Helping Others Make Sense of Retirement Planning

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Election Year Woes: Has Obamacare Impacted the Nursing Profession?

By Carol Trehearn

Ever since back in those early days when President Obama made a huge push for the Affordable Care legislation there has been a great deal of controversy as the nation split into two camps. On the one side there were those who, like President Obama, felt that every man, woman and child has a right to healthcare and on the other side there are those who believe that healthcare shouldn’t be a social program.

The most vocal critics said that Obamacare wouldn’t be financially feasible and that it would put the country in even greater debt than it was already in. Several years in, five to be exact, the debate is still raging. What will this do during an election year and will Obamacare have anything to do with the decisions voters must make come the first week in November?

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A Look at the Plus Side of the Issue

On the plus side, all Americans now have the right to affordable healthcare and those who can’t afford health insurance are being covered by federal funds. Now everyone has a right to care no matter what their gender is and whether or not they can afford to pay for it. The government is subsidizing those who don’t have the financial means to pay the even higher cost of insurance.

It had been the hope that having health insurance would keep the indigent out of ER, thus freeing doctors and nurses to deal with life and death emergencies, whilst those suffering from such things as colds and flus would go to their primary physician.

What Critics Are Saying

If it had been the hope that the workload in the nations ERs would lighten up, those hopes were not realized. It is unclear why but Emergency Rooms are still as busy as ever, if not busier. With a shortage of doctors, more patients are being seen by nurse practitioners with a masters of science in nursing and physician’s assistants who can also prescribe medications and do many of the tasks M.D.s and D.O.s can do.

This is the ‘proof’ critics need to blame Obamacare and it’s all about money. Doctors are now making less money due to strict cost control established by Medicare and Medicaid and so they are leaving the profession by the droves. Old doctors are simply retiring and with the allure of a high paying job no longer realistic, fewer young men and women are seeking to become doctors.

The Impact on Nursing

With a shortage of doctors, more and more nurses are seeking a master of science in nursing which does give them a higher income but does not speak to the nation’s need for more doctors. As a result, there are those who are pushing for a requirement that nurses go even further, getting their doctorate in the nursing sciences field. Doctors and insurance companies are just not making the money they once had and this is significantly impacting the type and amount of services consumers are getting.

In other words, nurses have had to step up to the plate, going further in their education than they ever thought they would need to although you won’t hear complaints from them.

Only Time (and the Voters!) Will Tell

Based on the fact that Obamacare is still a partisan issue, how much weight the Affordable Care Act holds in the eyes of the voters may impact the outcome of the November election. Those who see a financial drain are likely to vote Republican but those benefiting from the ACA will most likely vote Democrat.

When November rolls around, it will be interesting to watch the exit polls to see just what an impact, if any, Obamacare had on the decisions voters made. The one fact is clear however and that is the shortage of doctors said to be the result of the ACA has led to more nurses furthering their careers and that’s a very, very good thing.

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Alleviate dry mouth and throat while using CPAP device

Marijoyce Perona

If you’re currently using a continuous positive airway pressure (CPAP) nasal pillow or a nasal mask and your mouth or throat is drying out, then you’re most likely breathing from your mouth. It is a normal occurrence for people who use CPAP therapy since they’re not used to air blowing into the throat to hold it open.

Dry mouth is sometimes worsened for people who wear a nasal CPAP mask, especially if the jaw drops open during sleep. This contributes to a lesser efficient therapy because of leakage while causing dry mouth. Thankfully, there are a couple of simple solutions to help prevent this problem.

Use a Chinstrap. The simplest solution is to wear a snoring chin strap that quickly and comfortably holds the jaw in place. For most people, chin straps completely stop the escaping air, or dramatically reduces it. This means little or no dry mouth as well as reduced snoring.

Install a Humidifier. The second solution is to use a humidifier on the CPAP machine. Take note that newer models already include one like the ResMed AirSense 10. If yours don’t have one pre-installed, then you can either attach one or put a standalone unit near your bed. Humidification is vital when dealing with symptoms of dry mouth because it supplies both warm and room temperature air. This helps the nasal passages to stay hydrated.

Get a Full face mask. This covers the entire nose and mouth area. Using a full-sized mask could seem confining or even claustrophobic, but there isn’t any single solution here since no single mask is right for everyone. The solution here is doing an experimentation to find the right CPAP mask which best meets your need for efficacy and comfort.

Choose the right size. In relation with the above, the size of your CPAP may be what’s causing the issue. Work closely with your doctor or CPAP supplier to ensure that you have a mask that suits your needs and fits you. Everyone has different shaped faces, so the right style and size mask for someone else may not work for you.

Drink plenty of water. This may be obvious, but you’ll be surprised how many people don’t follow this simple advice. Dry mouth and throat while using CPAP is worsened by dehydration. The general rule is to drink eight 8 oz. glasses of water daily. If you drink a lot of coffee or other caffeinated beverages, or sweat a lot during the day, then make sure to rehydrate to avoid dry mouth and throat.

Allow yourself time to adjust. When people are diagnosed with sleep apnea and start CPAP therapy, there is normally a period of adjustment. With any change in a person’s routine, understanding what changes need to be made and adapting to those unique changes will provide a baseline for recovery or improvement. In most cases, you will automatically adapt to CPAP.

That’s it! Simply follow the recommendations above to alleviate your dry mouth and throat while using CPAP. With time and patience, this device will positively affect your quality of sleep, and thus your life and health. The treatment will be worth it!

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The Secret is Out

Guest post by by Marcia Casar Friedman of Aging is a Full Time Job

Have you ever wondered about the instruments used to measure the aging process?  What does aging mean?  Is it a tag for a numerical age group called Old?

When I pondered that question, my mind automatically went to physical changes which might or might not affect me as I navigated life as a silver sage (aka senior).  Much has been written about the wear and tear on the body and how our past activities will affect the aging process.  The vast unknown of heredity, environment, emotional changes and medical treatments led me to wonder if I could ever find satisfying answers to my questions about aging.

Then I went to my favorite question “Why?” to look for answers.  It took five years of writing questions and answers, researching and writing articles and authoring five manuscripts, for me to accept aging as a process that starts at birth.  Realistically, it starts at conception.  From that point forward we are always making changes and always aging.  Each stage of development paves the way for the next stage.  We start as a fetus and newborn, then move on to infant, toddler, child, puberty, adolescence and so on.  So why did I get stuck lamenting about aging as a description pertaining to old people?

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No doubt the articles I read and the television shows I watched, confirmed aging as a term used to discuss the body breaking down due to aging.

What about psychological changes which come to the fore with life style adjustments?  Many body weaknesses originate from emotional changes. “Gut wrenching” is a term used when describing extremely sad experiences. “Feeling nauseated” is an expression used when hearing about a gruesome crime. “Butterflies in the stomach” come at times of stress such as preparing for an upcoming presentation.  These types of expressions are used when we feel sad, angry, anxious, or frustrated. They come from chemical and physical responses in the body.

I researched many situations where physical illnesses could be traced to relationship stress and this can happen at any age.

The concept of aging belonging to old people now seems silly, yet hurtful.  We have been brain washed to accept the concept of aging as debilitating, sad, scary, unchangeable and extremely troublesome.  Aging is a diagnosis given to anyone who is no longer considered young. I wonder when society forgot to accept maturing and wisdom as a positive which comes from chronological aging.

The secret is now out in the open.  Aging is a full time job.

Yes, it’s true, the wear and tear on the body and heightened emotions do dictate the path we follow to be the best we can be.  The side roads give us opportunities which we would never be able to understand or appreciate in younger, less experienced days gone by.

Among the perks to entering those phases of life is a unique maturity and huge learning opportunities which provide us with a wonderful wealth of wisdom.

By now you are probably wondering why I say aging is a good thing. Here is a sampling of 10 things I’ve learned:

  1. I earned the right to be me. If I want to type on the computer until 3:00am and sleep until noon the next day, it’s my choice.
  2. I have become kinder and less critical of myself. Hooray! I’ve become my best friend.  I deserve the best out of life.
  3. I rejoice in accepting the truth — life is not perfect. Nothing and no one is ever perfect.
  4. I can’t go back to the past because I was a different person then. I am now the me of today.  I know the past is done and over, it cannot be changed.  My perception of the past can be improved.
  5. The surest way to failure is trying to please everyone. The result is no one is pleased.  In fact, those discontented people will turn on you.
  6. Problems are opportunities. During a crisis the focus is on the predicament. After months and years, it becomes easier to find the opportunities that were created by the problems.
  7. Learning never ends. So much to learn, so little time.  I strive to learn something new every day.
  8. It is true, I know I am sometimes forgetful. It’s frustrating. That proves some of life is just as well forgotten. And … I eventually remember the important things.
  9. I don’t question myself as much anymore. I’ve earned the right to be wrong, sometimes.
  10. Expressing gratitude every day enables me to have a more positive outlook on life and on aging.

Aging has set me free to be the person I was meant to be.  I like being a silver sage!  I don’t want to live forever, so while I’m still here I won’t waste precious time feeling sad about what could have been or obsessing about what will be in the distant future.

Join me on this personal journey of being a silver sage, to be the best you can be today.  Aging is a journey of changes.

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Millennials: Embrace Weird, Retire Early

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Social Security for US Expats and Dual-Citizens

By John Ohe, CFA and IRS Enrolled Agent. John is a partner at Hola Expat (www.holaexpat.com), which specializes in preparing tax returns for U.S. expats.

John Ohe 1

Social Security is a lifelong pension provided by the US government. It can be a critical source of income during one’s retirement years. Most important to note, it is a very attractive investment option for low to modest income earners – what one receives during retirement is far greater than what one contributes. Unfortunately, many US expats do not plan appropriately, and will miss out on this great opportunity.

To qualify for Social Security, one needs to earn 40 credits. In the United States, most people work a job and pay Social Security taxes (automatically taken out of the paycheck). After about ten years of employment, one has acquired the necessary 40 credits.

US expats, however, are often unable to contribute to Social Security. This becomes an issue when one has earned less than the necessary 40 credits. Fortunately, there are ways to contribute to Social Security while working abroad.

Let’s use an example to illustrate:

Jane is 30 years old. She has been living outside the US since she was 25, and does not have any plans to move back to the States. She works for a foreign company. Jane is interested in qualifying for Social Security, so she checks online at SSA.gov. Jane learns that she has earned 10 credits. She needs 30 additional credits.

If Jane earns a modest income from the foreign company, she may want to report her income as self-employment on her US tax return (certain requirements apply). Jane would not owe any income taxes on her tax return, if properly prepared. However, she would owe self-employment (SE) tax, which is how she would earn Social Security credits. SE tax is roughly 15% of the reported income.

Alternatively, Jane could start a small business (on the side). Any profits from that business could be reported as self-employment income. She would pay the 15% SE tax, and earn credits.

How quickly can one earn credits?

A person can earn a maximum of 4 credits per year. For 2016, one needs to report at least $5,040 in income to earn 4 credits ($1,260 per credit). Therefore, one would pay approximately $770 in SE tax to acquire the 4 credits.

To summarize:

Social Security can be an important source of income during one’s retirement years. It is a very attractive investment option for low to modest income earners. One needs 40 credits to qualify for Social Security. Find out how many credits you have earned.

For more information on Social Security and other tax-related issues, visit us at: holaexpat.com.

Other posts by this author:

2016 Key Tax Changes

U.S. Expats – College Planning

FATCA – Practical Guide

Free Money from the IRS – Child Tax Credit

Buying and Selling Real Estate (Foreign or Domestic) from a Tax Perspective

U.S. Expat Taxes – An Introduction

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Peace Corps After 50

Reprinted with permission from David Jarmul. Read the original post here

Before Champa and I joined the Peace Corps at the age of 63, people asked us how we’d feel to be surrounded by volunteers younger than our two sons.

Well, many of our fellow volunteers are indeed in their 20s, and most of them are smart, enthusiastic and fun to be around. Yet Champa and I are hardly outliers. Fourteen of the 58 people in our training group — nearly one in four — are 50 or older.

PeaceCorps1

Worldwide, Americans over age 50 comprise about 7 percent of the nearly 7,000 Peace Corps volunteers now serving in 63 countries around the world. With its better medical facilities and programs in fields such as business development that attract people with lots of real-world experience, Moldova attracts higher numbers.

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Whatever their reasons for choosing Moldova, the older volunteers here are impressive. They’ve worked as professors, attorneys, IT managers, nonprofit leaders, teachers, city administrators and management consultants. They come from across the country, including two other older volunteers from North Carolina. They are single, widowed, divorced or, as with us and one other older couple, married and serving together. Like the volunteers here generally, they are also diverse, reflecting the country we represent.

PeaceCorps2

We differ from our younger counterparts in some ways. Learning a new language may be tougher for us, although many of us are doing fine in our Romanian classes. We may run slower in a group soccer game, if we participate at all. When several younger friends went to get tattoos recently, they knew better than to invite me along. They also may party harder and make surprising cultural references. When I was in the Peace Corps office the other day, a Carole King song started playing and the young woman next to me said, “Hey, it’s that song from the Gilmore Girls!”

On the other hand, they’re usually polite when we make our own references to people and events from before they were born, so it tends to even out.

In Moldova and other Peace Corps countries, there are advantages to being an older volunteer. Many of these countries show great respect towards older people. Similarly, having children and grandchildren has provided Champa and me with an instant bond with older members of our new communities. Our experience enhances our credibility in our workplaces as well; my future colleagues have already checked me out online. Older volunteers can share their hobbies, too, as Champa hopes to do with art and gardening.

Peace Corps has a special website for older Americans interested in becoming volunteers. The site reviews the application process, which is competitive and includes an extensive medical clearance process.

One of my reasons for writing this blog, and this post in particular, is to encourage older readers to consider the Peace Corps or some other new challenge for themselves. It’s not as strange or exotic as they might think and shouldn’t just be dismissed with “Oh, I could never do that at my age.”

Obviously, many people have family obligations, medical problems and other constraints that make Peace Corps unrealistic. Nonetheless, it’s a proven program through which more than 220,000 Americans of all ages have served their country and the world — and had a great adventure in the process.

Personally, I’m already wondering what it will be like in two years to be back in America and surrounded by friends who are mostly older than the ones I’ve made here.

For more information on Volunteering, click here.

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Getting a Retirement Visa for an EU Country

Q&A with a Reader 

I am signed on for your email blog posts on retirement options of which I received the latest issue today. I realize the focus is on ‘early’ retirement but my wife and I are about your age and have planned a more traditional retirement.

We have lived in Europe for 4 years previously while I represented the US Department of Labor. We are very comfortable there and, of course, it was easy living there because the US government took care of everything for us, including visas, drivers licenses, taxes, living allowance, etc. I early retired myself and we are financially comfortable. My wife plans to leave her position within the next 12 months.

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We also love to travel and have been to 75+ countries but enjoy cruising so much we have narrowed our search for a permanent retirement location to the European locations of Barcelona, Athens, and Venice, primarily because of their cruising capability, international airport, other general travel options available, and relatively low cost of living. Also, our mutual opinion on these locales versus other international locations is very favorable as we have visited all of these cities several times.

Since you have already done significant research on this retirement out of the US subject area, are there any resources you could point me to get specifics on a retirement visa for an EU country and other considerations to living overseas in a European location on a more permanent basis?

Certainly, your blog is an excellent resource but I am trying to develop a specific check list for what we need to do to accomplish this particular lifestyle change.

I have found it is just about impossible to get anything definitive from a European consulate in America by telephone for various reasons. We don’t live near one so I am thinking we may need to head to the city we decide on, as a tourist for 3 months, and park out at the consulate there until we get somewhere … ??? …

Thanks for any help you can provide … Daniel

Hi Daniel,

Thank you for taking the time to write and for your interest in our website.

In your situation, I would recommend that you click on the following article by Nomadic Mike and read it through. At the bottom of the article he speaks to long term visas and mentions Italy and Spain (two of your choices) as places that offer them for retirees. He also tells you what you need to bring with you and how to go about applying.

Schengen Visa Info A blog post from Nomadic Mike on How to (Legally) Stay in Europe for more than 90 Days. Detailed and clear with useful information. 

Certainly, if you have further questions, go to his Contact Page and write him an email.

How exciting for the both of you. Good luck, and do feel free to write to us any time. I’m sure this information will be a great start for you.

Best Regards,

Akaisha

Akaisha,

Very helpful, courteous and prompt response to my inquiry  – thank you for all you do – Daniel

 

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Tennis Club in Chapala, Mexico

Q&A with a Reader

Hi There,

How does one go about joining the Cristiania Tennis Club in Chapala, Mexico?

Many thanks,

Paul

All of our books lead to adventure. Don’t miss out on yours!

Hi Paul,

Cristiania is not a private club, so my advice to you is to go there and hang out and work your way into games. It will not be long before people will be asking you to play. Introduce yourself to Oscar and Denise and tell them I sent you.

It is a good group of people there.

Good luck,

Regards,

Billy

Many thanks Billy!!

Paul

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5 Tips on How to Reduce Stress

 

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