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Compass & Clock Fall/Winter 2018 Publication

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Navigating life today to remain independent tomorrow
&C MPASS CL CK
Explore the
World 46
FALL/WINTER 2018 WESTSOU...
© 2018 Morgan Stanley Smith Barney LLC. Member SIPC. CRC 1988327 MAR014 01/18 CS 9297803 07/18
The riskiest financial
move...
• Elder Law
• Estate Planning
• Medicaid Planning
• Wills & Probates
• Powers of Attorney
• Guardianships
• Special Needs ...
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Compass & Clock Fall/Winter 2018 Publication

Compass & Clock is proud to share the Fall/Winter 2018 Publication online with our readers. Look for our magazine in your neighborhoods that helps educate & empower individuals and families to strengthen their quality of life as they age. It's all about the journey & enjoying life.

The publication will be in distributed in the WestSound, Gig Harbor to Port Angeles by November 1st 2018. It is a FREE publication and can be found in HealthCare Provider Offices, Housing Communities, Financial Institutions, Professionals Offices, Places Where People Hang Out, Chambers of Commerce, Senior Centers, Auto Dealerships & Repairs, Hair Salons & Restaurants, and so much more.

Our audience are folks 40 + older. We are trying to reach the Adult Kids & their Aging Parents. Having knowledge and doing a little pre-planning will set you up to be better equipped to deal with unanticipated life events. There are solutions! That's why we are so proud to present our 2nd edition of Compass & Clock as your comprehensive guide to:
Housing Choices
HealthCare
Financial Planning
Legal Guidance
Family Support
Leisure Pursuits

Don’t wait until you’re overwhelmed by illness and uncertainty. Hold on to that independence you seized as a young adult by taking advantage of the vast services Compass and Clock has to offer; from complex legal advice, to simple recommendations for remaining healthy and active, or enjoying a night on the town.

We will help guide you through middle age, retirement & your senior years. Welcome to a community conceived to guide you into your best future!

Compass & Clock is proud to share the Fall/Winter 2018 Publication online with our readers. Look for our magazine in your neighborhoods that helps educate & empower individuals and families to strengthen their quality of life as they age. It's all about the journey & enjoying life.

The publication will be in distributed in the WestSound, Gig Harbor to Port Angeles by November 1st 2018. It is a FREE publication and can be found in HealthCare Provider Offices, Housing Communities, Financial Institutions, Professionals Offices, Places Where People Hang Out, Chambers of Commerce, Senior Centers, Auto Dealerships & Repairs, Hair Salons & Restaurants, and so much more.

Our audience are folks 40 + older. We are trying to reach the Adult Kids & their Aging Parents. Having knowledge and doing a little pre-planning will set you up to be better equipped to deal with unanticipated life events. There are solutions! That's why we are so proud to present our 2nd edition of Compass & Clock as your comprehensive guide to:
Housing Choices
HealthCare
Financial Planning
Legal Guidance
Family Support
Leisure Pursuits

Don’t wait until you’re overwhelmed by illness and uncertainty. Hold on to that independence you seized as a young adult by taking advantage of the vast services Compass and Clock has to offer; from complex legal advice, to simple recommendations for remaining healthy and active, or enjoying a night on the town.

We will help guide you through middle age, retirement & your senior years. Welcome to a community conceived to guide you into your best future!

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Compass & Clock Fall/Winter 2018 Publication

  1. 1. 12 3 6 9 Navigating life today to remain independent tomorrow &C MPASS CL CK Explore the World 46 FALL/WINTER 2018 WESTSOUND, GIG HARBOR TO PORT ANGELES F REEPUBLICATIO N *FREE*PUBLIC ATION*FREE*P UBLICATION * TAKE ME I'M YOURS! Health Care Housing Choices Financial Planning Legal Guidance Family Support Leisure Pursuits The Caregiving Role Reversal 16 The Caregiving Role Reversal 16 NEW Stroke Center in Kitsap 28 NEW Stroke Center in Kitsap 28 Explore the World 46
  2. 2. © 2018 Morgan Stanley Smith Barney LLC. Member SIPC. CRC 1988327 MAR014 01/18 CS 9297803 07/18 The riskiest financial move is doing nothing. Your wealth plan should keep up with the changing circumstances of your life, as well as with the cycles in the financial markets. A new career, a new grandchild, a new business, a significant shift in your portfolio—any of these events could necessitate a fresh look at your strategy. As Morgan Stanley Financial Advisors, we can work with you to develop a plan and then help you manage your investments and assets through life’s changes. Call today to arrange an appointment. We’ll work together to plan for what may come. The Casacade Group at Morgan Stanley Doug Berger Senior Vice President Financial Advisor Jason Berger Associate Vice President Financial Advisor Jan Morris Financial Advisor 2011 NW Myhre Road, Ste 301 Silverdale, WA 98383 360-613-0212 fa.morganstanley.com/thecascadegroup thecascadegroup@morganstanley.com L to R: Diane Boileau, Registered Associate; Tiffany Timar, Senior Registered Associate; Doug Berger; Jason Berger; Jan Morris
  3. 3. • Elder Law • Estate Planning • Medicaid Planning • Wills & Probates • Powers of Attorney • Guardianships • Special Needs Trusts • Adoptions • ...and More     “If you fail to plan, you have planned to fail.”~Benjamin Franklin What does the future hold for you? Let us help you plan for the future with practical tools and advice to guide you to a comprehensive Life Care Plan™ that addresses your future housing, healthcare, financial and legal needs. FREE Legal + Estate Life Care Planning Seminars 19717 Front Street NE Poulsbo, WA 98370 www.westsoundlegal.com      Richard C. Tizzano Elder Law & Estate Planning Attorney Text MYNEWSLETTER to 42828 to receive our FREE monthly E-newsletter. PEACE OF MIND PROVIDING LEGAL 360-779-5551 Richard’s book, Accidental Safari: A Guide for Navigating the Challenges that Come with Aging, is available NOW at www.Amazon.com
  4. 4. Mary Coupland Publisher/Editor-in-Chief Owner and Operator, Compass & Clock Past President, Board of Directors, Mavericks Bainbridge Director of Marketing, Homeport Photography Member of Kitsap Provider Group Member of Jefferson County Provider Group Member of Silverdale Chamber of Commerce Member of Aging Smart Gig Harbor Group 206-321-8016 compassandclockmc@gmail.com www.compassandclock.com WELCOME TO COMPASS AND CLOCK Richard C. Tizzano, JD Consultant/Advisor Elder Law Attorney and Principal of Sherrard McGonagle Tizzano & Lind PS. Specializes in Elder Law & Estate Planning, Personal Healthcare Crisis Management, Strategic Health Cost Risk Mitigation, Sustainability of Care, Guardianships, and Adoptions. Member of the Washington & California State Bar Assocation Member of the Kitsap County Bar Association / BV-Rated Lawyer by Martindale Hubbell Board Member, Puget Sound Youth For Christ Member of Poulsbo Rotary & Chamber Past President, Kitsap Community Foundation Community educational instructor/ speaker on estate planning & elder care issue Published Best Selling Author: Accidental Safari, a guide for navigating the challenges that come with aging. Available on www. Amazon.com www.westsoundlegal.com Compass & Clock is far more than these pages. It’s an educational program with a mission to help you become financially and physically strong. Strong enough to “age in place.” To protect your home, your savings, and your health well into your senior years. It’s a community of experts in financial planning, legal guidance, health care, housing, and family support - all represented in this publication and dedicated to the mission. I’d like to share a shining example of this dedication. Vivian had been weakened after a hospitalization and transferred to a rehabilitation (rehab) facility to regain her strength. When she was well enough to go home, she learned she could not. Discharge required a safety assessment of her home. They found her husband David too frail to care for her, and the house in such disrepair it was deemed unsafe. The facility would not discharge her to a dangerous environment. This lovely couple, both in their 80s, had no children, relatives or friends capable of assisting them. Distraught, David turned to his attorney, Richard Tizzano, a specialist in elder law and estate planning and, fortunately, a member of the Compass & Clock community. Mr. Tizzano contacted Joan Qvigstad, a reverse mortgage specialist with Fairway Mortgage. He knew a reverse mortgage would allow the couple to convert a portion of their home’s equity into cash for repairs. That one call triggered a remarkable cascade of events. When Ms. Qvigstad visited David at home, she was dismayed to discover their living situation was dire. The couple had been physically unable to maintain the home for years. Damage was extensive, along with clutter and unsanitary conditions compounded by pets. And with the bedrooms upstairs, the floor plan was unsuitable for Vivian’s walker. Ms. Qvigstad quickly processed the loan application; upon its approval the couple secured half the market value of their home in cash. She then went above and beyond the role of any mortgage specialist. Backed by the entire Compass & Clock community she orchestrated: • Massive renovations by Blue Cedar Construction. Teri Tennyson of Kitsap Seniors Real Estate specializes in seniors’ estate preservation. Her network of contractors was invaluable. • Senior advocacy. Sue-Marie Casagrande of Care Plans Plus liaised with physicians, home health care, and insurers. Medical beds were delivered and a stair chair lift installed. • Clutter removal by Sheila Taylor of Clutter Controllers. Meantime, Vivian remained safely in rehab where Ms. Qvisgstad visited almost daily. The project was completed in six weeks and Vivian was moved to tears by the astonishing transformation of their home. I am so proud of the extraordinary response from our community to safeguard this couple. If you’re lucky, you too will live long enough to grow old. Compass & Clock was founded to help protect your senior years from being consumed by anxiety, confusion, and financial ruin. And when illness inevitably strikes Compass & Clock can help. Frankly, I’d rather you didn’t wait that long. By Carol Fisher for Compass & Clock
  5. 5. Volume 2 We are Proudly Printed in the USA! Bonnie Dickson Editor Contributing Writer Creative Services - Print WriteEditDesign 253-279-6401 writeeditdesign15@gmail.com Carol Fisher Contributing Writer Better Days Writing & Editing 402-301-6376 thecarolfisher@gmail.com FINANCIAL PLANNING 4 How to Break the Ice Around Family Finances 6 Do You Need Renters Insurance? 7 Is LTC Insurance a Good Option? 8 Repaying the Debt 10 Buyer Beware 12 A 911 Buddy 14 Tips for Handling the Financial Challenges of Alzheimer's HEALTH CARE 16 The Caregiving Role Reversal 18 Feel Good Without the Paranoia 20 16 Steps for Diabetic Foot Care 22 Eat Well and Stay Healthy 24 Preventing Falls 26 Avoiding Food Fights 27 10 Ways to Love Your Brain 28 Exclusive Stroke Recovery Help HOUSING CHOICES 30 Portable Businesses Making Staying at Home Easier than Ever 31 Products to Help You Age in Place 32 Should I Stay or Should I Go? 34 Care Solution Assessment 36 Shopping for a New Home 37 Senior Housing Community Notes LEGAL GUIDANCE 38 To Will or Not to Will? That is the Question LEISURE PURSUITS 40 Join the Ranks of the Self-Employed 42 Project Bucket List 44 Sunday Driving 46 Explore the World 48 9 Facts About Sun Protection FAMILY SUPPORT 50 Caring for the Vulnerable 51 Are You Prepared For When Disaster Strikes 52 Volunteering Feeds the Soul 54 Multi-Generational Living and the Benefits of Being a Sandwich Family 55 RESOURCE DIRECTORY Table of Contents We are a group of compassionate, experienced professionals dedicated to your well-being and safety. Our goal is to share knowledge, tools & resources to educate & empower you, and help you strengthen your quality of life as you age. 12 3 6 9 Navigating life today to remain independent tomorrow &C MPASS CL CK Cover Photo Justin Saetrum Nurse Manager of Marina Unit Martha & Mary
  6. 6. 4 Fall/Winter 2018 W hat’s the hardest thing to talk about? Death, religion, politics? Would it surprise you to know that one of the most difficult things to discuss is money? When polled, 44 percent of Americans claimed that personal finance was the hardest to discuss – beating out politics and even death. Perhaps this is because money represents more than a topic – it can represent control, power, embarrassment, insecurity, fear. For some people, the hesitation stems from a natural reluctance to confront their own mortality or their potential for future disability. For others, avoiding the topic is caused by the perception that planning is associated with complicated—and expensive—legal and tax issues. Silence Can Be Harmful: Avoiding these sometimes difficult conversations can have detrimental outcomes and unexpected consequences for your family, such as: Passing On Bad Habits - Talking to your children about money now can help them avoid mistakes in the future. The key is to talk about what money means to you and why you worked hard to achieve your success. It involves being open about the challenges and responsibilities that accompany wealth – including what you might have wished you’d done differently when younger. And, most important, it’s about your values and what you wish for yourself and your children to accomplish with your privilege. The conversation can serve as an empowering first step to forming a healthy relationship with wealth. Lost Opportunities - It’s never too early for your children to understand the value of creating a wealth plan that takes family members’ needs into account. Family members may not be aligned on priorities, such as long-term health care needs, charitable giving and generational gifting strategies, and taking the time to establish common goals is the first step in understanding how all members can participate in achieving them.  The reality is that 70 percent of families lose their wealth by the second generation. Lack of communication can ultimately lead to misunderstandings and divergent objectives that could jeopardize your legacy and work against your values. Costly Procrastination - Perhaps the hardest of conversations to have as an adult is with your aging parents. This is where the danger of putting it off grows exponentially. According to the U.S. Department of Health and Human services, 70 percent of people over 65 will require some long-term care at some point in their lives. [i] Once a crisis hits, it’s often too late. Now is the time to determine if sufficient long-term health care plans have been made, as well as who will make financial decisions on your parents’ behalf if they lose the ability to safely handle their money. Proper planning gives you time to discuss your decisions with family members. This open communication can help to reduce, if not eliminate, the risk of family discord, resentment or conflict. Having a hard time starting a conversation about family finances? Here are a few questions that can make it easy for you. How to Break the Ice Around Family Finances Money is one of the trickiest topics to discuss. But avoiding the conversation can lead to problems. Learn how to start the dialogue with your family
  7. 7. 5www.compassandclock.com/ Financial Planning • At what age do you hope to retire? • When is it OK to borrow money? • Is it important to talk about money as a family? • What’s your favorite charitable cause and why? • How is your generation different from the generations before you? • Should children give to charity? Align Your Goals with Strategies for Reaching Them Morgan Stanley’s goals-based wealth planning framework strives to guard against more than just market volatility. We believe that a successful planning strategy must meet the following criteria: 1. Your plan should be customized to reflect what you care about most. It should address both the goals you hope to achieve and the risk of outliving your assets. 2. Your plan should address the shifting nature of issues and unknowns you face at different stages of your life and consider risks beyond market volatility, like inflation. 3. Your plan should seek to mitigate judgment and behavioral risks such as panic selling in difficult markets or overspending. Smash the Taboo: We know it’s hard. Sitting down to discuss your parents’ long-term health needs or checking in with your siblings to see if you are all on the same page relating to any inheritance isn’t easy. What about your children; do they value the same causes that have moved you all your life? Is your spouse prepared should something happen to you? The tough part is getting started, and that’s where bringing in an objective financial professional can help. We understand that wealth is about much more than just money, and can guide the conversation down those difficult paths to uncover the things that matter most to you and your family. We don’t believe in having a single conversation, but rather a series of talks that shift as your life changes. It’s a road. And you don’t have to travel it alone. It starts with family, but doesn’t have to end there. We are ready to provide the guidance, tools and information that can help you tackle these difficult topics and transform them into meaningful discussions for your future. Uncover what matters most to you and find a Morgan Stanley Financial Advisor to help guide the conversation. Because the road starts here. This material does not provide individually tailored investment advice. It has been prepared without regard to the individual financial circumstances and objectives of persons who receive it. The strategies and/ or investments discussed in this material may not be suitable for all investors. Morgan Stanley Wealth Management recommends that investors independently evaluate particular investments and strategies, and encourages investors to seek the advice of a Financial Advisor. The appropriateness of a particular investment or strategy will depend on an investor’s individual circumstances and objectives. Morgan Stanley offers a wide array of brokerage and advisory services to its clients, each of which may create a different type of relationship with different obligations to you. Please consult with your Financial Advisor to understand these differences.
  8. 8. 6 Fall/Winter 2018 Financial Planning I f you are looking at selling your home and moving to an apartment, downsizing to a smaller home or even an assisted living center, it is important to have protection for your remaining assets. Often, these are the most valuable and need special consideration. The main benefit of renters insurance is that it will replace lost or stolen items, but it also includes personal liability. Most policies come with standard levels of liability to cover such things as dog bites for your favorite little fur baby or if you accidently start a fire that damages an adjoining apartment or home. It is that liability that saves you from huge mistakes and protects your hard-earned life savings and possessions. Even better, renter’s insurance will cover your possessions and liability outside your apartment or rented home. If you are traveling or visiting your grandchildren, rest assured, your computer and jewelry can be covered. Some people call renter’s insurance “worldwide coverage.” If you travel, you will want this insurance. What about living at an assisted living facility? Yes, even then, renter’s insurance can be a smart option. For example, many of the newer facilities allow you to keep your small pets with you. What protection would you have if your dog bites or cat scratches visitors or workers in your building? Without liability insurance, you can be responsible for any medical expenses. In addition, most facilities encourage you to bring in your own personal items. Protecting those family heirlooms and items from loss and theft can be covered under your renter’s policy. For peace of mind, the price of renter’s insurance can run as low as $8.00 per month. The greater the value of the items covered, the higher the premium. A safe range to start with is between $20,000 to $30,000. Some of the confusing choices can be whether to choose Actual Cash Value (ACV) or Replacement Cost Value (RCV). ACV will include depreciation, so a couch you purchased 5 years ago will have a lower value, based on age and use. RCV will give you the value of a new couch at time of loss. RCV coverage costs more but is likely worth it. Another good idea is to know what level of coverage to have for more expensive items such as jewelry, tech items, and even securities kept in the home. Each company will have different maximum limits. Most companies offer higher limits or the ability to insure individual items at a “Stated Value.” Usually stated value requires recent appraisals, so be prepared to get those to your agent. Finally, there are some additional coverages that you may want to add. Two of those include Flood Insurance and Sewer Backup. Flood insurance is an option if your rental qualifies for this based on National Flood Maps. Sewer Backup Insurance covers your personal items if they are damaged by sewer lines getting clogged and backing up. Typically, these coverages are not included in standard renter’s policies. High-value items like artwork, music equipment, antiques and even your wedding ring, may not be covered in the base renter’s policy but can be added. Loss of use is another good possibility to add. This helps you if your residence is uninhabitable from a covered loss. It will help with the temporary housing for a limited time and limited coverage. Identity protection, and credit card coverage is relatively new, but important to add to your policy in these uncertain times. Finding an agent that has experience working with downsizing age groups is important. Renters insurance for a young couple starting life is much different than someone with years of memories and possessions to protect. Review your policy so you know what additional coverages you may want to add. Keith Hafner, Account Executive Farmers Insurance, Thompson Agency 1703 SE Sedgewick Rd, Suite 103, Port Orchard WA (360) 602-6999 https://agents.farmers.com/vthompson1 Do You Need Renters Insurance? INSURANCE YOU CAN DESIGN TO MEET YOUR EVER CHANGING NEEDS Restrictions apply. Discounts may vary. Not available in all states. See your agent for details. Insurance is underwritten by Farmers Insurance Exchange and other affiliated insurance companies.Visit farmers. com for a complete listing of companies. Not all insurers are authorized to provide insurance in all states. Coverage is not available in all states. Call 360.602.6999 today! For Home, Auto, Life and Business. ThompsonAgency Victor Thompson 1703 SE SEDGWICK RD STE 103 PORT ORCHARD, WA 98366 VTHOMPSON1@FARMERSAGENT.COM https://agents.farmers.com/vthompson1 ■ Farmers Identity Shield fraud assistance ■ Insurance you can tailor to meet your needs ■ Products and services to meet all your insurance needs By Keith Hafner
  9. 9. 7www.compassandclock.com/ Financial Planning Elder Law Estate Planning Probate Mediation     RICK BIEHL Principal Attorney 360-552-2662 18442 WA-3 in Allyn www.rickbiehllaw.com (up to 60 minutes) My office has over 25 years of work experience with State Farm. We are a trusted resource for both personal and business insurance needs. We also provide flood insurance and FREE notary services. We look forward to working with you! Let us show you how to save money! Paula K Weissinger Agent, CPCU, CLU 206-855-0855 175 Parfitt Way SW, Ste 180 Bainbridge Island, WA AUTO • HOME • LIFE • HEALTH • BANK • BOAT • BUSINESS www.PaulaMyAgent.com Bainbridge Island, Kingston and Poulsbo Chamber Member Is LTC Insurance a Good Option? My grandma purchased long-term care (LTC) insurance back in the 80s. I remember that her new husband was not happy because it seemed extremely expensive and it was pretty new-fangled. However, unlike all the other things that commissioned sales people got her for, the LTC insurance turned out to be a good deal. There are plenty of people since that don’t have much beyond bird cage liner. However, at the time, my grandma’s premium was “locked in” and though it was a great deal more expensive than homeowner’s insurance or even car insurance it turned out to be a bargain due to the years she lived needing nursing care. In the 80s, senior housing began to mean more than the local nursing home. The problem was that health care insurance didn’t cover what was a really expensive health care option and people went bankrupt paying for that care. By the late 80s, more and more health care organizations offered LTC insurance. It was wildly popular and everyone sold it. Everyone wanted what my grandma had. It was a good time for the insurance companies until people got sick and started needing that coverage. We’ve all gotten a little complacent about it because every year for years now the news covers how the cost of health care rose in the double digits. Well, insurance companies determine the cost of their insurance coverage by determining their risks and what they found was that they really miscalculated their risks. The result was that over very short periods of time, LTC insurance premiums doubled or worse. People who purchased LTC insurance found they couldn’t afford to continue paying for their premiums and they lost what they put into their coverage as they dropped the coverage. Over the course of the last two decades, most of the hundreds of insurance companies offering LTC insurance disappeared. There is only a few dozen left. It doesn’t mean that LTC insurance doesn’t have its uses because it does but it isn’t your only option. A lot is going to depend upon your health and age, whatever support system you have, your ability to withstand heavy increases in premiums and whatever savings you might have. If you think you want to consider LTC insurance, spend time talking to an elder law attorney so you know your options and have a realistic view of what it can and cannot do for you.
  10. 10. 8 Fall/Winter 2018 Financial Planning Eligible Wartime Periods The VA uses the following wartime periods to determine eligibility for VA Pension benefits: •Mexican Border Period (May 9, 1916 – April 5, 1917) •World War I (April 6, 1917 – Nov. 11, 1918) •World War II (Dec. 7, 1941 – Dec. 31, 1946) •Korean conflict (June 27, 1950 – Jan. 31, 1955) •Vietnam (Feb. 28, 1961 – May 7, 1975 in the Republic of Vietnam; otherwise Aug. 5, 1964 – May 7, 1975) •Gulf War (Aug. 2, 1990 – through a future date) F orty-five years ago, as the Vietnam War drew to a close, the United States entered a new era in its military power as it switched from the draft to an all-volunteer army. The result of that change was that today less than 1 percent of Americans join the military compared to the more than 12 percent that served during World War II. Of the nearly 18.5 million American Veterans alive today, more than half (about 55 percent) are 60 or older. Yet few older veterans (or in some cases their spouses) take advantage of benefits that exist specifically with them in mind (estimates indicate that roughly 5.5 percent of eligible individuals receive Pension benefit). Leaving those assets on the table is akin to foregoing a retirement benefit. For many veterans and their families utilizing veterans’ benefits is the difference between a retirement lacking basic essentials and one that is not. Early in my career, a woman grasped my hand, hugged me quite hard for someone only three quarters my height and thanked me profusely. I was amazed and profoundly touched. One because someone had actually read something I wrote, remember it was early in my career, but two because that something was a sidebar. A sidebar is that bit of information along the side of a page sometimes used as a filler and sometimes as a way to add a bit more information to an article without actually being the article. The sidebar in question was about veterans benefits. The specific piece of information that granted me a warm hug was about Aid and Attendance and the reason I got a hug was that a spouse of a deceased veteran was living in near poverty and after reading that article was able to improve her circumstances dramatically. Disability Pension and Death Pension are disability VA programs available to veterans, veteran spouses or the surviving spouse of a deceased veteran. Disability is not Compensation, the other pension program available through the VA. Compensation is for veterans injured or with an illness that they incurred while still on active duty. We will not be covering compensation in this article. You cannot receive disability and compensation at the same time. Aid and Attendance is a benefit paid in addition to a VA basic pension. Veterans must meet service, disability, and income and asset requirements. The service periods are listed below. The veteran must leave the service under conditions that are not dishonorable and have served 90 days of continuous military service (active duty) with at least one day during the wartime periods listed below. If the veterans or surviving spouse is at least 65 years old, he or she meets disability requirements if they require aid from another for activities of daily living (ADLs) such as bathing, feeding, dressing, or toileting. Medical and non-medical expenses associated with long-term care options such as nursing care, assisted living, or home care require significant outlays of money and usually trigger the benefit. There is also an income requirement, which must be below a yearly limit set by law. The amount differs depending upon whether the veteran is single, married, or married to another veteran and whether the household includes dependents. In 2018, that amount is as low as $1176 per month for a surviving spouse to up to $2903 per month for two veterans married to each other. Repaying the Debt Long-term care benefits for vets and their families
  11. 11. 9www.compassandclock.com/ Financial Planning Each Home Instead Senior Care franchise is independently owned and operated. © 2017 Home Instead, Inc. The greatest breakthrough in senior care? Your cozy cottage. We help Seniors stay at home, whether they’re dealing with Alzheimer’s, arthritis or anything in between. Gig Harbor to Bainbridge Island 360.782.4663 Port Angeles to Port Ludlow 360.681.2511 HOSPICE SUPPORT | MEALS AND NUTRITION PERSONAL CARE | 24-HOUR CARE | MEMORY CARE THE ARBOR at Bremerton The Arbor at Bremerton is a Memory Care community designed exclusively for the compassionate care of individuals with Alzheimer’s and other forms of dementia. • Life-Enriching Activity Programs • Support Groups and Family Education • Cognitive and Behavioral Support • Medication Management • Activities of Daily Living Assistance • Weekly Housekeeping Services PREMIER MEMORY CARE 3510 9th St. Bremerton, WA Your Life. Our Commitment. www.arboratbremerton.com 360-525-9000 The veteran’s countable family income must be below a certain level set by law. Countable Income means income received by the veteran and his or her dependents, including earnings, disability and retirement payments, interest and dividends and net income from farming or business. The veteran can exclude unreimbursed medical expenses and public assistance such as SSI. The maximum allowable Aid & Attendance benefit is $1,794 but the veteran must have countable income at $0 to receive it. Generally, veterans cannot have assets above $80,000. There used to be some wiggle room for those that had assets above the allowable amount. Veterans were able to divest themselves of some of their assets without penalty but beginning this year, the VA started a look back period of three years similar to the requirement for Medicaid. That look back period can last as long as three years- long enough to significantly affect the benefit of Aid and Attendance. Sadly the Veterans Administration is not the best resource for getting assistance with Aid and Attendance however, there are some great programs out there to help veterans and their families get past the morass of regulations such as https://www.veteransaidbenefit.org/ and https://www. veteranaid.org/.
  12. 12. 10 Fall/Winter 2018 Financial Planning F or those of you who don’t know me, I am a funeral director in Kitsap County and I am not only 4th generation but also have 32 years’ experience in my profession. When I started, things were much different and certainly much more traditional. Families contacted their preferred funeral home (family-owned of course), and the funeral director would immediately begin making arrangements for the funeral. The family would come in to make arrangements and usually would choose an appropriate casket and all the services and other items necessary to provide the most fitting tribute...right down to the limousine. Well, as we all know, things have certainly changed. Today, over 65 percent of people in our area of the country choose cremation. Gone are the days of the pomp and circumstance of the “traditional funeral.” Even the family- owned funeral homes have diminished in numbers due to the entrance of large “Death Care Providers” as they are called, into our profession. Not all of the changes are bad however. Transparency in pricing and giving people choices is certainly beneficial. The changes in types of services and the way people choose to remember their loved ones has brought to light that life should be celebrated and death should not be hidden and feared, but rather respected and embraced.  People’s views towards death have changed as well, leading to families discussing wishes more openly so as not to leave anything undone. So where is the increasing problem I have seen, you ask? The answer to that question is actually quite evident and that is in the number of alternative providers in our profession. You will see the “low cost providers” with the ads that tout that funeral homes are overpriced and taking advantage of people. Or those that have you join a group or society as some are called, and for your membership you are guaranteed to be cared for by the organization to which you belong regardless of where your death occurs in the world. There is even one organization I recently found, that uses the word “affordable” in their name online claiming that there is a network of providers nationwide willing to provide these affordable services. This is where I repeat the title of this article...”Buyer Beware!” There are two sayings I like to use; the first is an old familiar piece of advice. “If it sounds too good to be true, it usually is” and one I have created recently.“If they have to buy you lunch or dinner you are probably paying too much!” Folks, I will tell you from experience that funerals cost a determinable amount of money. I’m not saying that you have to spend a fortune for services, but you do have to spend something to be provided with quality, reputable service. Time and time again, I receive calls from survivors who are finding out after the fact, that their loved one has been taken to an undisclosed location somewhere out of the area and that there is a lot of difficulty dealing with the provider. They are requiring payment up front before any services, including transportation, are being provided. There are mistakes and extended time delays, or the family is left to figure things out on their own. Or you have the opposite side of the coin where the price advertised has some very small print stating “cremation or burial only” which leads to everything else being an additional cost. As for the “affordable” company I mentioned earlier, I did some simple figuring of my own, and determined they are actually more expensive and leave a lot of questions unanswered. I hope this helps and please remember that a good reputable funeral home will be more than willing to help you walk you through this difficult time. Tim Dinan Owner, Cook Family Funeral Home 206-842-2642 Buyer Beware 163 Wyatt Way NE, Bainbridge Island, WA 98110 206-842-2642 360-779-7872 www.cookfamilyfuneralhome.com 100% Trusted/Insured Funds Affordable and Portable Payment plans available Plan ahead. For peace of mind. Complete Pre-Arranged Burial and Cremation Plans Complete Pre-Arranged Burial and Cremation Plans BY Tim Dinan
  13. 13. 11www.compassandclock.com/ with a Reverse Mortgage Loan Let us MOVE you... to the lake... ..by the grandchildren... Into your DREAM home! Are you looking to move into a home that better suits your retirement lifestyle? One borrower must be 62 years or older Purchased home is required to be your primary residence New property must be: single-family home, 2-4 unit dwelling or FHA approved condo You must have an adequate down payment for your new home No credit score requirements, some income and credit qualifications apply to make sure you have the ability to pay taxes and insurance. Whether you are looking to downsize, move closer to family, live in a more affordable home with less upkeep Fairway is here to assist you with your Reverse Mortgage needs. Copyright © 2018 Fairway Independent Mortgage Corporation. NMLS#2289. 4750 S. Biltmore Lane, Madison, WI 53718, 1-877 699-0353. All rights reserved. This is not an offer to enter into an agreement. Not all customers will qualify. Information, rates, and programs are subject to change without prior notice. All products are subject to credit and property approval. Not all products are available in all states or for all dollar amounts. Other restrictions and limitations may apply. Equal Housing Lender. WA License Number MLO-38002. Joan Qvigstad, Senior Reverse Mortgage Planner Direct: 360-949-1595 Mobile: 360-271-5946 Location: 19410 8th Ave NE, Suite 103 Poulsbo, WA 98370 Email: Joanq@fairwaymc.com www.reversemortgagewithjoan.com NMLS #38002 Want more information? Attend one of my monthly educational seminars. Visit our website at www.reversemortgagewithjoan.com or call 360-949-1595 to register! A Home Equity Conversion Mortgage (HECM)*, or Reverse Mortgage, might be the perfect solution to fit your specific needs. With a HECM, seniors are able to use less of the equity from the sale of their previous residence to purchase their next primary home in one simple transaction. *Most, but not all, reverse mortgages today are federally insured through the Federal Housing Administration’s Home Equity Conversion Mortgage (HECM) Program. This advertisement talks about HECM loans only. Qualifications
  14. 14. 12 Fall/Winter 2018 Financial Planning M ost Accidental Safari’s begin suddenly, with an unwelcome surprise such as a fall, stroke, or heart attack. Are you prepared for the sequence of events that usually follows that first 911 call? If you are the one who has just entered the Safari, you need an advocate! An advocate is someone who will be in your corner and at your side, from the moment the gurney is forced through the emergency room doors. Your sudden arrival kicks into motion a series of events that can mean the difference between life or death, recovery or remaining in a care facility. Some of these decisions will save or cost you thousands of dollars. Once you are inside the emergency room, the physician will order tests that he or she thinks is necessary to determine or confirm your condition. If the tests indicate a serious problem, you will be admitted to the hospital as a “patient” for treatment. If the test results are negative, you will be sent home. But what happens when the test results are inconclusive? The test results may suggest that there could be an underlying, undiagnosed issue. If the hospital has sent you home and you collapse soon afterward from that “unknown something connected to the test that showed a little something was going on”, the hospital could be liable for not taking additional measures to avert your ensuing ride through town under sirens and flashing lights. Test results with “gray areas” present a serious quandary for hospitals, which must maintain a balance between compassionate care and financial stability. In order to admit you as a “patient,” they must be able to check enough of the required boxes on the Admittance Form to satisfy Medicare’s admission requirements. Medicare controls how much the hospital gets paid for the services it provides and the sad reality is that hospitals must consider that Medicare might not pay and, even worse, that a Medicare audit could suggest that the hospital is guilty of Medicare fraud. Faced with this conundrum, the safest option for the hospital is to place you in a hospital room, “under observation”. Sadly, this will NOT be the best option for you! Whether you are admitted as a “patient” or placed in a room “under observation” will determine who will pay for your future treatment. If you are admitted to the hospital as a “patient” for three full days, and are subsequently moved to a rehabilitation facility, Medicare will pay all the costs of the first 20 days of rehab, where costs can easily exceed $500 per day. Medicare will also pay all but the first $157 per day for the following 80 days in rehab. Also, most Medicare supplemental health insurance plans will cover the first $157 per day if Medicare is paying the back end. Being in the hospital “under observation”, but not a “patient” of the hospital, will not qualify you for Medicare to pay for your future rehabilitation period. This is where your advocate should step in to protect you. The advocate should confirm your status in the hospital from day one: “patient” or “under observation”? If you are “under observation”, the advocate needs to immediately ask two important questions: 1) Why aren’t you a “patient” and 2) What can be done to allow the hospital to check enough boxes on the Medicare form to admit you as a patient. The hospital knows how the system works and although they would like to admit you as a patient, you must meet the Medicare requirements. By asking the medical team what is missing from the form, your advocate may be able to provide the additional information necessary to qualify you as a “patient”. Advocacy is an essential part of your life care plan. Do you know who your best advocate is or will be? More importantly, does your advocate know that you are expecting them to step up on your behalf? Does he or she know what the issues are that you are expecting them to address? An Accidental Safari often begins in the Emergency Room, and the dangers there are as perilous as those in a jungle. Let’s take the steps to prepare to meet whatever challenges may come around the next turn in the road. Written by Richard C. Tizzano, a Poulsbo, WA attorney. Richard specializes in the field of Estate Planning, Elder Law and Long Term Care Crisis Management, Strategic Care Cost Risk Mitiga- tion and Sustainability. 360-779-5551 / www.westsoundlegal. com A 9-1-1 Buddy 911
  15. 15. 14 Fall/Winter 2018 Financial Planning 14 I f you are, or will be, a caregiver for elderly parents or another close family member living with Alzheimer’s disease, you may experience some emotional stress – but you also need to be aware of the financial issues involved and what actions you can take to help address them. You will find few “off the rack” solutions for dealing with the financial challenges associated with Alzheimer’s. For one thing, family situations can vary greatly, both in terms of the financial resources available and in the availability and capabilities of potential caregivers. Furthermore, depending on the stage of the disease, people living with Alzheimer’s may have a range of cognitive abilities, which will affect the level of care needed. Here are some general suggestions that may be useful to you in your role as caregiver: • Consult with family members and close friends. It’s extremely hard to be a solo caregiver. By consulting with other family members or close friends, you may find that some of them have the time and ability to help. • Consider obtaining durable power of attorney. If you possess a durable power of attorney for finances, you can make financial decisions for the person with Alzheimer’s when he or she is no longer able. With this authority, you can help the individual living with the disease – and your entire family – avoid court actions that can take away control of financial affairs. And on a short-term basis, having durable power of attorney can help you take additional steps if needed. You’ll find it much easier to acquire durable power of attorney when the individual living with Alzheimer’s is still in the early stage of the disease and can willingly and knowingly grant you this authority. • Gather all necessary documents. You’ll be in a better position to help the individual living with Alzheimer’s if you have all the important financial documents – bank statements, insurance policies, wills, Social Security payment information, deeds, etc. – in one place. • Get professional help. You may want to consult with an attorney, who can advise you on establishing appropriate arrangements, such as a living trust, which provides instructions about the estate of the person for whom you’re providing care and names a trustee to hold title to property and funds for the beneficiaries. You also might want to meet with a financial advisor, who can help identify potential resources and money-saving services. And a tax professional may be able to help you find tax deductions connected to your role as caregiver. Finally, use your experience as a caregiver to reminder yourself of the importance of planning for your own needs. For example, a financial professional can suggest ways of preparing for the potentially huge costs of long-term care, such as those arising from an extended stay in a nursing home. Caring for an individual living with Alzheimer’s has its challenges. But by taking the appropriate steps, you can reduce uncertainties – and possibly give yourself and your family members a greater sense of security and control. This article was written by Edward Jones for use by your local Edward Jones Financial Advisor. Tips for Handling the Financial Challenges of Alzheimer's
  16. 16. IRT-2735D-A EXP 31 JUL 2019 © 2017 EDWARD D. JONES & CO., L.P. ALL RIGHTS RESERVED. www.edwardjones.com Member SIPC Schedule your retirement review today. It’s been said that we spend more time planning vacations than planning for retirement. Schedule your retirement review so you can understand: • How much you’ll need to retire • If you are on track for your retirement goals • Which IRA is right for your retirement needs – Roth or traditional • The importance of asset allocation and how it can help as you work toward your long-term goals Let’s set aside some time to make sure you are on track for the retirement you have envisioned. An Hour of Your Time May Be Worth More Than You Think Stephen Sklar Financial Advisor (360) 385-2243 2500 W Sims Way Suite #202 PORT TOWNSEND Calvin Christensen Financial Advisor (360) 698-6092 3100 NW Bucklin Hill Rd Suite #115 SILVERDALE Todd E Tidball Financial Advisor (360) 779-6123 18887 State Hwy 305 Suite #100 POULSBO Dan Abbott, CFP Financial Advisor (360) 683-0605 990 E. Washington St. Suite #2B SEQUIM
  17. 17. 16 Fall/Winter 2018 Health Care The Caregiving Role Reversal Managing a Healthy Caregiving Relationship with Your Aging Parent I t is no secret. Being a caregiver for an aging parent is hard work. The role reversal that takes place in the “adult child-parent” relationship as parents age frequently makes the difficult job of caregiving all the more stressful for both parties. Cynthia is in her mid-80s and still lives fairly independently at home not far from her son Eric’s home. Eric, Cynthia only child has taken on the role of primary caregiver. He keeps close tabs on his mom with the help of paid in-home caregivers who visit her three time a week to help tidy the house, ensure there is food in her fridge and remind her to take her medications. Despite this well-working arrangement, as his mother’s caregiver, Eric has had to make some tough decisions to ensure Cynthia’s health, safety, and wellbeing. For instance, after a fender-bender, Cynthia no longer drives because Eric felt she didn’t see well enough to manage driving safely. Additionally, Eric cancelled her credit card account because Cynthia was using it recklessly, ordering various decorative items from television shopping shows and quickly draining her financial resources. Although Eric’s motives were purely from the heart and with the best of intentions, these decisions were not well received by Cynthia. In fact, animosity has grown substantially between the two of them, with Eric feeling rather upset that his mother is not only unappreciative of his efforts to keep her safe and healthy, but downright angry with him. Many would say that Eric and his mom are dealing with the expected symptoms related to their role reversal - that they have simply switched sides in the parent-child dynamic now that Eric is his mother’s caregiver, meaning that he has taken on the parental responsibility of caring for his parent as he might for his own child. But, that isn’t exactly true. The change-up in their relationship is really much more complex. First off, Eric’s mom isn’t like a child. Children are learning and maturing little people that can be reasonably expected to grow out of the dependency on their parents with each passing year. The same does not hold true for older people. Cynthia likely will continue to decline with age and eventually need more support, becoming less independent over time. Cynthia recognizes that point all too well and that is likely contributing greatly to her hostility towards Eric. So, is caregiving for one’s aging parent doomed to be a bitter and emotionally draining experience? Hopefully not! To keep resentment at bay, there are things to be mindful of to establish a healthy and successful caregiving relationship with your elderly parent: Change your mind-set: When serving as your parent’s caregiver, keep in mind that you are not “parenting” your parent. Instead, your primary goal is to help your parent deal effectively with the changes they are experiencing as they age. Be Honest …and Respectful: There is nothing to be gained by pretending you don’t notice changes in your parent’s health and wellbeing. Speak honestly and respectfully with them about any worries you may have about their health and safety. As your parent learns to accept any limitations brought on by aging, they will need to ask for support from you with the same honesty. Work to establish a respectful tone with your parent about these matters, so that going forward, you can together assess your parent’s overall wellbeing and look for warning signs of any emerging problems. Don’t Over-Rescue: Your elderly parent will be stronger if you allow them to do as much for themselves as they still can. Your parent’s role should not be to become overly dependent on you, while your goal should be to help them take full responsibility for themselves by acknowledging when they need help and providing help when needed. Manage Your Stress: Don’t let stress interfere with your ability to appropriately and compassionately care for your aging parent. Easier said than done, for sure! Removing unnecessary stress is critically important for the wellbeing of both you and your parent. The stress of caregiving may be getting to you if you find yourself making judgmental or patronizing remarks to your parent, such as “you could do this by yourself,” “you’re just not trying” or “let’s see if we can put our own clothes on today.” It is crucial that you find effective ways to manage your stress before it gets in the way of maintaining a positive relationship. Get Some Help: You may be the designated primary caregiver for your parent, but you simply can’t do it all. You just can’t. Many caregivers start by asking siblings and family members for help, but give up when these folks won’t make the commitment to assist. Don’t give up! By Jennifer Bailey
  18. 18. 17www.compassandclock.com/ Health Care Investigate resources in your community to find alternative support options, including respite stays at area senior care centers or help from a reputable home care agency that will send trained caregivers to your parent’s home. Take Care of You: Help with your caregiving duties is essential, but so is taking care of yourself. Make rest, a healthy diet and exercise a priority. Even a daily 20-minute walk can substantially relieve personal stress. If it gets to be too much, you might consider consulting with others for support and a new perspective on your situation. Although family or friends might prove to be great sounding boards, don’t discount the skills of a professional counselor. Relationships change over time and the one you have with your elderly parent when you begin caregiving for them will surely change, too. Your attitude is key to leading this new relationship on a positive and proactive path as you begin this journey together. By keeping acceptance, honesty, and faith in one another at the center of the relationship, you and your parent have an excellent chance of managing and adapting to your new roles with one another. Jennifer Bailey is the Marketing and Communications Manager at Martha & Mary, a non-profit care organization that has been serving children, seniors and families since 1891. Son. Best Friend. Caregiver. He’s always taken care of you, and now you’re taking care of him. Let Discovery Memory Care help in this new stage of life. Our specialized Memory Care Community can provide you, Dad, and your entire family, with the comfort and support you need. 408 W. Washington St. Sequim, WA 98382 www.discovery-mc.com Tour Today! (360) 207-0009 A Senior Services of America Managed Community 360.626.7840 www.MarthaandMary.org 2018 BEST OF HOME CARE PROVIDER OF CHOICE Nationally recognized for exceptional in-home care. Offered to seniors and adults throughout Greater Kitsap. We are your trusted care partner. athome@marthaandmary.org
  19. 19. 18 Fall/Winter 2018 Health Care Feel Good Without the Paranoia What You Should Know About Cannabidiol (CBD) By Carol Fisher for Compass & Clock Caring for Families one generation at a time. Home Care: • Companionship • Personal Care • Respite Care • Meal Preparation • Transportation • Medication Reminders • Homemaker Services Registered Nurse Delegation • Live-in and 24-hour Care 360-895-3980 Licensed & Insured Specializing in Hospice Care Serving Kitsap, Mason, Jefferson, Pierce and King Counties M any cannabidiol (CBD) users sing its praises a holistic alternative to conventional opioids and antipsychotic medications. Now that CBD is legal nearly everywhere, the market has exploded with brick-and-mortar businesses and online sellers. As a result, regulations and quality control have lagged behind the rapid growth of this young industry; thus, not all CBD products are created equal. Before you shop, understand what it is you’re buying. What is Cannabidiol? Cannabidiol, commonly known as CBD, is one of dozens of unique compounds produced by the plant genus Cannabis; varieties of which include marijuana and hemp. When obtained from hemp CBD contains no delta-9 tetrahydrocannabinol (THC), the compound that induces euphoric sensations, or a “high”. What does CBD do? Most notably, CBD is not psychoactive. It does not change the user’s state of mind. When taken without the popular compound THC, the user does not experience the effects of getting stoned. Some early scientific research suggests CBD has medical and therapeutic benefits. Users have found CBD useful in: • Acne treatment • Pain relief • Fighting cancer • Diabetes symptoms • Glaucoma • Sleep disorders • Smoking cessation and drug withdrawal • Treatment of mood disorders such as post-traumatic stress disorder (PTSD), general anxiety disorder, panic disorder, social anxiety disorder, eating disorders, and obsessive-compulsive disorder • Treatment of some types of epilepsy as a result of its anti-seizure properties • Neurological diseases such as multiple sclerosis (MS), Parkinson’s, and Alzheimer’s disease (AD). Initial research published in the Journal of Alzheimer’s Disease found that CBD might help people in the early stages of AD retain the ability to recognize the faces of people they know. How does CBD work? While extremely complex, in simple layperson’s terms, it is thought that CBD acts upon our endocannabinoid system which has receptors throughout the brain, organs, connective tissues, glands, and immune cells. This system appears to have an important modulatory role in brain function, endocrine, and immune tissues, regulating the secretion of hormones and response to stress. Currently, the medical community knows very little about CBD. While the World Health Organization (WHO) announced in December 2017 that CBD does not appear to pose any harmful effects to users, there are no studies yet on its long-term effects. Nevertheless, should you have questions do not be discouraged from discussing CBD with your healthcare practitioner, especially if you are already on medication. If you decide to use CBD, be sure to include it as a supplement whenever asked to provide a list of your current medications. Your dog and CBD: Similar to the benefits experienced by humans, early research is promising, and your beloved
  20. 20. 19www.compassandclock.com/ Health Care Learning about the plant with a purpose Hwy 420 Herbalist | 11493 Clear Creek Rd, NW, Silverdale,WA 98383 360-440-8671 | Hwy420herbalist.xyz |Located next to Hwy420 Cannabis Store and Annex The Health Benefits of Non Hallucinogenic-CBD • Pain Management • Anxiety Relief, PTSD, and Depression • Inflammation Treatment • Parkinson’s, Alzheimer’s, and Epilepsy • Obesity and Anorexia • And More Convenient, personal and professional one on one consulations HerbalistHerbalistHerbalistHerbalist canine can be treated with CBD for: • Pain relief • Cancer • Anxiety • Seizures • Bowel disease • Reduction of inflammation • Protection of the heart and the nervous system • Stimulation of appetite While CBD is available in dog treats, consider purchasing the oil as a tincture. This will allow you to adjust the dosage drop by drop. Buying CBD: Hemp-derived CBD oil is legal in Washington, as it is in all fifty states, and can be purchased locally or online. First-time buyers might do well to visit a local dispensary to browse their inventory and ask questions. It is imperative to find a trusted manufacturer as high-quality CBD oil should provide the full spectrum of its health benefits. A trusted CBD oil manufacturer will: • Source their CBD oil from 100% organic, non-GMO (non- genetically modified organism) certified hemp • Use CO2 extraction (SCFE) as their method of collecting the oil from the plant • Provide certification of licensed laboratory analysis for cannabinoid content and potency, potential contaminants, and mycotoxins • Use the full spectrum of cannabinoids in their extracts • Outline a clear shipping and return policy Cannabidiol receptors are found throughout the entire body. Therefore, CBD is available in a mind-boggling array of products including oils, vaporizers, ointments, balms, moisturizers, shampoos, facial cleansers, edibles, capsules, protein powder, CBD-infused teas, tinctures, and bath bombs. Be mindful of product labeling and note the dosage and actual active CBD in the product. CBD oil should contain no THC, or trace elements less than 0.3 percent. Remember, non-organic oil may contain solvents, pesticides, or fungicides. When shopping for CBD oil locally or online, it would be wise to choose a company based in the United States with a solid reputation. Be diligent, request expert advice whenever possible, and thoroughly investigate consumer reviews. Look for high-quality CBD; be wary of bargain- priced products.
  21. 21. 20 Fall/Winter 2018 Health Care D iabetic foot care is imperative to your overall health and can be dangerous to your feet with possible serious consequences. Diabetes can cause nerve damage that takes away the feeling in your feet. In many cases, numbness or tingling in the feet is the first clue patients have of their new diabetes diagnosis. Diabetes may also reduce blood flow to the feet, making it harder to heal an injury or resist infection. Because of these problems, you may not notice injury or blisters to your feet, often resulting in diabetic foot ulcers. Ulcers often lead to infection or a nonhealing wound that could put you at risk for an amputation. To avoid serious foot problems that could result in losing a toe, foot or leg, follow these guidelines provided by the American College of Foot and Ankle Surgeons at ACFAS.org 1. Inspect your feet daily. Early detection is key!! Check for cuts, blisters, redness, swelling or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Call your doctor if you notice anything. Avoid blisters; if you have shoes that are giving you blisters, talk to your doctor about special diabetic shoes and inserts 2. Bathe feet in lukewarm, never hot, water. Keep your feet clean by washing them daily. Use only lukewarm water—the temperature you would use on a newborn baby. 3. Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting and carefully dry between the toes. 4. Moisturize your feet but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking. But don’t moisturize between the toes—that could encourage a fungal infection. 5. Cut nails carefully. Cut them straight across and file the edges. Don’t cut nails too short, as this could lead to ingrown toenails. If you have concerns about your nails, consult your doctor. IF YOU HAVE NEUROPATHY OR BLOODFLOW ISSUES- your nails should be trimmed by your Podiatrist! 6. Never treat corns or calluses yourself. No “bathroom surgery” or medicated pads. Visit your doctor for appropriate treatment. 7. Wear clean, dry socks. Change them daily. 8. Consider socks made specifically for patients living with diabetes. These socks have extra cushioning, do not have elastic tops, are higher than the ankle and are made from fibers that wick moisture away from the skin. 9. If your feet get cold at night, wear socks. Never use a heating pad or a hot water bottle. 10. Shake out your shoes and feel the inside before wearing. Remember, your feet may not be able to feel a pebble or other foreign object, so always inspect your shoes before putting them on. 11. Keep your feet warm and dry. Don’t let your feet get wet in snow or rain. Wear warm socks and shoes in winter. If your feet may get wet (especially in the Northwest!), carry an extra pair of dry socks 12. Consider using an antiperspirant on the soles of your feet. This is helpful if you have excessive sweating of the feet. 13. Never walk barefoot. Not even at home! Always 16 Steps for Diabetic Foot Care
  22. 22. 21www.compassandclock.com/ Health Care wear shoes or slippers. You could step on something and get a scratch or cut, resulting in dangerous foot ulcers! 14. Take care of your diabetes. Keep your blood sugar levels under control. 15. Do not smoke. Smoking restricts blood flow in your feet. 16. Get periodic foot exams. Seeing your foot and ankle surgeon on a regular basis can help prevent the foot complications of diabetes. Follow up with your Primary Doctor or Endocrinologist regularly for help managing your diabetes.  To find out what Diabetes-specific care our office can offer you, click: https://peninsulapod.com/diabetic-wound-foot-care/ For more information of how to care for your feet and other common foot conditions, go to https://www. foothealthfacts.org/ or ACFAS.org. Article submitted by: Sarah A. Neitzel, DPM Peninsula Podiatry 360-286-0404 9927 Mickelberry Rd., Suite 121, Silverdale Choose the Best for your Foot Health Serving the Kitsap & Olympic Peninsula 360-286-0404 9927 Mickelberry Rd Suite #121, Silverdale www.peninsulapod.com Sarah A. Neitzel DPM These Feet Are Made For Walking • Walk-ins & Limp-ins, Same day / Next day Appointments Available • Podiatric Medical & Surgical Care, all Ages & Conditions • Specializing in Diabetic Foot Care & Wound Care It's 3.6563" wide X 4.7813" high When living at home is no longer an option, I want a place.caring Our mission is to exceed your expectations for loving, thoughtful memory care, in a secure community focused on independence and life enrichment. ~ Respite and Daycare Services Also Available Please call or drop in for a tour, a meal and more information. San Juan Villa Memory Care Community 112 Castellano Way Port Townsend, WA 98368 Phone: 360-344-3114 www.CaringPlaces.com million Americans have diabetes $245 30 billion annually Americans pay more than for the emotional, physical and financial burdens created by diabetes 9.4% of Americans have diabetes 25% of seniors with diabetes have diabetes 7thDiabetes is the leading cause of death in the U.S. Diabetes by the numbers Compiled from the American Diabetes Association
  23. 23. 22 Fall/Winter 2018 Health Care T here are many aspects important for maintaining health as we age. Inarguably, good nutrition is one of the most important of these factors. Diseases such as diabetes, hypertension, cardiovascular diseases, and cancer are linked to diets lacking adequate nutrients and/or having an excess of fat or calories. Good nutritional intake is necessary for managing illness. In addition to prevention of disease there are many benefits to good nutrition including increased energy, improved mood and cognitive function, maintenance of muscle and bone mass and achieving and maintaining an ideal body weight. A nutritious diet is a key factor in ensuring you remain healthy and energetic throughout your life. The great news is that regardless of where you are currently in your nutrition and health journey, making changes to improve your nutritional intake now can make a difference in your health and wellbeing. Most people are familiar with the food groups: fruits, vegetables, grains, proteins, dairy, and oils. For more information on your suggested intake and details about each food group visit: http://www.choosemyplate.gov/olderadults. I would also encourage you to share your nutritional goals with your physician and if needed meet with a registered dietitian who can help you reach your dietary goals. Aside from the general nutritional recommendations, there are additional considerations for different life stages. As adults age, they need fewer total calories, but also need an increase in certain nutrients. These needs can be met by choosing foods that are nutrient-rich. The following is a list of specific nutrients along with good sources and/or suggestions for ensuring adequate nutrient intake. Calcium helps to maintain bone strength and keep bones and teeth healthy. Older women in particular suffer a higher rate of bone loss after menopause: Calcium can be found in dairy (milks and cheese products), fortified soy and nut milks, tofu, calcium fortified cereals and fruit juices, canned sardines or salmon with bones and some green leafy vegetables such as collard and turnip greens, kale and bok choy. Vitamin D boosts your immune system, keep your nerves healthy, and helps turn the food you eat into energy: Vitamin D is found naturally in very few foods, but amazingly, is produced in our skin when we absorb sunlight and is found in fatty fish, such as salmon, tuna and mackerel, beef liver, and egg yolks. Manufacturers fortify it into cow’s milk, soy and nut milks, and sometimes into juices and cereals. Vitamin B12 is important for creating red blood cells and DNA, and for maintaining healthy nerve function: Meats, dairy products, and fortified breakfast cereal provide good sources of B12. Potassium is vital for cell function, helps reduce high blood pressure and the risk of kidney stones, and keeps bones strong: Potassium is found in fruits and vegetables, especially bananas, citrus, melons, raisins, dates, apricots, cucumbers, cooked spinach and broccoli, peas, mushrooms and potatoes. Fiber is an important nutrient to ensure a healthy and active digestive tract.: Whole grains, beans, legumes, fruits and vegetables are fiber full, so be sure to include these regularly in your dietary intake. Choose whole grain products, whenever possible. You might be surprised by how much tastier whole grain pastas, crackers or baked goods are! Protein is vital for muscle maintenance, immunity, and recovery: Try to include a high protein item with each meal. You can pump up your protein intake by adding protein rich food to your snacks such as seeds, nuts, nut Community Dining Meal Sites | Home Delivered Meals Nutrition Education & Dietary Counseling Senior Farmers Market Vouchers |Volunteer Opportunities 360-377-8511 888-877-8511 www.mealsonwheelskitsap.org Proudly “serving more than a meal” for 45 years! For information contact us at Eat Well and Stay Healthy
  24. 24. 23www.compassandclock.com/ Health Care Putting the Needs of our Patients First Dr. Mark Hoffman, Dr. Teresa Andersen, Dr. Brad Andersen, Dr. Charles Power Providing the Best Quality Care • Members-Only Relational Primary Care (RPC) Practice • Membership $150 Annually • Most Insurances Accepted • New Patients Welcome • Founded in 2009, Independently Owned Practice • All 4 Physicians are local community members Hours of Operation: Monday - Friday, 7:30 am - 5:00 pm 22180 Olympic College Way NW, Suite 201, Poulsbo www.soundfamilyhealth.com 360-394-3500 butters, cheese, hard-boiled eggs, plain yogurt or sliced deli meats. Increase the fiber and protein content of many dishes by simply adding canned or frozen beans When shopping for groceries, a good suggestion is to buy most of your groceries from the perimeter of the typical grocery store layout. Visit the inside aisles for some pantry staples and whole grains. Most of the processed “junk foods” are found in inside aisles. If you need to lessen the amount of work to prepare meals, already chopped or frozen fruits and veggies are a great convenience. Choosing to shop only sale/discounted items and using coupons can help with the affordability of groceries. Other tips include first checking the day old rack from the baked goods and looking for the discounted stickers often put on foods in the refrigerated section that need to sell quickly. Bargain grocery stores or outlets and wholesale grocery chains that sell bulk items are often the better option for those needing to maximize their grocery budget. It also is worth noting that many chain stores offering groceries online will deliver to your home or bring items out to your car. These services can be beneficial to those with mobility issues. Local farmer’s markets and farm stands provide another means of accessing fresh fruits and vegetables. Most markets open in early spring and remain open through late fall. For a complete list of state- approved markets, visit http://wafarmersmarkets.org/ washingtonfarmersmarketdirectory/ . Purchasing and preparing nutritious foods is not easy, especially for those on a limited budget or with mobility issues. Fortunately, there are programs that help. The Senior Nutrition Program is available to all adults 60 and older and is available in counties all around the Olympic Peninsula. The location and contact info to find out more about each of these programs is available in the directory. These programs provide a nutritious meal that is designed to meet at least one third of the daily recommendations for nutrients and are served in a communal dining setting. For those who are unable to travel to a meal site due to mobility or health issues, many of these programs also offer home delivery options. Good nutrition is important to living a healthy, happy life. Older adults ideally need more of certain nutrients as part of a healthy intake. Smart grocery shopping techniques and participating in the Senior Nutrition Program are great ways to reach your nutritional recommendations. By Christine Michelle Hamilton Registered Dietitian Consultant Meals on Wheels Kitsap
  25. 25. 24 Fall/Winter 2018 Health Care D r. Daniel Morris practiced internal medicine for 35 years before retiring in 2010. As a retired physician, Morris knows the risk factors for falls – such as muscle weakness, vestibular (inner ear) dysfunction, cardiovascular disease, and environmental factors. However, he didn’t relate those factors to his own life until he was injured in a fall. “I knew I had some muscle weakness, but I didn’t realize how extensive it was,” he says. “And I didn’t realize I had as much vestibular dysfunction.” On a cold January morning last year, Morris rushed up the short ramp to his workshop outside his house, slipped on ice, and fell. Attempting to break the fall, he dislocated and fractured his right shoulder. For a month, Morris couldn’t drive and was limited in his ability to perform routine tasks such as eating and dressing. When he started a rehabilitation program for his shoulder at Kitsap Physical Therapy (KPT), he wanted to understand what factors contributed to his fall. With a referral from his primary care physician, Morris undertook a fall-risk evaluation at KPT, where he learned the extent of his muscle weakness and vestibular dysfunctions. The evaluation includes a full assessment of all the involved systems: musculoskeletal, neuromuscular, cardiovascular/pulmonary, proprioceptive (space perception), vestibular and the cognitive changes that need to be managed as part of the aging process. Additionally, there’s a vision screening, prescription review and a discussion of the home environment. “We try to evaluate all the modifiable risk factors that we can improve upon,” says Richard McDowell, a board- certified geriatric physical therapist at KPT. “If a risk factor is not modifiable, then we look at adaptive techniques, such as using equipment.” The evaluation placed Morris in the high-risk category for falls. He advocates for an evaluation for anyone who has fallen or has had an injury, is afraid of falling or has balance issues. He feels that self-knowledge and self-awareness would have made a difference in preventing his fall. Adults are at an increased risk for falling as they age. Most often, patients do not report a fall to their family or primary care physician due to fear of losing independence. Unfortunately, that is counter intuitive, since reporting the first fall can save your life. According to the National Council on Aging: • Every 11 seconds, emergency rooms treat an older adult for falls. Two thirds of those who fall will fall again within six months. • One in 3 people aged 65 years and older fall at least once every year. One in 40 of those will be hospitalized and only half of those hospitalized will survive the year. • Sixty percent of fatal falls occur in the home. Imagine preventing the fall from happening in the first place. “Our evaluation can provide a risk predictor for falls,” McDowell says. “During the treatment, we’ll challenge the patient’s systems in a risk-free environment. To improve your balance, you need to be near a fall and the best way to do that is in an environment where a physical therapist can support you.” For Morris, the risk decreased from high to low after just 15 physical therapy sessions. With a year of physical therapy now behind him, his recovery and the return of 90-95 percent of his shoulder function took a lot of work. Preventing Falls • Professional • Of Good Character • Veteran Broker Let’s Sit Down & Talk Today 360.731.7655 (c) johnt@johnlscottt.com | www.johnt.johnlscott.com • Comprehensive Services • 28+ years with John L. Scott • Testimonials & References Available John M. TaylorJohn M. Taylor Your Personal Realtor®
  26. 26. 25www.compassandclock.com/ Health Care Yes (2) No (0) I have fallen in the past year. Yes (2) No (0) I use or have been advised to use a cane or walker to get around safely. Yes (2) No (0) Sometimes I feel unsteady when I am walking. Yes (2) No (0) I steady myself by holding onto furniture when walking at home. Yes (2) No (0) I am worried about falling. Yes (2) No (0) I need to push with my hands to stand up from a chair. Yes (2) No (0) I have some trouble stepping up onto a curb. Yes (2) No (0) I often have to rush to the toilet. Yes (2) No (0) I have lost some feeling in my feet. Yes (2) No (0) I take medicine that sometimes makes me feel light-headed or more tired than usual. Yes (2) No (0) I take medicine to help me sleep or improve my mood. Yes (2) No (0) I often feel sad or depressed. Total ____ Add up the number of points for each “yes” answer. If you scored 4 points or more, you may be at risk. Contact one of KPT’s geriatric specialists with your results for a FREE screening and recommendations to help you stay independent and active for life. Ask Yourself These Questions... Circle “Yes” or “No” for each statement below Bainbridge Island (206) 842-6288 Bremerton (360) 792-1015 Kingston (360) 297-7050 Port Orchard (360) 895-9090 Poulsbo-NKMC (360) 779-3764 Poulsbo-Village (360) 779-3777 Silverdale (360) 613-1834 locations to serve you7 www.KitsapPT.com He’s also taken preventive steps in his home environment by installing a handrail on his shop ramp. As a physician, he knows the importance of prevention as well as of maintaining progress. This perhaps explains why, unlike a typical patient, he not only continued physical therapy for an entire year but also went in for a risk reevaluation several times. “With most major injuries, you’re never as good as before and it’s important to maintain what you’ve gained through physical therapy,” he explains. “It’s easy to get distracted with everyday life, and physical therapy is adding one more routine into your weekly schedule.” “I really believe that being fit and continuing the physical activity really makes a difference,” he says. “I put balance and strength training in the same category as brushing and flossing -- we all know we need to do it, but we don’t all do it, and then we pay the consequences.” Morris, who lives in Indianola, is thankful that he could use the fitness center at KPT’s Kingston clinic for exercising. According to McDowell, research suggests that creating any significant change takes 120 hours of physical activity. That’s why it’s critical to exercise at home or in the community after going through physical therapy treatment. An individual walking program or a group exercise program like SAIL can help older adults maintain their physical fitness and reduce the likelihood of falls. For a free screening, contact any of the KPT’s seven locations. For more program information, visit www. kitsappt.com. In collaboration with the Kitsap County Fall Prevention Coalition, Kitsap Physical Therapy is one of the first organizations to offer SAIL (Stay Active and Independent for Life) classes in the county. SAIL is an evidence-based program for adults 65 and older that helps improve strength, balance and cardiovascular fitness. Classes are conducted two times a week by staff who are SAIL-certified instructors. The class is designed to help increase energy, improve walking and flexibility, maintain healthy weight, and improve self-image and sleep. It uses a group approach, providing a social environment where peers interact and can create new relationships. KPT currently offers classes at the following locations: Village Green Community Center: (360) 297-1263 Bainbridge Island Senior Center: (206) 842-1616 The Washington Department of Health in alliance with Wellness Place, Inc. administers the SAIL Program in Washington State. KPT’s commitment to SAIL is part of a larger Kitsap area effort to help seniors age in place. KPT is joined by the Retired and Senior Volunteer Program (RSVP) of Kitsap, CHI-Harrison, and local, county, and state agencies for older adult services. The common goal is for aging to be safe, healthy, and happy.
  27. 27. 26 Fall/Winter 2018 Health Care Support Groups Early Stage Memory Loss Programs 24/7 Helpline 1.800.272.3900 alzwa.org Washington State Chapter Serving Washington & Northern Idaho Information and support for people affected by Alzheimer’s and dementia. Proper nutrition is important at every stage of life but it can be especially important for people with dementia as poor eating habits may increase behavioral issues and cause weight problems. People with dementia may have no desire for food or drink. Skills such as using utensils may disappear and favorite foods may no longer entice the same response they once did. Understanding which strategies work and which do not will help eliminate some of the frustration. Let’s start with the don’ts. Luckily this list is short. • Don’t harass, harangue or argue with someone who is not interested in eating. • Don’t force them to sit with the food in front of them once it becomes clear they are not interested in it. The dos. • Keep distractions limited. Too many options, too much activity, too much clutter all limit the ability to focus on eating. If only a spoon, a bowl and a glass is needed, don’t add a fork, a knife and other items in order to have a proper place setting. Keep tablecloths plain, dishes unadorned, and decorations out of the view of your loved one. People with dementia often have perception problems so make sure dishes and tablecloths or placemats are different colors. AARP advised in one article that a study found that people with dementia ate more food if it was served on a red plate rather than a white plate. • Switch to finger foods or cut chewy items into smaller pieces. Feed smaller meals more often. Consider feeding only one item at a time. • Use unbreakable place settings. They will limit the mess, improve the ability to grasp and make cleanup easier and safer. There are dementia friendly place settings available that make holding and using utensils easier. Straws can make liquids easier to handle. • Allow time to eat. Use that time to sit with your loved one and assist if necessary. All people need some companionship. It does not go away with dementia. • Make sure that there is not a physical reason such as poor fitting dentures or mouth sores getting in the way of eating. • Make sure food is the right temperature to eat at the time offered. Avoiding food fights
  28. 28. 27www.compassandclock.com/ Health Care 10 Ways to Love Your Brain When possible, combine these tips to achieve maximum benefit. If it seems overwhelming, start with one or two changes and build on them gradually. The most important thing is that you start now. It’s never too late or too early to incorporate healthy habits! Growing evidence indicates people can reduce their risk of cognitive decline by adopting key lifestyle habits. Healthy behaviors known to combat cancer, cardiovascular disease and diabetes are also good for your brain health. These include staying mentally active, engaging in regular physical activity, and eating a heart-healthy diet. Here are a few tips to get you started: Studies show regular cardiovascular exercise that elevates your heart rate and increases blood flow to the brain and body can reduce the risk of cognitive decline. Education in any stage of life will help reduce your risk of cognitive decline and dementia. Take a class at a local college, community center or online. Evidence shows smoking increases risk of cognitive decline. Quitting smoking can reduce the risk to levels comparable to those who have not smoked. Evidence shows risk factors for cardiovascular disease and stroke – obesity, high blood pressure and diabetes – negatively impact your cognitive health. Take care of your heart and your brain will follow. Brain injury can raise your risk of cognitive decline and dementia. Wear a seat belt, use a helmet when playing sports or riding a bike, and take steps to prevent falls. Eat a healthy and balanced diet lower in fat and higher in fruit and vegetables. Although research on diet and cognitive function is limited, certain diets, including Mediterranean and Mediterranean-DASH (Dietary Approaches to Stop Hypertension), may contribute to risk reduction.  Not getting enough sleep due to conditions like insomnia or sleep apnea may result in problems with memory and thinking. Take care of your mental health. Some studies link a history of depression with increased risk of cognitive decline, so seek medical treatment if you have symptoms of depression, anxiety or other mental health concerns Pursue social activities that are meaningful to you. Find ways to be part of your local community or share in activities with friends and family. Challenging your mind may have short and long-term benefits for your brain. Build a piece of furniture, complete a jigsaw puzzle, do something artistic, or play games that make you think strategically. Article provided by: Alzheimer’s Association Washington State Chapter alzwa.org | 1.800.272.3900 a sweat Break   Hit the books  Butt out.  Follow your heart.   Heads up!  Fuel up right.  Catch some Zzz’s. Buddy up.  Stay socially engaged  Stump yourself. ZZZZ
  29. 29. 28 Fall/Winter 2018 Health Care 2701 Clare Avenue Bremerton, WA 98310 www.bremertonskillednursing.com 360-377-3951 Points of Difference ~ Service ~ Care Options • Member of the National Stroke Association • Close proximity to Hospital • Direct ER Admissions • Therapy provided 7-days a week • State of the Art Rehabilitation Gym & Therapy Staff • 24-hour licensed Nursing Care • On-staff Wound Care Certified Nurse • Extend to Home Program • Life Enhancement Speciality Services • Short Term and Traditional Long Term Care • Respiratory, Palliative, Renal Disease and Cancer Recovery Services • Medicare and Medicaid Certified • And More Convalescent and Rehabilitation bilitation S troke is the sixth leading cause of death in Washington and the leading cause of adult disability in the United States. When it comes to stroke, time lost is brain lost because while a stroke causes permanent damage, most people recover. The significance lies in how well they recover. The patient’s fight to return to normalcy does not end with discharge from the hospital. Recovery requires time and advocacy. The most likely candidate for a stroke is someone who has already had a stroke so rehabilitation has to be immediate to avoid a recurring stroke. Stroke victims need a partner in their corner. Unfortunately, said Matthew Macklin, the Executive Director for Bremerton Nursing and Rehabilitation (BHR), until recently there was a gap in meeting the needs for inpatient rehabilitation in Kitsap. The Kitsap area didn’t even have a support group. If recovery partners existed at all, they often existed in Tacoma, and were insufficient for Tacoma let alone for those in other areas of Washington. “Everyone does stroke rehab,” said Macklin, so the question became “how can we do it better.” BHR extends the level of skilled nursing therapy with a one of a kind program called Project Endogeny. Endogeny refers to development or growth from within. The program seeks to fill the gap between intense inpatient rehabilitation and traditional skilled nursing therapy by utilizing stroke recovery technology not available in any other facility in western Washington. Project Endogeny uses the best and most recent technology for therapy relying on patterned electrical neuromuscular stimulation (PENS) to reeducate and treat muscle atrophy caused by stroke. PENS is used to enhance muscles and coordination used for swallowing. Therapists are able to see the swallowing and convert it to a game. “No one else in the state can do that,” said Macklin. Macklin is extremely proud of his team at BHR because while the technology is innovative it needs support, so BHR invested heavily in people. All BHR clinical and support staff are certified to support stroke recovery, prevention, and intervention. He extends an invitation to anyone in the community who would like a tour to see what makes them different. Exclusive Stroke Recovery Help
  30. 30. 30 Fall/Winter 2018 Housing Choices Christopher Morgan Postural Alignment Specialist 360-271-1517 VerticalPostureTherapy.com • Eliminates chronic pain, addresses posture • Focuses on the cause not the source of pain • Returns body back to its proper alignment & function • Improves energy level, mood & overall health Neck ~ Wrist ~ Back ~ Hip ~ Carpal Tunnel Syndrome ~ Plantar Fascitis ~ & More Mobile & Clinic Services Available Serving Kitsap County & Surrounding Area Types of chronic pain that Posture Therapy eliminates O nce upon a time, the milkman delivered his products to your doorstep; the tinker stopped at your door and offered to sharpen your knives; and someone went door-to-door offering encyclopedias. In fact, while you would certainly go to town for some items, many services and products were offered in your parlor. For the last few decades, the trend has been to have products and services move to the big box stores as a cost saving measure and a convenience—to the business. Only the very wealthy experienced anything different. While encyclopedias will probably never return to being a door-to-door product, many of those other in-home services are experiencing a resurgence. We’ve returned to the days of milk delivery but while that is useful, it isn’t just products offered at your home. Much of the newest and hottest industries revolve around the change brought on by the advent of technology in nearly everyone’s life. Whatever you need or want, in today’s world, there’s an app that addresses it and one of the things those apps address is how to offer services to customers outside the sphere of the corporate office. Just as a significant number of Americans work from their own homes, a growing number has begun to work from their customers’ homes. You may be quite familiar with some of them. Most auto glass is replaced at your home; there are portable mechanics for RVs and other vehicles; and there is an army of people who offer mobile pet wash services, mobile spa services, mobile barbershops, or mobile beauty shops. Some banks and lawyers offer mobile notarized services. Mobile services cut down on the costs for the storefront for the business but they also make certain services more convenient for people who are housebound, for pets that don’t like the panic induced ride to the vet, and for people who lead really busy lives. Mobile services also make it possible to live just about anywhere. If you want to stay at home rather than live in a nursing home, hire an in-home care service to provide meals, housekeeping, and personal care. There is Meals on Wheels if you need food and companionship, or a growing number of delivery services if you just want some of Billy Bubs All You Can Eat Ribs because it is Friday night. What’s more, if leaving home isn’t convenient due to health reasons, some doctors have returned to making house calls. Some labs offer portable x-ray services and portable prescription services. In addition, most places, regardless of isolation, offer in-home health care for those with medical needs. It’s not just care services being offered. The Kitsap Library offers mobile services to some of their borrowers who can’t get out for health reasons. That can be just as important if you are missing the latest bestseller due to an accident on the ski slope keeping you immobile, as it is if you are bedbound. These services are no longer for those living in big cities either. It’s a good guess that if it would make your life easier to have a service offered at home, it will make many other people’s lives easier as well. If there is a demand, someone is doing it. If no one is doing it then someone might if they knew there was a need for it. Please call one of our advertisers in your area of need. They will be able to offer recommendations for businesses that do offer mobile services if they do not provide those services themselves. Portable Businesses Make Staying at Home Easier Than Ever
  31. 31. 31www.compassandclock.com/ Housing Choices We’re by your side so you can stay in your own home. HomeInstead.com Whether you are looking for some help for a few hours a week or need more comprehensive assistance, Home Instead can help. Gig Harbor to Bainbridge Island 360.782.4663 Port Angeles to Port Ludlow 360.681.2511 Call for a free, no- obligation appointment Home Instead CAREGivers can provide a variety of services. Some include: • Companionship Care • Transportation • Hospice Care Support Services • Personal Care • Household Duties • Meals & Nutrition • Respite Care • Memory Care W hen we think technology we often think mobile apps and for good reason. There are apps for just about everything if you want to learn, do, or watch something. There are apps to order food from your favorite restaurant or to get you from point A to point B but technology isn’t limited to just your smartphone. The sheer volume of new technology designed to help older adults can be overwhelming. Here are a few items you may not be aware of: • These days nearly everyone walks around with a Fitbit or similar item for tracking their daily activity and food intake. That same type of technology can monitor if someone falls, provide a location for someone who wandered away and keep track of whether or not meals are being eaten. • At least as important as eating is making sure that medications have been taken and at the right time. Programmable Medication Management Systems alert the user about medications and dosage. • We’ve come a long way since the “Help I’ve fallen and I can’t get up” ads. While the ads are hokey, the need is not. Those emergency alert devices are smaller than ever so it isn’t as obvious that someone is wearing one and yet for a monthly fee one of these devices can go anywhere its user goes. • Touchscreen technology takes a lot of the fuss out of computer use. The iPad and other tablets make it easy to set up and keep up with email and social media. Safety features for your home can also be built into a smart device such as the Ring Video Doorbell that allows users to see who is at the door on your tablet before you open the door. • New technology makes driving a vehicle easier and safer than ever. Back up cameras, automatic braking systems, lane departure warnings, and blind spot detection are just a few of the new safety features that add to a driver’s ability to avoid a crash. • The Amazon Echo can play music, read a book, and make phone calls all by voice command. • It’s easy for even the most conscientious of us to leave something on the stove unattended but the Stove Guard CookStop will turn the stove off if it is left unattended for a predetermined time. Products to Help You Age in Place
  32. 32. 32 Fall/Winter 2018 Housing Choices Teri Tennyson KITSAP SENIORS REAL ESTATE (360) 440-6211 www.kitsapseniorsrealestate.com Holistic Real Estate Uniquely Qualified Seniors Real Estate Broker 25+ years combined experience in Real Estate, geriatric and construction services. Planning for Quality Living with a Team that Cares SERVICES • Individual customized plan • Seller, buyer representation • POA, estate sales, wills, probates and trusts experience • Trusted service provider referrals • Home safety assessment • Worldwide relocation contacts teri@teritennyson.com  9226 Bayshore Dr. NW, #140 Silverdale, WA 98383 “ Should I stay or should I go,” is the title of a 1982 popular song by The Clash. That same question is just as relative today, as many Baby Boomers ask themselves, “Should I stay” and retire in my current home or “should I go,” and find the new home I have always dreamed about? As with any major life change, it is always wise to have your local experts assist you. After all, “you don’t know what you don’t know.” In your community, you have a Seniors Real Estate Specialist professional who can consult with you. The National Association of Realtors created a designation requiring additional education for realtors to meet the needs of boomers. This specialist will work alongside you in considering affordability, current equity availability, home style, maintenance costs, property taxes, community security, mobility barriers both now and in the future, lifestyle convenience, proximity to family, universal design, legal options, home adaptability considerations, and costs. They can provide you with a cost analysis for remaining in your current home or making a move. This additional knowledge and advice are at no additional fee to you. Its comprehensiveness serves as a reminder that not all Real Estate Professionals are created equal. Many seniors are choosing to do a home conversion. A Seniors Real Estate Specialist can identify and calculate these costs and discuss financing options including the potential use of a reverse mortgage. In addition, they can schedule contractors and trades to handle changes such as, zero clearance curbless showers, creating a bedroom on the main floor, laundry relocation, and eliminating stairs by converting to ramp entries. The installation of stair lifts, if appropriate, may be utilized on the interior or exterior of the home and are permitted, licensed and inspected by Labor & Industries for compliance. Your local Seniors Real Estate Professional has the experience to come alongside you or your family members to create an plan for successful and safe independence. The desire to remain at home after retirement continues to be extremely important as Americans age. A September 2018 report from AARP found that almost 80 percent of adults age 50 and older want to remain in their communities and/or homes as they age. However, for many older homeowners, a monthly mortgage payment, rising property taxes and maintenance costs, drains savings or retirement funds, and makes staying in their home difficult. Increasingly, Baby Boomers are considering the Should I Stay or Should I Go? (360) 337-5700 (800) 562-6418 www.agingkitsap.com • Preserve and promote choice in how individuals and families receive long term services and supports • Support families in caring for loved ones while increasing the well-being of caregivers • Delay or avoid the need for more intensive Medicaid- funded long-term services and supports (LTSS) when possible Aging & Long Term Care Promoting the well-being of older adults and assisting them in maintaining their independence. 9857 Silverdale Way NW Silverdale Care for Yourself... ...Care for a Loved One • Support group options • Resources & education • Case manager support • Caregiver lending library • Caregiver respite options • Counseling https://spf.kitsapgov.com/hs/Pages/Aging-Landing.aspx
  33. 33. 33www.compassandclock.com/ Housing Choices FHA- insured Reverse Mortgage as a way to pay for their home and living expenses. There are three ways you can access the funds; 1. A lump sum to eliminate your mortgage payment, (and pay taxes, insurance, and maintenance of the home) 2. A tax-free line of credit; flexible withdrawals and growth option (applied to unused funds) 3. Monthly term or tenure payments. If you qualify, you can have a combination of the three. It was a dream come true for David and Vivian D., to continue to live in the home they built over 40 years ago. The 80-year-old couple mentioned in our publisher’s welcome article, owned their home free and clear. However, they did not have the cash to make the needed repairs and modifications for Vivian to live at home, forcing her to reside in a nursing home for six months until their attorney advised them that they could qualify for a reverse mortgage. They used a portion of their tax-free line of credit from their reverse mortgage to pay for the required home modifications and repairs necessary to make a safe and secure environment for Vivian and David. Fortunately, they both have long-term care coverage that pays for eight hours of daily in-home care. At Vivian’s homecoming celebration, she said, “Getting the Reverse Mortgage saved my life and allowed me to live in the comfort of my home. I am so grateful.” An H4P reverse mortgage loan combines a reverse mortgage loan with the equity from the sale of your previous home – or from other savings and assets to buy your next primary home in a single transaction. How does an H4P work? Regardless of what happens to your home’s value or how long you live in the home you only make one down payment towards the purchase. However, you must continue to pay taxes and insurance (and homeowner association dues if applicable), and maintain the home. You can use any additional equity after paying the down payment, for upgrading your new home or any other expenses that you might have. The basics factors in qualifying for an H4P are: • You must be 62 years or older • Current interest rates • The lesser of the home’s purchase price or the appraised value determines the amount of the down payment. • The new property must be your primary residence for more than six months out of the year. Contributors to the Article: Teri Tennyson, SRES Kitsap Seniors Real Estate 360- 440-6211 www.KitsapSeniorsRealEstate.com Joan Qvigstad, Reverse Mortgage Specialist Fairway Independent Mortgage Corp 360-271-5946 www. ReverseMortgageWithJoan.com Excellence • Comfort, dignity, respect at end of life Care in any setting, home or facility • RN, Home Health Aide, Social Work, Spiritual Care, Comfort Therapy, and Volunteers • Staff available for consult-Medical/ Psychosocial/Spiritual Hospice • Pediatric Hospice Services available with Dr. David Brunell as consult Timely admissions • Same day admissions available • Experienced Hospice Providers can serve as the Hospice Attending SERVING Kitsap, Pierce & King Counties All Insurance Situations All of Humanity Contact us: 253.301.6500 888.516.4505 Clinical Staff with over 30 years experience! Our hospice professionals help patients live with dignity when a cure is no longer possible. We deliver expert medical care, pain management and emotional and spiritual support tailored to your needs, as well as those of your loved ones. Call us today to learn more about hospice in the comfort of home. 360.582.3796 Serving Clallam, Jefferson, Lewis, Mason and Thurston 360.582.3796 www.assuredhospiceolympicpeninsula.com

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