In a recent Risking Old Age in America podcast, I had a fascinating discussion with Israel (Issi) Doron, chair of the Department of Gerontology at the University of Haifa in Israel, about the differences in the systems of elder care in our two countries. Unlike the United States, Israel provides up to 20 hours a week of free home health care for all but its most affluent residents. Here are some excerpts from our conversation: ROA: You and I have talked before about the differences between Israel and the U.S. in elder care — how it’s provided, how it’s paid for. Could you talk a bit about how that all works in Israel? Doron: Elder care is a challenge all across the world, so t…

Almost everyone struggles with debt at some point. In my early 20s, I learned some hard lessons about credit card debt. In my early 30s, I paid back graduate student loans that soaked up a huge share of my income. I came out intact both times, but I can relate to having a big debt load. Recently, I’ve worked with several married couples who are approaching retirement and carrying significant debt. Amid the student loan crisis, I’ve seen parents carrying tens of thousands of dollars in loan debt for their kids. Reducing debt is a critical piece of a sound financial plan, but it’s hard to know where to start. People often look for a magic bullet like debt consolidation,…

In a recent podcast, I talked with Dr. Anthony Zizza, medical director of Element Care, about the Program for All-Inclusive Care for the Elderly (PACE) that provides comprehensive care to low-income older adults. Unlike the piecemeal approach of most healthcare in the United States, participants in PACE receive one-stop-shopping for all their health needs. PACE is available to patients who have both Medicare and Medicaid (MassHealth in Massachusetts, where Element Care is located) and agree to receive all their care through the PACE program. Medicare and Medicaid pay a fixed amount per participant, which gives the program a financial incentive to keep them healthy and living in the community. As a result, many PACE programs offer nonmedical as well as medical care. W…

I clean the filter on my septic system twice per year – an awful job that I handle myself because it’s fairly quick and easy, despite how gross it is. I still remember the septic guy’s technique for remembering when to do it: “Check it at spring training and the World Series.” This spaces it out twice a year, when it’s not covered in snow. In financial planning, we can use another calendar event as a similar reminder to perform a quick financial checkup: the middle of the year. Mid-year is a good time to go back to your New Year’s resolutions, if any of them were financial, and recommit as necessary. A few items that are always worth reviewing:…

In recent years, Massachusetts has taken significant steps to improve care for seniors, most notably the Act to Improve Quality and Oversight of Long-Term Care. In a recent Risking Old Age in America podcast, Rep. Thomas M. Stanley, Co-chair of the Elder Affairs Committee, describes this initiative as well as further steps in the works. These include creating a family caregiver commission, licensing home health agencies, and working towards universal long-term care insurance. Here are some excerpts from our conversation: Senior Living Facilities Risking Old Age in America (ROA): You have been working [to make improvements] across the whole continuum of care from nursing homes [to] assisted living facilities to home healthcare. Please talk about the legislature’s initiatives in these areas. Rep. Thomas…

I recently met with a 71-year-old retiree who relies on Social Security for a sizable share of her retirement spending. She’s concerned about recent news that the Social Security retirement trust fund will run out in 2032 – just six years from now. Having read the headlines, she is now worried she’ll lose much of her retirement benefits. In truth, payroll taxes at that time will be enough to pay 78 percent of scheduled Social Security benefits. That means the worst case is that she’ll face a 22-percent reduction in benefits, something we could accommodate in her financial plan. But it shows how common misconceptions can cause us unnecessary stress and lead to such fear-based decisions as living well below…

I recently toured Opus, an inspiring new senior living development in Newton, Massachusetts, and then had a conversation with its founder, Amy Schectman, on my Risking Old Age in America podcast. Amy explained to me how she had helped develop both a high-end senior living development, NewBridge on the Charles, and lower-income senior housing, Brown Family Life. With Opus, she was seeking to create housing for the often-overlooked middle market. She said that she and her team worked through many challenges in making the economics work without the prices they could bring for the higher-end market nor the subsidies available for lower-income housing. She feels that they can repeat this prototype elsewhere. Excerpts from Our Conversation Risking Old Age in America (ROA): The peo…

One of the most fortunate events of my life was my first job after college at the Center for Retirement Research at Boston College (CRR). Not because of the salary — I think I earned less than $40K. What was fortuitous were the early lessons I learned about building toward a secure retirement. Those lessons boil down to two simple but critically important points I urge you to share with any new graduate: Simple, yes — but in a world of financial complexity, these two things do most of the heavy lifting toward long-term retirement planning. My first project at the CRR was building a game where a fictional character named Sally makes financial decisions at different ages — how…

Neal K. Shah, the founder of CareYaya, a company that links students in the healthcare field with seniors needing assistance, has some strong opinions about elder care in the United States. The word Yaya means ‘grandmother’ in Greek and ‘caregiver’ in Swahili and Thai. As an acronym, it also means ‘You Are Your Advocate.’…