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October 2014

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Harvard, AARP Say Senior Housing is Next Big American Crisis

A shortage of caregivers for baby boomers, the high cost of senior living products and services, and the lack of disability-equipped housing reveal a seniors housing crisis as the 50-and-over population is projected to increase about 20% by 2030.  This is according to a new report released  last month by the Harvard Joint Center for Housing Studies and the AARP Foundation.

“We have a big problem,” said Henry Cisneros, executive chairman at CityView and former Secretary of the Department of Housing and Urban Development, during a presentation on the study’s findings. “Many aging Americans don’t have personal savings, and governmental budgets are strapped.”

Shortage of Family Caregivers:  Two out of three older adults with disabilities who receive long-term care services at home get their care exclusively from family members; yet, a significant share of the youngest baby boomers, aged 50 to 59, do not have children who might take care of them as they age.

Currently, just 9% of older adults with disabilities who receive long-term care services at home rely solely on paid help, and that may be attributed to cost, said Chris Herbert, acting managing director of   the Harvard Joint Center for Housing Studies. The median monthly cost for a home health aide is $2,568 — or $30,810 annually, data show.

The ratio of potential family caregivers to those over 80 will decrease from 7- to-1 today to 4-to-1 by 2030, and to less than 3-to-1 by 2050, AARP estimates.

“The family care ratio is going in the wrong direction, and is going to put more pressure on other resources of care,” Herbert said.

Senior Living Too Expensive for Average Homeowner, Renter:  While a growing number of the population will require the care that assisted living or nursing home facilities provide, the cost of senior living is too much for the average older homeowner and renter, data show.

The typical homeowner aged 65 and over has enough wealth to cover nursing home costs for 42 months and enough non-housing wealth to last 15 months. The median older renter, in contrast, cannot afford even one month in a nursing home without assistance. And, only 18 percent of renters could pay for nursing home care for more than a year.

“While we have these growing options for care, the cost is very high,” Herbert said, noting the hit those 50 to 64 years old took from the recession. “The renter population is one we need to spend a lot of time thinking about.”

In fact, even as the older population has grown in recent years, the number of adults living in senior living communities has shrunk, with the share of the 65-and-over population in nursing homes falling by 20% between 2000 and 2010.

“We need more skilled nursing [facilities],” Cisneros said, noting that the demand for quality memory care facilities will also increase. “But, we need ways to pay for them.”

Lack of Disability-Equipped Homes:  The majority of residential housing structures fail to meet the needs of its aging residents, the study finds.

Among households that are headed by someone at least 50 years old and include a person with serious difficulty walking or climbing stairs, only 46% have homes with no-step entryways.  The cost to retrofit homes to meet aging Americans’ needs add up. A wheelchair ramp can cost between $1,600 and $3,200. “But when adding a bathroom or bedroom to the first floor, that cost rises substantially,” Herbert said.

Five features to make homes more accessible include no-step entries and single-floor living, which eliminate the need for stairs; switches and outlets reachable at any height; extra-wide hallways and doors to accommodate those in wheelchairs; and lever-style door and faucet handles.

While nearly 90% of existing homes have at least one of those features, only 57% have more than one, the study finds.

When devising solutions to address the looming crisis, industry experts say it’s important to go to the source — ask aging Americans what they need.

“Go to the older people themselves,” said Lindsay Goldman, project director at New York Academy of Medicine. “Ask, ‘What is your day-to-day like?’”

Read the full report here.

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Thinking About Retiring to Belize?

Belize’s year round warm climate makes it a number one vacation, and now retirement destination. The Qualified Retired Person’s Programme provides exemption from taxes on income and import duties for expats living in Belize, adding to its attractiveness that includes plenty of recreational options as well as daily familiarities, like an easy currency exchange, for Americans.

The following are 15 reasons to consider becoming an expat that makes Belize their new home away from home.

  1. There is no need to learn a new language before you move to Belize. Belize is a former British colony and while Spanish is commonly spoken, most in Belize are bilingual and most media, signs and documents are in English.
  2. If you have children, the schools are English speaking and highly regarded by locals and newcomers alike.
  3. Like Mexico, the U.S. dollar is still accepted nearly everywhere except for government offices. Currently, the Belize dollar is locked in at 2 BZD to 1 USD, so figuring costs is a snap.
  4. The Belize economy has a very low inflation rate when compared to the rest of the globe.
  5. Access to the internet and smart phone support is improving. Internet access and mobile phone service are still more expensive than in America, but this should change in the future as the infrastructure continues to improve and competitive pricing begins to set in. A way around this is to set up satellite services, which are available for only a little more than U.S. prices.
  6. Whereas many property investments are rapidly losing value in the U.S., property values are increasing in many areas of Belize.
  7. The legal system is familiar. Based on British law, incoming Americans are not confused by local legal standards as they are by other South American systems.
  8. There are no restrictions for foreigners who want to buy property in Belize. Whether you are a foreigner or a native, you have the same property rights and your property is securely yours unless you abandon it for 20 years or fail to pay taxes.
  9. It is much more affordable to live in Belize. Medical care, entertainment, gardening, insurance and property taxes all cost less in Belize than in the United States.
  10. Food is much more affordable, especially seafood and fresh produce which is available year round due to the tropical climate.
  11. Food is higher in quality. Beef is grass fed, chickens and eggs are free range and fresh, unprocessed fruits and vegetables are cheap and available all year.
  12. Living in Belize is healthier. Those who retire in Belize report living a much healthier and more active lifestyle due to the availability of affordable fresh foods and beautiful climate which encourages physical activity.
  13. Belize real estate is much more affordable. Roughly $20,000 will buy a modest, prefabricated three bedroom house, fully equipped with plumbing and power. More substantial homes which are designed to handle the occasional severe storms will cost between $40 to $80 a square foot. If you are considering where to retire in Belize, the beach is affordable; with the cost of a waterfront lot runs from $40,000 to $110,000, a huge discount compared to southern California or Florida property. Rent runs around $400 a month for a decently sized home.
  14. You won’t get bored. Belize retirement homes offer plenty of exciting activities from exploring the great outdoors and ancient Maya ruins to making new friends. There is always something to do in Belize that provides far more interest than vegetating on a sofa in front of the TV.
  15. The natives are friendly. Belizeans put friends and family first, which creates a very warm and welcoming atmosphere. Many citizens of Belize have relatives in North America or have even lived there themselves, so they don’t mind giving tips or showing newcomers how to live or retire in Belize in style.

Read more here.

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Retiring to a CCRC?  Check the Fine Print

Continuing care retirement communities CCRCs) offer beautiful surroundings and luxury amenities. But don’t let the bucolic grounds and heated pool distract you from the finances and the quality of the health care. Here’s what to consider.

Contracts: You usually have a choice of four types of plans. Communities with life care contracts, also known as Type A plans, typically provide unlimited access to assisted living or long-term care, with only modest increases in monthly fees. For this security, you’ll pay a substantial fee up front.

With modified, or Type B, plans, residents pay a lower entrance fee than for a life care contract, but they may receive only a specified number of days of assisted living or skilled nursing care or be responsible for a percentage of health care costs.

Fee-for-service, or Type C, plans usually charge lower entry and monthly fees than A and B plans, but the fees don’t include the cost of assisted living or skilled nursing care. Unless you have long-term-care insurance, you’ll pay the full cost at market rates.

With rental contracts, residents pay no entrance fee, but monthly fees are usually higher than those for Type A and Type B contracts. If you need skilled nursing care, you cover the cost. Some CCRCs allow residents to buy their units and pay monthly service fees plus the cost of any care.

Refunds:  Most CCRC contracts allow a full refund of entry fees if you move or die during the first two to four years. Some contracts will guarantee you or your heirs a refund of 50 percent to 100 percent of the entrance fee no matter how long you live in the community in exchange for a higher entrance fee.

Taxes:  The percentage of your fees that covers health care is a deductible medical expense. If you’re 65 or older, you may deduct unreimbursed medical expenses that exceed 7.5 percent of your adjusted gross income. You must itemize to claim this deduction.

Long-term-care Insurance.  A full-service CCRC offers many of the same benefits as a long-term-care insurance policy, so if you already have the insurance, you may be better off choosing a modified or fee-for-service contract. Even if you do opt for a full-service contract, don’t drop your LTC coverage. Your contract may not cover all of your health care costs.

Financial Stability:  Ask for the CCRC’s audited financial statements and review them with an accountant or financial adviser versed in retirement communities. The CCRC should be able to cover expenses out of operating income. Ask the CCRC what provisions it has to assist residents who run out of money. Many have a benevolent fund for that purpose.

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Boomers Look to College Towns to Stay Active, Cut Costs

Baby boomers are continuing to look beyond traditional retirement settings to places that will better suite their active lifestyles, according to a Fox Business article.  Like everything else they’ve touched, baby boomers promise to reinvent retirement. And, with 8,000 boomers retiring every day over the next 15 years, they are bound to reshape the second home market. Forget the armchair and the rockers, more and more boomers are opting to retire in cities and college towns where they can have access to museums, free classes, restaurants and a faster pace of living. Plus, many want to downsize and trade in their home and yard for a condo or townhouse.

Pied-a-terre which literally means “foot on the ground” in French is typically a small or undersized apartment capable of doubling as a retirement location. As cities have become safer, boomers have been lured back to metropolitan areas largely because of their entertainment attractions, but also because dwellers can walk their neighborhood and enjoy public transportation. Plus, many parents find they may be closer to the children. Because retirees don’t care about school districts buying in town can be affordable. Buyers should keep in mind that most co-ops try to restrict pied-a-terre purchases.

Another popular option for boomers is buying in a college town because prices are typically low and benefits are high.  Home prices are typically near the median national average price of $212,400 or below and real estate taxes tend to be low. What’s more, many colleges allow seniors to audit courses at no or low cost and attend college sporting events at bargain prices, too. Some developers build retirement communities affiliated with universities in college towns. Kendal Corp., for example, is building such communities in Ithaca, N.Y., home of Cornell University and Hanover, N.H., home of Dartmouth University.

Florida and Arizona may have been traditional retiree havens, but boomers are changing all that, opening up new locations that fit their wallets.   For a list of colleges affiliated with retirement communities, click here.

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How the Apple Watch Will Revolutionize Senior Care

Apple made headlines last month when it announced several new product launches, namely the iPhone 6 and it’s long-rumored foray into the wearable device market, the Apple Watch. But while neither device was created specifically for healthcare use, it’s the latter that carries vast implications for senior care.

The market for healthcare technology is rife with devices that record and monitor physical activity, vital signs, among other health-related metrics. And now it appears that Apple is joining the club, albeit on the outskirts, with the creation of the Apple Watch.

The device incorporates several technologies and functions that play into the healthcare arena.

For one, the watch has a digital touch feature that provides a new way to connect intimately with others, whether it’s getting another watch-user’s attention with a simple tap on the device or even sharing something as personal as a heartbeat, said Jony Ive, Apple’s senior vice president of design.

“These are subtle ways to communicate that technology often inhibits rather than enables,” he said during a video detailing the watch’s complete features.

Vital Signs  At the heart of the watch is a chip that integrates many subsystems the technology encompasses into one compact module, which essentially minimizes an entire computer system onto a single chip, Ive added.

Adding to this technology, the watch’s zirconia back contains four lenses crafted from crystal sapphire that, along with infrared invisible light LEDs and photo sensors, are able to detect the wearer’s pulse rate.

Designed particularly with fitness and exercise in mind, these components work in tandem with a built-in gyroscope and accelerometer that help provide a comprehensive picture of an individual’s physical activity using GPS location services and Wi-Fi from an iPhone.

Instant Communication:  The device also makes calling family and friends easy. The watch senses when its wearer is raising his or her wrist, upon which it activates the display screen. Users can then push a button located on the side of the device that instantly brings up the individual’s contacts, enabling them to connect with them, either via text or standard call, in seconds, Ive said.

Though the device has yet to be put into the circumstantial application, for example, in the event of an emergency such as a fall, contacting help in a matter of seconds, in theory, is the premise of all personal emergency response systems out there today.

Individual Approach:  Another aspect where Apple taps into the essence of senior care lies in the watch’s robust customization.

The company has designed a variety of watch “faces,” or displays, and bands to choose from that are easily interchangeable. Users can choose from a range of styles, including a classic leather buckle design, a stainless steel link bracelet, a loop that comes in a soft, quilted leather, or for the sporty types, a chemical- and sweat-resistant sport band made from a durable high-performance elastic material.

“We know that wearing something all day and everyday becomes as much about personal preference and self-expression as functionality,” Ive said.

It’s no secret that what today’s senior resident wants in terms of housing and services won’t be the same as the future senior living consumer’s, and providers have largely recognized this shift. Many have already begun to implement tailor-made features into their communities, whether it’s designing more personalized resident programming, or greater customization in living arrangements and dining services.

Though it isn’t targeting seniors specifically, the need to personalize and self-express is an inherent human desire, and one that Apple plans to capitalize upon.

“Creating beautiful objects that are as simple and pure as they are functional, well that’s always been our goal at Apple,” said Ive. “I think we’re now at a compelling beginning of actually designing technology to be worn, to be truly personal.”

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