Tips for Organizing Health Information

Tips for Organizing Health Information

A trip to the emergency room made me realize why caregivers are advised to organize heath information. When Mom broke her hip, I called an ambulance. When it arrived, I confidently recited Mom’s Medicare number. When asked what medications she took, I pulled out our basket of pill bottles. At the hospital, the questions got more complicated. Still, I knew enough to fill out the forms.
However, while I did not know it then, I would be joining Mom in the hospital the next day with an emergency of my own that kept me in the hospital for six weeks. As we both recovered, I looked for the best way to store her health information. I especially wanted an easy way to share it with others in case I am not around.

I now have a folder for paperwork that is portable and easy to maintain. It isn’t just for emergencies. We take it to every doctor visit. Now anyone who has the folder can see when Mom had her last flu shot, what medications she takes and that she had a malignant mole removed in 1981. We can all see when all medical appointments are scheduled. Even my brother, who lives at a distance, could answer medical questions if he had to take Mom to the doctor while visiting.

Information to collect

You probably have most of this information readily available. If not, begin with what you have and add information as you can. Useful information to collect includes: A medical history; health insurance and Medicare cards; a list of medications including dosages, frequency, date started and reason; a list of emergency contacts, relationship, addresses and all phone numbers; any special logs such as blood pressure readings, blood sugar levels or symptoms; a copy of a health care proxy, advanced directives or living will; and a power-of-attorney, if one is used.

What should you keep in a medical history?

Names of all physicians; known allergies or reactions to medications; all medications, including over-the-counter medicines, vitamins and herbs; health conditions and date of diagnosis; dates of most recent exams, tests and immunizations; dates and reasons for hospitalizations; dates and details of surgeries; dates and length of major illnesses; history of smoking and use of alcohol; location of living will or medical directives; history of exposure to dangerous conditions or hazards; family history including illnesses or conditions of parents and siblings; cause of death of parents and siblings and their age at death.

Recording and storing the information

While the primary copy of the health information is more practical to keep in physical form due to various cards, forms and original documents that are part of the medical record, it is highly recommended that at least the medical history also be recorded digitally so that a “backup” copy is available in case of emergencies, disasters, or as the need arises to provide other family members or doctors with the information if needed remotely.

  • For the primary copy, use a pocket folder or small three-ring binder that will hold several pages. We purchased a multi-page presentation folder with clear pockets from an office supply store.
  • Use a bold color for the cover, such as red or yellow, so that it is easy to distinguish from other papers. Label the front clearly: EMERGENCY MEDICAL INFORMATION.
  • Keep the folder in a handy location, such as a desk drawer near the entry. Make sure every potential caregiver knows where it is kept.
  • Use top loading, clear sheet protectors to hold papers. These make it easy to remove papers for photocopying or for handing to a healthcare worker.
  • Pick up a business card from each healthcare provider you see. Cards usually contain the name, specialty, address, phone and fax number. There are vinyl business card holders available at office supply stores that are the most practical way to store business cards.
  • Each time you have an appointment, take the reminder card or jot the appointment details on a 3X5 card. Slip these cards into a page protector just as you did the business cards to keep a record of the visit.
  • When you add any information to a document, put the date at the top of the page to show how current the data is.

With a Medical History in hand,  I will never again have to phone a doctor’s office to relay information I didn’t have with me at the appointment, and I’m confident that if I’m not around, someone else can tell the emergency room doctors what they need to know about my loved one.

Shopping on a Fixed Income

Shopping on a Fixed Income

Over the course of the last two years, grocery prices have been going up at a rate of about 7-9%—a whole lot more than most people’s incomes have been going up, fixed or not. This means learning how to shop in ways you might not have considered before.

Cutting Grocery Costs

Plan your grocery shopping trip. It’s a simple fact. When we impulse shop, we always buy differently than if we plan the trip and stick to the plan. Running to the store for a half dozen items costs more, than if we shop once or twice per week and make it a longer but more comprehensive trip. Plan your meals so that you can work them around fewer ingredients.

Create a list. You are much more likely to stick to what you need when you have a list than if you don’t. No list means you are likely to buy based on what looks good rather than what your budget, diet, and common sense will advise.

Eat a snack or lunch before you go. There’s a reason why food looks good when you buy it at the store. It’s supposed to. And if you are hungry, this appeals to your desire to buy it even more. If you shop after you’ve had a good meal, you will be more resistant to impulse buying.

Study sales cycles —Most foods go on sale about every 10-12 weeks. Around major holidays such as Memorial Day, Labor Day, Independence Day, Thanksgiving, and Christmas, these cycles are shortened. Look for sales on turkeys near Thanksgiving, and hams for Easter and Christmas.  Steaks go on sale for summer holidays, and you can get some great deals on corned beef around the 2nd week of March. These cycles also exist outside of holidays. Look for sales and stock up.

Use coupons but look out. Every buying guide tells you how much money you can save with coupons. They are right, so long as you would buy that item and brand with or without a coupon. If it is still more expensive than you otherwise would spend on a different product or you wouldn’t buy it at all, the coupon has hurt your budget, not helped it.

Shop the perimeters. The stuff that makes up most of your budget and that you plan your meals around like bread, veggies, meat, and dairy are on the sides and back of your supermarket. Shop these areas first, find the savings, and then work out the rest of your budget from there. Studies show that when people get the things they need first, they are less tempted to buy the prepackaged convenience stuff in the center of the store.

Don’t shop in front of your face. The most expensive and popular items are generally at eye level.  More frugal options are generally above that level and near the ground.  This isn’t always the case, but it is often enough to make worth noting.

Convenience foods. We all know these are easier, but we also know that it costs time and money to produce and package convenience foods. Pre-cut veggies and meat, peeled and mixed fruits, pre-made salads, and other convenience foods are more expensive than if you do it yourself.

Get your card. Many supermarket chains carry a discount card. Get one and use it to save some serious money.

Buy bulk stores. It might pay to shop bulk stores like Sam’s Club and Costco using a bit of strategy. If you have friends with the same tastes, agree to buy certain items and divide them up. A few storage bags can help you cut your food costs by as much as 40%. Also consider cooking around certain items. You won’t want enough spaghetti sauce to feed 20, but use it for that first, then convert the remainder into chili and freeze part of that for later. Finally, it might pay to buy it, use most of it and throw away the rest. This is particularly true with spices you use a lot. You can often get a full pound of a spice for the same price you can get for an ounce of it in the supermarket.  So if you only used up half the container, you’ve still come out money ahead.



Your Hobbies Can Make You Money

Your Hobbies Can Make You Money

If you’re looking to generate extra income during retirement, you might want to explore ways to make your hobby into a more profitable venture. After all, hobbies are the activities that, in most cases, you’d happily do for free. And pursuing a hobby-related business can make for a relatively smooth second-act transition since you likely have many of the skills, expertise and personal connections needed for success.
Thanks in large part to advances in technology, the possibilities for monetizing your hobby—both locally and online — have never been better. So, if you’re eager to turn your hobbies into retirement cash, here are six winning strategies to consider.

1. Teach Your Hobby
Whether you’re a skilled photographer, an experienced chef or a talented musician, there’s a good chance that others will pay you to teach them what you do so well. There are lots of ways to share your expertise. For example, you can set up shop in your home — just like your neighborhood piano teacher — or teach at a local adult education program or school. Alternatively, you could aim to reach a broader audience and create your own online courses and deliver them using an online instructional platform like or

2. Sell Your Products Online
Thanks to the proliferation of online marketplaces, the options for selling your products online have improved dramatically. Etsy is probably the best-known marketplace for artisans and crafters, but there are plenty of other smaller sites you might want to consider like, and

3. Write About Your Hobby
Hobbyists enjoy reading books, magazines and how-to articles about their passions. So, if you love to write, there might be a way to profit from writing about your hobby. You can search for freelance writing assignments on sites like, or
Another option is to start your own hobby-related blog. While it will take time to build up a significant fan base, once you do, you can monetize your site through advertising, sponsorships or by selling your own digital information products—like e-books, downloadable tool kits, worksheets and more.

4. Create New Products Related to Your Hobby
Every hobby comes with its own set of specialized clothing, accessories, gear or gadgets. Hobbyists tend to be willing to buy products related to their hobby, so if you can craft, invent, or import an accessory for your hobby, you might be able to build a profitable income stream to supplement your retirement.

5. Find a Part-Time Job Related to Your Hobby
From the baseball enthusiast who gets paid to write about spring training for his local paper to the theater lover who works as an usher at the local arts center, finding a hobby-related job is a wonderful way to blend work and fun. Think about the places you’d happily spend time at for free—a ballpark, bookstore or gardening center—and see if they have any part-time job openings.

You might also find seasonal work at places like resorts, parks or tourist attractions.

An excellent resource for sourcing and learning about seasonal jobs is

Nancy Collamer

Lowering Your Tax Burden on Retirement Savings

Lowering Your Tax Burden on Retirement Savings

You worked hard to put money away for retirement, so it is important that you understand the various strategies available to you to make sure you maximize that savings by minimizing taxes and avoiding penalties. Here are several tips to maximize your retirement savings:

Avoid early withdrawal penalties. Over and above the income tax due on your withdrawals, you must wait until age 59 ½ before tapping your retirement savings to avoid the 10% early withdrawal penalty. However, you can take penalty-free 401(k) withdrawals beginning at age 55 if you leave the job associated with that 401(k) account at age 55 or later.

Roll over your 401(k) when changing jobs. If you withdraw money from your 401(k) when you change jobs, 20 percent will be withheld for income tax, as well as paying a penalty for early withdrawals. The mechanism to avoid these costs is to roll over your 401(k) into either a new 401(k) or an IRA.

Mixing your types of retirement accounts. If you qualify for a Roth IRA, these accounts have a variety of benefits a traditional IRA does not, including more flexibility on penalty-free withdrawals and no required minimum distributions. However the biggest difference between the two types of accounts is how they are taxed. IRAs are tax-deferred, so they provide you with an immediate tax benefit, but you must pay taxes when you withdraw the money during retirement. Roth IRA accounts require paying taxes when you deposit the savings, but that means you don’t pay taxes on them during retirement. Diversifying your money in a traditional IRA as well as a Roth IRA will allow you to moderate your tax burden during retirement. Also, if you expect to be in a higher tax bracket during retirement, maximizing your retirement funds in a Roth account will allow you to lock in today’s low tax rate.

Understanding minimum distribution. You are required to withdraw money from your traditional 401(k) and IRA after age 70 1/2. If you miss a required withdrawal, you must pay a 50 percent penalty on the amount that should have been withdrawn. Make sure you mark your calendar for that cutoff date and make arrangements with your financial institution to remind you automatically about your required distribution.

Understanding the rules on your first distribution. Your first required minimum distribution is due by April 1 of the year after you turn 70 ½. All subsequent distributions must be taken by Dec. 31 each year. If you delay your first distribution until the same tax year as your second distribution, you will be required to take both distributions in the same tax year, which could result in an unusually high tax bill.

Start withdrawals in your 60s. While you must begin traditional retirement account withdrawals at age 70 ½, you can lower your tax burden by take smaller distributions starting at age 59 ½, which can spread the tax bill over more years, potentially allowing you to stay in a lower tax bracket and reducing your lifetime tax bill. Check with your financial advisor to find out if this option would make sense for you.

Calculate your tax burden with added Social Security or Pension Benefits. If you’re going to be receiving Social Security benefits or regular payouts from a pension, it’s important to incorporate them when planning your withdrawal strategy. Even if you’re receiving a relatively small amount each month from these sources, the extra income may increase your tax burden.

Keep tax-preferred investments outside retirement accounts. Investments that generate long-term capital gains receive preferential tax treatment when held outside of a retirement account. However, if you put them in a retirement account, you will pay your typically higher regular income tax rate when you withdraw the money from the account. In contrast, you can lower your tax bill by holding more highly taxed investments, including Treasury inflation-protected securities, corporate and government bonds and funds that generate short-term capital gains, inside retirement accounts.

By Caren Parnes

Hospice Care Might Benefit Your Loved One Sooner Than You Think

Hospice Care Might Benefit Your Loved One Sooner Than You Think

Promoting independence and “successful aging” is a laudable goal for many. But it’s not the reality for people caring for anyone diagnosed with a terminal illness or a relative who struggles to manage day to day as a result of debilitating health conditions and growing frailty. Most people would prefer to talk about wellness rather than illness, so we tend to avoid planning for advanced illness and ultimately death. One valuable, often overlooked, and generous Medicare benefit for those caring for a family member or friend is hospice care.

Medicare coverage for hospice
Since 1983, Medicare has paid for most hospice care received in the United States. Other payers of hospice care include Medicaid (in most states), the Department of Veterans Affairs and most private insurance plans. Typically, no one is turned away from receiving hospice. Private contributions and donations are used to help cover the cost of care for those who have no other ways to pay for this service.

Beneficiaries are eligible for hospice care when they are entitled to Medicare Part A and are certified by a physician as having a life expectancy of six months or less if the illness runs its normal course. However, living longer than six months doesn’t mean the patient loses the benefit. After the initial certification period, each beneficiary receives an unlimited number of additional 60-day periods.

Although cancer patients used to make up the vast majority of hospice recipients, that is no long the case. An increasing number of people diagnosed with late-stage Alzheimer’s disease, non-Alzheimer’s dementia, heart disease, stroke, Parkinson’s and other conditions benefit from hospice.

Hospice is underutilized
People often wait too long before seeking hospice care. In the United States, the average length of hospice care is less than 60 days with 30 percent of those who elect hospice care dying in seven days or fewer. It seems that misinformation about the benefit coupled with our general discomfort talking about end of life prevents Medicare beneficiaries and their family from taking advantage of the valuable benefit.

What services are provided?
An interdisciplinary team of health and social service professionals joined by volunteers work together to provide the following:
• Comfort care for pain and symptom management
• Maintenance care for existing chronic conditions such as diabetes or emphysema
• Support for emotional, social, psychological and spiritual needs and issues related to dying
• Needed drugs, medical supplies and equipment
• Mentoring for the individual, his or her family, and friends on best practices in patient care
• Services like speech and physical therapy, which can be accessed when needed
• If receiving hospice at home, payment for short-term inpatient care is available when symptoms become too much to manage or when caregivers need a respite break to take care of themselves
• Grief counseling is available and can take the form of a support group, one-to-one therapeutic counseling, spiritual counseling, phone check-in calls and educational materials to surviving family and friends.

Those receiving care are allowed to keep their regular physician or nurse practitioner to oversee their care or to receive care from the doctor associated with the hospice organization.
Hospice is offered by both for-profit and not-for-profit organizations and can take place:
• At the home of the patient, a family member, or friend
• At a stand-alone hospice center
• In a hospital
• In a skilled nursing facility or other assisted care residence

Pursuing the Medicare benefit and accepting help from hospice can feel like a major change in how the person receiving care and their family considers the remaining time they have together. Caring for someone with serious illness and at the end of life is a daunting task, both mentally and physically. Having a dedicated, skilled and caring team of professionals to help can allow you to focus more on quality time with the person and less on the care and maintenance of the disease. Accepting help can make a difference in everyone’s well-being.

By Leah Eskenazi, Family Caregiver Alliance, for

Reevaluating Your Investments in an Uncertain Market

Reevaluating Your Investments in an Uncertain Market

While most economic experts agree that the fundamentals of the economy are sound, many market watchers are beginning to ask the question: Is this Bull coming to an end? 2018 was a year of uncertainty, and most financial advisors are recommending investors revisit their portfolios with at least an eye to rebalancing. Here are some suggestions for weathering a potential downturn in the market.

Know that you have the resources to weather a crisis. If you’re retired, knowing that you have the next couple years’ worth of living expenses in a bank account—and several more years in bonds that mature when you need the money—can help keep you calm and clear-headed. You might think you are risk tolerant, but if you haven’t structured your investments to handle a sharp drop, your financial capacity to handle risk may change your attitude when the market does drop.

Match your money to your goals. Map out a plan that takes into account what you’re saving for, whether near-term expenses or future financial goals like retirement. Structure your portfolio to match those goals. Money that you’ll need in the short term or that you can’t afford to lose—the down payment on a home, for example—is best invested in relatively stable assets, such as money market funds, certificates of deposit (CDs) or Treasury bills. Goals that need funding in three to five years should be addressed with a mixture of investment-grade bonds and CDs. For money you won’t need for five or more years, consider assets with the potential to grow, such as stocks, which are more volatile. Your allocation should also account for your time horizon and risk tolerance.

Remember: Downturns don’t last. The Schwab Center for Financial Research looked at both bull and bear markets in the S&P 500 going back to the late ’60s and found that the average bull ran for more than four years, delivering an average return of nearly 140%. The average bear market lasted a little longer than a year, delivering an average loss of 34.7%. The longest of the bears was a little more than two years—and was followed by a nearly five-year bull run. No bull market endures forever, but neither does a bear. And historically the market’s upward movement has prevailed over the declines.

Keep your portfolio diversified. Let’s say there is a slump—what is the best way to insulate against losses? Being well diversified is a preventive measure you can take now. Being diversified means you have a wide variety of investment grade bonds—corporate, municipals, Treasuries and possibly foreign issues. And they should have varying maturity dates, from short-term to mid-term, so you always have some bonds maturing and providing you with either income or money to reinvest. Your long-term assets should be divvied up among a wide array of domestic stocks—big and small, fast-growing and dividend-paying—as well as international stocks, real estate investment trusts (REITs) and commodities. This mix of assets gives you enough diversity that it provides a cushion in your portfolio if specific parts of the market are taking a hit so your exposure in a downturn is lessened.

Include cash in your portfolio. Cash in your portfolio offers protection against volatility, and cash reserves can come in handy in down markets. With cash you can buy in when prices are attractively low—without having to sell securities at a loss, if they are also at a low point.

Find an expert you can count on. If you’re not sure how to structure your portfolio correctly, or you think you’d be tempted to do something rash in a market slide, you should find a financial professional you trust to collaborate with you. That person can walk you through a complete portfolio review and help prepare you and your portfolio for times when the market gets tough.

By Caren Parnes