A recent study suggests that people with moderate to severe anxiety in middle age may be more likely to develop dementia as they get older. The study based its conclusions off of data from four previously published studies that tracked a total of 30,000 individuals over a 10-year period and clearly shows a link between living with anxiety in middle age and developing dementia later on in life.

The findings were published in the BMJ Open, a an online, open access journal, dedicated to publishing medical research from all disciplines and therapeutic areas. While the study was not a controlled experiment designed to prove whether or how anxiety might directly contribute to the development of dementia, it is nonetheless shines light on how mental health is just as important as our physical health as we age.

One of the study’s senior authors believes that dementia may develop after anxiety during middle age because of the increase in and constant elevation of stress hormones may cause brain damages across regions associated with memory. However, that same author is unsure whether treating the underlying anxiety and reducing the levels of elevated hormones would end up reducing the risk of dementia in old age.

The $1.5 trillion tax bill passed last year will likely have far reaching consequences on millions of seniors across the country, some good and some bad. While only time will truly tell how things will shape out, there are a number of areas many tax lawyers and elder law attorneys believe senior citizens and retired persons are likely to see an impact to their finances.

For the most part, the overwhelming majority of elder Americans will not see an increase to their taxes because most senior citizens have incomes that rely on Social Security which for the most part is not taxable at lower levels of income. Furthermore, because most older households do not itemize deductions they are not likely to see an impact because the new tax laws target taxpayer who have major itemized deductions on their taxes, particularly in states where there are high state and local income and property taxes.

The one proposed change to itemized deductions that did not make it into the final draft of the 2017 tax bill was the elimination of deductions for medical bills, a major deduction that would have had far reaching effects on senior citizens. An outcry from AARP, the National Academy of Elder Law Attorneys, the public, and other advocacy groups was successful in preventing any changes to itemizing medical bills and actually expands it for two-years.

High income retirees could see some of their Medicare premiums skyrocket up to 203 percent in 2018 due to shifts in the income brackets that are used to determine how much older Americans will pay for their Medicare Part B and Part D coverage. Those predictions come from an analysis by HealthView Services, a provider of health-care cost projection software used to prepare current and future retirees for the impact of health care costs which includes Medicare costs, long-term care expenses, and Social Security optimization strategies.

The additional surcharges for Medicare Part B, which covers preventive services, and Medicare Part D, which covers doctor visits, could end up diverting larger portions of the income seniors and future retirees expected to put towards their retirements. For example, a 55-year old couple earning a combined $140,000 could anticipate their lifetime Medicare surcharges rise by over $120,000 due to the changes to how the health-care program charges its beneficiaries, according to the Health View Services analysis.

The factors driving up the cost of Medicare for seniors comes from a 2015 bill known as the Medicare Access and CHIP Reauthorization Act or “DocFix” law which adjusted the way premiums are calculated for high-income individuals. The bill also lowered the range for the third, fourth and fifth-income brackets, which moved some retirees into the next higher bracket thus increasing their Medicare costs. Those changes began to take effect in 2108.

As more nursing homes and assisted living facilities begin to shift toward a more pet friendly approach to help accommodate the emotional needs of their residents, seniors and their families should begin to examine the pros and cons of living with pets where facility rules permit. In addition to accounting for size and weight restrictions of pets that facilities may impose, individuals need to consider whether or not their age and health allow them to properly care for the animal as well.

For elders who have lost a spouse, living with a pet can provide much needed companionship, emotional support, and to provide the unconditional love and support we all need. However, pets need medical attention of their own which includes trips to the vet for shots, checkups, and medical treatment. Furthermore, animals can suffer from their own health problems like arthritis, pneumonia, and even the flu.

Other issues like the health of the elder can affect whether or not it may be suitable to keep a pet in old age or in an assisted living facility as canes and walkers do not always make for a good mix with certain types of pets. Frail elders with balance issues or those with vision problems may not be safe with even small dogs that run, jump, or are otherwise rambunctious. Additionally, it is not fair to the animal if its owner cannot take it for a walk, necessitating outside care for the animal.

The U.S. Department of Labor is expected to release new guidelines that will allow small businesses to band together to purchase insurance for their workers with “association health plans” that could end up disrupting healthcare markets. The once common association health plans were attractive to scam artists that took advantage of the states’ inability to regulate these types of health care planes, leaving hundreds of thousands of patients with unpaid medical bills totaling over a quarter of a billion dollars.

Fortunately for patients, the Affordable Care Act (ACA) impose requirements on healthcare companies that effectively prevented association health plans from doing business because of the types of coverage plans needed to offer. For the most part, health insurance plans must offer coverage for the 10 essential health care benefits which include emergency services, habilitative and rehabilitative services, inpatient care, outpatient care, maternity and newborn care, mental health and addiction treatment, laboratory services, prescription drugs, and preventative services and chronic care treatment.

However, the loosening of these regulations could allow association health plans to become big enough that they may be considered “large group” insurance plans, which cover more than 50 individuals. These large group insurance plans are subject to far less state regulation and fewer ACA requirements than small-group or individual plans. In particular, large group insurance plans do not have to offer coverage for mental health services and other vital care mandated by the ACA.

A recent report by the Old-Age, Survivors, and Disability Insurance Trust (OASDI) Board of Trustees indicates that funding for the nation’s Social Security program will face massive funding deficits in the coming future. According to OASDI’s 2017 Report, Social Security will begin paying out billions more than it takes in starting in 2022, due in large part to waves of Baby Boomers entering retirement.

Currently, more than 62 million Americans rely on benefits from Social Security to help pay for basic expenses like food and shelter. Of that number, 42.8 million are retired workers who have already paid into the system while the remainder are beneficiaries are those who are the disabled or and the survivors of workers who’ve passed away. The Center on Budget Policy and Priorities found in 2016 that Social Security’s guaranteed monthly payout ensures that over 22 million people are kept out of poverty, 15 million of which are retired workers.

Since 1982, the OASDI trust has consistently taken in more income than it has paid out to American retirees. OASDI’s reserves currently sit at $2.9 billion, which is primarily invested in special-issue bonds, and is expected to hit roughly $3 trillion by 2021. However, just one year after the reserve assets peak, funding is expect to take a sharp downturn as millions of Baby Boomers enter retirement.

A recent analysis of generic drug prices paid by Medicare Part D enrollees by healthcare consulting firm Avalere Health determined that despite the relatively stable prices of these medications, some seniors find themselves paying more and more each year. The reasons, according to the report, have to do with the way insurance companies place enrollees into pricing tiers and the lack of policy changes to curb higher out of pocket costs for elders.

As reported by Avalere, insurance companies have been moving many generic drugs into copay tiers requiring patients to pay larger portions of the drugs’ cost, thus shifting more costs onto patients this way and keeping Part D premiums stable. The moves are important to insurance companies because they understand enrollees decide on their Medicare Part D plans based on the price of the premiums. Unfortunately for patients, they do not realize the full costs of their healthcare plans until they start filing prescriptions.

The numbers on just how much Part D enrollees are paying for their generic drugs is quite staggering. Despite the average prices of generic drugs increasing by on 1 percent from 2011 to 2015, total out of pocket costs increased by $6.2 billion, or 93 percent. Unfortunately, some of the drugs subject to these massive upcharges include some of the most widely prescribed and low cost medications for chronic conditions such as cholesterol, hypertension, and diabetes.

Federal regulators recently issue a warning health care providers accepting federal funding to be on the lookout for inappropriate prescriptions of a powerful antipsychotic drug commonly used in nursing homes to treat a host of disruptive behaviors. The memo comes from the Centers for Medicare and Medicaid Studies and applies to providers accepting Medicare Part D,  including nursing homes and pharmaceutical distributors.

The drug in question is called Nuedexta and is commonly used to treat a rare condition marked by uncontrollable laughing and crying, called pseudobulbar affect (PBA) but is suspected to also be overprescribed for so-called “off label” uses. In the past year, several media reports have indicated that doctors at nursing homes have been overprescribing Nuedexta in order to control not only the symptoms of those struggling with dementia but also generally unruly behavior in residents without dementia.

While Neudexta’s maker, Avanir Pharmaceuticals, claims many dementia patients suffer from PBA and benefit from the drug, the company has also generated millions of dollars in annual sales in nursing homes since the drug launched in 2011. In most cases, the federal government picked up the costs for those bills when it reimbursed nursing homes through Medicare’s Part D program.

A recent survey of family home caregivers revealed that many of these individuals are strained and stressed out by their duties the demands of their loved ones with developmental disabilities and deeply concerned about the future. The survey analyzed the feelings of over 3,000 individuals caring for family members at home with developmental disabilities and found that 95 percent said they were stressed out with nearly half describing themselves as very or extremely stressed.

The questionnaire was conducted by Family & Individual Needs for Disability Supports (FINDS) Community Report and released by The Arc and The University of Minnesota’s Institute on Community Integration. The data collected is based on responses from 3,398 unpaid caregivers across the country who responded to an online survey conducted between January and April 2017.

Researchers conducted the FINDS primarily through an on-line survey administered between January to April of 2017 and made available in English and Spanish paper versions. Those invited to take part in the survey included caregivers who were family members or friends providing support to people with intellectual or developmental disabilities.

A recent analysis by researchers at the University of Wisconsin-Madison revealed that employers contributed significantly higher amounts of capital to defined-benefit pension plans in 2017, likely because of the new tax law signed by President Donald Trump. That law cut tax corporate tax rates from 35 to 21 percent starting this year and provided an incentive for corporations to increase deductions in 2017, including deductions for pension contributions.

The study analyzed data samples taken from over 400 non-financial firm which calculate their financial statements on a calendar-year basis and found that, on average, that firms increased their unexpected pension contributions by $16 million each. These unexpected pension contributions are considered the difference between the amount a firm contributed and the amount of money it was expected to contribute on prior-year financial statements.

Those numbers came out to a 24-percent increase in 2017 on average compared to the same averages for individual firms from 2014 to 2016. Furthermore, the study determined that taxpaying firms made larger unexpected contributions than non-taxpaying firms which the researchers took as a sign that the increased contributions could be due to the cut in corporate tax rates.

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