Category: Date

Can You Save Your Vision?

My patients often ask: “Doctor, what can I do to save or preserve vision for myself and my family?”

Prevention: Wear sunglasses! Over time, sunlight damages the lens of the eye, causing cataracts. More Medicare dollars are spent for lens replacements than for any other kind of surgery. The average age for cataract surgery is 72. Sunglasses slow the development of cataracts, and that goes for kids, too. Prevention and treatment of visual problems in childhood results in improved vision throughout life. Don’t smoke. Smoking makes you four times more likely to develop cataracts. Exercise and a healthy diet are important, too.

Early Detection: Get regular eye exams! We seniors may develop disorders like age-related macular degeneration (AMD) and loss of reading vision. Vitamins and minerals found in some foods and NIH-approved dietary supplements may help Dry (without bleeding) AMD to some degree.

“Wet”(bleeding) AMD occurs in 15 percent of patients. Treatment calls for injections into the eye every four to six weeks — probably for life.

People with diabetes suffer bleeding and swelling of the retina, inside the eye. Anyone may develop glaucoma, or “hard eyeball disease,” which is treated with eye drops and lasers. The earlier you seek treatment the better. Getting checkups can help save your vision.

Hawaii Vision Clinic
1330 Ala Moana Blvd., Suite “One Poolside,” Honolulu
P 808-955-5951 | F 808-941-8646
office.personnel@malcolmingeyemd.com
www.malcolmingeyemd.com

My patients often ask: “Doctor, what can I do to save or preserve vision for myself and my family?” Prevention: Wear sunglasses! Over time, sunlight damages the lens of the eye, causing cataracts. More Medicare dollars are spent for lens replacements than for any other kind of surgery. The average age for cataract surgery is…
Alzheimer’s Disease

Alzheimer’s is a progressive illness that involves the destruction of brain cells. In its earliest stages, symptoms include a decrease in short-term memory and forgetfulness, often accompanied by a diminished ability to find words. Emotional and personality changes in the early stages maAlzheimer’s is a progressive illness that involves the destruction of brain cells. In its earliest stages, symptoms include a decrease in short-term memory and forgetfulness, often accompanied by a diminished ability to find words. Emotional and personality changes in the early stages may include depression, anger and paranoia. As the disease progresses, the memory loss becomes severe and may be accompanied by marked disturbances in behavior and emotion; the ability to reason is lost. In its final stages, a person is unable to perform most tasks and requires total assistance with feeding, bathing and basic hygiene.

Twenty-six-thousand people have been diagnosed with Alzheimer’s in the state of Hawai‘i as of the year 2015. Alzheimer’s ranks as the sixth leading cause of death nationwide. Of the top 10 causes of death in America, it is the only one that cannot be prevented, cured or slowed. Almost two-thirds of Americans with Alzheimer’s disease are women. One in three seniors die with Alzheimer’s or another dementia. Payments for health care are estimated to reach $226 billion in 2015. If medical researchers cannot find a solution to the disease, Alzheimer’s is estimated to be the number one disease which will bankrupt the health care system.

If you or a loved one has been diagnosed with Alzheimer’s or a related dementia, you are not alone. Go to www.alzheimernavigator.org to create a customized action plan and connect with local support services.

Alzheimer’s Association Aloha Chapter
24/7 Helpline: 1-800-272-3900
Informtion and Virtual Library: www.alz.org

Alzheimer’s is a progressive illness that involves the destruction of brain cells. In its earliest stages, symptoms include a decrease in short-term memory and forgetfulness, often accompanied by a diminished ability to find words. Emotional and personality changes in the early stages maAlzheimer’s is a progressive illness that involves the destruction of brain cells. In…
Meet Joan Packet at 94

She works on her health and fitness every day with Diane Cadinha.

Our friend Joanie Packer says she doesn’t worry about things she can’t do anything about — so she lives in the present, works at being as healthy as possible and tries to show appreciation to those around her.

At 94, how is your life different than when you first retired?

(left) Joan Packer at 49 yrs. and (right) at 94 yrs.

Joan: Back in Missouri, I used to rise at six a.m., spend my days teaching high school English and dream about a life of leisure when I could sleep late. But when I did retire, I was bored and depressed. In my 70s I moved from my farm to a condo in Waikiki. When I saw how physically fit and healthy everyone looked walking around Kapiolani park, I decided I wanted to be like that, too. Now, 28 years later, I exercise six days a week and I’m no longer bored and depressed.

Six days a week sounds like a lot. What kind of exercise classes are you taking?

Joan: It didn’t happen overnight. At age 77, I started an exercise plan. We began with tubing and light weights, and worked up to the stability ball and balance work to prevent falls. Strength training keeps my muscle mass and bone density, so I don’t get frail and weak. The better I feel, the more I want to try other classes like Pilates and Yoga. In class we all encourage each other.

Believe me, I am inherently lazy and do not really relish working out. So going to classes and having a trainer to ride herd on me and hold me accountable is important. I figure my health and independence are worth the effort.

What else you do to stay fit?

Joan: I think walking is really important. On the days I don’t walk to class, I walk around the park, the zoo and sometimes up Diamond Head Road. That 40- to 60-minute trek never fails to make me feel better than when I started out. Socializing is also healthy and fun. Two days a week, my group does tai chi in Kapiolani Park.

Besides exercise — do you have any other recommendations?

Joan: Food! I gave up my starchy Midwestern farm fare for fruits, vegetables, fish and poultry, soups and lentils. Now I crave healthy foods. I also recommend a positive mental outlook — that makes life fulfilling at any age.

Shaping Up Fitness Studios
Mililani and Downtown: 250 Ward Ave., Suite 206
808-221-3905 | shapingup@hawaii.rr.com
www.shapingup808.com

Our friend Joanie Packer says she doesn’t worry about things she can’t do anything about — so she lives in the present, works at being as healthy as possible and tries to show appreciation to those around her. At 94, how is your life different than when you first retired? Joan: Back in Missouri, I…
Helping as a Representative Payee
If you handle the finances for a Social Security beneficiary or know someone who may need help managing benefits, you may consider applying to become a representative payee.

A representative payee is someone who receives Social Security or Supplemental Security Income (SSI) payments on behalf of a person not capable of managing the funds on his or her own. A representative payee meets the individual’s basic needs by using the money to provide food, clothing, and shelter for the person and saving any left-over money in an interest-bearing account or as savings bonds for the beneficiary’s future needs.

As a representative payee, you must:

know the person’s needs so you can decide how to meet those needs with the benefits provided.

be responsible for letting Social Security know about any changes that may affect the person’s eligibility for benefits or the payment amount.

complete a yearly report of how the funds were spent. (You can do this online.)

To help a friend who receives Social Security or SSI benefits and is not able to manage his or her own finances, help them contact us. Social Security will help determine if a payee is needed and who would be best suited to act in that capacity.

For more information, read, A Guide For Representative Payees, at www.socialsecurity.gov/pubs and When People Need Help Managing Their Money, at www.socialsecurity.gov/payee.

Thank you to all caregivers and represntative payees helping people in need.

_________________________________
Questions, online applications, or to make an appointment to visit a Social Security office, contact:
1-800-772-1213 (toll free) | 1-800-325-0778 (TTY)
www.socialsecurity.gov
If you handle the finances for a Social Security beneficiary or know someone who may need help managing benefits, you may consider applying to become a representative payee. A representative payee is someone who receives Social Security or Supplemental Security Income (SSI) payments on behalf of a person not capable of managing the funds on…
Keiko Matsui Higa Recalls Being Local

It is said that many people want to write a book, but few do. Keiko Higa did it, and rich memories about growing up in Hawai‘i will inspire you to get started on your own story — even if it’s only for your grandchildren.

Like so many “locals,” Higa comes from many cultural traditions. Her dad was Japanese, her mother Okinawan and her husband Filipino. Add to that her respect for Hawaiian culture and you have “chop suey” talk story — something for everyone. Woven through family history, descriptions of local places and times past, are Higa’s heartfelt concerns — social injustice of the Japanese internment era, low plantation wages and tracking by race when she was in school. Higa was educated at UH Manoa, Claremont School of Theology and UC Berkley, and was a city planner for the City of Las Vegas. Her stories are at once ethereal and mundane. She mixes the salt of her ideas on global oppression and colonization with the pepper of pidgin poetry, ethnic traditions and church potlucks. It is local, candid and engaging. Even if you do not agree with her views, you will understand exactly how she came to them — and respect her courage to put words into action, and follow her deep passion for justice and peace.

Being Local in Hawai‘i is available online at www.KeikoMatsuiHiga.com and at Amazon:www.tinyurl.com/BeingLocalInHawaii.

She also does talks for community groups. For information and details call,808-944-0317.

It is said that many people want to write a book, but few do. Keiko Higa did it, and rich memories about growing up in Hawai‘i will inspire you to get started on your own story — even if it’s only for your grandchildren. Like so many “locals,” Higa comes from many cultural traditions. Her…
Sandwich Generation Conversation

Kirk: We hear a lot about the Sandwich Generation these days.

Linda: You know me … I love a sandwich.

Kirk: No, we’re talking about the generation that has to take care of their parents and their children; they’re in the middle.

Linda: Baloney!

Kirk: Not! Not that kind of sandwich. More than ever, there are three generations in one household. Sandwiches are stacking up.

Linda: But a sandwich needs condiments — mayonnaise, lettuce, mustard.

Kirk: Exactly. That’s where resources come in — resources that can help the sandwich generation cope. Generations Magazine includes a lot of assistance that way.

Linda: So instead of a club sandwich, it’s a… sandwich club!

Kirk: And the club is growing. One in eight Americans are in the sandwich generation and the number is likely higher here in Hawai‘i. The important thing to remember is you are not alone.

Linda: What happens if there’s a “next” generation added? Do you want small fries with that?

Kirk: Good question. It helps to think of that ahead of time. By the way, if you were a sandwich, what kind would you be?

Linda: I would be a sweet honey on nut bread.

Kirk: I’d go along with that. What kind would I be?

Linda: You would be a ham on wry!

Retired broadcast personalities and Journalists Kirk Matthews and Linda Coble speak from the heart on issues concerning boomers and seniors. Post comments for them on Generations808.com.

Kirk: We hear a lot about the Sandwich Generation these days. Linda: You know me … I love a sandwich. Kirk: No, we’re talking about the generation that has to take care of their parents and their children; they’re in the middle. Linda: Baloney! Kirk: Not! Not that kind of sandwich. More than ever, there…
Metal-Free Biocompatible Restorations
Conservative Restoration

Dental toxicity can occur when materials placed in a patient’s mouth cause that person’s immune system to react and “reject” the restoration. Serum compatibility testing provides dentists with one way to help determine which materials will react in a test tube with a patient’s serum proteins. Today’s dental patients have the opportunity to select:

Highly aesthetic, tooth-colored fillings — created and placed during a single dental appointment, with no temporary crown.

Metal-free, bio-compatible materials for restorations that will not cause an allergic reaction with the body.

CEREC Restoration

The CEREC procedure was developed at Zurich University 25 years ago. The CEREC system uses restorative material and the conservative removal of dental enamel to restore the diseased tooth.

In the past crowns were made for teeth requiring removal of a lot of tooth structure. With the new materials, the dentist can preserve precious tooth enamel and effectively restore the tooth. Enamel is the only tissue in the body that once removed, will not regenerate.

Hawaii Center for Cosmetic & Laser Dentistry
808-526-0670 | www.smilepower.net
Dental toxicity can occur when materials placed in a patient’s mouth cause that person’s immune system to react and “reject” the restoration. Serum compatibility testing provides dentists with one way to help determine which materials will react in a test tube with a patient’s serum proteins. Today’s dental patients have the opportunity to select: Highly…
Paying for Long-Term Care

According to an article published in the Wall Street Journal on May 14, 2012, if you are married and you and your spouse both reach the age of 65, there is a 70 percent probability that one of you is going to need long-term care. As if that is not troubling enough, a great many of us are completely unprepared to pay the cost of long-term care. Skilled nursing in Hawai‘I can easily top $8,000 per month. How do people handle that?

For those of us who are not incredibly wealthy, one approach is long-term care insurance. You should talk with an insurance agent who focuses on the complexities of long-term care insurance before you plunk any money down. The older we get, the odds of being insurable decrease, and the premiums get higher. The bottom line is that the sooner you look into long-term care insurance and get your policy in place, the more likely you will be able to afford the premiums.

An alternative to insurance is Medicaid. It goes by different names in different states (Hawai‘i’s version is called MedQUEST), but it is run jointly by our federal and state governments. The federal government sets the overarching rules and provides funding. States are allowed to adopt their own rules for qualification and enforcement. Think of it as government nursing home care insurance for those with limited financial resources.

Medicaid is “means-based.” Having too much income or too many assets will disqualify a Medicaid applicant. However, having “assets” is not the same as having the money to pay for care. Those undeveloped lots in Nevada that you own, are assets, but they may be impossible to sell.

For those with assets exceeding the Medicaid limits, giving assets away may disqualify them from Medicaid assistance too — if the transfers violate the “look-back” period designed to keep people from gaming the system. Of course, a kupuna might have had innocent intentions when making a disqualifying gift — before the need for long-term care arose. Regardless, any gift (even charitable) is a red flag on Medicaid applications.

Each state takes a different approach; it is easy to run afoul of the rules and be disqualified from benefits. The good news is that knowing the rules can help you plan for a worst-case scenario where you or a loved one might need assistance with long-term care costs.

Another critical consideration is that Medicaid may limit your options for care facilities or quality of care. So we should not all assume that Medicaid is the best option for us or our family.

Scott Makuakane, Counselor at Law
Focusing exclusively on estate planning and trust law.
Watch Scott’s TV show, Malama Kupuna
Sundays at 8:30 p.m. on KWHE, Oceanic channel 11
www.est8planning.com
O‘ahu: 808-587-8227 | maku@est8planning.com

According to an article published in the Wall Street Journal on May 14, 2012, if you are married and you and your spouse both reach the age of 65, there is a 70 percent probability that one of you is going to need long-term care. As if that is not troubling enough, a great many…
Calling the Police: It’s Called ‘Tough Love’

Wanda (not her real name) took out a home equity loan on her Waianae house. She intended to renovate her home so that her adult daughter could move in, care for Wanda and help repay the loan. Once the $290,000 was in their joint checking account, however, her daughter withdrew it and took her family on a first-class trip to Disney World. Wanda has not seen her daughter for two years and is now going through the foreclosure process.

Steve (not his real name) was the caregiver of his disabled sister and had established a sizable savings account for her care. When Steve’s daughter offered to help care for her aunt, Steve gladly accepted and gave her access to the bank account. After six months of being a caregiver, she withdrew all the money from the bank account (about $120,000) and moved in with her new boyfriend.

These are just two calls I got recently from victims who wanted to report what happened to them, but did not want the police to get involved. Their voices were full of despair and frustration. Each could not believe what had happened, and despite the fact that they were informed a crime had occurred, did not want the police or the court system to get involved — even if that was the only way to get their money back.

As a deputy prosecuting attorney in charge of the Elder Abuse Unit, I advocate that all cases of financial abuse be reported to the police, even if the person taking the money is an adult child or another relative of the victim. It is not blind faith in the criminal justice system that leads me to this school of thought. Twenty years of experience has proven to me repeatedly that showing “tough love” and calling the police on a loved one who has stolen money is actually helping that person stop a behavior, like drug usage, which will prove harmful to them in the long run.

More than once have I had parents call me up years after their child had been arrested to thank me for the work our office and the court system did to help their child get their life back on track. Drugs, alcohol, gambling or mental health issues have ruined the lives of many people and have caused family to victimize family. Oftentimes, those suffering from these afflictions will promise their kupuna they will get help, only to later on steal from them to feed their habit. Police intervention gives these people opportunities to either go to counseling or go to jail. Often they choose to get help and rehabilitation, with good results.

If you are in a situation where you have been the victim of a crime committed by someone you know, please call the police. There is no shame in reporting a loved one’s destructive actions to someone who can force them into a rehabilitation program or other help they may need. It’s hard to do, but that is why it’s called “tough love.”

To report suspected elder abuse, contact the Elder Abuse
Unit at:808-768-7536 | ElderAbuse@honolulu.gov
www.ElderJusticeHonolulu.com

Wanda (not her real name) took out a home equity loan on her Waianae house. She intended to renovate her home so that her adult daughter could move in, care for Wanda and help repay the loan. Once the $290,000 was in their joint checking account, however, her daughter withdrew it and took her family…
Total Knee Rehab and Recovery

The knee is the most often replaced joint in the body. Usually, total knee replacement (TKR) surgery is performed when people have knee damage and pain caused by osteoarthritis, rheumatoid arthritis or alignment problems in the leg that make walking or performing daily activities difficult. Successful recovery requires a considerable investment of time and energy in rehabilitation following surgery. A strict timetable of exercise, rest and medication is crucial to heal muscles and tendons. Your physical therapist can speed up your return to normal activity and help make your new knee better than the old one! A rehab program tailored to your specific needs may include land or aquatic range of-motion and muscle-strengthening exercises, activity-specific training, and body awareness with balance training. You may also receive manual therapy and pain modalities to minimize swelling, as well as a custom home exercise program. Prepare for surgery by losing weight. Staying active, even beyond your home exercise program, will help hasten your recovery — but activities should never be done to the point where they cause more pain. Follow your physical therapist’s instructions and take care to protect your new knee and your general health. These are ways you can contribute to the success of your total knee replacement.

Moon Physical Therapy,
320 Ward Avenue, Suite 107, Honolulu, HI 9681
Aquatic, Land-based and Manual Therapy and
Cardiopulmonary Rehab Programs
808-597-1005 | Moon Physical Therapy, www.moonpt.com

The knee is the most often replaced joint in the body. Usually, total knee replacement (TKR) surgery is performed when people have knee damage and pain caused by osteoarthritis, rheumatoid arthritis or alignment problems in the leg that make walking or performing daily activities difficult. Successful recovery requires a considerable investment of time and energy…
What’s the Right Life Insurance?

For most people, it isn’t a question of whether to own life insurance, but what kind of coverage is most appropriate for their circumstances. There is no “one-size-fits-all” policy. You need to determine what works best for you.

Choosing life insurance involves finding the right balance between the cost of insurance and the most appropriate coverage for y our family.

Two Basic Life Insurance Options

Policies that provide a death benefit for survivors after you die, but no other features, for a specified period of time. These are typically referred to as term life insurance.
Policies that combine a death benefit for survivors with a cash value that can be accessed while you are still living, often referred to as whole-life or permanent life insurance.

Term insurance — cost effective coverage

If keeping premiums as low as possible and replacing your income stream for your family are your priorities, term insurance can be a good option. The younger and healthier you are when first purchasing a policy, the less it will cost. Newly married couples may buy this type of policy to provide a financial cushion in the event one spouse dies. Your employer may offer term insurance as part of your employee benefits plan.

The amount of coverage that seems sufficient early in life may not be enough to protect your family later on when you have dependent children, aging parents to support or when your income rises. Term insurance typically expires after a stated period of time or once you reach a specific age. After the term policy expires, you must reassess your insurance needs.

Permanent life insurance — coverage beyond death benefits

You may choose from a variety of permanent life insurance policies, such as traditional whole life, variable life, universal life or variable universal life. Like term policies, they pay designated beneficiaries at your death. Unlike term policies, they do not have a termination date. As long as adequate premiums are paid and the policy remains in force, your beneficiaries will receive the death benefit. Premiums or additional costs are generally higher than term insurance.

Another important feature of permanent life insurance is that a portion of your premiums accrue within the policy on a tax-free basis; over time, the policy builds a cash value. Some forms of this type of insurance give you the ability to make investment choices within the policy. The cash value is not guaranteed, but it can act as an asset while you are living. This is an important benefit that can give the policy owner much more financial flexibility.

Like anything else in your financial life, the need to protect your loved ones requires that you carefully assess which available options work best for your circumstances and needs. When insuring your life, be sure to discuss your options with a financial advisor or insurance specialist first, before making any decisions.

Michael W. K. Yee, CFP
1585 Kapiolani Blvd., Suite 1100, Honolulu
808-952-1222 ext. 1240 | michael.w.yee@ampf.com

Michael W K Yee, CFP®, CFS®, CRPC®, is a Financial Advisor and CERTIFIED FINANCIAL PLANNER practitioner™ with Ameriprise Financial Services, Inc. in Honolulu, HI. He specializes in fee-based financial planning and asset management strategies and has been in practice for 30 years.

Ameriprise Financial and its representatives do not provide tax or legal advice. Consult your tax advisor or attorney regarding specific tax issues.

Life insurance benefits are subject to the claims paying ability of the issuing insurance company. Ameriprise Financial Services, Inc. Member FINRA and SIPC.

© 2015 Ameriprise Financial, Inc. All rights reserved. File #1156277

For most people, it isn’t a question of whether to own life insurance, but what kind of coverage is most appropriate for their circumstances. There is no “one-size-fits-all” policy. You need to determine what works best for you. Choosing life insurance involves finding the right balance between the cost of insurance and the most appropriate…
June – July 2015

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Sandwiched: Baby Boomers Face the Challenge

Category: Date

Two Basic Life Insurance Options

Term insurance — cost effective coverage

Permanent life insurance — coverage beyond death benefits