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A healthier choice for seniors (and everyone)

How have other countries faced rising drug costs?  And why do Canadians get the splintery tongue depressor when it comes to prescriptions?

pills

First of all, because we do not have universal prescription coverage, we pay too damn much for the drugs we are getting.  According to this CBC Report, drug company representatives influence doctors’ choices in prescribing:

The research conducted for the fifth estate by health benefits company Express Scripts Canada shows employer-funded private insurance plans in Canada wasted more than $3 billion per year between 2011 and 2015 by covering the cost of expensive drugs that have cheaper options, as well as paying for unnecessary dispensing fees.

Adding to that is the fact that other countries tell the drug companies how much they will spend on drugs.  In this report we learn

An analysis by the fifth estate shows that Canadians, for example, pay far more than people in New Zealand for drugs produced by the largest Canadian-owned pharmaceutical company.

For every dollar Canadians spend on seven popular drugs sold by Apotex in both countries, Kiwis spend just 11.5 cents.

And overall, according to several studies, Canadians pay the second-highest drug prices in the world, after only people living in the United States.

So add those two problems — higher drug costs and lack of universal coverage — and you have one big problem.  Many people do not fill or take their prescribed drugs.  And THAT costs us money, too.

A study at the University of British Columbia showed that

In an analysis of survey responses from all 11 countries, the researchers found that Canada had the second-highest prevalence of skipped prescriptions due to cost, at 8.3 per cent. Access was worse only in the United States, where 16.8 per cent of respondents reported such financial barriers to filling prescriptions. In contrast, fewer than four per cent of the populations in most other comparable countries reported skipping prescriptions due to cost.

And the result of that barrier to filling prescriptions?

“When patients stop filling their prescriptions, their conditions get worse and they often end up in hospital requiring more care which in the long run costs us more money,” said Steve Morgan, senior author of the study and professor in UBC’s school of population and public health.

It’s time for federally-funded prescription coverage.

Keeping healthy at a price — that seniors can’t pay

Looking forward to my retirement (133 days but who’s counting?) isn’t all sunshine, roses, and fluffy puppies.   I know I will have to pay a price for continued health care.

medical devices

It’s more important than ever that we stay in tippy-top health.  I have promised myself to increase my exercise regime and to eat right to bring down my slightly elevated cholesterol numbers.  And it seems unfair that now, as I retire,  I am responsible for paying out more money just to stay in good health.

Here in BC we have to pay our own MSP rates (we’re the only province where the provincial government doesn’t cover that cost) and right now my employer picks up that tab.  After retirement that will be $150 a month for the spouse and myself. That’s the highest amount on a sliding scale that tops out at a mere $42,000 net income per year.

Plus right now my employer generously provides me with a medical plan to cover my prescription drugs, dental care, and other extended benefits (thanks, CUPE 2950!).

But as of July 1, 2017, I will have to pay for those.  BC has a system called Fair Pharmacare, a means tested subsidy based on your income that has a hefty deductible based on your income — from two years previously.  For us that could be $1200 a year. Yikes! And it only covers 70% of drug costs up to a maximum, after which we’d get 100% coverage.

You can spread your deductible over a payment plan, but for someone on a fixed income there could be a struggle to afford needed medication. Plus basing the payments on our income from two years previously means that it will be two years before my significantly lower retirement income is reflected in our deductible.

If we lived in Ontario, as a senior my drug costs would be covered with a deductible of $100 A YEAR!

There are private insurance plans which we will certainly consider.  I’ll have to do some very tedious spreadsheet work to see which plan will work out best for us.  As with all insurance, you should buy before you need it.

But it’s not like that in other countries.  Canada is the only country enjoying universal health care that does not have universal prescription  coverage.  And that costs us money.  It seems counter-intuitive that paying for everyone’s prescription could save the health-care system money, but it’s true.

More on that tomorrow.

 

 

Aging in Place in our Laneway

 

What does it mean to get older?  Don’t shake your head at me, I’m serious.  What will it mean to me, physically, to get older?  Not just greyer and wrinklier, but weaker and more frail.

But still, you know, hip

But still, you know, hip.

I recently had the pleasure of spending some weeks with a relative as she started her recovery from hip replacement surgery.  Overnight a healthy, athletic lady became disabled, albeit temporarily.  She needed a walker to get around even short distances.  She had trouble getting up and down stairs.  And she wasn’t allowed to bend over from the waist, meaning she needed devices to grab items, a long-handled shoe horn, etc.  She’d prepared for the recovery by having a sturdy metal bar installed in her bath/shower and used a bench when she showered.

She’s well on way to regaining her bouncy life.  But staying with her really brought home how prepared we have to be for getting older without having to move.  Because moving is out of the question.  So I looked it up on the AARP website to see if they had any good ideas.  And they did!

Of course, it’s more than making a cozy home, it’s safety, too.

Aging in place isn’t just about comfort. In very basic terms, it’s about avoiding falls. If an older person can avoid falling and breaking a hip, he can prevent a cascade of other health problems.

We have stairs, not ideal in a home where we’ll be getting older.  But our bathroom and bedroom are on the same floor so we don’t have to try to go up and down a flight of stairs in the middle of the night.  And our shower is big enough to get a bench in.  The sink and shower faucets are easy to operate, and we set the temperature on one fixture without having to fiddle with knobs.  Living small means our sink counter is close enough to the toilet to supply a hand-hold if we need assistance standing up.  Also in our shower,

a tiled shower area with recessed shelves at arm’s level to stop you from having to stoop down to the floor or reach up to a shower rack

The kitchen/living room area on the top floor has enough places to hold onto to make it easy to get around if balance is a problem.  And we can sit at our counter and work, so won’t have to stand for long periods if we are trying to avoid that. The dishwasher is in a counter-level drawer for easy loading and unloading, we have deep drawers instead of under-counter cabinets, so no stooping and reaching into the depths.

All our flooring is laminated hardwood, no carpets to trip on.  We do have an area rug, a cowhide in front of the TV with no pile.  But if we ever had problems with tripping, out it would go, decor be damned.

Elsewhere, we have lever-style door handles, again, no knobs to turn.

Some other ideas for making your home senior-friendly can be found at this Reader’s Digest article.  This includes

• No-step entry: You should have at least one step-free entrance (either at the front, back, or side of the house) so everyone, including wheelchair users, can enter the home easily and safely.

OK, we have a very small sill, easy to step over but definitely a problem if we are in a wheelchair.  But then, if DH or I end up in a wheelchair we are kind of screwed.  The doorways are not wide enough to accommodate one, the hallways are too narrow.  But short of that, our place is pretty well set up for aging in place.

If you’re thinking of making some changes in your home, though, read this article on things to consider about putting in expensive renos like stair glides, elevators, or even walk-in tubs.  At first glance they look like a great idea, but they might not be suitable for you.

Of course, another reason we’re set to get older in our laneway is the proximity of our family.  If (or when) the time comes that we aren’t able to get around town by walking and transit, they’ll be close enough to take us for an occasional shopping trip or medical appointment.  But we are also really lucky that transit is so close to our home, and shopping is a pleasant walk down and up the hill.

How do I get there from here?

My Facebook pal, let’s call her Ann, has retired after 24 years in a civil service job.  Now she is ready to take on her next career – real estate agent.  She has taken the courses and got her license, and she is raring to go!  And more power to her for following her dream.  But it’s not my dream.

Ann loves being around people, loves being part of their lives. In short, she is not like me at all!

Planning for retirement is like planning for so many other things.  Weddings, education, vacations — for all these life-changing events it’s a highly personal journey.  And when you’re on a journey, the first place to start is with a map.  (I know, the first place to start is the internet, but go with me here).  A personal map, that shows you all the marshy bits and pitfalls that you might not be aware of.

X marks the retirement

X marks the retirement

So a couple of days after my most recent birthday, I signed up for and filled out a Retirement Success Profile. This is a series of questions that focuses on how you feel about retirement, and therefore, how prepared you are for retirement.   There are 15 factors that are examined and each is rated for your expectations, your present behaviour, and the variance between the two.  A large variance between what you expect in retirement and what you are doing now means that you will have to do some work in that area to transition to a happy retirement.

I’m not going to give you a complete rundown on my scores because it would be of no more help or interest to you than if I showed you my x-rays.

Chatting with the counselor who explains the results was very helpful and interesting.  But I found it most enlightening that the test scores showed three areas I should work on — focus factors:

  • Health Perception
  • Leisure Interests
  • Replacement of Work Function

The first was a surprise to me because I’m in pretty good health and don’t complain about it much.  But I also realize that this is a bit of a wake up call because I’m now aware that I’ve been taking my good health for granted and I know I’ll have to exercise more and work at staying healthy. The counselor  pointed out that when I retire I will not be taking transit every day and will not be exposed to the amount of germs and viruses I am now (that knock me out on a regular and seasonal basis).  Also I will have enough time to go to the gym and take fitness classes, maybe get a personal trainer to help me get back into shape.

The flag on Leisure Interests intrigues me.  And it ties in with the replacement of work function.  Because I’m kind of an introvert (a loner), I rely on my work for a lot of my socialization. I also rely on my workday to schedule my time.  Again, the counselor pointed out a couple of things I hadn’t thought of:  I’ll have time to take courses in anything that really interests me (currently I am quite fascinated by geology.  Yes, I meant to say geology.) Also there are meet-up groups for various activities.  I love to read (not really a hobby as such, I regard reading as necessary as breathing) so could join a book club.  Also cooking classes could expand my repertoire, and maybe lead to a group of like-minded people to hang out with.

Obviously a lot to think about.  But I have time to make some plans. The next question to be answered:  Can I afford to retire?

 

 

 

 

 

 

 

 

 

The little old lady who lives

I had a photo taken recently, just a head-and-shoulders, taken in natural light.  A little something to update my LinkedIn page.  And, looking at it, I realized something…I look my age.

This is not a terrible thing, of course, there is nothing wrong with looking your age.  It’s just that without deluding myself, my face could cheat a little.  I used to hear it all the time, “You look too young to….be a grandmother, have cataracts, remember the 60s.” They say that mirrors don’t lie, but mine does, its kind light filling in all the little crinkles and wrinkles and throwing a camouflaging shadow beneath my softening jawline.  But a photograph is proof.  I am looking my age. I am getting old, not just older.

There’s more reminders.  A news report describes someone younger than me as “elderly”.  A visit to my employer’s Pension Fair reminds me that my retirement age, once soooooo far away, is approaching.  Rapidly.  I stopped colouring my hair last year, wondering what my “natural” colour would be.  It’s grey, a kind of pewter rather than silver, but grey it certainly is.  There’s a shortness of breath when I attempt to climb a long flight of stairs, a reminder of the pneumonia I had in the spring that does not go away.  I am too tired after a full day’s work and two hour-long commutes to go to the gym, or a concert, or the movies.

It seems to me that youth is inherited at birth.  And you ease into middle age; the male gaze slides over and around you rather than lingering, people seem more willing to help you out, and you realize well, that’s over.  But old age seems like a decision.  You accept your grey hair, you opt to take the escalator more often, you make plans to retire.

And that’s the rub.  I have been working for over 40 years.  When I had small children I worked for them.  Other than the child-bearing years I have held paying jobs, and all of that comes with its own regimen.  Your days are nicely laid out for you, even your weekends are defined by the fact that you are not working for two days, it’s your chance to catch up on everything you didn’t have time for during the work week.

But just thinking about retirement…day after day with no one telling me what to do, no duties arranged in a never-ending list.  It’s disconcerting.  And even the flexibility we have now to retire at age 55 or 60 or 65 or 67 and-a-half or 70 is stressful to think about.

I don’t have any big plans for retirement.  We want to travel, but there are no solid plans, just a general wish to do so.  I haven’t put off writing a book, or getting a degree, or taking up flamenco dancing, waiting for my retirement to get it done.  My children and grandchildren need and want my help, but that’s not a full-time gig, they are quite independent and want to stay that way.

So I have decided to approach old age the same way I would any new challenge — by learning all I can about it.  The more I learn the less intimidating it will be.  And I’ll be ready to face it. With this face:

X_44A1541

Lofty Living

http://www.houzz.com/houzzTvWidget/62333729/4815380783001

Back in the 20th century, when DH and I decided to cohabit, we went looking for a condo to buy.  This was in the halcyon days when two people making not much money could afford to buy in this city.  **sigh** Nostalgia.

We looked at a lot of places that looked exactly the same, and at one loft.  It was in a new build, in a neighbourhood of single family homes, so it wasn’t the “Downtown/Gastown/Yaletown” experience you would expect with loft living, and it never made the top ten of our favourites. But it also had one glaring problem.  It was basically one large room with a bathroom.  You can put that loft bedroom anywhere you want, but it’s still in the same room as the living room.

DH fell in love with the idea, and said that if he was NOT moving in with someone, he would buy it in a snap.  A spirited discussion ensued.

But one couple has solved the “one big room” problem (and in a lot less space than we were offered).  Once again, design trumps size. Check out the linked video from Houzz to see how clever they’ve been.

They’ve placed the office where the night-owl works directly below the loft bed.  With his headphones on he can work into wee hours without disturbing her sleep.  That work space also changes into a guest room AND a dining area.

Plus they’ve worked in a custom library ladder (another of DH’s favourite things).

 

Ta ta to teensy weensy

Over the holidays I found myself prone on the couch watching those marathons on HGTV.  I had never really watched those tiny home programs during the season, so it was quite the eye-opener.  I was truly surprised by some people who really, really wanted a tiny home but still had to have full-size appliances, a bath tub, and a king sized bed.  Something tells me these people are not ready to make the sacrifices involved in living in a super-small space.

So it doesn’t surprise me to learn that many tiny house dwellers have given up on the idea of spending the rest of their lives in a space that is typically between 100 and 200 square feet.  In this Globe and Mail article, author Erin Anderssen recounts summers spent in a 320 square foot cottage without hot water, indoor toilet, privacy, nice appliances, and presumably wifi.  It’s a summer house, not built for permanent, year-round occupation.  But it gave this family a taste of tiny-house living, and it’s not for them.

And, it is pointed out, it’s not for a lot of people who thought they wanted it.

Melanie Sorrentino and her husband, Mark,.parked their 150-square-foot tiny house on a wooded four acres in Eureka Springs, Ark. … They lasted one year.

The tiny-house movement is really good philosophically, but it shouldn’t be whitewashed with cutesy little houses,” she says. “My advice for anyone looking at a tiny house – or any lifestyle painted so perfectly – is to try to imagine whether you can grow as a human being in that space.”

For another couple with a child:

Travis Marttinen, who built his own 187-square-foot home in Barrie, Ont., while completing an architectural technology diploma. He sees people jumping on the trend but expecting to live exactly as they did before. “You need to radically simplify. Not only in the number of possessions, but in lifestyle. You cannot have all of the creature comforts that most people are used to. It simply doesn’t work.”

No.  Tiny-house living, even small-house living is not for everyone.  I think it’s best for those who know they are there for a limited time.  A married couple staying in a tiny house before children arrive.  Someone in transition between homes or lifestyles.  Someone coming from “straitened circumstances” like homelessness.  Or those, like this community in Portland, who have their own tiny homes but share amenities.

When DH and I moved to our laneway, we were coming from a good-sized condo (over 1100 square feet).  And we knew that there would be room for us each to have some private space to ourselves.  And we’d lived in lots of other places, mostly houses and large apartments.  We knew what we were giving up.  And what we gained.

It always amazes me when I see people who have never spent so much as a wet weekend in a small motel room with their beloved think they can move out of houses into, basically, less room than the average living room.  Forever.

My advise is to rent before you buy into the tiny-house lifestyle.  It can be done.  But it’s not for the dreamy-eyed.

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