Daily Snapshot

How seniors control healthcare costs

The two most costly budget items for older adults are housing and health care. Health care takes a $3 trillion dollar hit on the U.S. budget. Deloitte reports that we spend more on medical expenditures over many countries in the world. In 2013 alone, our nation paid 117% of Gross Domestic Product (GDP) and in 2014, it grew by 4.9 percent.

Even Medicare has no cost protection for seniors. People over 65 have high medical bills because many of them live with at least one chronic illness, while others have two. And aging adults pay a larger share of the premiums. They also bear more out of pocket expenditures. As people endure chronic diseases, the costs will keep going up.

Several trends that seniors should pay close attention are identified below. These developments directly relate to the rising cost of health care. Below, are a few remarks and suggestions provided by aging experts. They focus on various health care issues.

The trend toward self-management/empowerment is already changing things and will continue to do so. Consumers seek out information and come prepared with questions for providers (and research who has best success rates, etc.). Online medical record systems and communications tools, transparent data etc. will be demanded by patients. They all have possibilities to improve healthcare. Shannon Martin

Information is power and wearables and apps that save patient’s doctor office appointments and help manage medical care and chronic conditions will empower patients. The apps will continue to transform healthcare. Artificial intelligence will become a significant segment in health care as the workforce shrinks and the older population grows. Betsie Sassen

Hospitals seem to be releasing patients who need extensive nursing and follow-up care earlier and earlier. Friends and family members are often ill-equipped and overwhelmed trying to care for their ailing loved one at home. Margo Rose

One trend that I earlier applauded was computerization. BUT if they follow the path many banks are taking, which is to make copies and then archive (and often LOSE) paperwork, it may become a serious issue! Kaye Swain

People ask if more health care tests and treatments are better than less? As Patient Advocates replace M.D.s, the secretary supplants the nurse, and the insurance customer service line encourages self-care, patients look at other sources for their health care advice. Many people will save money, and some will find real help while others may get sicker as they delay getting a real diagnosis and treatment. Caryn Issacs

Hopefully, the trend towards disease prevention will increase. People are drinking less soda, both regular and diet, which is good. Carefully constructed legislation, public health education efforts and personal responsibility are on the rise. It can potentially have an enormous impact not only on the lives of all but the healthcare bills in the United States. Kim Crawford, M.D.

People need to learn to be advocates of their health. Caregiving requires a new generation of thinking and blending innovative ideas to change health care. Remember to ask your doctor and other medical professionals more questions. Laurie Miller

The boomer cohort is being trained with the smartphone and fitness technologies to help them transition to telehealth and telemedicine. This disruption will challenge the existing health care delivery models as the expectations for the provision of services increase. Fritzi Gros-Daillon

Where are all the Caregivers? I see that as the trend for Home Care agencies. I hear all the time “we need caregivers.” We need to promote their work. Caregivers remain in the shadows, and that needs to change. Bryan London

Within the U.S. and around the world healthcare systems are facing depleting resources. For instance, with the growing pressure on our government to reduce costs there needs to be an expanded collaboration between government funding and the private sector for medical research. With intensified alliances between the two, we will see increased treatment options for numerous diseases. David Mordehi

People are receptive to using robotics in health care. Even drones become a strength for good medical care. You see individuals wearing trackable watches for physical activities and use apps on iPhones. These types of digital diagnostics will create robust health platforms that will move beyond popular apps and trackers. Evan Farr

As Healthcare Informatics continue to thrive, we must watch data and its integrity. As an advocate, my concern is how we will reach and maintain truth in data. Will it be used to market or muddy? Confirm eligibility or deny access? We all know numbers are massaged, and messages spun. Protection of data and processes will forever require the eyes of consumers and watchdogs. Nancy Ruffner

The Algarve is perfect for walkers like us

Our love affair with the Algarve began five years ago when we arrived in the southernmost region of Portugal to walk the Via Algarviana.

Unlike the majority of holidaymakers, we weren’t heading to the coast for a fortnight of sun, sand and Sagres (the local beer). In fact, we wouldn’t be setting foot on a beach for the next two weeks. Our mission was to walk the 186-mile trail stretching from Alcoutim on the Spanish border to Cabo de São Vicente in the west. Alas, the only guidebook on the market in 2015 was in German – and we didn’t use GPX back then – meaning we had to place our complete faith in the waymarking and just hope we didn’t get lost.

Our expedition introduced us to an Algarve few visitors get to see – a landscape of undulating hills, cork oak forests, centuries-old lanes and sleepy whitewashed villages. We backpacked, carrying everything with us and arranging our accommodation a day or two ahead (our wonderful hosts often phoned ahead on our behalf). Day-to-day life became simple: we hiked all day, often in blistering heat, and enjoyed good food and wine every evening.

I’d run the London Marathon the week before we set off, so I wasn’t unduly concerned with daily distances of up to 23 miles in blistering temperatures with virtually no shade. I was soon regretting my overconfidence. The 19-mile section from São Bartolomeu de Messines to Silves will remain in my memory forever as the day we nearly perished … from dehydration. Like many who are unused to hiking in high temperatures, we’d badly underestimated the amount of fluid we needed. Another mistake was arrogantly assuming everyone would speak English: they didn’t. On our first night in Balurcos, the bar owner’s wife – fearing we would otherwise starve – taught us two essential words: pão (bread) and queijo (cheese).

Five months later, we returned to the Algarve to walk the Via Algarviana link routes and an alternative finish via Aljezur and the Rota Vicentina – another long-distance trail exploring Portugal’s windswept Atlantic coast.

Wintering in the Algarve

Our positive experiences hiking in the Algarve meant it was our first-choice destination when we decided to spend our first winter abroad.

We rented a villa in the bustling coastal resort of Albufeira for three months, not really knowing what to expect but reasoning it would be better to stay on the coast where we could at least talk to people. Harri worked online on weekdays (he’s younger than me) and at weekends we would go off on overnight hiking expeditions across the Algarve, rediscovering the hills of the Serra do Caldeirão and the Serra de Monchique, exploring the spectacular coastline west of Albufeira, and enjoying the meandering historic trails and paths which crisscross the region.

The second winter we stayed for five months and never ran out of places to walk. We headed west and hiked the less populated coast favoured by surfers. A three-day trip saw us hiking twenty undulating miles to Salir – a village in the foothills of the Barrocal region – and back and climbing the limestone escarpment of Rocha da Pena. In our local bar, we became notorious for turning up on Sunday evenings exhausted and desperate for a beer … still carrying our rucksacks.

Leaving Wales

It was always my dream to live in a climate where you could spend most of your time outdoors. Harri took a little more persuading – he speaks Welsh and loves the Welsh mountains – but in the end it was the prospect of year-round hiking which won him round.

We left the UK permanently in November 2018 and spent our third winter in Albufeira, still walking miles every weekend and still catching the painfully slow Algarve trains to places farther afield like Faro and Lagos (the end of the line). We spent two weekends near Aljezur, enjoying the hiking opportunities afforded by the wild Atlantic coast and enjoying good food and music at the annual Sweet Potato Festival.

A chance encounter on the cliffs above Praia Marinha – considered to be one of the most beautiful beaches in the world – meant we now had friends in the eastern Algarve. I often hopped on a train to meet Denise and Geoff and hit the walking trails in the Ria Formosa Natural Park. Here there are no hills, just mile after mile of level walking with spectacular views of the barrier islands, salt pans and marshes, all teeming with marine birds.

The Silver Coast

Even the best-laid plans can go awry and so it was with us. Our house sale had been fraught with problems and the property chain ultimately collapsed. Algarve rental prices soar during the holiday season, meaning we couldn’t stay where we were: we needed a Plan B.

In 2017, we’d done a two-week hike in central Portugal. I’d simply listed the places I wanted to visit and Harri worked out how we could travel between them on foot (and occasionally train). We’d really liked the Silver Coast, an area about an hour north of Lisbon. Rental (and property) prices were cheaper there too. It was definitely worth investigating.

We rented an apartment in São Martinho do Porto, a popular seaside resort with one of the only sheltered beaches along the Atlantic coast. I soon learned there was a local walking group (Silvercoast Walks) which organised free, twice-weekly walks. Though the weather wasn’t as warm – or dry – as I’d have liked, it was great to explore this new region with others who shared my passion. At weekends, Harri and I went for longer hikes, including in the Serra dos Candeeiros, where the scenery – and the cloudy skies – reminded us of our beloved Brecon Beacons in Wales. My only real gripes about the Silver Coast are the endless eucalyptus groves – they stifle the native vegetation and impede views – and the distance between various towns. In the Algarve, we felt we could travel anywhere on foot without needing to walk on busy roads, whereas on the Silver Coast that wasn’t the case.

Spain and the Alentejo

With our house sale still limping along, we needed to make plans for the summer months. A friend suggested we considered pet sitting and, after Skype interviews, we secured two fantastic jobs, the first looking after two cats in Órgiva, Andalusia, and the second looking after goats, ducks, chickens, dogs and cats on a small farm near Grândola, in the Alentejo.

At any other time of the year hiking the spectacular Alpujarras around Órgiva would have been a dream come true, but we arrived at the end of June when the temperatures were soaring and the most we managed to cover in one day was eleven miles. A circular walk through the stunning Poqueira gorge to visit the whitewashed villages of Pampaneira, Bubión and Capileira (4,711 feet above sea level) was a killer (it took us over an hour to walk one mile). After that, we mostly hiked at lower levels, often around the spa town of Lanjarón, where the many acequias (irrigation channels) provided relatively easy walking with magnificent, far-reaching views.

Grândola proved disappointing from a walking point of view. Despite our excitement at being back in Portugal (by now we were certain we wanted to make this beautiful country our home) and the presence of some beautiful nearby beaches, the need to look after so many animals restricted us to short afternoon walks in the surrounding woods of the Serra de Grândola and prevented us from exploring further afield.

Return to the Algarve

In the end, there was no decision to be made. We returned to the Algarve and bought our home in Armação de Pêra in November. We’re located a mile from the beach and Salgados lagoon, an idyllic spot which attracts many migrating birds, including flamingos. Our car sits unused for weeks as we need only to walk a short distance from home to reach sandy tracks winding through pine trees, wooded valleys with dry riverbeds, and orchards of figs and almonds. There are vineyards and cacti everywhere, plus drystone terraces. Stray a mile and we can enjoy distant views of the Algarve’s highest peaks, Fóia and Picota, where chestnut trees grow tall, and hiking has a truly alpine feel. Often, we’ll pass a crook-yielding shepherd tending his many goats – or sometimes sheep – in the traditional way.

Nearly every time we go out, we stumble upon a hitherto undiscovered footpath or track, linking places in new and different ways. Throughout winter, there was colour everywhere: the almond trees were in blossom, and wild poppies and Bermuda buttercups burst through the fertile, rust-coloured soil. By spring, the enormous variety of flora, natural and cultivated, makes even a stroll to the recycling bins a visual delight.

Moving to the Algarve didn’t happen overnight. We came and went, we explored other parts of Portugal and even southern Spain, but in the end we knew this was the place for us. The perfect spot for a hiking-obsessed Welsh couple who wanted to do the thing they love best throughout the year – yes, even in midwinter.

Positive Aging: You Can Do It If You Try (And Are Not Afraid To Modify)

When my youngest son was a toddler, he loved Fred Penner….I mean he absolutely IDOLIZED him! That was mostly good, except that twenty-seven years later, many of those songs have a way of creeping back into my head.

When I was asked if I would write a guest post on positive aging for Retirement and Good Living, Fred’s words once again sprang to the forefront of my mind.

“You can do it if you try, you can do it if you try, you can do do doodly do it if you try.”

Many of us know the basic research on longevity and aging well (as much of it is based on common sense). We just need reminders to try…and sometimes to creatively modify! When browsing the research on positive aging, you will typically find:

• Eat your vegetables.
• Get off the couch (i.e. stay physically active).
• Get your sleep.
• Manage your stress.
• Build a close network of family and friends.
• Find your purpose.
• Keep learning (i.e. stay mentally active).
• Help others.
• Maintain a positive mindset.

Regarding healthy living advice, many of us need prompts (sometimes frequently). More importantly, we need to prevent ourselves from putting things in the ‘too hard basket,’ or it’s twin ‘I’ve already failed at this basket’. Equally, we need the strength to pull things out of these baskets when they do end up in there.

Let’s take vegetables for example. Most food guides recommend a minimum of seven servings of fruits and vegetables each day. A cup of leafy greens or a half cup of fresh/frozen/canned fruit/veggies counts as one serving. Although dial-a-pizza can seem quicker and more convenient, even a vegetarian pizza usually offers less than one meal’s worth of vegetables. (American Institute for Cancer Research). But that doesn’t mean we need to give up on pizza altogether. Here’s where the modification part comes in…brilliantly.

Hankering pizza but want to maintain your seven-serve vegetable intake? If you’ve just dialed, why not steam up some extra veggies (yes they can originally be frozen) to add on top. Or make/order a side salad. Feeling supercharged and motivated? Why not do both? If watching your weight, remember that a typical delivery or frozen vegetarian pizza weighs in at 240—340 calories per slice, while a homemade version with whole wheat crust and reduced fat cheese often starts at 185 calories. (Livestrong)

Let’s try another. Alex, I’ll take ‘Get off the Couch’ for 200! Our muscles tend to become shorter and lose their elasticity as we age. But we don’t need to accept this fate. Even fifteen minutes of regular stretching each morning and before exercise can make a huge difference. So much so that most fitness experts agree that regular stretching is equally important to regular exercise.

Hate gyms and don’t have the commitment to stick to your own exercise routine? Why not try a yoga class? They are gender-neutral, available most places and at most levels. And most yoga instructors are gurus at helping you to modify movements that are right for you. I’m sure that there’s no one who has taken more advantage of this than me. Extended sitting in legs-crossed position = prop! Butterfly = another prop! Dreaded Downward-Facing Dog= two props. It’s gotten to the point that I’ve often entered the yoga studio, grabbed all the props that my arms could hold and then sheepishly asked the others, “no one else was hoping to use props today, were they?” It’s a good thing that my yoga studio offers a large stock of supplies! Once you get into a routine, you can easily practice yoga at home…or even on the beach!

Let’s do one more. Long for the peaceful sleep of childhood? You can modify for this too. Also, you can often combine this with another item off of the healthy aging list to get double benefits with one fell swoop. For example, instead of sleeping pills why not try a few natural remedies? Regular physical exercise is known to help improve sleep, just ensure you have completed all vigorous workouts four hours (or more) before bedtime. Also, be sure that there are no blue lights illuminating from your computer, television or phone as this form of light has been proven to interfere with sleep. You might also try reducing/eliminating your caffeine intake in the afternoon, not going to bed on a full stomach and investing in a good pillow/mattress.

It is important to make all positive aging and healthy living tips your own. We’ve reviewed a few examples of modifications together. I’d love to hear from you in the comment section on which healthy aging tips work best for you, and how you have modified them.

Let’s connect!