If music hath charms to soothe the savage breast, then playing music hath charms to heal the savage breast, or, more appropriately, the damaged lungs.

This is what Tom Zoe of Austin, Texas believes. So he helped create a program at Seton Medical Center in Austin, where he volunteers, to teach sufferers of chronic obstructive pulmonary disease(COPD) and other chronic lung diseases to play the harmonica as part of their physical therapy.

The blowing and drawing required to play the harmonica are excellent exercises that help patients with COPD. The exercise also improves muscle tone in lips, cheeks and tongue.

Whether they’re playing fairly easy songs like ‘You Are My Sunshine’ or blowing a blues harp, harmonica players exercise their lungs effectively

Zoe emphasizes that no musical knowledge is necessary, just a willingness to use the harmonica as a therapeutic tool. In classes, he teaches students the basics of making sound from the harmonica and how to play simple songs. They use a method that shows which note to play and whether to draw in or blow out.

Zoe says the patients enjoy the classes much more than just doing breathing exercises, because they all get to play songs together and feel like musicians, not patients.

And whether they’re playing fairly easy songs likeYou Are My Sunshine or blowing a blues harp, harmonica players exercise their lungs effectively.

Why Music Is A Multi-Faceted Therapy

Music therapy has been around for a long time — Hippocrates was known to have played music for his mental patients as early as 400 B.C. — but only recently became a recognized medical discipline with board certification.

It is a helpful tool for therapists in treating mental health disease, developmental and learning disabilities, dementia, and acute and chronic pain.

Music therapy also provides therapists with important clues to help assess emotional and physical health — we’ve witnessed how up-tempo and dance music sparks toe-tapping, even in individuals with late-stage dementia. And music from the distant past, often when they were young adults in their early 20s, will elicit a response and singing along from patients who are otherwise non-communicative.

But so-called “harmonica therapy,” or the playing of an instrument that produces music, is a tool that therapists have just recently endorsed to make physical and occupational therapy more interesting and more effective.

While musicians have long gone to physical therapists seeking help because playing their instrument had caused pain or dysfunction, harmonica therapy turns the whole thing around. As Zoe observes, “It gives me pleasure to hear how all these people talk about how much it helps. They’ve worked hard to develop the ability to play, and they get a huge reward, both physically and emotionally.”

Lifelong, Proven Benefits of Playing Music

In her article, Joanne Loewy, director of the Louis Armstrong Center for Music and Medicine, explains how playing a wind instrument like the harmonica or recorder not only builds lung capacity but also helps patients control their breathing and regulate heart rate and blood pressure. She writes of an asthma patient who, for many years, had relied on a quick-relief inhaler when experiencing shortness of breath. Through learning to play the recorder, she learned breathing techniques she can now use instead of her inhaler.

I recall my own introduction to music therapy from my aunt Sally.

When I was a kid, she would sit at the piano and hammer out tunes at every family function. We all gathered around harmonizing, making those family get-togethers much more enjoyable to the kids as we competed to earn that one solo line she would award. As she aged and became riddled with arthritis, she told me that rather than just do the exercises that her physical therapist had assigned to help with her dexterity, she would sit at the piano and try to play. It frustrated her, for sure, because she could no longer dance around the keys as she used to. But playing tunes, albeit more slowly, made the exercises fun, and both she and her therapist were convinced it helped her physical condition.

My aunt Sally was a natural, playing piano by ear. But since not everyone has that gift, there are many websites that offer instruction on playing harmonica, as well as most other instruments. As Zoe encourages, “Learn to play an musical instrument. and it just might change your life.”

 Editors Also Recommend:

• Why You’ll Live Longer If You Take Music Lessons

• Want to Age Better? Join a Choir

• The Surprising Health Benefits of Drumming

By Bart Astor

Bart Astor, an expert in life transitions and elder care, is the author of the book AARP Roadmap for the Rest of Your Life: Smart Choices About Money, Health, Work, Lifestyle and Pursuing Your Dreams and Baby Boomer’s Guide to Caring for Aging Parents. His website is BartAstor.com and he can be reached at Bart@BartAstor.com.@bartastor

Next Avenue Editors Also Recommend:

• Why You’ll Live Longer If You Take Music Lessons

End-of-life planning is often avoided or delayed by Americans. In the United States, names like Terri Schiavo and Dr. Jack Kevorkian clutter our collective understanding of what to expect at the end of life. And thus, we ignore the topic altogether.

Questions like the following can help guide one’s thinking on the topic:

• How do I define quality of life?
• What would a good death be for me?
• Who do I want near me at the end of my life?
• Where do I want to die?
• If given the option, would I use hospice?
• What kind of medical treatment do I want?
• Is being lucid more important than complete pain management?
• Who would be my best advocate at the end of my life?
• How do I want to be remembered after I die?

While potentially sad or uncomfortable, talking about end-of-life wishes can be a relief to loved ones who want to know how to best advocate on behalf of friends and family members. Documenting end-of-life wishes increases the odds that family, friends and medical professionals are all advocating in tandem. The following resources encourage conversation, ask important questions and help document end-of-life wishes.

Aging With Dignity

This national not-for-profit organization strives to promote better care for individuals as they age and particularly at the end of their lives.

Consider the Conversation

This evocative documentary urges individuals and families to journey into the uncomfortable territory of end-of-life conversations.

Directives by Design

This website offers tools intended to guide end-of-life planning and the option to create a health care directive that meets state legal requirements and can be stored securely online.

My 5 Wishes Online

A project of Aging With Dignity, this secure online system allows people to document end-of-life preferences in a printable format.

My Voice, My Choice

From the creator of Directives by Design, this book offers practical guidance on writing a health care directive.

Respecting Choices

This not-for-profit organization focuses on the process of end-of-life planning.

The Conversation Project

This website includes tools for talking about end-of-life wishes and real stories about end-of-life planning, loss and death.

Whether you elect to purchase a service or use a free tool, starting the conversation and articulating your wishes is an important step toward a good death.

Next Avenue Editors Also Recommend:

• My Mother’s Death Taught Me a Lesson I Wish I’d Learned Much Earlier
• 5 Reasons I Won’t Die the Way My Mother Did
• How to Help a Loved One With End-of-Life Decisions

Crossing the threshold into retirement can feel like a high-wire act without a net. As a retired therapist, I can tell you that during this transition, whether we are retiring or rewiring, feeling disoriented or purposeful, most of us have moments of fear, confusion and conflicting inner voices.

You might hear voices like these:

“I wonder what else I could do with my time?/I wonder what I need to stop doing?”

“I want to continue to be productive./I want to slow down.”

“I think I should do more./I think should do less.”

“I need to earn more money./I can downsize and live on less.”

“I want to keep working to feel relevant./I want to stop working to try something new.”

Sources of Inner Conflict on Whether to Retire

Which voices do we validate? Which voices do we ignore?

I suggest that the sources of our inner conflict around retirement reside in a blind spot, outside of awareness. (In psychology, we call this the unconscious mind, or Shadow.) When we learn how to see the unconscious sources of our conflict, the call to retire can lead us to a deeper awareness and a different kind of calling.

After interviewing hundreds of people about this struggle for a book I’m now writing — The Reinvention of Age: How to Cross the Threshold from Role to Soul  — I came to see that my personal story of struggling with the inner voices around retirement is a common one. (I realize many boomers can’t afford to retire. So, I acknowledge my privilege even to have this opportunity to let go of my income as my husband continues working.)

When I entered my 68th year of life experience, two years ago, I noticed a restlessness that I had felt earlier in life at the end of one cycle and at the beginning of another.

What My Inner Voices Were Saying

After decades of exploring and teaching Shadow-work, I had learned how to attune to my inner voices. So, I stopped and listened. This allowed me to detect my deeper yearnings in the hidden dimension of retirement: the call to change my life, my resistance to the call and the promises of heeding the call.

I heard inside my mind a choir of dissension.

Like many boomers, I had found meaning and even love through my work. So, one part of me wanted to continue to do what I had always done: push hard to be productive so that I could enjoy a feeling of well-being at the end of the day.

But another part wanted to leap into the unknown, letting go of old roles until a new beginning emerged.

What stopped me initially from taking the leap?

Fearing Traditional Retirement

My fears of life after work were shaped, even unconsciously, by watching my father’s forced retirement in his 50s. Rather than taking an entrepreneurial initiative, engaging in volunteer work or launching creative projects, he spent his days playing bridge and going to lunch.

My mother and grandparents provided no role models of wise elders either.

So, my internal images of late life were ageist: useless, irrelevant, dependent and unhappy. Those were my associations to retirement. They’re what stopped me from stopping.

My ‘Inner Ageist’

I began to call this part of me that resisted the transition “my inner ageist.” But another part of me knew that I was a child of the 1960s and 70s . We boomers reinvented everything, from music to work to relationships to parenting to health care to spirituality. So, my retirement would not be my father’s retirement. I could reinvent that too!

These kinds of life transitions demand that we change more than our roles or activities. When we step across a threshold to become an adult, change careers, marry or have children, divorce or suffer a serious illness, we step into a new life pattern. In late life, this is not a conscious process, though; our society doesn’t offer adult rites of passage to become elders.

With retirement, this shift occurs when our roles and responsibilities fall away, the structure of our day dissolves and the people who formed our teams and work families go on without us.

At a deeper level, the ego’s lifelong identity of do-er is shattered and a primary source of meaning and purpose is lost.

Who Are We Beyond Work?

How do we explore who we are beyond work? How do we uncover the unconscious material that erupts around losing our roles? And how do we overcome the denial, resistance and distraction that arises with this change?

To answer those questions, I began to pose to myself these tough inner questions (and I suggest you ask yourself them, too, if you are struggling to decide whether to retire):

What is the role that no longer serves me? How is my identity tied to that role? Who am I if I am not that role? What has been sacrificed during my career to maintain that role? What is my fantasy of the future? Am I drawn to serve others? Am I drawn to a spiritual or contemplative practice? What stops me from engaging in service or meditation?

An Incomplete Legacy

With those questions posed, I knew that my legacy was not complete. I also knew that, if I needed to tackle these questions, others did too.

So, I decided to write The Reinvention of Age to continue guiding readers in ways I have done through my earlier books.  In this one, I hope to help them orient more deeply to their inner worlds in this challenging and promising stage of life. My goal: to guide other boomers past their denial and fears, to reimagine age for themselves.

And, in this way, I reinvented my retirement.

I now hope to contribute without the internal pressure of the do-er driving me from within. It’s my intention to write and teach for as long as I can. But I will release old roles and responsibilities. And I will find a new rhythm for this stage of life.

Now, two years after I first struggled with the idea of whether to retire, I wake up each morning, breathing into the open space and looking around in wonder.

Next Avenue Editors Also Recommend:

• I’m Retired: So Who Am I Now?
• Tips on How to Transition Into Retirement
• 4 Secrets to Overcoming Unexpected Life Transitions

(This article is adapted from The Book On Retirement: Are you ready for the Second Half of your financial life? by Kevin Houser and Gary Plessl.)

Most people think estate planning is about their death. But it’s really not. It’s about your control over your assets — control while you’re living, and control after your death. One of the most basic ways to gain control is through a simple will. But for people with more complex concerns, a trust can also come in handy for controlling your assets.

Trusts aren’t for everybody, though. While roughly 75 percent of our clients ask if they need a trust, less than half truly need one for what they are trying to accomplish. Often, a simple will can accomplish the same thing as a trust for much less than the typical legal cost of establishing a trust — a few thousand dollars.

What drives the need for a trust is the level of control you want to maintain over your assets. A trust provides flexibility — even creativity — with the control that a will alone might not.

What drives the need for a trust is the level of control you want to maintain over your assets.

— Gary Plessl and Kevin Houser

One common misconception about trusts is that they provide an extensive tax shelter. Generally, having a trust won’t save you or your heirs any more in taxes than basic estate planning. Trusts can help avoid estate taxes, but federal estate taxes only impact a fraction of 1 percent of the population — those with well over $5 million in assets.

What a Trust Is

A trust is a legal arrangement in which a person’s property or funds are entrusted to a third party to handle that property or funds on behalf of a beneficiary. A typical example would be a parent who wants to leave assets to a child, grandchild or even a charity.

The parent might establish a trust in which upon his or her death, certain funds will be held by a financial institution (that’s the third party) to be distributed to the heir upon her 18th birthday. Or if the parent wants to ensure the child has a financial foundation well into adulthood, the funds might be dispersed in annual increments through age 30, 35 or 40 or whatever the parent decides.

In that example, the parent — the person who creates the trust — is known as the “settlor.” The “trustee” can be an individual, an institution or a combination of both and is responsible for managing the property owned by a trust for the benefit of the beneficiaries.

Two Types of Trusts

There are essentially two basic types of trusts. A living trust or “inter vivos,” is one in which the settlor is still alive. A testamentary trust doesn’t take effect until after one’s death; it’s set up as a provision in a will.

Living trusts can be either revocable or irrevocable. With a revocable trust, you can make changes if, for example you subsequently get divorced or a beneficiary faces a major life change like an accident leaving him mentally debilitated. Or perhaps a beneficiary, as he becomes a teenager, starts exhibiting irresponsible behavior that makes his parents doubt whether he’ll have the maturity to receive a lump sum and would be better served receiving installments well into his adulthood.

With an irrevocable trust, the settlor gives up ownership (or title) of the property to the trustee. At that point, to make changes, the settlor would need to get the permission of the trustee and beneficiary. Because the trust property is no longer owned by the settlor, it’s also no longer a part of the settlor’s estate, so it provides a level of protection from taxes and other threats to your assets. In a divorce or bankruptcy, funds in an irrevocable trust likely wouldn’t factor into a settlement

How Trusts Can Address Your Concerns

Now that you understand what a trust is, the next question is: What can you do with it? Here are a few common estate-planning concerns and the types of trusts that might help address them (there are more in the book):

Concern: You want to avoid estate taxes.           

Solution: A Credit Shelter Trust (CST)      

For married couples with a sizable net worth, a credit shelter trust (CST) can help them — or more accurately their heirs — avoid estate taxes. Basically, both spouses write into their wills a provision setting up the CST. Upon the death of the first spouse, the CST springs to life and is funded up to the federal estate tax exemption amount, which (indexed for inflation) is $5.43 million per person or $10.86 million per couple in 2015.

Suppose the couple has a net worth of $12 million. Upon the death of the first spouse, $5.43 million would move into the CST, which would let the surviving spouse use a small percentage of that money for income. But because the funds were moved into a trust, they are no longer part of the estate. When the second spouse dies, the funds in the CST can pass to the heirs free of federal estate taxes.

So because of the CST, the second spouse’s estate is approximately $6.6 million rather than $12 million. And of that $6.6 million, upon the death of the second spouse, he or she could shelter $5.43 million of the estate using the unified credit exemption. In the end, after both spouses die, less than $1 million of the original $12 million is subject to estate taxes.

Concern: You want your money to last long enough to benefit your grandchildren.          

Solution: A Generation-Skipping Trust (GST)

In a Generation-Skipping Trust (GST), the assets put into the trust are transferred to the grandchildren. This is not necessarily about disinheriting your children, though.

For one thing, you can set up the trust so the children can draw the income/earnings from the trust while the grandchildren stand to inherit the balance. One big advantage to this is avoiding estate taxes.

For example, let’s start with a hypothetical $10 million estate that’s vulnerable to an effective 40 percent in federal and state estate taxes. If that estate passes to the children, it would be reduced to perhaps $6 million. Now suppose the children live off the earnings from the $6 million, but manage to preserve the original $6 million and later pass it on to the grandchildren and that this time $6 million is vulnerable to a 30 percent effective estate tax. The result is that the grandchildren are receiving just $4.2 million.

In such an instance, setting up a GST that gave the parents access to earnings from the trust but kept the original funds in the trust for the grandchildren would have accomplished pretty much the same thing but saved the grandchildren $1.8 million.

Other times, a GST is indeed about skipping a generation. Perhaps your son has remarried and you’re concerned his second wife won’t necessarily pass along his wealth to the children of his first wife. If that’s the case, you might not want him to ever take ownership of the assets, because once he does, it becomes marital property. A GST could carve out an inheritance for them.

Concern: You want your estate to reach your heirs but also want to take care of your spouse.

Solution: Qualified Terminable Interest Property Trust (QTIP)

Similar to a GST, a Qualified Terminable Interest Property or QTIP trust can let you pass earnings from assets to one person while the assets themselves will wait in trust for, say, your children, possibly decades after your death.

Upon the death of the first spouse, typically the assets of the deceased are transferred to the spouse if that spouse didn’t already own them as marital property. But the QTIP enables the first-to-die spouse to actually control how his or her assets are distributed after the other spouse dies.

You could simply will your assets to your spouse and hope that he or she will then pass them on to your heirs. But suppose the spouse has children from another marriage: will they also get a piece or even most of your estate? Or suppose your spouse is terrible with money and you wonder whether your estate will survive long enough to make it to your children. Or what if you’re concerned that your spouse will remarry and the new spouse takes marital ownership of your estate? The QTIP can be a perfect remedy for these concerns.

Let’s say you fund a QTIP with $5 million. That $5 million would be put in a trust for your children to receive upon the death of your spouse. In the meantime, although your spouse couldn’t touch the $5 million or change the trust, he or she can receive the earnings from the $5 million (which at 3 percent interest is $150,000 per year).

Concern: You don’t want your heir to take his IRA benefit check to the Ferrari store.

Solution: An IRA Trust

Normally, with IRAs you name a beneficiary and he or she receives the money upon your death. But what if you have $3 million in your IRA and that child is 15? One way to control that is to put the money in an IRA Trust where the child will get the money in installments well into adulthood.

An IRA Trust can also be set up like a QTIP, where it can support your surviving spouse with the income it generates, but the principal assets will go to the heirs designated in the trust.

Some Cautionary Advice

Beware of the fly-by-night trust mills doing seminars and selling people trusts they don’t really need for thousands of dollars. At best, they are selling — usually to seniors — trusts that are unnecessary. At worst, they are selling financial instruments chosen more for the sales commissions they generate than for the client’s needs, and they actually leave the victim less financially secure.

Time and again, we’ve seen trusts set up by a trust mill that never get funded. If the property or funds never get transferred to the trust, the trust is completely useless after the person dies.

Legal or not, these types of trusts are essentially scams. Your trust should always be set up by a qualified estate attorney and you should have your accountant and financial planner in the loop.

Next Avenue Editors Also Recommend:

• 5 Steps to Creating Your Digital Estate Plan
• Americans’ Ostrich Approach to Estate Planning
• What You Should Tell Your Heirs While You’re Around
• 2 Money Moves to Help You Leave a Legacy

• Get details on how fees will be charged.
• Familiarize yourself with inheritance laws in your state.
• Write down questions before your meeting.
• Be prepared to answer questions regarding your assets, guardianship decisions, medical preferences, end-of-life bequests and more.
• Prepare to discuss the need for a will, the possible need for a trust and choosing an executor of your estate.

Next Avenue Editors Also Recommend:

• 5 Steps to Creating Your Digital Estate Plan
• How Strong Is Your Living Will?
• What Heirs Want Even More Than Money
• Best Ways to Give Your Heirs Money While You’re Alive

(Next Avenue invited all our 2016 Influencers in Aging to submit essays about the one thing they would like to change about aging in America. This is one of the essays.)

Most adults have at least heard of the phrase “advance care planning” and know that it has something to do with living wills or medical powers of attorney — documents we generally refer to as advance directives.

But most adults have not thought about the fact that everyone has a default advance care plan, regardless of age or health condition. Medical decisions will be made for you when you can no longer make those decisions for yourself. By procrastinating important advance care planning, however, you are ceding control over your fate to others whose behavior will likely not be primarily driven by devotion to your personal values.

Alternatively, you can shape your plan to reflect your identity and values, just as you shape your relationships, your environment and your work.

Let’s take a look at four common reasons for avoiding advance care planning:

1. I’m uncertain about the documents needed. This may seem blasphemous from a lawyer, but here’s a secret — you don’t have to use any particular document.

Ambivalence is OK. Guidance in an advance directive can be very general, describing what values or priorities are important to you.

It’s true that every state has approved forms created by legislation or authoritative state groups such as the bar or medical association. But, these forms are intended to provide just one clear pathway to document wishes, not to eliminate all other avenues.

Other avenues may include less formal writings such as a letter to family members, answers written in an advance care planning workbook, statements recorded on video or documented discussions with one’s health care providers.

The point is that, in its broadest sense, any documented expression of your future wishes about health care is an advance directive. And most health care providers are respectful of a patient’s expression of wishes in any form, as long as they know of them and there’s no doubt about their authenticity.

2. It’s not necessary until I’m seriously ill. It’s true that the majority of us will die after a relatively long decline due to one or more chronic illnesses. So, we naturally think advance-care planning can wait. And wait. And wait. We also ignore the fact that most of us will have one or more periods of temporary illness or accidental injury during which we will be incapable of making decisions for ourselves.

Having a clearly identified decision-maker with knowledge of your treatment goals and knowledge about what it means to be your advocate is a priceless gift. Indeed, this is the first task in all advance care planning — naming a willing health care agent or proxy and discussing your health care values and goals with that person. This is equally as true for an 18-year-old as for a 98-year-old.

3. I’m putting it off because I don’t really know what I want. We are all ambivalent about illness and death to one extent or another. And, most of us will likely change our minds more than once about when “enough is enough” during the experience of serious illness.

Ambivalence is OK. Guidance in an advance directive can be very general, describing which values or priorities are important to you. Specific instructions tend to be reliable only when you have had considerable personal experience with a particular illness and its treatment.

Don’t get bogged down in details — the only matter that really needs specificity is the breadth of authority you give to your agent or proxy. It should be broadly defined to cover all health decisions flexibly and with broad discretion to interpret your values and wishes in light of the medical circumstances you face.

4. My family members and health care providers will probably do what I would want anyway. It’s true that most family members and health care providers want to do the right thing. But in this age of sophisticated, high-tech medicine where different teams of medical providers have responsibility for each of your organ systems, decisions are driven by forces you may not be able to predict.

Providers generally have one more treatment they can try and get paid for, even if it degrades your quality of life further. Health care providers and facilities are too often poorly coordinated, so without someone at the helm, treatment suffers.

Family members with whom you never talked about your health care priorities, goals and wishes will likely be in great distress at the realization that they don’t truly know what you would want. Or they may apply their personal preferences to your situation. Few families agree about everything, so conflict about what to do about your health care becomes highly probable if you haven’t engaged in serious advance care planning.

You may be asking: How do I begin? You can find the best advance care planning tools that I know on the website of the American Bar Association, where I direct the Commission on Law and Aging. Try any or all of the tools and follow whichever resonates with you.

You will find that the process is surprisingly uplifting. But no matter which tool you use, know that, in the end, it is only as good as the degree to which you engage your family or friends and your primary care provider in the process. In this case, talk is action.

Next Avenue Editors Also Recommend:

• How to Prevent a Real-Life Nightmare at Life’s End

• Don’t Let Fear Stop You from End-of-Life Planning

• How to Protect Yourself or a Loved One from an Abusive Guardianship

By Charles Sabatino

Charles Sabatino is director of the American Bar Association Commission on Law and Aging. He has devoted more than three decades to his work at the ABA, specializing in research and project development in health law, long-term care planning and access to legal services for older adults. He has also written and spoken widely on advance care planning. In addition, Sabatino has shared his expertise with students at Georgetown University Law Center as an adjunct professor in elder law since 1987. Sabatino served as president of the National Academy of Elder Law Attorneys and has been active in the organization’s public policy efforts. His work on elder law issues began at the ground level, when he joined Legal Services of Northern Virginia as senior citizens project counsel.