Grand Living Magazine Winter 2013

1 Grand Living Magazine Winter 2013

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013 ComplimentaryGrand Living

Buying Medicines & Medical Products Online: FAQs

Women In Transition

Travel Discounts for Grand CitizensHelp to Lighten Your Load

Delmarva’s Premier 50+ Magazine

Women In Transition

The Return of the Pin Up CalendarThe Return of the Pin Up Calendar

Impotence Impotence

2 Grand Living Magazine Winter 2013Brandywine Senior Living has Locations throughout NJ, PA, DE, CT, NY

www.Brandycare.com • 1-877-4BRANDY • Relax...We’re here.

B

BRANDYWINE SENIOR LIVING AT FENWICK ISLAND

21111 Arrington Drive | Selbyville, DE 19975 | 302.436.0808

BRANDYWINE SENIOR LIVING AT SEASIDE POINTE

36101 Seaside Blvd. | Rehoboth Beach, DE 19971 | 302.226.8750

G O R G E O U SGorgeous

Ms. January, Shirley Sylvester

Ms. February, Martha Daisey

March Couple, Sam & Lila Pennell

Brandywine Senior Living & Grand Living Recreate the “Pin-Up” Calendar.

In the fall of 2012, Brandywine Senior Living at Fenwick Island and Grand Living Magazine partnered to compile a very unusual “Pin-up” calendar. Kathy Jacobs, Director of Community Relations for Brandywine Senior Living, had an idea to create the calendar and have residents of the facility appear as models. The calendar compilation was Kathy’s way of meeting the corporate objective for National Assisted Living Week, entitled “Art for the Ages.” Each year, Brandywine’s 27 facilities hold a themed competition. The competition coincides with the National event. The annual challenge benefits not only the house team that creates the celebration, but the residents who are also engaged in a unique fun-filled week. “I thought a Pin-up calendar would really connect to our residents,” says Jacobs. Many of them served in the armed forces and can relate directly to the period when Pin-up girls were popular. What I need is a production team to bring the project to life,” she continued. “That’s where the Grand Living team comes in.” While Kathy recruited residents and gathered costumes, Grand Living’s creative team began to plan for the shoots. Since the door was open to all residents, both male and female, we had to get outside of the box a bit. In typical Pin-up, only women appeared for a shoot, but this gave us the opportunity to stretch the topic just a bit, and the men were up for any challenge we presented to them. The day of the shoot came quickly, and with quite a lot of bustle at Brandywine. Profes-sional hair stylists, make-up artists and of course our photographer, Kyle Hughes pulled everything together. Costumes were period appropriate, and the residents told Grand Living it was a wonderfully nostalgic event. Family members arrived to share the experi-ence with their parents as the models got a real taste of the hard work involved in being in front of the camera. While several shots took place in a portable studio right at the Brandywine Senior Living, several shots were taken on location. In Brandywine style, residents accompa-nied by their make-up artist, were transported via Town Car to their shoot. While at one location, the model told us that he “felt like a young man all over again,” and it was truly visible with the swagger in which he worked for the camera. The residents were fully involved in their shoots, and it was an experience they will never forget. The calendars were released just a few weeks later and sold to raise money for the Alzheimer’s Association. “A perfect way to share the calendars with the community,” said Jacobs. The calendars, selling for $19.95 each, to date have raised $5100 for the cause. Our story doesn’t end there. At the end of National Assisted Living Week; Brandywine celebrated the “Pin-Up” calendar release with a party. Each of the calendar models arrived at the event via Town Car, were escorted into the building, and introduced as Ms. January, Mr. March, etc. to a large crowd of family and friends. Party goers had the opportunity to meet the models in person and have their calendars signed as a memento. Whoever said a senior living was a boring, stuffy place for “old people” has surely not been to Brandywine Senior Living at Fenwick Island!

by Sandy Phillips

Continued Page 7

Calendars are still available. Call Kathy Jacobs today at Brandywine Senior Living at Fenwick Island, 302-436-0808 for your copy. They will make a wonderfully nostalgic gift for the Grand Citizen in your life!


Grand Living Magazine is published six times a year; Jan., Mar., May, July, Sept., and Nov. It is circulated throughout Worcester, Wicomico & Sussex counties, by Grand Living Magazine, LLC. Grand Living Magazine is protected under trademark registration. “Grand Citizens”™ is also protected under trademark. No portion in whole or part may be repro-duced without written permission of the publisher. Copyright 2010 ©, Grand Living Magazine LLC. All rights reserved. Content in Grand Living Magazine is intended to provide information only, and is in no way meant to treat or diagnose. Always consult with a speciality professional (i.e. medical, financial, etc.) to address your own personal needs. The company makes every effort to ensure that all information presented is correct. However, we do not make any representa-tions or warranties as to the accuracy of the information, and reliance on information provided is solely at your own risk.

For advertising, contact:Grand Living Main Office

(410)726-7334 [email protected]

About Grand Living MagazinePublisher

Sandy Phillips

Creative DirectorFarin Phillips

Editor

Lou Ann Hill-Davis

Photography DirectorKyle Hughes,

Next Wave Studios

Contributing Writers Patrick Anderson

Therese H. Ganster, ACSW, MPM. Raquel. S. HunterRoxana Laguerre

James W. Respess, Esq.

Issue Contents Cover Story 3 Reinventing “Pin Up” 5 Learning Curve Home & Hearth 9 How to Reduce Caregiver Stress Well Being10 Open Communication about MOLST 12 Buying Medicines & Medical Products Online: FAQ’s 20 Impotence Financial Strength 15 Women in Transition Grand Escapes 18 Cross Country Skiing 19 Travel Discounts for Grand Citizens Help to Lighten Your Load 20 Hearts Desire

12 Buying Medicines & Medical Products

Online: FAQ’s

Grand Living Magazine Winter 2013 5

Learning Curve

The Office of Research on Women’s Health (ORWH) at the National Institute of Health (NIH) offers a free app for smart phones entitled, “A Primer for Women’s Health: Learn About Your Body in 52 Weeks.” The resource aims to promote a healthy lifestyle by offering practical guidelines and strategies women can use everyday to reduce the risk of developing an illness or a condition that can effect quality of life. You can find the app, free of charge in your App Store, by typing, “52 Weeks For Women’s Health.”

The National Institute of Health (NIH) offers a free online assessment and down loadable booklet entitled, “Rethinking Drinking: Alcohol and Your Health.” The booklet discusses the risks associated with your style of drinking and resources for making positive changes.

According to the Department of Homeland Security, Americans can follow simple steps to keep themselves, their personal assets, and private information safe online. Here are a few tips all Internet users can do to practice cybersecurity during National Cyber Security Awareness Month (NCSAM) and throughout the year: •Set strong passwords and don’t share them with anyone. •Keep your operating system, browser, and other critical software optimized by installing updates. •Maintain an open dialogue with your family, friends and community about Internet safety. •Limit the amount of personal information you post online and use privacy settings to avoid sharing information widely. •Be cautious about what you receive or read online – if it sounds too good to be true, it probably is.

January is Cybersecurity awareness month.

Are your drinking habits risky?

52 Weeks Of Healthy Info.

A Brief History of Pin-Up

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The Pin-up girl was a man’s “ideal” woman of the 1940’s. Men wanted to look at them and women wanted to look like them. In actuality, Pin-up girls date to the late 1800’s, but they became very popular during the ‘40s serving as a reminder of the girl back home for servicemen overseas. The girls represented what the average women aspired to be and

reflected the glamorous side of life that seemed to be missing during that time period. Pin-up images could be found most everywhere, in magazines, on calendars, newspapers, postcards and even on the nose cones of American military planes. During World War II, popular Pin-up girls were often movie stars too. Actresses like Betty Grable, Rita Hayworth to name just a few were very popular Pin-up models. In fact it is said that Hayworth’s image could be found in most any G.I. locker or in any mess hall of the period. As Pin-Up became a part of the war effort, it naturally became a central part of “Nose Art.” “Nose Art,” which frequently appeared on the nose cones of U.S. Army planes, was created by Corp. Pilots. Images were painted on the planes of fierce animals, such as tigers and sharks, but may have been accompanied by the voluptuous women of Pin-up. In 1941, it is said that Chuck Yeager broke the sound barrier in his jet decorated with a beautiful Pin-up of his wife, naming the plane “Glamorous Gynnis.” It was a unique way for the pilots to make the planes their own and now is an interesting part of art history. Nose Art’s portrayal of women in the World War II era can be characterizes as daring and carefree. Artists of that time period were not censured as they are today, and the art was reflective of the racy images seen in most any type of media. Nose art appeared, once again, on military planes during the Korean and Vietnam wars, before sexual harassment and exploitation of women was brought to the forefront. Nose Art was officially banned 30 years after its creation. Interestingly, the ban was lifted in 1998, but the glamorous Pin-ups which once graced the military planes, can now only be found in history books and museums.


Happy

Holidays

Ms. April, Lila Pennell Mr. May, Jimmy Dieter Ms. June, Wilma Evans

Ms. July, Shirley Sylvester Ms. August, Lee DeMarie Ms. September, Wilma Evans

Mr. October, Jimmy Dieter Ms. November, Mary Timmons Ms. December, Lee DeMarie


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How To Reduce Caregiver StressHome & Hearth

by Roxana C. Laguerre

may not be able to do much physically. This was my father’s favorite game, and even on days when he wasn’t able to do much physically, he was always up for the challenge of a riveting game of Scrabble! Do not hesitate to ask for help: This is often the most difficult barrier to overcome. As caregivers, we feel that we know our loved one best, and no one can do it as well as we do. In most cases that’s true, however, it’s also impossible to care for your loved one if you’re sick or run down physically. Most people say “I don’t know what you can help me with” or “I can handle it; don’t worry about me.” Next time someone offers help, don’t turn them away. Have specific chores in mind which you know you don’t have time or energy to get done. Maybe it’s time to tackle 1 or 2 loads of laundry, running to the hard-ware store, or cooking a couple meals to have ready for the next few days. You may say to yourself “How am I supposed to do all these things when I’m caring for someone else?” If that’s the answer you hear all too often, then those are signs to consider asking for help on a rou-tine basis, beyond family and friends. Consider hiring a professional caregiver service or agency. In most cases, families use a combination of both family and well qualified professionals to equally share care-giver responsibilities. GLM

With over 10 years of extensive geriatrics experience, Roxana provides a depth of working knowledge with local senior care providers, and has maintained lasting relationships with service providers. Roxana has worked with home healthcare agencies, adaptive equipment providers, as well as skilled nursing and rehabilita-tion facilities, and assisted living facilities. This allows her to help families with a variety of needs unique to seniors. Call Roxana Laguerre, Senior Care Advisor at Family Tree Senior Care, Inc. at 443-880-7382 to discuss which senior care options can work for you and your loved ones.

C Caregiving for a family member can be very rewarding, especially knowing that you have your loved one’s best interests at heart. At the same time though, the rollercoaster of emotions and physical feelings brought on can be over-whelming for one person. I often see situations, especially with spouses, where the once physical-ly healthy spouse feels the need to “do it all,” and spirals into a cycle of declining physical health, along with emotional detachment from friends, family and social circles. What are some practical ways to reduce caregiver stress? Care for yourself physically: Proper rest, eat-ing right and moderate exercise go a long way to reduce caregiver stress. To get restful sleep, be sure to keep yourself in a proper sleep routine. This means giving yourself adequate time every night to “wind-down” from the events or stressors of the day, and to have a fairly consistent night- time ritual of getting ready for the next day. I tend to sleep better if I have my “to-do” list done for the next day, along with my materials out for the next day’s events. Eating right may sound like a major chore in this day and age, but it doesn’t have to be time consuming. Keeping food choices can be simple like baked chicken or fish, and keeping three or four different vegetables stocked in the refrigera-tor (frozen vegetables are nutritious too and last longer!), along with some rice, pasta or sweet potatoes, which are easy and nutri-tious choices. Exercise is a word that stirs up thoughts of going to the gym, lift-ing weights, and having a strict routine 6 days per week. Let’s get real! As a caregiver, you may say to yourself “there is no time left for exercise” especially if your duties are physically demanding. Exercise can be as simple as a brisk walk for 20 minutes, stretch-ing with deep breathing, or just dancing to a few favorite tunes. The key is to relieve stress through moving large muscle groups and a basic routine. Make time for your own social life: Humans were designed to be social creatures. Isolation from friends and social situations, for long periods of time, can lead to feelings of sadness, anxiety, and loneliness, which may lead to depression. If you can’t get out for your social time, invite a friend or two over who you know you can really be yourself and relax with, or pick up the phone and just catch up with a friend or two for 10 or 15 minutes. Regularly enjoy at least one hobby: You may be the kind who enjoys crafting, puzzles, board games, writing, poetry, music, art, photography, sports or outdoor activities. Set a goal to enjoy your hobby at least once every two weeks. I’m a music lover, and I have an extensive collection of music, and I have found that listening to music actually lifts my spirits. My mind becomes more alert, and I often have more energy after enjoying my favorite artists. Another hobby I enjoy is playing scrabble, because it’s competitive and exercises the brain, but it’s also handy to play with someone who


Open Communication About MOLST

by Therese H. Ganster, ACSW, MPM

Around this time last year, my article addressed the Medical Orders for Life Sustaining Treatment (MOLST). It talked about the differences between this physician’s order and an Advanced Directive. The opportunity to com-plete a MOLST had been in effect for one year. Beginning January 1st, 2013, with modifications made, the questions regarding a MOLST will be asked of you, if you receive medical treatment. Effective July 1st, 2013, healthcare entities will be responsible to carry this paperwork from one facility to another. Hospitals, home care nurses, dialysis centers, nursing homes, assisted living facilities and hospices will be asking if you have one. I am asking our Grand Citizens, their children and caregivers to complete this important task. I understand that talking about one’s mortality can be very difficult for several reasons. You may believe that your faith or customs prohibit these discussions, or that discussing these issues in-creases your vulnerability in accepting your eventual death. You may feel that your physician or loved ones would not agree with your request so you would prefer not to think about those things. You may not feel comfortable asking your-self questions regarding life sustaining treatments, and you may also perceive that your decision may bring about an uncomfortable death.

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It is because of all those uncertainties, you need to have open communication! As we become older and have more illness, a discus-sion, face to face with your physician, can help you understand your personal situation and what to expect. It can help answer the questions you will be asked on the MOLST. Remember, your Physician is just as uncomfortable as you in approaching this topic. But if you understand your illness, and how it relates to your quality of life, then you will have a working knowledge of what would be best for you, and be able to make the choices. Your decisions should be based on your preferences and values. Remem-ber, you have the right to agree or disagree with medical treatments recommended to you. You may want to ask your loved one or care-giver, the person you want making decisions for you if you are unable, to visit your doctor with you. That way, everyone’s questions are an-swered. If they are unable to attend the visit, be sure to share your decisions with your family. The MOLST will be honored whether you have an Advance Directive or not. Remember, an Advance Directive helps you designate who will make healthcare decisions for you if you are not able to do so. Many of the questions regarding end of life are also on the MOLST. However the MOLST is a physician’s order, and is carried across healthcare facilities. It will be honored by EMS and all the facilities men-tioned previously. When you have the MOLST, keep a copy readily available so that emergency staff will abide by those orders. You may wish to keep it on the refrigerator door, or on your bedside table. In knowing what my family wanted, I was able to advocate for them. Because of this, some of the last words my mom was able to say to me were: “Thank you. I’ve prayed to St. Joseph for a happy death. You have made my wishes come true.” While I miss her terribly, I am at peace because we’ve had these conversations. I wish all of you the same peace of mind.

Therese H. Ganster, ACSW, MPM is a resident of the lower shore and Branch Manager of Peninsula Home Care in Salisbury, MD.

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Well Being

Buying Medicines & Medical Products Online: FAQsin fact it is not. Websites that sell prescription drugs without a valid prescription deny consumers the protection provided by an examination conducted by a licensed practitioner.

2. Are there any benefits to purchasing approved drugs online? Yes. Legitimate pharmacy sites on the Internet provide con-sumers with a convenient, private, way to obtain needed medi-cations, sometimes at more affordable prices. The elderly and persons in remote areas can avoid the inconvenience of travel-ing to a store to purchase medications. Many reputable Internet pharmacies allow patients to consult with a licensed pharmacist from the privacy of their home. Moreover, Internet pharmacies can provide customers with written product information and references to other sources of information like the traditional storefront pharmacy. Finally, the increasing use of computer technology to transmit prescriptions from doctors to pharmacies is likely to reduce prescription errors.

3. How many web sites sell prescription drugs? The National Association of Boards of Pharmacy has identified approximately 200 domestic web sites that dispense prescription drugs but do not offer an online prescribing service. Accord-ing to a recent Chicago Tribune article cited by the American Medical Association, there are at least 400 web sites that both dispense and offer a prescribing service -- half of these sites are located in foreign countries. Some have estimated that the num-ber of Websites selling prescription drugs may now be closer to 1,000. The number of Websites, however, fluctuates from day to day, and seems to be growing.

4. How many people have been harmed from drugs pur-chased over the Internet? It is impossible to accurately quantify adverse event rates because FDA's postmarketing surveillance system receives reports on only a relatively small percentage of all adverse events caused by drugs. However, as a result of postmarketing surveillance data collected by FDA, we know that the sale of unapproved drugs and the illegal sale of approved drugs over the Internet poses a serious public health risk. We know, for example, of many adverse events resulting from the use of the drug GBL and the date rape drug GHB, which are unapproved drugs sold illegally over the Internet. FDA learned recently of a person who was harmed by the use of Viagra purchased from a Website without an examination by a healthcare professional. Unfortunately, the man had a family history of heart disease and died after taking the drug.

1. Why is FDA concerned about unlawful drug sales on the Internet? Patients who buy prescription drugs from Websites operating outside the law are at increased risk of suffering life-threatening adverse events, such as side effects from inappropriately pre-scribed medications, dangerous drug interactions, contaminated drugs, and impure or unknown ingredients found in unapproved drugs. The current system of federal and state safeguards for protect-ing patients from the use of inappropriate or unsafe drugs has generally served the country well. These laws require that certain drugs be dispensed only with a valid prescription because they are not safe for use without the supervision of a licensed health care practitioner. Generally, before the practitioner issues a prescription for a drug the patient has never taken before, he or she must first examine the patient to determine the appropriate treatment. Subsequently, the patient receives the drug from a registered pharmacist working in a licensed pharmacy that meets state practice standards. The Internet makes it easy for unscrupulous people to sell drugs to patients without these safeguards in place. A Website may appear to be associated with a legitimate pharmacy when

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We also know of cases where people choose the Internet for treatment to avoid consulting a health care professional. These consumers, however, run the risk of purchasing inappropriate drugs or unknowingly purchasing counterfeit or sub-potent drugs.

5. If FDA is not aware of adverse events associated with approved drugs sold online, why does the agency think that unlawful online sale is a big problem? We know that adverse events are under-reported and we know from history that tolerating the sale of unproven, fraudulent, or adulterated drugs results in harm to the public health. It is rea-sonable to expect that the illegal sale of drugs over the Internet and the number of resulting injuries will increase as sales on the Internet grow. Without clear and effective law enforcement, vio-lators will have no reason to stop their illegal practices. Unless we begin to act now, unlawful conduct and the resulting harm to consumers most likely will increase.

6. Why shouldn't the online pharmacy industry be self-regu-lated? Industry self-regulation has a role to play when applied to legitimate businesses. However, self-regulation is an insufficient mechanism to control illegal practices.

7. Some Websites offer to prescribe medication based only on a questionnaire. Is this a safe practice? Is it legal? Unlike the traditional relationship between a patient and the patient's health care professional, some online practitioners issue prescriptions in the absence of a physical examination or direct medical supervision. According to the American Medical As-sociation, a health care professional who offers a prescription for a patient the practitioner has never seen before and based solely on an online questionnaire generally has not met the appropriate medical standard of care. As a result, patients may receive a drug that is inappropriate for them to use and may sacrifice the oppor-tunity for a correct diagnosis or the identification of an underly-ing medical condition for which use of the prescription drug may be dangerous. It is a violation of the Federal Food, Drug, and Cosmetic Act to dispense prescription drugs without a valid prescription. FDA will work with the states to determine the validity of online pre-scriptions and to bring enforcement actions under state law, fed-eral law, or both, as appropriate. In addition, several state boards of medicine have ruled that such practice is medical misconduct and have fined and suspended the licenses of health care practi-tioners who have prescribed drugs in this manner.

8. How many states have acted against web sites selling pre-scription drugs? Several states have taken or are contemplating taking action against illegitimate online sellers of prescription drugs. Four-teen states (Arizona, California, Colorado, Connecticut, Illinois, Michigan, Kansas, Nevada, New Jersey, Ohio, Texas, Washing-ton, Wisconsin, and Wyoming) have already taken some action against physicians prescribing drugs over the Internet. Although most of these cases involve cease and desist orders, some states have assessed fines and are contemplating stiffer penalties. One

state has issued a temporary restraining order against an Internet pharmacy selling drugs without a valid prescription.

9. Who will FDA refer complaints to at the state level? FDA has been working with the National Association of Boards of Pharmacy, the Federation of State Medical Boards, and the National Association of Attorneys General to establish points of contact in all states specifically for Internet related problems. Both the FDA and NABP Websites have online reporting forms for consumers to use in referring complaints to the appropriate regulatory authorities.

10. How will FDA integrate its efforts with the White House Electronic Commerce Working Group? FDA believes its activities will complement those of the White House working group and are consistent with the Administra-tion's July 1997 Framework for Global Electronic Commerce and the President's November 1998 Memorandum on Successes and Further Work on Electronic Commerce. Effective consumer protection is necessary to foster legitimate electronic commerce. Because legitimate electronic commerce activities may involve the practice of medicine or the practice of pharmacy, FDA will work with state law enforcement and regulatory bodies to better define the boundaries of legitimate online practices. By reducing the availability of illegal and harmful products in the electronic commerce marketplace, FDA enforcement activities will increase consumer confidence in the Internet.

Continued on page 14


11. What are international organizations like WHO doing about Internet prescrib-ing and dispensing? The World Health Organization is in the process of developing a guide entitled "Medical Products and the Internet." In addition to providing tips on finding reli-able health and medical information on the Internet, it will provide advice on buying medical products online. FDA participated in the development of this guide.

12. Can an American patient get a medi-cation not approved in the U.S. from a foreign dispenser? As a general matter, it is illegal to import an unapproved drug into the U.S. However, under FDA's personal importation policy, FDA has authorized its inspectors to use their enforcement discretion to allow U.S. residents to import certain products under certain limited conditions. Under this policy, FDA may allow a U.S. resident to bring into this country an unapproved drug for their personal use for a serious condition, if there has been no commercialization or promotion of the drug to U.S. residents.

13. Is it illegal for a foreign pharmacy to ship prescription medicines into the U.S.? It is illegal for anyone, including a foreign pharmacy, to ship prescription drugs that are not approved by FDA into the U.S. even though the drug may be legal to sell in that pharmacy's country. Under the scheme that Congress established to ensure that drugs are safe and effective, drugs are tested and test results are thoroughly reviewed by FDA scientists. U.S. law also requires that prod-ucts approved for sale in the United States have their formulation approved by FDA, be made in a plant registered with FDA, and be produced under quality standards enforced by FDA. Prescription drugs available from a foreign pharmacy that are products that FDA has not approved; products with similar, but not identical formulations as FDA-approved products; products not made under the qual-ity standards required by U.S. law or labeled according to U.S. requirements; or products not stored or distributed under the quality conditions required in the U.S. cannot be legally sold in the U.S.

Continued from page 13

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Financial Strength by James Respess Esq.

IThe Legal & Financial Transitions can be triggered by the following:

–Moving out on your own (away from parents)–Getting married or cohabiting–Having children (single parent, cohabiting, married)–Divorce or legal separation–Widowhood–Financial Reversal - loss of a job, bankruptcy–Unexpected Health Issues–Repeating any of above

Gaining Confidence Again–Take care of the well-being of yourself and loved ones during health, disability and at death (“babysitter instructions”)–Keep your personal matters private–Control your affairs with people you select and trust –Maximize your assets & minimize or avoid unnecessary costs, expenses, taxes –Protect yourself/loved ones from creditors and “predators,” “outlaws,” or bad choices –Keep assets in your family

Dangers–Loss of control - Guardianship–Unintended consequences (faulty asset ownership/beneficiary designations, outdated directives, lack of planning)–Creditors and Predators (lawsuits, divorce, freeloaders and bad choices)–Unnecessary costs - legal and administrative costs and expens-es, taxes

Does Everyone Need a Financial and Estate Plan?Everyone HAS a financial and estate plan whether they know it or not!–Whether your assets are generous or modest–Whether you take steps to create one or not –When you name beneficiaries on insurance policies or retire-ment accounts or create joint titles on deeds or bank accounts

State law dictates “default” plan if there are gaps or conflicts in your plan

What Is Financial & Estate Planning?–Creating a combination of “directives” to authorize others to manage and direct your affairs when you are incapacitated and at your death.–Wills, Trusts, Powers of Attorney, healthcare directives, asset ownership, deeds and beneficiary designations are common ex-amples of directives which could make up a person’s plan. –Creating cohesive plans to meet your objectives during life, through disability, and at your death – Health, Disability, Retire-ment, Wealth Protection, Long-Term Care–The number and type of directives can be simple or complex depending on your needs, goals and budget

The Key to Good Planning–Identify your goals for taking care of yourself and your loved ones (including pets), especially when you are no longer avail-able to do so through incapacity or death

Navigating the Legal and Financial Challenges in Your Life

Women In Transition


James W. Respess is an Estate Planning, Elder Law, Veterans Advocate and Business Succession Planning Attorney with offices at 213 W. Main Street, Salisbury. He can be reached at [email protected]. For more informa-tion visit JamesRespess.com or Estplan.net. For more on Estate Planning visit EstatePlanning.com.

– Understand your options – Work with team of professional advisors–Coordinate goals and directives to eliminate planning conflicts and gaps –Understand how each goal or directive either works with or against your overall ideas about what you want to achieve for yourself and your loved ones

Maintaining ControlControl During Disability–Durable Financial Power of Attorney–Healthcare Directives–Pre-Need Guardian Nomination for Self (subject to court ap-proval)–Living Trust(s) with substantial instructions

Control at Death–Wills–Trust(s)- testamentary–Joint Tenancy with Rights of Survivorship–Beneficiary Designations, Transfer or Payable on Death–Guardian Nomination for Minors (subject to court approval)–Instructions for relocating pets

Durable Financial Power of Attorney– Most overlooked directive!!– “Durable” means it retains its power when principal/creator is mentally disabled–“Springing” versus Immediately Effective–Limited versus General –Elder Law Language – benefits planning–State’s “default” plan (guardianship)

Healthcare DirectivesDurable Healthcare Power of Attorney–Your instructions about everyday or routine medical decisions when you can’t communicate (not brain dead or terminal)–“Durable” withstands mental incapacityHIPPA Declaration–Appoints “personal representative” when you are unable to act on your own behalf for release of medical informationLiving Will–Your instructions about heroic life-sustaining efforts–Applies only if mentally incompetent AND end-stage condition, terminal illness or persistent vegetative state (varies by state)–Special instructions? (religious prohibitions, denominations, etc.)–Withhold hydration and nutrition–Comfort care to alleviate pain

Wills–Only controls assets in your own name; does not control assets held jointly or with beneficiary designations–Only effective at your death; does not give management control or instructions for care during disability–Requires probate (court process to follow instructions in a Will)

with court costs, delays and publicity–May be effective to eliminate/identify creditor claims

Trust–Like “babysitter instructions” you leave for others to follow when you are not available, either due to mental incapacity (liv-ing trust) or death (testamentary trust)–Manage or distribute property for you & loved ones –Private (no living probate for disability or death, probate with exceptions)–Can protect assets from predators and creditors–Can keep assets in the family (bloodline protection)–Can carry out legacy instructions –Assets must be titled in the name of the Trust for Trust instruc-tions to control

Beneficiary Designation Forms–First beneficiary - Primary–Second beneficiary – Secondary (“runner up” in case first ben-eficiary dies before you or in common accident)–Avoids probate (unless you put “my estate” or all named benefi-ciaries have died before you) – then contract controls–No way to hold for benefit of minor or disabled beneficiary without statutory trust reference (e.g. – UGMA, UTMA)–Coordinate with overall Estate plan – review at least annually

Make Sure Your Plan Keeps Up With You–Financial and estate planning is not a one-time event–Personal changes: Birth, health issues, mental incapacity, marriage, divorce, cohabitation, move to another state, death, financial reversal, legacy desires–External changes: Laws, financial status, financial and legal tools, advisor expertise

Where To Start and/or What To Review –List your assets and their values –List liabilities–Verify ownership titles, beneficiary designations and successor(s)–Review existing financial and estate plans with professional team–Identify current and future financial needs for yourself and loved ones–Advisor team should coordinate strategies–Update strategies regularly to take advantage of latest strategies and protections

To receive copies of the preceeding, or to get current information on upcoming seminars, send an email to [email protected]: Estate Planning Worksheet; Inherited IRA’s; Power of Attorney Description; How Old is Old?

Continued from page 17


Inside Salisbury, Salisbury’s Official Concierge, is an annual, hardbound coffee-table book that delights readers with

a savvy, insider’s view of the area. It is available, in-room, at Salisbury hotels and

waiting rooms all over town. Through gorgeous photography and

insightful articles, Inside Salisbury is a publication visitors are compelled to pick

up and want to linger over—timely yet timeless, and reflective of the soul and

spirit of the city. Its modern, eye-catching designs and innovative layout create an

environment designed to attract advertisers, impress hotels and the travelers who

stay in them. Inside Salisbury offers useful information that helps tourists and locals decide where to go, what to do, what to eat, what to buy and what attractions to visit during their

time in town. Inside Salisbury offers rich content and editorialized layout for

advertisers, offering them the opportunity to share the scope of their business as

opposed to a snapshot.

Inside Salisbury

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A

Grand Escapes

Cross-Country Skiing 101

Are you looking for a way to stay fit and have fun in the win-ter? Consider cross-country skiing! Depending on your weight, the intensity of your skiing, and whether or not you choose to ski many hills, cross country skiing may burn between 400 and 1,400 calories per hour. In fact, since cross-country skiing involves a simultaneous use of the arms and legs, many exercise physiologists consider it to be the best form of aerobic exercise. The main difference between cross country skiing and alpine or downhill skiing is that with cross country skiing, the skier is attached to the ski only with the toe of the boot. In alpine skiing, the entire boot is attached to the ski. The free heel allows cross-country skiers to climb uphill which is not very comfort-able in alpine skis. Cross-country skiing dates back to Scandinavia 4000-4500 years ago, when it was used as a method of transportation. Today, the sport is divided into two disciplines: Classic skiing, which uses a straight-ahead gliding motion, and ski skating which makes use of glide and edge movements similar to ice skating or roller blading. Cross-country skiing is part of the Nordic family of sports, which include a number of exciting ways to play in the snow. Biathlon is a combination of cross-country skiing and rifle marksmanship. Nordic combines scoring of jumping and cross-country skiing events. Ski ori-enteering involves a marker search on skis with the help of a compass and map. Compared to downhill skiing, the gear used for cross-country skiing is some of the most affordable outdoor sports equipment available. You will need the following types of equipment for cross-country ski-ing: - Skis with bindings attached, - Poles and boots. - Clothing suitable for cold-weather aerobic activity

Some people choose to go cross-country skiing on snow packed trails, while others like to ski anywhere there is snow. There is a dis-tinct difference between skiing on packed trails and skiing "off-track." On packed surfaces your skis will have greater gliding ability, and with classic tracks, you will have two grooved channels which your skis follow. Off-track ski conditions are dependent on the weather and any previous skiers that have been in the area. However, off-track skiing can feature obstacles such as fallen trees, swollen rivers and inconsistent snow quality. This is usually not an issue in commercial cross-country ski areas, as extensive trail work is conducted through-out the summer months.

by Raquel. S. Hunter


I It PAYS to be a Grand Citizen! Around town and while traveling, make the most of your Grand years by using the travel senior discounts listed below. Make sure to ask your favorite local establishments for their Grand Citizen specials!

Alaska Airlines: 10% off (65+) Alamo: Up to 25% off for AARP members American Airlines: Various discounts for 65 and up (call before booking for discount) Amtrak: 15% off (62+) Avis: Up to 25% off for AARP members (50+)Best Western: 10% off (55+) Budget Rental Cars: 10% off; up to 20% off for AARP members (50+) Cambria Suites: 20%-30% off (60+) Clarion: 20%-30% off (60+) Comfort Inn: 20%-30% off (60+) Comfort Suites: 20%-30% off (60+) Continental Airlines: No initiation fee for Continental Presidents Club & special fares for select destinations Dollar Rent-A-Car: 10% off (50+) Econo Lodge: 20%-30% off (60+) Enterprise Rent-A-Car: 5% off for AARP members Greyhound: 5% off (62+) Hampton Inns & Suites: 10% off when booked 72 hours in advanceHertz: Up to 25% off for AARP members (50+)Holiday Inn: 10%-30% off depending on location (62+) Hyatt Hotels: 25%-50% off (62+) InterContinental Hotels Group: various discounts at all hotels (65+) Mainstay Suites: 10% off with Mature Traveler’s Discount (50+); 20%-30% off (60+) Marriott Hotels: 15% off (62+) Motel 6: 10% off (60+) Myrtle Beach Resort: 10% off (55+) National Rent-A-Car: Up to 30% off for AARP members (50+)Quality Inn: 20%-30% off (60+) Rodeway Inn: 20%-30% off (60+) Sleep Inn: 20%-30% off (60+) Southwest Airlines: various discounts for ages 65 and up (call before booking for discount) Trailways/Greyhound Transportation System: Various discounts for ages 50 and up. United Airlines: Various discounts for ages 65 and up (call before booking for discount) U.S. Airways: Various discounts for ages 65 and up (call before booking for discount)

Travel Discounts for Grand CitizensHelp to Lighten Your Load

by Lou Ann Hill-Davis, Professional OrganizerLighten Your Load Solutions, LLC

(NOTE: Ms.Hill-Davis would like to thank Nancy Larson for her invaluable information used for this article.) Lou Ann Hill-Davis is the President of Lighten Your Load Solutions, LLC. Offices are located in Jacksonville, FL. www.LightenYourLoadSolutions.com.


Impotence, also known as erectile dysfunction (ED) is a man’s inability to achieve or maintain an erection. This is a condition that is rarely talked about amongst men but can have a devastating effect on a man’s confidence and self-esteem. This can subsequently lead to depression, which only serves to aggravate the condition further. Unfortunately, impotence is a very common problem and affects over 2 million men in the US alone. In fact, over half the male population over the age of 40 will suffer from some form of impotence at some stage. Despite these statistics, only a small number of men, about 10%, will seek medical assistance, mainly due to feelings of embarrassment. Many medical doctors will prescribe chemicalised drugs, such as the blue pills to combat impotence. These are of course, not without their side effects and these things should be throughly discussed with your physician before beginning use. Most young men in their 20’s or early 30’s dismiss erectile dysfunction as something that will never happen to them. Yet ED is a condition that can be caused by a number of factors.

Psychological

Often the layman’s reason for the number one cause of impo-tence, yet according to studies, psychological factors account for less than 20% of impotence in men. It is the subsequent feeling of depression and anxiety after one incident of impotence that can compound any underlining medical condition and worsen the problem.

High Blood Pressure

Aside from psychological factors, physical condition can also precipitate impotence. It is well documented that high blood pressure and high levels of cholesterol can lead to impotence. This is due to the copious amount of pressure on the blood vessels that causes damage to the arteries of the penis, severely restricting the flow of blood and resulting in an ineffective erection.

Stress and Fatigue

This one falls into the category of psychological. Although some men find stress to be a motivator, too much stress and fatigue can lead to erectile dysfunction. Stress can be in the form of financial, sexual, work or relationship, and this can cause erectile problems. Fatigue is normally the result of stress that can zap a person’s physical and mental energy. Once the cause of stress or fatigue is resolved, then any erectile challenges should be too.

Impotence, A Man’s Worse Nightmare!

Excess Weight

Over weight is seen as a contributory factor to increased level of impotence. Excessive fat blocks the arteries in the penis which restrict the flow of blood to the penis resulting in difficulty in achieving or maintaining an erection.

Treatment

Impotence is a very real and serious concern for many men at some stage in their life. The causes range from the psychological, to the physical. There are preventative actions that you can take, such as regular exercise, adequate sleep, reducing levels of stress and consulting your doctor as soon as possible if the challenge occurs. Most causes of impotence can be identified and treated. Talk to your doctor about the best options for you.

by Patrick Anderson Well Being Supplemental

Patrick Anderson is an expert in issues affecting mens' sexual health and wellbeing. He is an advocate for natural and herbal solutions to men's sexual health problems. (Please seek the advice of a medical professional before begin-ning any treatment regimen.)

Winter 2013 Grand Living Magazine 21

Live Life To The Fullest

“See the Arc de Triumph, in Paris.” P. Bunting - Age 59 - Fenwick Island, DE

“Vacation at a Ritz Carlton.” M. Mylert - Age 48 - Salisbury, MD

We all have a list of things to do in our lifetime, and the list often begins in our childhood. Things like college, marriage, children, and home building, take center stage. There are many other things that make your

“list of a lifetime.” Consider adding some of the suggestions below, because you’re only as old as you think you are! Send your “Heart’s Desire” for an upcoming issue, to [email protected] or call us at 410-726-7334.

Heart’s Desire

“Visit the Vatican.” K. Lichick - Age 61 - Laurel, DE

“Shower in a waterfall.” S.Cruller - Age 46 - Millsboro, DE

Documents

Grand Living Magazine Winter 2013