June 2012 - Senior Spectrum Newspaper

Editor’s Desk:County Commissioners FundStretched Seniors ServicesState Expected to Shift MoreProgram Costs to CountiesThe Washoe CountyBoard of CountyCommissionersapproved the Fiscal Year2012-2013 budget May 21,with no lay-offs throughJune 2013. The budget has$6.3 million in operatingreductions due to a declinein property and consolidatedtaxes. Fifty-onevacant full-time positionswere eliminated. In spiteof the revenue decline,county commissionersmanaged to balance thebudget as required by law.A budget shortfall in seniorservices totaling morethan $230,000 wasrestored for FY 2012-2013,funding the Adult DayHealth Care Program andother services assistingelders. Washoe CountySenior Services has beenchallenged in providingservices as ad valoremtaxes have declined, yetthe aging population hasgrown more than 27 percentover the last decade.With high unemploymentand the increasing cost ofliving, more elders areseeking public assistance.County Commissionerswill be discussing optionsto increase senior servicefunding including raisingthe ad valorem tax implementedin 1985 from 1cent to possibly 2 or 3cents. An ad valorem taxto increase senior serviceswould have to be approvedby the voters.Aging and DisabilityServices DivisionAdministrator MaryLiveratti told theCommission on Servicesfor Persons withDisabilities (CSPD) at aMay 23 meeting, thatADSD would be reorganizing.Liveratti said discussionsare underway tomove DevelopmentalServices, EarlyIntervention Services, andVocational Rehabilitationto ADSD. Liveratti saidother Health and HumanService Departmentchanges may include movingmental health servicesto county public healthdistricts. Currently, onlyWashoe County, ClarkCounty and Carson Cityhave public health departmentsof the states 17counties. In July 2009, theDivision of Aging Servicesmerged with DisabilityServices to serve peoplewith disabilities of all ages.Nevada Association ofCounties, ExecutiveDirector Jeff Fontaine toldCSPD commissioners heanticipated the state toshift more costs to countybudgets. Fontaine said themove would come inunfunded mandates, cutsto programs the state pre-(Editor’s Desk page 6)This Issuepage 3 - Editor’s Deskpage 4 - RTC White HouseRoundtable on transportationpage 5 - Chronic Disease Self-Management Program Meets Goalspage 19 - Social Security: ThisFather’s Day Give Dad Extra Helppage 22 - Exercise May HelpTame Type 2 DiabetesEvery Issuepage 27 - Calenderpage 23 - Eydie Scher - ExcerptsJune 2012page 26 - Biggest Little CityNevada State Prison - Harry Spencerpage 30 - Eclectic ObserverJanet Rosspage 32 - Seniors 4 TravelRobert Boyd & Carolyn Prusa32Healthpage 10 - Aging with Choice,Independence, DignityDr. Lawrence J. Weiss, Ph.D.Center for Healthy Agingpage 14 - Ask Dr. MarionLong-Term Carepage 16 - CMS: Medicare andMental Healthpage 18 - Ophthalmology:Dr. Michael Fischer, M.D.Financialpage 7 - What Does It Mean tobe a Trustee?Bradley B. AndersonWealth AdvisorsSenior Spectrum NewspaperP.O. Box 7124 • Reno, NV 89510(775) 348-0717e-mail: Seniorspectrumnv@aol.comSeniorspectrumnewspaper.comPublishers: Chris & Connie McMullenSenior Spectrum is a monthly publication dedicated to inform, serve, and entertain.Publication of advertising contained does not constitute endorsement. Signed columnsare the opinion of the writers, and not necessarily the opinion of the publishers.Copyrighted publication. All rights reserved.June • 2012 • 3

RTC White House Roundtableon TransportationThe RegionalTransportationCommission held aWhite HouseRoundtable at theDiscovery MuseumMay 15, on transportationissues.Federal TransitAdministrationAdministrator Peter Rogoffdiscussed his agency’s contributionto highway and transitfunding specific to the West,followed by a question andanswer session. Communityleaders expressed concernregarding transportationimpacts on education, jobgrowth, community development,and tourism. Lack oftransportation funding forRTC Photoparatransit and fixed routeservice in rural counties wasalso voiced by advocates.Rogoff was in Reno toannounce a $5.1 milliongrant for 10 new hybrid-electricbuses, and to build a newfueling station. Theimprovements will enhanceBus RAPID Transit service of14 new state-of-the-art busstation shelters on VirginiaStreet.4 • 2012 • June

Editor’s Desk / page 3viously funded, and lessmatching revenue for medicallyindigent services.Fontaine said decliningproperty tax revenue and therecession have impacted thecounties ability to provideservices for people in need.He anticipated the shift ofcosts to be a significant issuein the upcoming legislativesession. For the past twosessions, funding for theFund for Hospital Care forIndigent Persons, and theSupplemental Fund forMedical Assistance toIndigent Persons have beenswept to fill the states budgetdeficit.6 • 2012 • JuneJune 15th is the 7th AnnualWorld Elder AbuseAwareness Day. This yearthe White House Office ofPublic Engagement, in collaborationwith federal partnersfrom theAdministration, is hosting aday-long symposium June14th in recognition of ElderAbuse Awareness. The eventwill highlight the problem ofelder abuse, neglect, andexploitation, which likedomestic violence and childabuse, comes in many forms.It is recognized by experts asa public health crisis forwhich there are no socioeconomicborders. Millionsof older Americans areabused, neglected, orexploited each year, with anestimated 84 percent ofcases going unreported.Organizers say the event willbring together public andprivate partners with keyroles in addressing financialexploitation from across thenation, including the uniquerole that financial exploitationplays in the wider problemof elder abuse.

What Does It Mean To Be a Trustee?Brought to you byBradley B. AndersonAnderson, Dorn, & Rader, Ltd.The American Academy of Estate Planning Attorneyswww.probatebusters.com • blog.wealth-counselors.comIf a family member orfriend has chosen you toserve as Trustee of theirLiving Trust, you’ve beengiven a great honor. It meansthey believe you are honestand responsible, and theyhave a great deal of faith inyour abilities and your personalintegrity. It also meansthat you have an important,and sometimes complicated,job to do.Basic DutiesWhile no two Trusts areexactly alike, all Trusteesshare the same basic obligations.A Trustee is chargedwith the responsibility ofmanaging the assets thatbelong to the Trust. In doingthis, the Trustee is requiredto follow the terms of theTrust document.Current vs. SuccessorTrusteeYour obligations might beginimmediately, or they may notstart until some point in thefuture. This depends onwhether the person creatingthe Trust – called theTrustor – has named you thecurrent Trustee or the successorTrustee.Let’s imagine your father isthe Trustor. It’s common forsomeone creating a Trust toserve as his own Trustee aslong as he is alive and well,and your dad is no exception.He has chosen you as hissuccessor Trustee, so youdon’t have any obligationsuntil your father dies, oruntil he suffers an illness orinjury that renders him incapableof managing the Truston his own.If your dad became mentallyor physically incapable ofserving as his own Trustee,you would step in and followthe instructions in the Trustdocument for having yourfather removed as Trustee.Normally, this means gettinga physician’s statement thatyour father is no longer ableto manage his own affairs.You would then follow theterms of the Trust to manageTrust assets for your dad’sbenefit. If your father laterregained the ability to serveas his own Trustee, he wouldhave the option to once againtake over that role.If your father died, youwould need his death certificateto take over the role ofTrustee.AdministrationAs Trustee, you have theresponsibility to follow theterms of the Trust documentand manage the Trust assets(Trustee page 8)June • 2012 • 7

BEHAVIORAL HEALTHHINPATIENT PROGRAMRAMSenior Bridges provides total care for the mindand body for patients 50 years of age andolder.The inpatient program ram combines expertiseeinpsychiatric treatment with the medical resourcesof Northern Nevadaa Medical Center.CALL 356-4071TO SCHEDULE A FREE,CONFIDENTIAL ASSESSMENT.www.NNMC.comPhysicians areindependent practitioners who arenot employees or agents of Northern nNevada Medical Center.The hospital shall not be liable for actions or treatments provided by physicians.8 • 2012 • JuneTrustee / page 7in a prudent manner.This not onlymeans preservingthe property yourfather transferredinto the Trust, it alsomeans investing theTrust assets responsibly.Each state hasits own standardsthat define what itmeans to investTrust assets prudently.In addition to followingthe terms ofthe Trust, you as Trusteehave a fiduciary duty to thebeneficiaries of the Trust.This means you must managethe Trust in the bestinterests of all the beneficiaries,rather than using theassets in a way that solelybenefits you.You’ll also need to keep upwith administrative duties,such as keeping an inventoryof Trust assets, keepingaccurate records of transactionsyou make on behalf ofthe Trust, and filing incometax returns and, possibly,estate tax returns for theTrust.DistributionsNot only are you responsiblefor the management of theTrust, you are also responsiblefor distributing the Trustassets in accordance with theterms of the Trust. Trustsvary widely when it comes tothe discretion Trustees aregiven in making distributions.For instance, yourfather’s Trust documentmight name you and yourtwo siblings as the sole beneficiariesof the Trust, andinstruct that the Trust assetsbe sold and the money dividedevenly among the three ofyou.On the other hand, the documentmight give you thediscretion to distribute Trustfunds to provide for the“health, education, maintenance,and support” of yoursiblings. This would leaveyou to decide how much of adistribution – and how often– is reasonable given yoursiblings’ circumstances.Just as no two Trusts arealike, no two Trustees haveexactly the same responsibilitiesand challenges. Anexperienced estate planningattorney can help you understandyour duties so that youcan fulfill your role with confidence.The Law Firm ofAnderson, Dorn & Rader,Ltd. is devoted exclusively toestate planning. They aremembers of the AmericanAcademy of Estate PlanningAttorneys and offer guidanceand advice in estate planning.For more informationor attend an upcoming seminar,please contact them at(775) 823-WILL (9455) orvisit us online at www.probatebusters.com.

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Adding Life to YearsAging with Choice, Independence,and Dignity: Planning ConversationsDr. Larry WeissCenter for Healthy AgingChoice andIndependence arecornerstones of beingAmerican. So why do we notplan for our futures as weage? We can make decisionsthat express our needs,desires, and wishes and prepareourselves now, while wecan. But you say...“I alwayswill have choice.” However,disability, disease, and loss offunction, including cognitivefunction, are somewhatinevitable. The reality is that70 percent of us 65+ willneed help with daily activitiesat some point and thathelp lasts an average of threeyears, which could result inlack of choice, independence,and/or dignity.If you want to live ahealthy life to its fullest withchoice, independence anddignity, and given you havenot planned for loss of function,disease, or even death,here are some questions toask yourself and conversationsto have with significantothers to help with that planning.Living SituationWhere do I want to live?Is it a “livable” community?Is it close to shops, medicaloffices, etc? If I stay in mycurrent home, is it accessible?Does it have a bed andbath on the ground level? Isthe bathroom (toilet, bathtub,shower) accessible?What modifications are ormight be needed? If I do notstay in my home, what typeof living community do Iwant? Senior living? In whatlocation?If I need assistance, arethere family or friends thatcan help? Who do I want tobe with? Where? Can I manageit financially?If considering moving,when should that occur?Health and WellnessWhat foods are the mostnutritious and that I enjoythe most?If I can’t get out or cookfor myself, who would help?Or what services are available?What is my favorite physicalactivity?What is my favorite socialactivity?If I need someone to talk(Life to Years page 11)10 • 2012 • June

Life to Years / page 10to...?Who is my primary medicaldoctor? Other medicaland health professionals thatknow me?When was my last physicalexam?What current conditionsdo I have?Do I have an accessiblelist of my medications? Havethey been reviewed by a certifiedgeriatric pharmacist?Do I take them per instructions?If I need help, whoprovides that help?Emotionally, am Ihappy? If not, what do I dothat makes me laugh andbe happy?Do I have fun in mydaily life? If not, what can Ido to have more fun?What beliefs are mostimportant to me? Do I livethose beliefs?What are my religiousor spiritual beliefs? Do Ipractice those beliefs?One step I could take tobecome healthier is...? Nowdiscuss this with a significantother.Financial ConsiderationsWhat is my currentincome, expenses, debt,spending, and assets?What are my liquidassets if I need more medicalcare and/or daily supportin personal assistance?Health and medicalinsurance covers...?What are the costs forlong-term care supportand services, i.e., nursinghome, assisted livingWhen I need long-termcare support, do I have theresources to pay for it?Long-term care Insurance?Values and BeliefsWhat are my life's lessons,values, hopes, beliefs,and dreams for the future?What am I most proud ofhaving done?What do I hope toaccomplish before I die?What are the most powerfullessons I have learnedthroughout my life? Withinthe last year?How have my beliefsimpacted my behavior?What are my goals for thefuture? What is on my“bucket list”?How do I plan on accomplishingthese goals? When?Community ServicesIf I need help with dailyactivities (e.g., transportation,dressing, bathing andcooking), do I know where togo? Who to contact?Given that Medicare andhealth insurances do notcover long-term care andsupports, do I know howmuch they cost and can Iafford them? If not, what aremy options?Do I know an agency or“Come in!”person that I can obtainexpert advice with care planningand life or servicecoaching?Important PeopleHave I prepared a list ofimportant or key persons inmy life (e.g., family members,friends, medical and healthprofessionals, insuranceagents, financial planners,accountants, lawyers)?Who are they? How arethey contacted? Where is the(Life to Years page 12)Welcome to your all-inclusive,locally-owned retirement community!www.PromenadeReno.comCall 775-786-8853for a personal guided tour!June • 2012 • 11

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Ask Dr. MarionDr. Marion somers, Ph.D.Long-Term Care InsuranceMy husband and I are divorcing, andour kids are grown up and out of thehouse. Should I consider long-termcare insurance? What are the pros andcons? Mary, 52, MilwaukeeLong-TermCareDr. Marion Somers insurancehelps cover the cost of longtermhealth care, and generallycan help pay for carenot covered by most healthinsurance or Medicare.The benefits are thatlong-term care insurancecovers home care, assistedliving, adult daycare, respitecare, hospice care, nursinghomes, and Alzheimer’sfacilities. If you purchasehome care coverage, it paysfor home care, often fromthe first day it is needed. Apolicy may pay for a visitingor live-in caregiver, companion,housekeeper, therapist,or private duty nurseup to 7 days a week, 24-hours a day. Without Long-Term Care insurance, the(Long-Term Care p. 15)14 • 2012 • June

Centers for Medicare and MedicaidBy David SayenMedicare and Mental HealthMental healthproblemslike depressionand anxiety canaffect anyone’s life atany age. If you thinkyou have a mentalhealth condition,David SayenMedicare may beable to help.The symptoms of mental healthissues include feelings of sadness,emptiness, or hopelessness; a lack ofenergy and difficulty concentrating orsleeping. You might find yourself losinginterest in activities you used to enjoy,or even having thoughts of ending yourlife.If you have any of these symptoms,talk to your doctor or other health careprovider.Medicare’s coverage of mental healthincludes outpatient and inpatient treatment,as well as prescription drugs.If you get your Medicare benefits16 • 2012 • Junethrough a Medicare Advantage healthplan, check your plan’s membershipmaterials. Or call the plan for detailsabout your Medicare-covered mentalhealth benefits.If you have Original Medicare, PartA covers inpatient care and Part B coversoutpatient care. Part D covers medicationsyou may need.Part A helps pay for mental healthservices given in a hospital that requireyou to be admitted as an inpatient.These services can be provided in ageneral hospital or in a psychiatric hospitalthat cares exclusively for peoplewith mental health conditions.How much do you pay? Medicaremeasures your use of hospital servicesin benefit periods. A benefit periodbegins the day you go into a hospitaland ends after you’ve had no hospitalcare for 60 days in a row. If you go intoa hospital again after 60 days, a newbenefit period begins, and you must paya new inpatient hospital deductible.There’s no limit to the number ofbenefit periods you can have when youget mental health care in a general hospital.You can also have multiple benefitperiods when you get care in a psychiatrichospital, but a lifetime limit of 190days applies to inpatient psychiatriccare.For each benefit period, you pay a$1,156 deductible (in 2012), and nocoinsurance for days 1–60. For days61–90 of each benefit period, your costwould be $289 per day.Medicare Part B helps cover servicesby doctors and other providers if you’readmitted as a hospital inpatient. Youpay 20 percent of the Medicareapprovedamount for these serviceswhile you’re an inpatient.Part B also helps pay for outpatientvisits to psychiatrists or other doctors;clinical psychologists, social workers,and nurse specialists, and other professionals.(Make sure your provideraccepts Medicare payment before youschedule an appointment.)Outpatient services are coveredby Part B as well. These includepsychiatric evaluation; medicationmanagement; individual and grouppsychotherapy with doctors orcertain other licensed professionals,and family counseling if themain purpose is to help with yourtreatment.For outpatient care, you’ll haveto pay the Part B deductible, whichis $140 this year. After that, howmuch you pay depends on whetherthe purpose of your visit is to diagnoseyour condition or to gettreatment.When you visit a doctor orother professional diagnostician,you pay 20 percent of theMedicare-approved amount. Foroutpatient treatment such as psychotherapy,you pay 40 percent ofthe Medicare-approved amount in(Medicare page 18)

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OphthalmologyAccordingto the mostrecent estimates,1.7 million Americanmen over age 50, and morethan three million AmericanA Drop in TearsMichael J. Fischer, M.D.Eye Physician & Surgeonwomen of comparable agesuffer from dry eyes. Knownas dry eye syndrome, thiscondition is characterized bythe production of too fewtears, resulting in a grittyfeeling in the eyes that maybe accompanied by pain,stinging, and burning. Somecases of dry eye can beattributed to the agingprocess, which involves anatural decrease in tear production.Dry eyes might alsoresult from the use of certainmedications including antihistamines,decongestants,anticholinergics (used totreat intestinal and urinaryproblems), drugs used totreat Parkinson’s disease, certainpain relievers, sleepingills, and tranquilizers. Incases of severe dry eye, ophthalmologistmay prescribecyclosporine ophthalmic(Restasis), to help tear production.18 • 2012 • JuneMedicare / page 162012. (Recent legislationreduced these co-insuranceamounts to keep them inline with other types ofmedical services; mentalhealth co-insurance willdrop to 35 percent next yearand 20 percent in 2014.)Part B also covers “partialhospitalization” in somecases. This is outpatient psychiatrictreatment that’smore intense than the careyou get in a doctor’s or therapist’soffice. It’s providedduring the day, usuallythrough hospital outpatientdepartments and communitymental health centers.Many MedicareAdvantage plans cover prescriptiondrugs. If you haveOriginal Medicare, you canjoin a Part D drug plan.Medicare drug plansaren’t required to cover alldrugs. However, they mustcover all or almost all antidepressant,anticonvulsant,and antipsychotic medications.David Sayen is Medicare’sregional administrator forCalifornia, Arizona, Nevada,Hawaii, and the Pacific TrustTerritories. You can getanswers to questions by calling1-800-MEDICARE (1-800-633-4227).