Health Mistakes to Avoid after 50

Everyone can improve their health as they age by avoiding key health mistakes people make after age 50.

Many of our clients are concerned with their health as they age.  All of us can improve the odds of a longer, more healthful life simply by avoiding the health mistakes that people tend to make after age 50, published in Money Talks News’ recent article entitled “7 Deadly Health Mistakes People Make After Age 50.”

  1. Loss of Social Connection. COVID-19 taught us many things, among them, people shouldn’t be alone. A 2018 study found that isolation may double a person’s risk of dying of cardiovascular disease. What’s more, social isolation is linked to increased risk of depression, cognitive decline, obesity and a weakened immune system. Men are at greater risk of suffering from social isolation, as a recent survey found just 48% of retired men living alone were very satisfied with the number of friends they had. However, about 71% of retired women living alone were very satisfied with their number of social connections.
  2. High-sodium foods. A very common health mistake is eating too many high-sodium foods.  About 90% of the sodium that we consume comes from salt. 90% of Americans over age two also consume too much sodium, so reduce your sodium intake. Do that and your blood pressure should fall within a couple of weeks, helping to lower your risk of deadly heart disease and stroke, the CDC says.  Several online sources list common high-sodium foods in our diets.
  3. Postponing colorectal cancer screening. Medical experts say that all adults 50 to 75 should have colorectal cancer screening. This test can find precancerous polyps, which are the main source of colorectal cancer, which is treatable when found in its early stages. With the Affordable Care Act of 2010, colorectal screening is among a list of preventive services that generally are free for people who have health insurance and are between the ages of 50 and 75.
  4. Not taking a daily aspirin. Not everyone over 50 should take an aspirin every day, but it can be good for those with certain potentially life-threatening health conditions. The Mayo Clinic says, “The U.S. Preventive Services Task Force recommends daily aspirin therapy if you’re age 50 to 59, you’re not at increased bleeding risk and you have an increased risk of heart attack or stroke of 10 percent or greater over the next 10 years.”

Taking aspirin makes blood platelets less “sticky,” helping to prevent the clots that lead to heart attacks and strokes, explains Harvard Medical School. Talk to your doctor before starting a daily aspirin regimen.

  1. Failing to lift weights. As we get older, the risk of the bone disease osteoporosis increases. About 10 million people have osteoporosis, and 44 million more have low bone density, which puts them at risk for the disease, according to the National Osteoporosis Foundation. Women are especially at risk for osteoporosis, since one in two women will break a bone due to osteoporosis. This happens more often in women than a heart attack, stroke and breast cancer combined. Getting sufficient calcium and vitamin D is critical to preventing osteoporosis. Weight-bearing exercise is also a great way to strengthen bones.
  2. Not drinking enough water. Anytime my kids tell me they have an upset stomach, don’t feel well or have a headache,  I respond the same way.  Drink some water.  Hydration is key for health, and the Mayo Clinic says that older adults carry a lower volume of water in their bodies. In addition, they are more likely to take medications that boost the risk of dehydration. Their sense of thirst is less acute, making it easy for them to forget the need to drink. Severe dehydration can lead to:
  • Seizures
  • Life-threatening heatstroke
  • Urinary and kidney issues; and
  • Hypovolemic shock (low blood volume shock).

As a general rule, men should drink 15.5 cups (3.7 liters) of fluids and 11.5 cups (2.7 liters) of fluids a day for women. 20% of daily fluid intake also typically comes from food.

  1. Continuing to smoke. Quitting smoker is easier said then done, but kicking the nicotine habit pays dividends at any age. The improvements accumulate over the next nine months, and by one year after quitting, your heart attack risk drops dramatically. However, improvements can be fast. For example:
  • Your heart rate and blood pressure drop 20 minutes after quitting:
  • The carbon monoxide level in your blood drops to normal a few days after quitting; and
  • Circulation improves and your lung function increases two weeks to three months after quitting.

Reference: Money Talks News (May 24, 2021) “7 Deadly Health Mistakes People Make After Age 50”

Continue ReadingHealth Mistakes to Avoid after 50

How Do Special Needs Trusts Work?

Special needs trusts (SNT) are critical tools for protecting a beneficiary with disabilities’ benefits while providing for their needs.

Special needs trusts (or supplemental needs trusts) have been used for many years. However, there are two factors that are changing and clients need to be aware of them, says the article “Special-Needs Trusts: How They Work and What Has Changed” from The Wall Street Journal. For one thing, many people with disabilities and chronic illnesses are leading much longer lives because of medical advances. As a result, they are often outliving their  primary caregivers. This makes planning for the long term more critical, and the use of special needs trusts more critical.

Second, there have been significant changes in tax laws, specifically laws concerning inherited retirement accounts.

Special needs planning has never been easy because of the many unknowns. How much care will be needed? How much will it cost? How long will the person with disabilities need them? Tax rules are complex and coordinating special needs planning with estate planning can be a challenge. A 2018 study from the University of Illinois found that less than 50% of parents of children with disabilities had planned for their children’s future. Parents who had not done any planning told researchers they were just overwhelmed.

Here are some of the basics:

A special needs trust, or SNT, is created to protect the assets of a person with a disability, including mental or physical conditions. The trust may be used to pay for various goods and services, including medical equipment, education, home furnishings, etc.

A trustee is appointed to manage all and any spending. The beneficiary has no control over assets inside the trust. The assets are not owned by the beneficiary, so the beneficiary should continue to be eligible for government programs that limit assets, including Supplemental Security Income or Medicaid.

There are different types of Special Needs Trusts: pooled, first party and third party. They are not simple entities to create, so it’s important to work with an experienced estate elder law attorney who is familiar with these trusts.

To fund the trust after parents have passed, they could name the Special Needs Trust as the beneficiary of their IRA, so withdrawals from the account would be paid to the trust to benefit their child. There will be required minimum distributions (RMDs), because the IRA would become an Inherited IRA and the trust would need to take distributions.

The SECURE Act from 2019 ended the ability to stretch out RMDs for inherited traditional IRAs from lifetime to ten years. However, the SECURE Act created exceptions: individuals who are disabled or chronically ill are still permitted to take distributions over their lifetimes. This has to be done correctly, or it won’t work. However, done correctly, it could provide income over the special needs individual’s lifetime.

The strategy assumes that the SNT beneficiary is disabled or chronically ill, according to the terms of the tax code. The terms are defined very strictly and may not be the same as the requirements for SSI or Medicaid.

The traditional IRA may or may not be the best way to fund an SNT. It may create larger distributions than are permitted by the SNT or create large tax bills. Roth IRAs or life insurance may be the better options.

The goal is to exchange assets, like traditional IRAs, for more tax-efficient assets to reach post-death planning solutions for the special needs individual, long after their parents and caregivers have passed.

Reference: The Wall Street Journal (June 3, 2021) “Special-Needs Trusts: How They Work and What Has Changed”

Continue ReadingHow Do Special Needs Trusts Work?

Making Medical Decisions During Incapacity

Medical decisions during incapacity are made by the individuals named in a Medical Power of Attorney and Living Will following your wishes.

Today, there is greater awareness that incapacity from disease or injury is not a hypothetical. It’s reality, and there are tasks that must be done, as explained in a recent article entitled “Now Is the Time to Protect Your Health Care Decision-Making Rights” from Kiplinger, for making medical decisions during incapacity.

You have a fundamental right to make your own decisions regarding your healthcare decisions.  However, that can change quickly.  Failing to have your healthcare wishes documented properly also leaves your family in the terrible position of having to guess what you want, which puts them in a difficult and stressful position.

An estate planning attorney works with clients to plan how their assets will be distributed after they die (using a will and trusts, among other tools). However, they also help clients prepare for incapacity. Both are equally important, and incapacity planning might even be more important. There are three basic solutions used in most states, although each state has its own specific rules, so you will want to work with an estate planning attorney from your geographic area.

A Living Will (Directive to Physicians in Texas) addresses what you want to happen if you are in an end-stage medical condition or permanently unconsciousness. The living will can serve as an advance written directive for the type of treatment you want to have, or what treatments you do not want to have. If you are unable to communicate your wishes, this document conveys them in a clear and enforceable manner and indicates who can make that decision for you.

A Medical Power of Attorney works differently than a Living Will. This covers health care decision making when you cannot convey your own wishes. You appoint one or more agents to make health care decisions for you. They use their personal knowledge of you and the direction you indicate to make decisions on your behalf.

If you have not executed documents like these before becoming incapacitated, there are laws which provide for default decision-makers.  These laws authorize a list of individuals in order of preference to act as your health care representative and make health care decisions for you. This is the last and worst option.

It is much better for you and your family to have a plan and the proper documents for making medical decisions during incapacity. First, the state decides who will make healthcare decisions on your behalf, based on the law and not based upon people who you feel comfortable making these very personal decisions for you. If more than one person is named and the family cannot come to an agreement as to what your care should be, they may end up gridlocked, and you are the one who suffers.  This may also lead to delay in making the decision as the medical providers have to access who can make the decision based upon your family make-up, all while your medical care needs to be addressed.

Create a plan for your healthcare when you are creating or updating your estate plan. It will give you the peace of mind that, even in the worst of situations, your loved ones will know what you wanted to occur clearly and be able to go forward in following your wishes.

Reference: Kiplinger (April 29, 2021) “Now Is the Time to Protect Your Health Care Decision-Making Rights”

Continue ReadingMaking Medical Decisions During Incapacity