to objectivity and quality for customers; AARP’s experienced, broadly knowledgeable professional counselors for members; public service seminars offered by community institutions, such as libraries, universities, seniors agencies and centers; the federal IRS-sponsored Tax Counseling For The Elderly Project’s local counselors; and the Internet’s array of non-infomercial public-service articles sponsored by consumer and senior advocacy organizations and government agencies.

Ethical professional financial gurus offer genuine seminars and consultations, and don’t impose thresholds for many services.

Reader/student M illustrates a vexing widespread travesty: “My friend got all of her estate-plan documents in order, including her end-of-life Do Not Resuscitate, Medical Order of Life Sustaining Treatment, and Medical Directive “pull-the- plug” living will advance directive documents. But when she suffered her catastrophe, nobody followed her orders. She suffered terribly, expensively, futilely, and for a long time. How to prevent that unconscionable mistreatment?”

Estate affairs attorney Dundee Carter and professional fiduciary Stephen Mantell advise our OLLI estate-affairs students to make sure that those instruments are up-to- date and are legally valid and credible in your jurisdiction. Senior rescue EMT Len Newman suggests summarizing them for our “File of Life” on or near the refrigerator door and in our purse, wallet, and car, so that responders and medical staffs will discover them and thus be alerted to heed them. I’ve known folks who wear Medic-Alert style bracelets listing their allergies, but also “Do not resuscitate!”

Let’s also equip all of our emergency contacts, fiduciaries and attending physicians with copies. Coming: The health care industry is creating a system to coordinate all of everyone’s health care data and advance directives into a secure instant-access single-source data bank.

As attorney Regina Ward tells seminar audiences, hospitals are dedicated to saving and prolonging our lives. So are emergency responders and medical practitioners. They energetically work to do that, unless they can know that we order them not to and safely can rely on our mandates.

“Hey, Gary, last year you told us that doctors hate keeping us waiting, and are creating methods to improve that. So, how come I just spent an hour past my appointment time, surrounded by year-old magazines and a TV showing non-stop commercials?”

Yes, I did. And they do. And they are. More efficient care is happening, but better time control takes longer. The experts tell us that more innovations still are being carefully invented and tested.

Plus, in health care, unpredictable schedule-busting developments always will happen.

We’re advised that the new diagnostic coding system tells providers what’s wrong far more precisely. But we’re discovering that researching and deciding which of the 68,000-plus precise codes to input to avoid mis-stating your specific condition consumes five extra minutes (average) after every visit. It will until Doc knows frequent codes reflexively, and can recruit, train, and pay the new staff member scribe. Further, because the emerging single-source instant data system idea is so comprehensive, it needs a lot more development time to get it right, and to tune all providers who might need your info into it economically and securely. A promising emerging idea is the specialty team-practice firm that assembles all the needed services for a specific kind of disorder under one roof and in one visit.

Further, Medicare now pays for end-of- life care counseling, a great improvement to Doc’s treatment strategy for each of us, but it can substantially increase Doc’s patient-visit time. Besides, Medicare, Medicaid, and insurance companies increasingly limit their treatment allowances and require quality-control details. Doc has to reduce and streamline the office staff, yet everyone has more duties to perform. The fee structure’s hopeful long-run objective is to reward healing, rather than the number of patient visits and superfluous diagnostics.

It’ll take a lot more time, but we’re beginning to experience fewer and shorter visits, fewer unpredictable disruptions, more efficient time-management, lower costs and better results. But the magazine and TV scene won’t change. Feel better, anyway?

Yes, I’ll buy “Sage” Reader D’s profundity that “Too soon old, too late smart” out-pundits “With age comes wisdom”, my “Pennsylvania Dutch/Yiddish” proverb about four columns ago, but I didn’t know these languages’ words for it. Maybe you do.

Please tell us.

Contact Gary Newman at gary@gnewman.org. Your ideas and comments are always welcome.

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