Children's Book Published 2007

 
http://www.blurb.com/b/249310-once-upon-an-amber-sky-2nd-edition

Copywriting Portfolio Article 5 https://www.longtermcarelink.net/article-2014-11-17.htm

Did You Know...? There is a New Vaccine Recommendation for Adults Age 65 and Older

November 17, 2014 | by Lynda Neuenschwander

"Adults 65 years of age or older are at increased risk for pneumococcal disease. PCV13 [Prevnar 13®] is recommended for all adults 65 years of age or older," as stated by the Centers for Disease Control and Prevention (CDC). [1]
If you are someone over the age of 65, or if you know someone who is over the age of 65, take note of this new recommendation and take action. People of the age of 50 and older have taken comfort in the already existing vaccinations to fight pneumonia for years, but as of August 13, 2014, an additional pneumococcal vaccine called Prevnar 13® (PCV13) is recommended for all seniors aged 65 and older.
This recommendation is made by the Advisory Committee on Immunization Practices. "ACIP is chartered as a federal advisory committee to provide expert external advice and guidance to the Director of the Centers for Disease Control and Prevention (CDC) on use of vaccines and related agents for the control of vaccine-preventable diseases in the civilian population of the United States."[2]

Here are a few highlights:

1. For adults aged 65 or older who have not had any previous pneumococcal vaccine or whose history of vaccinations is unknown, a dose of the vaccine called Prevnar 13® (13-valent conjugate) is recommended. Furthermore, physicians are advised to recommend a dose of Pneumovax (23-valent polysaccharide) for these patients six to 12 months after their PCV13 vaccination.
2. Another aspect of this new recommendation from the Advisory Committee states that if a patient 65 or older has received one or more doses of Pneumovax, but no previous Prevnar 13® vaccination, that patient should receive a dose of Prevnar 13® at least one year after administration of the most recent dose of Pneumovax. Prevnar 13® vaccination should be given six to 12 months before any additional dose of Pneumovax and at least five years after the most recent Pneumovax vaccination. Prevnar 13® is a product of Pfizer, Inc. and Pneumovax is a product of Merck.

Why the new recommendation?

Pfizer conducted a trial in the Netherlands among 85,000 participants aged 65 or older. Half of the group received the Prevnar 13® vaccination and the other half received a placebo. "In the vaccine group, about 45 percent fewer first episodes of vaccine-type community-acquired pneumonia were seen compared to the placebo group. Also, a 75 percent reduction in vaccine-type invasive pneumococcal disease was seen in the vaccine group compared with controls."[3] The staggering evidence from this study that is demonstrating how Prevnar 13® decreases risk of serious illness propelled the decision of the ACIP to recommend Prevnar 13® for all adults aged 65 and older.

How does this new recommendation fit into your Medicare coverage?

Well, in an ideal world, patients would receive both the Prevnar 13® and Pneumovax "vaccines separated by six months to a year to retain the initial vaccine's efficacy. But currently, Medicare only pays for one dose of pneumococcal vaccine for patients older than 65."[4]
Medicare will have to take into account the new recommendation and possibly allow for two pneumococcal vaccines for adults over the age of 65, but Medicare is not able to possibly take it into account until at least early 2016, according to a Medicare representative who had been present at the ACIP meeting. If someone over 65 is still carried under traditional insurance instead of being enrolled in Medicare, that second pneumococcal vaccine is typically more easily covered since traditional insurers are required to adhere to ACIP guidelines in a much shorter time frame than Medicare.
Elderly patients are about 3 times more likely over the age of 65 to acquire community-acquired pneumonia than those aged 50-64 and the prevalence rate aged 50-64 is 25 in 100,000. After the age of 65, that number jumps to 70 in 100,000. If you yourself have not already suffered from pneumonia at some point in your life, you probably know someone who has. It can be very serious, cause hospitalization, and possibly be fatal. Pneumococcal pneumonia is an illness caused by the type of bacteria called Streptococcus pneumonia and can be "carried in the throats of up to 70% of healthy people."[5]
"Most pneumococcal deaths in the U.S. are in adults. Yet about 70 million adults at highest risk remain unvaccinated, leaving them vulnerable. If you are at risk, vaccination is the safest, most effective way to protect yourself."[6] If you are unsure whether or not you have been vaccinated for pneumonia or are eligible to be vaccinated for pneumonia under this new recommendation for Prevnar 13®, seek advice from your healthcare professional, take heart that there is something more you can do to protect yourself, and take action.

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Sources:
1. cdc.gov/mmwr/pdf/wk/mm6337.pdf
2. cdc.gov/mmwr/pdf/wk/mm6337.pdf
3. aafp.org/news/health-of-the-public/20140827pcv13vote.html
4. aafp.org/news/health-of-the-public/20140827pcv13vote.html
5. prevnar13.com/sites/default/files/PSA617300-01_Fact_Sheet.pdf
6. cdc.gov/pneumococcal/about/facts.html
Other Sources:
reuters.com/article/2014/08/13/us-pfizer-prevnar-idUSKBN0GD23I20140813
pfizer.com/news/press-release/press-release-detail/advisory_committee_on_immunization_practices_votes_to_
recommend_pfizer_s_prevnar_13_vaccine_in_adults_aged_65_years_and_older
cdc.gov/vaccines/vpd-vac/pneumo/vac-PCV13-adults.htm
infectioncontroltoday.com/news/2014/08/acip-votes-to-recommend-pfizers-prevnar-13-vaccine-in-adults-aged-65-years-and-older.aspx
activebeat.co/your-health/children/10-common-symptoms-of-pneumonia/2/
adult.prevnar13.com/?source=google&HBX_PK=s_prevnar13

Copy Portfolio Article 4 https://www.longtermcarelink.net/eldercare/funeral_trusts.htm

The Great Debate: Pros and Cons of Funeral Trusts

by Lynda Neuenschwander

The Great Debate:

To utilize a funeral trust or not to utilize a funeral trust…That is the question.

First, let’s define what a funeral trust is:

"Funeral trusts allow people to pay funeral expenses in advance, and that can spare survivors a lot of difficult decisions, say advocates. Some nursing homes even require a funeral trust as a condition of admission. But if the trustees aren't reputable or the information isn't current, financial planners warn that such trusts can bring bereaved families more grief."
The Internal Revenue Service defines a funeral trust as "a 'pooled income fund' set up by a funeral home or cemetery to which a person transfers property to cover future funeral and burial costs." They're often referred to as "pre-need programs." [1]
"A funeral trust is a contract you enter into with a provider of funeral or burial services. Often, the trust is entered into directly with the funeral home, which may agree to "lock in" costs for future funeral or burial services at an agreed upon price. The funeral home sometimes serves as trustee (manager of trust assets), and you usually fund the trust with cash, bonds, or life insurance. A revocable funeral trust can be changed and revoked by you at any time. An irrevocable trust can't be changed or revoked, and you generally can't get your money out except to pay for funeral services." [3]
"An 'Irrevocable Trust' is a 'Trust' that once established cannot be 'dissolved' until the terms of the 'Trust' are satisfied. In the case of an 'Irrevocable Funeral Trust' the person named as the creator [or grantor] of the 'Trust' must pass away before the terms and the assets of the 'Trust' can be put into motion because the wording in this 'Trust' states that the assets cannot be paid out UNTIL the creator passes away. It is very important that you realize that an "Irrevocable Funeral Trust' cannot be dissolved for any reason whatsoever. What these means is that NO PERSON or ENTITY, not even the person in whose name the 'Trust' was created, can gain access to the assets placed into the 'Trust' - EVER. This is the singular reason why no person or entity can confiscate the assets placed in an 'Irrevocable Funeral Trust'. This is also the reason why funeral trusts receive special tax treatment.
A 'Revocable Trust' is one that can be created by anyone, and at a later date, the 'Revocable Trust' can be 'dissolved' by the person who originally created it. Upon dissolution, the assets (if any) that were placed into the 'Trust' revert back to the ownership status they held before they were assigned to the 'Trust'. [4]

What expenses are paid for by a Funeral Trust? [4]

• Basic Services of Funeral Director & Staff
• Other Professional Services
• Embalming
• Other Care of Deceased
• Funeral Home Facilities and/or Staff Services
• Casket
• Cemetery Charges
• Cemetery / Burial Plot
• Other Funeral Merchandise

What are the advantages of having a funeral trust in place?

If you have a funeral trust already set up in advance, "any relative, other person, entity or funeral home" [2] can handle your arrangements when the time comes.
You may be able to increase the likelihood of becoming eligible for long-term care benefits available through Medicaid if you create an irrevocable funeral trust.
"An advantage of funding your trust with life insurance is that the trust will have no taxable income to report, since life insurance cash values grow tax deferred." [3]

What are the disadvantages of having a funeral trust?

It is advised to anyone contemplating a trust program through a funeral home to have an independent trustee in place who can "audit the funeral bill for reasonableness and pay any excess to the family." [1]
To avoid putting a burden on your heirs, confirm that proceeds from the trust will be accepted as means of payment before making a funeral home your trustee or beneficiary.
"A funeral trust seems like a great idea, but you must keep your information current or major problems will come your way. If you relocate, change the trustee and beneficiary to the new funeral home you will use. Provide your executor or all your heirs with a copy of the trust as well as contact information for the funeral home and the beneficiary, if they're different. A funeral trust should never be considered an investment vehicle." [1]
Otherwise, income from trust assets may be taxed to you as the trustor (creator of the trust) unless the trustee elects to treat the trust as a qualified funeral trust by filing form 1041-QFT with the IRS, in which case trust income is taxed to the trust." [3]
Because a 'Revocable Trust' can be dissolved by its creator, or some other person or entity at any time, a 'Revocable Trust' DOES NOT enjoy favorable tax treatment or exemption from being confiscated by nursing homes or Medicaid providers or even hospitals, doctors and the like. In the case of seniors seeking care in a nursing home, expecting their care to be paid for by the government, they are now subject to the "spend down" rules imposed by all states before providing free nursing home care." [4]

How do I set up a funeral trust?

There are a few different ways in which you can set up a funeral trust:

• You can set it up directly with a funeral services provider.
• Finding someone via the internet who deals specifically with funeral trusts and can walk you through it.
• "They are also often sold through insurance companies, in which case they are typically funded with single-premium whole life insurance." [3]

"There's some validity to locking in prices in advance, but its true value is your family's peace of mind." [1]

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1. bankrate.com/finance/insurance/pros-and-cons-of-funeral-trusts-1.aspx
2. funeraltrusts.com/betterSolution.cfm
3. 360financialliteracy.org/Topics/Retirement-Planning/Trusts/What-is-a-funeral-trust
4. funeraltrusts.com/questions.cfm

Copy Portfolio Article 3 http://www.longtermcarelink.net/article-2015-9-18-How-Elder-Law-Can-Help-You.htm

How Elder Law Can Help You

September 18, 2015 | by Lynda Neuenschwander

The specialty of Elder Law is becoming more important as our population ages. People are living longer, but in many cases, are not living better. "The number of older individuals in the population is projected to increase to 71.5 million in 2030, representing nearly 20 percent of the U.S. population. As a result, the need is growing for specialized legal advice about aging-related issues." [1]
First, let’s define exactly what Elder Law is and why it might be of interest to you.

What is Elder Law?

The National Academy of Elder Law Attorneys states the following about defining Elder Law:
"Elder Law is a specialized area of law that involves representing, counseling, and assisting seniors and their families in connection with a variety of legal issues, from estate planning to long term care issues, with a primary emphasis on promoting the highest quality of life for the individuals. Typically, Elder Law attorneys address the client’s perspective from a holistic viewpoint by addressing legal, medical, financial, social and family issues."
Does this sound like something that would be valuable to you or someone you know?
"Every day, 10,000 Americans celebrate their 65th birthday. While the U.S. is experiencing a longevity revolution, at the same time our aging nation is triggering a Silver Tsunami of chronic age-related disease that bring with it increased national health care spending, high rates of morbidity and mortality, and declines in quality of life." [2]

What are some specific examples of how Elder Law can help you?

Overcome the Potential for Financial Exploitation

The trusting nature of many elderly people makes them vulnerable to financial exploitation.
All elderly should be made aware of and told to avoid any financial transactions that require up front deposits. No contracts are to be signed without two or three days of consideration in consultation with knowledgeable family members. All dishonest schemes promulgated through the mail are guilty of mail fraud and appropriate complaints should be filed. All states have consumer-reporting departments to take complaints on consumer fraud. Again a good source for help is your local area agency on aging.
Here are some examples of the most common types of financial exploitation:

• Telephone Solicitations for Dishonest Charities or Fraudulent Investments
• Identity Theft to Get Credit Card Numbers and Other Information
• Pay in Advance Prize-Winning Schemes
• High-Pressure Door-To-Door Sales
• Dishonest Home Improvement Contracts
• Dishonest Miracle Health Cures
• Unnecessary Living Trusts through a Trust Mill
• Dishonest Funeral Arrangement Plans

Settle Family Disputes

"For some lucky families, having a bunch of adult siblings gather around and plan how to take care of Mom and Dad as their parents' health begins to fail is a great comfort. For some families, siblings who never got along as kids and have had little to do with each other as adults being thrown together to make touchy decisions is disastrous." [3]
It is becoming more common to use an attorney, an arbitrator or a mediator in solving disputes among family members relating to the care of elderly parents. For instance, one child may have stolen assets and the rest of the family wants that person brought to justice. There may be a disagreement over the final disposition of property in an estate plan and it may take an attorney to solve that. A lawyer may be necessary to settle the differences either through the courts or through mediation.
"Ideally, before things get to this stage, you've had conversations with your parents about how they want their needs met during their later years. They've made out the papers naming a Power of Attorney for Health Care (a health directive indicating who will make health decisions if they can't and detailing their preferences for treatment) and a Power of Attorney for financial affairs. A will should be part of this, as well as other personal papers. Ideally, as well, all siblings are aware of these papers, what they contain and all are in agreement. Ideally – taking care of the elders becomes a family affair. However, life is seldom ideal." [4]

Age Discrimination in the Workplace

The "Baby Boomers" will cause a significant increase in the older population until 2030, when the last of this group reaches old age.
The Age Discrimination In Employment Act protects people who have been laid off or fired because of age discrimination. Some companies consider older employees less valuable than younger employees. As baby boomers approach their 60s, many will be opting to continue employment or find employment with another company. Age discrimination issues will become more prevalent in the coming years.
"Nine Signs of Age Discrimination:

1. Biased comments
2. Comparisons
3. Disparate discipline
4. Promotions
5. Favoritism
6. Hiring younger employees
7. Suddenly stupid
8. Harassment
9. But the boss is older" [5]

Help with Medicare and Medicaid

Qualified legal help is available from elder law attorneys to help individuals in applying for and accelerating payments for Medicaid. An elder law attorney can also help with disputes with Medicaid. Likewise attorneys who specialize in Medicare can help with disability claims and sometimes this help is the only way claims are ever granted. The local area agency on aging has an advisory service for help with understanding Medicare, Medicare supplements, Medicare advantage and Medicare part D.

"People with Medicare, family members, and caregivers should visit www.Medicare.gov, the official U.S. Government site for people with Medicare, for the latest information on Medicare enrollment, benefits, and other helpful tools."[6]

If you feel that you or someone you know could benefit from having Elder Law services, one place you could look to find elder law attorneys is on the National Care Planning Council's Website at longtermcarelink.net.

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Sources:
[1]: www.naela.org
[2]: www.silverbook.org
[3], [4]: www.agingcare.com
[5]: http://jobs.aol.com
[6]: www.cms.gov

Copy Portfolio Article 2 https://www.longtermcarelink.net/article-2015-3-27-Mesothelioma-What-the-Elderly-Need-to-Know.htm

Mesothelioma Facts: What the Elderly Need to Know

March 27, 2015 | by Lynda Neuenschwander

Why do you need to know about mesothelioma?

The incidence of malignant pleural mesothelioma (MPM) in elderly patients is increasing. Owing to the long latent period following asbestos exposure, MPM is often diagnosed late in life. A high rate of diagnosis in elderly patients is reported by several mesothelioma registers and epidemiological studies (Price and Ware, 2004; Marinaccio et al, 2005). The median age of disease onset in the United States has been recently reported to be 74 years, according to the Surveillance, Epidemiology, and End Results database (SEER Database, 2007). [7]

What is Mesothelioma?

The tissue that lines your lungs, stomach, heart, and other organs is called mesothelium. Mesothelioma is a tumor of that tissue. It usually starts in the lungs, but can also start in the abdomen or other organs. [1] Most often, mesothelioma occurs in the lining of the lungs, called the pleura. [4] It can be benign (not cancer) or malignant (cancer.) Malignant mesothelioma is a rare but serious type of cancer.

Causes of Mesothelioma

Most people who get it have worked on jobs where they inhaled asbestos particles. After being exposed to asbestos, it usually takes a long time for the disease to form. [1] Other causes [of mesothelioma] include zeolites, radiation, and more. [2] There are many veterans who are now in their elderly years, and because they served in the military when asbestos was frequently used for many of military materials, they are at a higher risk for contracting the disease of mesothelioma.

Mesothelioma Among Veterans

Exposure to asbestos is the No. 1 risk factor for mesothelioma. There are numerous ways in which a veteran may have been exposed to asbestos while in the service of our country.

Navy - The most frequent asbestos exposures from any armed service occurred in the Navy due to the need for fire resistance aboard Naval vessels. Sleeping quarters, engine rooms, fire rooms, boiler rooms and insulated pipes were just a few of the many sources of asbestos a Navy Veteran may have been exposed to on a daily basis. The act of firing deck guns could cause a shockwave to reverberate throughout asbestos insulation aboard ships which released plumes of asbestos dust. Shipyard workers were also exposed to asbestos in insulation for boilers, miles of steam pipes, incinerators and hot water pipes. Gaskets, sealing compounds, packing for valves and even a hull of a ship often contained asbestos for fireproofing. Virtually every ship commissioned by the Navy between 1930 and 1970 contained asbestos or asbestos-containing materials.

Army – There are dozens of military bases around the U.S. and outside of the U.S. that have been proven to contain asbestos products. In addition to asbestos flooring tiles, ceiling tiles, insulation, and cements used in various army barracks, several trades in the army were frequently exposed to asbestos including, auto mechanics, firefighters, masons, carpenters, engineers, plumbers and electricians. A whole fleet of Army vehicles from Jeeps to tanks contained asbestos. Many Veterans working in the motor pool were exposed to asbestos containing brakes, clutches and gaskets. In the late 1990’s, the Army spent over $1 billion dollars on asbestos removal at 32 different Army bases.

Air Force – Asbestos was used in aircraft components including engine insulation, electrical insulation, brake pads and adhesives. Aircraft mechanics would also have been exposed to asbestos through fire and heat retardant insulation, heat shields, fire sleeves, and engine gaskets and clamps.

Marines – Similar to Army Veterans, Marines were exposed to asbestos in their barracks as well as through various trades. As Marines often coordinated with the Navy, they were likely to be exposed to asbestos aboard Naval ships. Other possible sources of asbestos exposures for Marines include land transports, airplanes and vehicles, and barracks exposure.

Proof of asbestos exposure in the service is necessary for compensation claims involving service connected disabilities. [6]

Agent Orange – Chronic Conditions, Service-Connected with No Time Limit

Herbicides were used in Vietnam to defoliate trees in order to remove cover for the enemy. During the manufacturing process, significance amounts of harmful contaminants called dioxins were produced. Different blends of herbicides were used but the most common was one called "Agent Orange." Being on the ground in Vietnam, during the war or on the inland waterways is sufficient for presumption for service connection. Harmful exposure other than the automatic "boots on the ground" for Vietnam is generally considered to be inhalation and not topical.

Exposure also occurred in Thailand, the demilitarized zone in Korea and presumably on certain ships offshore from Vietnam (those proven to be in harbor). In addition, numerous storage, spraying operations, testing and loading sites – outside the country and inside the US – could have resulted in exposure.

Kaposi’s sarcoma (or mesothelioma) is presumed by VA to be service-connected for Agent Orange veterans. [8]

Symptoms of Mesothelioma

            Trouble breathing

            Pain under the rib cage

            Pain, swelling, or lumps in the abdomen

            Weight loss for no known reason [1].

Diagnosis of Mesothelioma

Sometimes it is hard to tell the difference between malignant mesothelioma and lung cancer. [A] doctor uses imaging tests and a biopsy to make the diagnosis. Malignant mesothelioma is often found when it is advanced. This makes it harder to treat. NIH: National Cancer Institute [1]

Because mesothelioma is uncommon, it is often misdiagnosed initially. If you have symptoms that suggest you might have mesothelioma, your doctor will likely take a complete medical history to check for symptoms and possible risk factors, especially asbestos exposure. Your doctor will also ask about your general health and perform an exam to check for possible signs of mesothelioma. These may include fluid in the chest cavity, abdomen, or pericardium (the thin membrane around the heart). Depending on the findings of the exam, your doctor may refer you for mesothelioma testing. [4]

Prognosis of Mesothelioma

Certain factors affect mesothelioma prognosis as well as your options for mesothelioma treatment. They include the following:

1. The stage of the cancer, or the extent of cancer in the body. The stage is usually based on the size of the tumor, whether there are cancer cells in the lymph nodes, and whether cancer has spread beyond its original site.

2. The size of the mesothelioma.

3. Whether the mesothelioma can be removed completely by surgery.

4. The amount of fluid in the chest or abdomen.

5. Your age and general health.

6. The type of mesothelioma cells.

7. Whether cancer has just been diagnosed or has already been treated and come back. [4]

Treatments for Mesothelioma

WebMD Medical Reference

Three standard types of treatment are used: surgery, radiation, and chemotherapy. Treating mesothelioma often involves a combination of two or all three.

Surgery. The four main surgeries used in mesothelioma treatment are:

            Wide local excision, which removes the cancer along with some of the healthy surrounding tissue.

            Pleurectomy and decortication, in which the surgeon removes part of the covering of the lungs, chest lining, and outside surface of the lungs.

            Extrapleural pneumonectomy, which involves removing one whole lung and part of the lining of the chest, the diaphragm, and lining of the sac around the heart.

            Pleurodesis, which involves using chemical or drugs to make the lung lining scar and stick to the lung. The scarring stops the buildup of fluid.

Radiation Therapy. This type of cancer treatment uses high-energy X-rays and other types of radiation to kill mesothelioma cells or keep them from growing. Radiation may be administered externally or internally. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into the area near the mesothelioma.

Mesothelioma Medications (WebMD). Chemotherapy is a cancer treatment that uses drugs to stop the growth of mesothelioma cells, either by killing the cells or by stopping them from dividing. Chemotherapy can be given by mouth, injected into a vein or muscle to enter the bloodstream and reach mesothelioma cells throughout the body, or it can be placed directly into the affected area of the body to mainly affect mesothelioma cells in that area. Sometimes doctors use more than one chemotherapy drug. This is called combination chemotherapy.

Sources:

[1] nlm.nih.gov/medlineplus/mesothelioma.html

[2] webmd.com/lung-cancer/mesothelioma-directory

[3] webmd.com/drugs/condition-13394-Malignant+Mesothelioma+of+Pleura.aspx

[4] webmd.com/lung/mesothelioma-tests-diagnosis-and-treatments

[5] asbestos.com/mesothelioma

[6] mesotheliomabook.com/us-veterans-compensation-benefits.html

[7] nature.com/bjc/journal/v99/n1/full/6604442a.html

[8] Book: How to Apply for Department of Veterans Affairs Benefits for Senior Veterans and Their Survivors