Our children are our world. For my wife and me, our priorities for my son and daughter are to love, nurture and provide for them for a lifetime. Eventually as they leave the nest, our wish for them is to grow up into caring, intelligent, resilient, successful adults. However, despite their own successes and achievements or their lack of, we will also want to leave them a legacy. Legacy comes in many forms, but in this case I am talking about a financial legacy. Big or small we want to leave something behind for them to invest, enjoy or simply supplement their financial status. Most of us would agree, it’s part of being a good parent, a way for us continue to give and support them even after we are gone.

With that said, as a parent ages and retires that idea of a leaving a legacy starts to evolve a bit. Life gets in the way, like the cost of living, health problems, and crisis can arise. However, if we are fortunate enough, we can make it through to the other side. Therefore, if we have been smart with our investments, retirement, and managing our money, hopefully there will be a sizable nest egg to live on and enjoy after retirement and subsequently pass on to our kids – right?

Here’s where all this build up is leading to. I’m not a financial expert, so I’m not necessarily focusing on the size of that nest egg, but rather how prudent and accountable we will be with that money. Upon retirement – yes we’d like to travel, buy that RV, put that addition on the house, or as mentioned earlier leave an inheritance to family upon our demise. However, there is a very vital piece missing from this spending plan. And aside from having money to live on, pay bills, taxes, and other incidentals, we need to think about chronic health issues and the subsequent medical care and in many cases the need for long-term care, like nursing care or personal care. Unfortunately, there are many misconceptions about the costs, paying for and needing long-term care. According to a 2012 Metlife Mature Market Survey the national average cost of a nursing care is $90,520/year and assisted living or personal care comes in at $42,600 annually. Furthermore, for those who need care but don’t want to move from their own home, at $21/hour nationally you could end up paying $43,680 a year for 8 hours of care per day for 5 days a week for non-medical home care services. Next, most of these costs will be directly out-of-pocket or indirectly through privately purchased long-term care insurance coverage until you deplete all those assets. Lastly, to compound these continually inflating costs is the length of time people will need long-term care. It’s great that medicine and science are helping us live longer, but one of the consequences is that we will require more money to live on because we aren’t dying 5 or 10 years after retirement. It’s more like 15 or 20.

I digress – so what’s my point? First, that big shiny nest egg may not be as big as you might think. Also we need to change the conversation and our mindset on leaving that financial legacy to our descendants. Many people are aware of this dilemma, and they taking the right and legal steps to ensure all bases are covered. They realize their first priority is to cover their own healthcare and medical needs, and then what’s leftover can go to their loved ones. However, there are some estate-planning techniques out there that while legal are a bit unsavory. There’s a whole industry predicated on helping adult children “shelter” a parent’s assets, which could eventually put the burden on other taxpayers via Medicaid (a.k.a. Medical Assistance) to pay for nursing home care if they ever need it. Fortunately, there are some fail safes in place like the five year look back period required when someone applies for Medicaid. This can track back 60 months of spending to insure no large gifts or transfer of assets or properties were sold below market value which, if uncovered, could result in a period of ineligibility for Medicaid for a period equal to the amount those assets would have paid for nursing care. Therefore, this would render someone who is unable to pay privately and not yet eligible for Medicaid no way to pay for their care. Typically in this situation the nursing home would have to “eat” the cost. Additionally, even if someone lawfully transfers assets outside the 5 year look back period and are eligible day one for medical assistance, it can still create a precarious situation. As a Medicaid patient from day one, it really limits your choice of nursing home. Many nursing homes limit their amount of Medicaid patients. So it simply limits the number of nursing homes for you to pick from.

Along with state-funded medical assistance for nursing care, many facilities such as Messiah Village offer benevolent or charitable care in personal care and even in independent living. Quite often in non-profit communities, it’s a part of our mission to care for our residents even they have depleted all their assets. Our benevolent care is funded by the generosity of Messiah Village, its residents, families, staff (past and present), plus many other donor sources. Applying for benevolent care follows a similar process to the Medicaid application. So essentially, we need full disclosure of usable assets to prove a resident’s financial hardship. Over the years it has been a pretty elementary process. But as healthcare costs rise and consumers become savvier, the practice of sheltering, shielding or protecting assets is becoming more prevalent. Again while this practice is legal it begins to put a strain on systems like Medicaid and our benevolent care fund. It forces the government and us to dig deeper for financial disclosure and could limit the amount of free care we can provide. For our fiscal year ending June 30, Messiah Village will have paid out nearly $4 million in charitable care dollars. This includes the contractual loss we absorb from the low Medicaid per diem reimbursement as well as the direct benevolent care we provide. And while most have been good stewards with their money, spent down and will deservedly benefit from our charitable care, there are others that will receive it too, despite having manipulated the system.

Programs like Medicaid and our benevolent care program were created to care for the needy. Otherwise, we have an obligation to pay for our own care or to protect our wealth with private insurance and not by sheltering it to get early eligibility. As I stated in the very beginning, I love my kids and I will care and provide for them for as long as I can, but I expect my kids to understand and for myself to remain prudent if I need tap into and use part or all of my legacy to pay for my care.

If you recall from my earlier blog, Actively Engaged and Making a Difference, the desire for and value of an encore career or second act for older adults, particularly baby boomers, continues to mushroom. In it, I also mentioned the book, Prime Time, by Marc Freedman. It states that rather than a “retirement of leisure” that might separate [older adults] from the world, [seniors, retirees, baby boomers] want to be actively engaged and making a difference. He refers to it as “re-engagement of activity” to replace the “retirement of leisure.” After initial careers are over, encore careers and second acts that include civic engagement, volunteering, mentoring, and working for enjoyment and engagement are extremely satisfying and beneficial for the mind, body and soul. It can truly be a time of renewal and rediscovery at a point where traditionally many don’t see it that way.

This movement of “re-engagement of activity” is becoming the new normal, primarily because we are living longer and we simply have more time live, give and gain. This way of life is earning more exposure and manifesting itself in many ways. Groups like AARP and Encore.org are at the forefront of these efforts. But many other entities are joining in and understand the importance and value of older Americans changing their attitudes and their experience about aging and retirement. Locally WITF TV and Radio is promoting the launch of a national website called Next Avenue. It was designed to engage, inspire and inform individuals transitioning into retirement and focuses quite a bit on baby boomers. Next Avenue President, Judy Diaz, explains that “the variety of contributors and content is designed to offer Next Avenue visitors new perspectives and ways of thinking about their futures.” This effort really resonates with Messiah Lifeways, and we are proud to be a local sponsor for Next Avenue. And I love their tagline, “Next Avenue – Where grown-ups keep growing.”

Through WITF TV and the website, many pertinent topics are explored by various types of media. On the website their categories include: (click on)

Health & Well-Being      Money & Security     Work & Purpose    Living & Learning      Caregiving

These categories then include blogs, articles, slide shows and links such as: (click on)

Reinventing Yourself at 50

7 Steps to Aging Well

What Will You Do with the Rest of Your Life

Unconventional Career Advice You Need to Hear

Turning Volunteer Work Into an Encore Career

‘Positive Aging’: It’s Not an Oxymoron

Reinvention & Inspiration

Passions & Pursuits

This is just a sampling of some of the great content that Next Avenue has to offer. Certainly, some of the information and resources Next Avenue provides focuses on care and resources for medical needs as well as the trials and tribulations of growing older. Fortunately, as Messiah Lifeways dedicates itself to changing the conversation about aging, this website and national initiative also puts aging and retirement into a whole new perspective and way to think about one’s future.

To learn more about where grown-ups keep growing, go to nextavenue.org or how Messiah Lifeways continues to help older adults live a life embraced with purpose and zest, go to messiahlifeways.org/enrichment-opportunities or messiahlifeways.org/volunteer.

Ask most seniors what their secret to living a happier healthier life is and their answers are pretty simple. Eat well, get adequate sleep, schedule regular check-ups, and exercise your mind, body and soul. Sounds easy enough-right? Each suggestion has its challenges, but for certain people staying physically fit may be the most challenging. But thankfully as we enjoy spring and summer, we have fewer excuses and more opportunity to get out and get active.

Exercise and cardiovascular fitness are important at any stage in life, but particularly for older adults. According to the American Heart Association, “the older people become, the more they need regular exercise. Exercise helps prevent bone loss and subsequently fractures, and reduces the risk of diseases associated with aging like heart disease and diabetes and helps stave off depression. It also increases muscle strength and may improve balance and coordination, which can reduce the likelihood of falling. It also increases the ability for basic living, making it easier to do things like carry groceries, get up from a chair and take care of household chores. Being physically active is key in maintaining quality of life and independence.”

Committed to helping people stay physically active, Messiah Lifeways offers many great options for residents and community members alike to exercise and stay fit. The Messiah Lifeways Wellness program offers warm water aquatic classes, plus features two fitness centers on campus, with staff available to provide instruction and encouragement. Additionally, Messiah Village has resident walking clubs, staff and resident-run exercise classes, and activities that have fitness components built-in. We also have a beautiful 18-hole disc golf course and a nature trail located near the cottages on Willow Way. And lastly, we are now a host site for the Silver Sneakers® program.

The National Institute on Aging recommends you exercise at least 30 minutes every day if possible. And those 30 minutes can be broken up throughout the day. Now if group exercise classes or swimming are “not your cup of tea”- that’s ok. You don’t have to buy workout gear, join a gym or squeeze into that ole bathing suit. Instead, make physical activity a routine part of your everyday life. Find other activities you may enjoy doing. Take walks, garden, take the grandkids to the park, volunteer or try something new like yoga or dance lessons. Look for new ways to build physical activity into your daily routine and, of course,  you should consult with your physician. So challenge yourself this summer to become more active and fit. Then you too can know one of the secrets to a happier healthier life.

For a list of helpful websites containing exercise, fitness and wellness tips along with a listing of local parks and trails, go to MessiahLifeways.org/WellnessTips. Be sure to check out the Messiah Lifeways Wellness page at Messiahlifeways.org/Wellness to learn about the excellent exercise programs available to residents and the community.

(article adapted from Messiah Lifeways Magazine Summer 2013 Issue)

Awake bright and early, Ferne Niesley, takes a two-mile walk just about every morning she can. After what we can only assume is a breakfast of champions, Ferne heads over to the Village Center to either volunteer or work several hours for Messiah Lifeways At Home. And she does this with a smile on her face and a spring in her step. By the way, did I mention she will be 90 years old in May and has also lived at Messiah Village for the last 18 years?! You might call this amazing; Ferne just calls it an average day.

Ferne has worked part-time for Messiah Lifeways At Home for the last 10 years primarily as a one-on-one companion. She provides residents and clients company and social engagement to brighten their days and keeps on eye on them if they are struggling with health and mobility issues. Additionally, as a volunteer, she works in the gift shop as well as delivers flowers to residents in the Village Center. She also fills and delivers water pitchers to residents in nursing, sings in the church choir and helps out at fall festival, clothing sales, and various church committees.

In a recent interview by Coaching Intern, Lindsay Mumma, when asked what keeps her going, Ferne replied, “I have this drive and the drive comes from the Lord.” She also stated, “I don’t think about anything, I just do it.” “If you think about it too much, it’ll never get done.” She also believes she was born to work. That strong work ethic continues to live on at nearly 90 years young. She also said that when she watches television, she feels like she’s wasting time. She’s simply too busy for that, staying actively engaged and making a difference in the lives of others.

(continued from Messiah Lifeways Magazine Summer 2013 Issue- page 4)

Much ahead of the curve, Ferne represents a burgeoning and gainful movement often referred to as either an encore career or second act. This movement is associated a bit more with baby boomers, but certainly includes trailblazers in their 70s, 80s and 90s. In the book, Prime Time, author Marc Freedman states, that rather than a “retirement of leisure” that might separate [older adults] from the world, [seniors, retirees, baby boomers] want to be actively engaged and making a difference. Freedman refers to it as “re-engagement of activity” to replace the “retirement of leisure.” This wave is re-imagining retirement and is focused on writing a new chapter in their lives. Volunteering, mentoring, and working part-time for enjoyment and engagement are extremely satisfying and beneficial. And in doing so at 90, Ferne continues to nourish her mind, body, and soul. Active engagement and making a difference in the lives of others sure seems to be working for her.

Another prime example is my father-in-law, who at 80 years old still works full-time as a government relations consultant. Zipping all around the State Capitol and downtown Harrisburg, everyone knows Ron Lench. He also exercises several times a week and does a stretching routine every single morning. Ron is also dedicated to Beth El Temple, organizing and attending a daily prayer group that meets 6 days a week. He also is extremely devoted to his 5 grandchildren, constantly attending their basketball, baseball, and soccer games, plays and recitals as well as babysitting. He also does quite of bit of traveling for work and pleasure. Again I think it’s amazing, yet like Ferne, he modestly brushes it off as part of his normal routine.

I have learned a very a valuable lesson from people like Ferne and my father-in-law. For many years I have relished the idea of retiring, not because I didn’t like working, but rather not having to deal with the daily grind: getting up early, commuting, deadlines, meetings, the list goes on. I couldn’t wait till retirement so I could hop into my hammock at the beach and do absolutely nothing. I know better now. While relaxing and “doing nothing” in small doses might be ok, I have made a promise to myself. I will remain actively engaged and make a difference in the lives of others upon my retirement with opportunities like working part-time, volunteering, mentoring, and exercising my mind and body. I hope you do the same.

Earlier this week I held one of my Coaching workshops entitled “Making the Move versus Aging in Place.” It’s main purpose is to help individuals or their loved ones that are struggling with the choice of moving to a retirement community or care facility as opposed to continuing to live at home as they age. I highlighted the options, costs and the pros and cons to both paths. But an underlying theme of the workshop, along with Lifeways Coaching in general, is the virtue of planning ahead and being proactive. On average people do more planning and research on a summer vacation or a car than they do on choosing a nursing home or home care agency for themselves or a loved one. However, it’s nice to know that some people are starting to get it. The day after the workshop I was so pleased to receive this great article, by Jennifer Agiesta and Lauran Neergaard, from one of the workshop attendees that echos the concern for how unprepared and in denial people really are about future care.  Thank you Terri for sharing. Please read and heed…

Americans in denial about long-term care

     By Jennifer Agiesta and Lauran Neergaard, Associated Press

We’re in denial: Americans underestimate their chances of needing long-term care as they get older — and are taking few steps to get ready.

A new poll examined how people 40 and over are preparing for this difficult and often pricey reality of aging, and found two-thirds say they’ve done little to no planning.

In fact, 3 in 10 would rather not think about getting older at all. Only a quarter predict it’s very likely that they’ll need help getting around or caring for themselves during their senior years, according to the poll by the AP-NORC Center for Public Affairs Research.

That’s a surprise considering the poll found more than half of the 40-plus crowd already have been caregivers for an impaired relative or friend — seeing from the other side the kind of assistance they, too, may need later on.

“I didn’t think I was old. I still don’t think I’m old,” explained retired schoolteacher Malinda Bowman, 60, of Laura, Ohio.

Bowman has been a caregiver twice, first for her grandmother. Then after her father died in 2006, Bowman moved in with her mother, caring for her until her death in January. Yet Bowman has made few plans for herself.

“I guess I was focused on caring for my grandmother and mom and dad, so I didn’t really think about myself,” she said. “Everything we had was devoted to taking care of them.”

The poll found most people expect family to step up if they need long-term care — even though 6 in 10 haven’t talked with loved ones about the possibility and how they’d like it to work.

Bowman said she’s healthy now but expects to need help someday from her two grown sons. Last month, prompted by a brother’s fall and blood clot, she began the conversation by telling her youngest son about her living will and life insurance policy.

“I need to plan eventually,” she acknowledged.

Those family conversations are crucial: Even if they want to help, do your relatives have the time, money and knowhow? What starts as driving Dad to the doctor or picking up his groceries gradually can turn into feeding and bathing him, maybe even doing tasks once left to nurses such as giving injections or cleaning open wounds. If loved ones can’t do all that, can they afford to hire help? What if you no longer can live alone?

“The expectation that your family is going to be there when you need them often doesn’t mean they understand the full extent of what the job of caregiving will be,” Susan Reinhard, a nurse who directs AARP’s Public Policy Institute, said. “Your survey is pointing out a problem for not just people approaching the need for long-term care, but for family members who will be expected to take on the huge responsibility of providing care.”

Those who have been through the experience of receiving care are less apt to say they can rely on their families in times of need, the poll found.

With a rapidly aging population, more families will be facing those responsibilities. Government figures show nearly 7 in 10 Americans will need long-term care at some point after they reach age 65, whether it’s from a relative, a home health aide, assisted living or a nursing home. On average, they’ll need that care for three years.

Despite the “it won’t happen to me” reaction, the AP-NORC Center poll found half of those surveyed think just about everyone will need some assistance at some point. There are widespread misperceptions about how much care costs and who will pay for it. Nearly 60 percent of those surveyed underestimated the cost of a nursing home, which averages more than $6,700 a month.

Medicare doesn’t pay for the most common types of long-term care. Yet 37 percent of those surveyed mistakenly think it will pay for a nursing home and even more expect it to cover a home health aide when that’s only approved under certain conditions.

The harsh reality: Medicaid, the federal-state program for the poor, is the main payer of long-term care in the U.S., and to qualify seniors must have spent most of their savings and assets. But fewer than half of those polled think they’ll ever need Medicaid — even though only a third are setting aside money for later care, and just 27 percent are confident they’ll have the financial resources they’ll need.

In Cottage Grove, Ore., Police Chief Mike Grover, 64, says his retirement plan means he could afford a nursing home. And like 47 percent of those polled, he’s created an advance directive, a legal document outlining what medical care he’d want if he couldn’t communicate.

Otherwise, Grover said he hasn’t thought much about his future care needs. He knows caregiving is difficult, as he and his brother are caring for their 85-year-old mother.

Still, “until I cross that bridge, I don’t know what I would do. I hope that my kids and wife will pick the right thing,” he said. “It depends on my physical condition, because I do not want to be a burden to my children.”

The AP-NORC Center poll found widespread support for tax breaks to encourage saving for long-term care, and about half favor the government establishing a voluntary long-term care insurance program. An Obama administration attempt to create such a program ended in 2011 because it was too costly.

The older they get, the more preparations people take. Just 8 percent of 40- to 54-year-olds have done much planning for long-term care, compared with 30 percent of those 65 or older, the poll found.

Mary Pastrano, 74, of Port Orchard, Wash., has planned extensively for her future health care. She has lupus, heart problems and other conditions, and now uses a wheelchair. She also remembers her family’s financial struggles after her own father died when she was a child.

“I don’t want people to stand around and wring their hands and wonder, ‘What would Mom think was the best?’” said Pastrano, who has discussed her insurance policies, living will and care preferences with her husband and children.

Still, Pastrano wishes she and her husband had started saving earlier, during their working years.

“You never know how soon you’re going to be down,” she said. “That’s what older people have a problem understanding: You can be in your 60s and then next flat on your back. You think you’re invincible, until you can’t walk.”

The AP-NORC Center for Public Affairs Research survey was conducted Feb. 21 through March 27, with funding from the SCAN Foundation. The SCAN Foundation is an independent, nonprofit organization that supports research and other initiatives on aging and health care. The nationally representative poll involved landline and cellphone interviews with 1,019 Americans age 40 or older. It has a margin of sampling error of plus or minus 4.1 percentage point.

Here’s the direct link for this story:

http://vitals.nbcnews.com/_news/2013/04/24/17895542-americans-in-denial-about-long-term-care?lite