Dear Savvy Senior,
My 75-year-old mother is currently taking 16 different prescription and OTC medications and I’m worried she’s taking way too many drugs. Can you suggest any resources that can help us?
— Worried Daughter
Dear Worried,
Unfortunately, millions of older Americans are taking way too many medications today, which raises their risk of dangerous side effects and drug interactions.
According to the American Society of Consultant Pharmacists, people aged 65 to 69 take an average of 15 prescriptions a year, and those aged 80 to 84 take 18 prescriptions a year. And that’s in addition to the myriad of over-the-counter drugs, herbal remedies, vitamins and minerals they may take, any of which — alone or in combination — could cause more problems than they cure.
Even when older patients are taking only necessary and effective drugs, the dosages need a second look. As patients age, they tend to metabolize drugs more slowly, meaning the dose that was perfect five years ago may now be too high, perhaps causing dizziness and falls. Doses need to be continually adjusted with age, and most of the time that doesn’t happen.
Get a drug review
If you have concerns or questions about the medications your mother is taking, gather up all her pill bottles, including her prescription and over-the-counter drugs as well as vitamins and supplements, put them in a bag, and take them to her primary physician or pharmacist for a comprehensive drug review.
Medicare provides free drug reviews with a doctor during annual wellness visits, and many Medicare Part D prescription-drug beneficiaries can get free reviews from pharmacists, too.
At the drug review, go through each medication and find out if there are any duplicate meds or dangerous combinations your mom is taking, and if there are any drugs she could stop taking or reduce the dosage. Then, make a medication master list and keep it updated so it can be easily be shared whenever your mom sees a doctor.
To help with this, AARP offers a free “my personal medication record” form that you can download and print at AARP-medical-record-form.pdffiller.com. Or, if your mom uses a smartphone, she can use a pill tracking app like Medisafe — Pill & Med Reminder (MyMedisafe.com).
Other tips
If possible, your mom should also use a single pharmacy to fill all her prescriptions. The software that pharmacies use to manage patient prescriptions is designed to cross-reference all medications a patient is taking to ensure that there are no drug interactions that could cause harm.
Also, the next time your mom’s doctor prescribes a new medication, she should ask about non-drug treatment options that might be safer. If the drug is indeed necessary, she needs to find out how long she’s supposed to take it and the side effects it can cause.
Another good resource that can help keep your mom safe is the American Geriatrics Society, which has identified 10 different types of medications that people 65 and older should almost always avoid because of the risk of serious side effects. They include the anti-anxiety drugs diazepam (Valium) and alprazolam (Xanax), and sleep drugs such as zolpidem (Ambien) and eszopiclone (Lunesta). To see the complete list, visit HealthInAging.org and search “10 medications older adults should avoid.”
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Dear Savvy Senior,
My husband and I are looking for the simplest and least expensive way to dispose of our bodies when we die. We hate the idea of wasting a lot of money on high-priced funerals and would like some advice on some simple and cheap send-offs.
— Simple Seniors
Dear Simple,
With the average cost of a full-service funeral running around $11,000 today, many people are seeking simple ways to make their final farewell more affordable. Depending on how you want to go, here are several low-cost options to consider.
Direct cremation
If you and your husband are interested in cremation, direct cremation is the simplest and least expensive way to go. It includes picking up the body, completing and filing the necessary paperwork, the cremation itself and returning the cremated remains to the family. There’s no embalming, formal viewing or casket. A simple cardboard box called an “alternative container” is used to hold the body.
Depending on where you live and the funeral home you choose, the average cost for a direct cremation runs between $1,000 and $3,000. If you want additional services beyond what a direct cremation offers, ask the funeral home for an itemized price list that covers the other services cost, so you know exactly what you’re getting. All providers are required by law to provide this.
To locate nearby funeral homes, look in your local yellow pages, or Google “cremation” or “funeral” followed by your city and state. You can also get good information online at Parting.com, which lets you compare prices from funeral providers in your area based on what you want.
Immediate or direct burial
If you’re interested in being buried, an immediate/direct burial is the most basic and low-cost option. With an immediate burial, your body would be buried in a simple container shortly after death, skipping the embalming, viewing and use of the funeral facilities.
If your family wants a memorial service, they can have it at the graveside at your place of worship or at home without the body.
These services usually cost between $1,800 and $3,500, not counting cemetery charges, which can run you an additional $1,000 to $3,000. All funeral homes offer direct burial.
Green burial
An eco-friendly green burial is another affordable way to go that costs anywhere from $1,000 to $4,000 depending on the provider. With a green cemetery burial, the body is buried in a biodegradable coffin or just wrapped in a shroud, without embalming chemicals or a burial vault.
The Green Burial Council (GreenBurialCouncil.org, 888-966-3330) has a state listing of cemetery operators who accommodate green burials, as well as funeral professionals who provide the services.
Anatomical donation
If you’d like to eliminate your cremation/burial costs altogether, as well as help advance medical research, you and your husband should consider donating your bodies to science. This option won’t cost you a cent, however, some programs may charge a small fee to transport your body to their facility.
After using your body for medical research projects, anatomy lessons and surgical practice, your remains will be cremated and your ashes will be buried or scattered in a local cemetery or returned to your family, usually within a year.
To locate accredited university medical school body donation programs in your state, see the University of Florida’s U.S. program directory at Anatbd.acb.med.ufl.edu/usprograms, or call the whole-body donation referral service during business hours at 800-727-0700.
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Dear Savvy Senior,
Can you recommend any resources that offer help to family caregivers? I’ve been taking care of my 86-year-old mother and could use some help.
— Burned-Out Brenda
Dear Brenda,
Caring for an aging parent or other loved one over a period of time can be very challenging both physically and mentally. Fortunately, there are a number of tips and services you can turn to that can help lighten the load. Here are several to consider.
Assemble a care team: A good first step is to put together a network of people including family, friends and even neighbors that you can call on to help out when you can’t be there or need a break.
Tap local services: Many communities offer a range of free or subsidized services that help seniors and caregivers by providing things like home-delivered meals, transportation, senior companion services and more. Call 211 to find out what’s available in your community, or call AARP’s caregiving resource center (877-333-5885), which provides referrals to local resources.
Use respite: Respite services can provide short-term care to your mom so you can take some time off. To locate services in your area, try the ARCH National Respite Network and Resource Center at ARCHrespite.org.
Hire in-home help: You may want to consider hiring a part-time home-care aide that can help with things like preparing meals, housekeeping or personal care. Costs can run anywhere from $12 to $30 an hour depending on where you live and the qualification of the aide. To find help through an agency, use Medicare’s search tool Medicare.gov/care-compare. Or to find someone on your own, which is a more affordable way to go, try websites like Care.com or CareLinx.com.
Use financial tools: If you’re handling your mom’s finances, you can make things easier by arranging direct deposit for her income sources and set up automatic payments for her utilities and other routine bills. Also, consider setting up your mom’s online banking service at her bank so you can pay her other bills and monitor her account anytime. If you want or need help, there are professional daily money managers (see AADMM.com to locate someone) that can do it for you. They charge between $60 and $150 per hour.
Also, if your mom is lower-income, use BenefitsCheckup.org, a free, confidential website that will help you locate financial assistance programs that can help pay for her medications, utilities, health care and other needs.
Get insurance help: If you have questions about what Medicare or Medicaid covers, or about long-term care, your State Health Insurance Assistance Program (SHIP) provides free counseling on all these issues. Call 877-839-2675 or visit ShiptaCenter.org to locate a nearby counselor.
You can also get help at Medicare.gov or by calling 800-633-4227, and through the Medicare Rights Center, which staffs a helpline at 800-333-4114.
Tap other resources: There are a number of other organizations you can draw on for additional information like the Family Care Alliance (Caregiver.org/family-care-navigator), which provides a state-by-state listing of caregiving programs and services; Caring.com, which offers caregiving advice, senior housing information and online support groups; the Alzheimer’s Association (ALZ.org/care), which provides information unique to the challenges of dementia caregivers; and the U.S. Department of Veterans Affairs (www.caregiver.va.gov), which offers caregiver support services to veterans and even spouses of veterans.
And, if you happen to be sharing care responsibilities with others, sites like LotsaHelpingHands.com and CaringBridge.org can help you coordinate together.
Take care of yourself: Make your own health a priority. Being a caregiver is a big job that can cause emotional and physical stress and lead to illness and depression. The only way you can provide the care your mother needs is to make sure you stay healthy.
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Dear Savvy Senior,
Who qualifies for Social Security survivor benefits? My ex-husband died last year, so I would like to find out if me or my 17-year-old daughter are eligible for anything.
— Divorced Survivor
Dear Divorced,
If your ex-husband worked and paid Social Security taxes and you and/or your daughter meet the eligibility requirements, you may very well be eligible for survivor benefits, but you should act quickly because benefits are generally retroactive only up to six months. Here’s what you should know.
Under Social Security law, when a person who has worked and paid Social Security taxes dies, certain members of that person’s family may be eligible for survivor benefits including spouses, former spouses and dependents. Here’s a breakdown of who qualifies.
Widow(er)’s and divorced widow(er)’s: Surviving spouses that were married at least nine months are eligible to collect a monthly survivor benefit as early as age 60 (50 if disabled). Divorced surviving spouses are also eligible at this same age, if you were married at least 10 years and did not remarry before age 60 (50 if disabled), unless the marriage ends.
How much you’ll receive will depend on how much money (earnings that were subject to Social Security taxes) your spouse or ex-spouse made over their lifetime, and the age in which you apply for survivor benefits.
If you wait until your full retirement age (which is 66 for people born in 1945-1954 and will gradually increase to age 67 for people born in 1960 or later), you’ll receive 100 percent of your deceased spouses or ex-spouses benefit amount. But if you apply between age 60 and your full retirement age, your benefit will be somewhere between 71.5 — 99 percent of their benefit.
There is, however, one exception. Surviving spouses and ex-spouses that are caring for a child (or children) of the deceased worker, and they are under age 16 or disabled, are eligible to receive 75 percent of the worker’s benefit amount at any age.
Surviving unmarried children under age 18, or up to age 19 if they’re still attending high school, are eligible for survivor benefits, too. Benefits can also be paid to children at any age if they were disabled before age 22 and remain disabled. Both biological and adoptive children are eligible, as well as kids born out of wedlock. Dependent stepchildren and grandchildren may also qualify. Children’s benefits are 75 percent of the worker’s benefit.
You should also know that in addition to survivor benefits, a surviving spouse or child may also be eligible to receive a special lump-sum death payment of $255.
Benefits can also be paid to dependent parents who are age 62 and older. For parents to qualify as dependents, the deceased worker would have had to provide at least one-half of the parent’s financial support.
But be aware that Social Security has limits on how much a family can receive in monthly survivors’ benefits — usually 150 to 180 percent of the worker’s benefit.
Social Security also provides surviving spouses and ex-spouses some nice strategies that can help boost your benefits. For example, if you’ve worked you could take a reduced survivor benefit at age 60 and switch to your own retirement benefit based on your earnings history – between 62 and 70 — if it offers a higher payment.
Or, if you’re already receiving retirement benefits on your work record, you could switch to survivors benefits if it offers a higher payment. You cannot, however, receive both benefits.
You also need to know that if you collect a survivor benefit while working, and are under full retirement age, your benefits may be reduced depending on your earnings — see SSA.gov/pubs/EN-05-10069.pdf.
For more information on survivor benefits, visit SSA.gov/benefits/survivors.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.