It’s understandable to feel that you don’t need to think about this topic when you’re in good health! You should know, however, that putting your future health care wishes in writing can be very helpful to your family members if you were to suddenly find yourself in a position where you can’t make health care decisions for yourself due to being incapacitated by injury or illness.

 Every state has different rules about who makes decisions about your treatment if you are physically unable to do so. In many cases, the decision-making is left in the hands of your health care providers, unless you’ve assigned someone as your legal representative in advance.

 If medical decisions are casually left up to your family, it can be difficult and time-consuming for them to agree on different treatment options. It can also be costly for them to get the legal right to make medical decisions for you, and they may also disagree on who should make these decisions for you. Having a plan with your wishes written out ahead of time can help avoid confusion and disagreements, and it ensures your wishes are honored if you’re unable to speak for yourself!

 Start by talking to your family about your wishes. When you’re ready, completing an advance directive is one of the most important things you can do for yourself and your family to ensure your healthcare wishes are met.

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There are many types of services available to help meet the long-term care needs of an older person living at home. Family members and friends may be able to help with some personal and household tasks. But you might want to hire professionals to assist with others.

Home health care services

Home health care services may help older people with many aspects of health care, such as medications, wound care, medical equipment, and physical therapy. The provider may come for a few hours each day or stay 24/7.

Home health care services may include in-home nursing care to help a person recover from surgery, an accident, or an illness. If the person just left the hospital and still needs nursing care at home for a short time, the hospital can help arrange for a home health aide. In-home health services can also help manage long-lasting (chronic) conditions such as diabetes, for example, by testing a person’s blood sugar or giving insulin through a pump.

What to know about costs:

• Home health services charge by the hour.
• Medicare has limited coverage of home health service costs. The services must be short-term and provided by agencies certified by Medicare.
• Medicaid also provides coverage for home health service costs, but these benefits vary by state.
• Most private health insurance plans do not cover these costs.
• You must pay all costs not covered by Medicare, Medicaid, or private insurance.

To find a home health care service, ask your doctor or other health care professional about good options in your area. You can also ask friends or neighbors for referrals.

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Feeling down every once in a while is a normal part of life, but if these feelings last a few weeks or months, you may have depression. Read this article to find common signs and symptoms of depression, treatment options, and if you or your loved one may be at risk for depression.

What is depression?

Depression is a serious mood disorder. It can affect the way you feel, act, and think. Depression is a common problem among older adults, but clinical depression is not a normal part of aging. In fact, studies show that most older adults feel satisfied with their lives, despite having more illnesses or physical problems than younger people. However, if you’ve experienced depression as a younger person, you may be more likely to have depression as an older adult.

Depression is serious, and treatments are available to help. For most people, depression gets better with treatment. Counseling, medicine, or other forms of treatment can help. You do not need to suffer — help and treatment options are available. Talk with your doctor if you think you might have depression.

There are several types of depression that older adults may experience:

• Major Depressive Disorder – includes symptoms lasting at least two weeks that interfere with a person’s ability to perform daily tasks
• Persistent Depressive Disorder (Dysthymia) – a depressed mood that lasts more than two years, but the person may still be able to perform daily tasks, unlike someone with Major Depressive Disorder
• Substance/Medication-Induced Depressive Disorder – depression related to the use of substances, like alcohol or pain medication
• Depressive Disorder Due to A Medical Condition – depression related to a separate illness, like heart disease or multiple sclerosis.

Other forms of depression include psychotic depression, postmenopausal depression, and seasonal affective disorder.

Supporting friends and family with depression

Depression is a medical condition that requires treatment from a doctor. While family and friends can help by offering support in finding treatment, they cannot treat a person’s depression.

As a friend or family member of a person with depression, here are a few things you can do:

• Encourage the person to seek medical treatment and stick with the treatment plan the doctor prescribes.
• Help set up medical appointments or accompany the person to the doctor’s office or a support group.
• Participate in activities the person likes to do.
• Ask if the person wants to go for a walk or a bike ride. Physical activity can be great for boosting mood.

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Millions of people receive a subsidy to help with the cost of their healthcare plan premiums, through the Advance Premium Tax Credit (APTC), but they could end up owing money back to the government if the credit isn’t calculated correctly. That’s probably not what you were hoping for when you applied for a subsidy! So how does this happen, and what can you do about it?

The APTC is paid directly to health insurance providers to offset part of your premiums, and it’s based on your expected earnings for the year. These earnings are calculated when you apply for a healthcare plan and subsidy each year during Open Enrollment. But in some cases, your income can be estimated too low, and therefore the APTC will overpay the health insurance provider. You won’t cover enough of your share each month, and this problem might be discovered during the following year’s Open Enrollment period. At that point, you might be informed that you must repay the subsidy overage.

This can happen when you receive a raise after your income is estimated, or if you work a lot of overtime. Or, your spouse might earn more than expected. You might simply get married at some point during the year, and suddenly your household income doubles or more.

Luckily, there is an easy way to fix this problem, so that you don’t end up owing months of back premiums. Just write down your expected income each year when the calculations are made during Open Enrollment. And throughout the year, double-check to determine if your income is on track with those projections. If you’re earning more than expected, log into your online portal and change your income projection for the year. This way a new subsidy can be calculated, and you can avoid those overages which could trigger a large repayment demand later.

Of course, there are exceptions to this situation. If in doubt, discuss the matter with your healthcare plan’s customer support team to determine whether you might qualify for an excemption to repay this debt. But because it’s always better to prevent a problem, rather than try to resolve it later, we recommend staying on top of your earnings throughout the year.

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