As a professional trustee and executor, I have seen hundreds of estate-planning documents, including some from do-it-yourself online services. I appreciate that using a DIY site to draft a will can save money and time. But I’m also concerned that sometimes doing it this way could lead to expensive and unpleasant estate planning mistakes.

I recently saw one DIY estate-planning service that had typos on its site and its estate-planning “packages” had the same document labeled with three different names. Worse, the packages I looked at were missing a key estate planning document which very few users would know to ask about.

This service, like many other DIY estate-planning sites, has attorneys on staff, but access to specific help for your personal documents is rarely available. If personal advice is offered, it then appears to cost a great deal more to receive.

But what if you don’t know which questions to ask?

Online DIY Wills Vs. Hiring a Professional

For some people with complicated personal and financial lives, today’s complexities may not be fully addressed with a do-it-yourself service for wills and trusts. While many of us would prefer to fill in the blanks in silence than have to talk to anyone about our doubts or concerns, sometimes it helps — a lot — to get professional advice.

If you prepare your taxes yourself and they end up incorrect, you and the Internal Revenue Service may end up working things out. If you decide to do your estate planning by yourself,” however, youmay never know the results of your work, but your loved ones will.  

There are lots of DIY options for completing your own estate plan, and they have been available almost as long as we have had the internet. (Longer, if you count all the software packages you could buy off the shelf.) With the ease and availability of these programs, and their low price, you might think more of us would have an up-to-date estate plan.

Yet according to the AARP article, Haven’t Done a Will Yet?, “only 4 in 10 American adults have a will or living trust.”

What Good Estate Planning Is All About

Our power to express our preferences is what good estate planning (or life planning), is all about. In my work as a trustee and executor, I’ve learned that the documents which provide me with detailed instructions are critical to avoid court involvement, to reduce administrative confusion and to know when our job is done.

The four basic estate planning documents: a will, a trust, power of attorney for financial matters and an advance health care directive. If you plan to use any or all of them through a DIY site, expect to be offered a fill-in-the-blank approach. Keep in mind that each state has its own probate code (the body of law governing estate planning and implementation). The software package you use may have different names for the same documents I have listed above.

Some of the DIY sites I visited have all of these documents for you, but only if you purchase their higher-end packages. Some offer limited attorney consultation; on one site, it was really a drop-down of questions with pre-written responses, not an actual conversation with an attorney.

Pros and Cons of DIY Estate Planning

The advantage of using a DIY service is that you will have a plan, as quickly and cheaply as possible, and that may be better than having no plan at all. This is especially true regarding getting a will, power of attorney and advance health care directive. Those handle most emergencies for people who don’t own real estate or much else.

The range of DIY services also has a range of prices — like $69 for just a will, to several hundreds of dollars for what may be described as a “complete plan.” Some sites have more information than others about their options.

Most presume that you already know what you want. But the reality is that many people have no idea what they want or need. Once you get into the complexities of family dynamics and perhaps trust language specific to your state and situation, DIY estate planning can cause more challenges than working with a team of professionals.

My Caution About DIY Online Wills

Here is my caution, based on my experience: You don’t know what you don’t know. You know some things about how you want to dispose of your assets after you die. What you may not know is all the case law and legislation that have evolved into your state’s probate code.

If you do decide to look for an attorney who specializes in estate planning, I recommend interviewing two or more. This way, you will get a feel for how each handles client relationships, payment, follow-up and his or her own succession. You may already have other trusted professionals (a cpa, a financial planner) who can refer you to estate planners in your area.

However you choose to get your plan completed, DIY or with the help of an experienced attorney, please get your estate plan done, and soon. You never know what surprises life will bring that will invoke your estate plan.

By Marguerite C. Lorenz

Marguerite C. Lorenz is a partner in Lorenz Fiduciary Services, Inc. (LFS), and has served as a professional trustee and executor on over 100 cases. Ethics for Trustees, written by Jane and Marguerite Lorenz, gives further understanding to the work of a fiduciary, and its ethical considerations. Lorenz created the EstatePlanning101.org program in San Diego and is a member of PFAC,  president of the Estate Planning Group Network and vice chair of the board for the Independent Trustee Alliance. Follow her on Twitter @SanDiegoTrustee

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Your house, and what it contains, is a minefield in the eyes of your grown children. They can see from your example that collections of stuff are a curse; such objects are superfluous to a life well lived. They want a clean, clear field in which to live their lives. Your grown children will not agree to be the recipients of your downsizing if it means their upsizing.

In the following list of the Top Ten Objects Your Kids Do Not Want — inspired by conversations (or lack thereof) about my keepsakes with my 30-year-old son, Lock, and his wife, as well as by similar conversations I’ve had with hundreds of boomer clients and their millennial heirs — I will help you find a remedy for dealing with each:

No. 10: Books

Unless your grown kids are professors, they don’t want your books. There are a couple common mistakes my clients make in valuing books:

The 17th-century books are likely to be theological or grammar-based, and are not rare. The 19th-century books are probably not in good condition, and since most came in a series or set, it’s unlikely you’ll have a full (valuable) set.

Remedy: If you think the book is relatively common plug the title, author, year of publication, and publisher into a search engine. A favorite book site of mine is Biblio.com. Once you have background information, call a book antiquarian.

No. 9: Paper Ephemera

Things like family snapshots, old greeting cards and postcards are called paper ephemera. Old photos are not worth anything unless the sitter is a celebrity or linked with an important historical event or the subject is extremely macabre, like a death memorial image. Old greeting cards are not valuable unless handmade by a famous artist or sent by Jackie O. Postcards are valued mainly for the stamps.

Remedy: Take all your family snapshots and have them made into digital files. The other option is to sell those old snapshots to greeting card publishers who use them on funny cards or give family photos to image archive businesses like Getty. If the archive is a not-for-profit, take the donation write-off.

No. 8: Steamer Trunks, Sewing Machines and Film Projectors

Trust me, every family has at least three steamer trunks from the 19th century. They are so abundant that they are not valuable, unless the maker is Louis Vuitton, Asprey, Goyard or some other famous luggage house.

Likewise, every family has an old sewing machine. I have never found ONE that was rare enough to be valuable.

And every family has a projector for home movies. Thrift stores are full of these items, so, unless your family member was a professional and the item is top-notch, yours can go there as well.

Remedy: Donate this category and don’t look back.

No. 7: Porcelain Figurine Collections and Bradford Exchange “Cabinet” Plates

These collections of frogs, chickens, bells, shoes, flowers, bees, trolls, ladies in big gowns, pirates, monks, figures on steins, dogs, horses, pigs, cars, babies, Hummel’s, and Precious Moments are not desired by your grown children, grandchildren or any other relation. Even though they are filled with memories of those who gave them to your mom, they have no market value. And they do not fit into the Zen-like tranquil aesthetic of a 20- or 30-something’s home.

Remedy: Find a retirement home that does a gift exchange at Christmas and donate the figurines. If you want to hold on to a memory of your mom’s collection, have a professional photographer set them up, light them well and make a framed photo for your wall. Collector’s plates will not sell anywhere to anyone. Donate these to a retirement village as well or to anyone who will take them.

No. 6: Silver-Plated Objects

Your grown children will not polish silver-plate, this I can guarantee. If you give them covered casserole dishes, meat platters, candy dishes, serving bowls, tea services, gravy boats, butter dishes and candelabra, you will be persona-non-grata. They might polish sterling silver flatware and objects, but they won’t polish the silver-plated items your mom entertained with. The exception may be silver-plated items from Cristofle, Tiffany, Cartier, Asprey, and other manufacturers of note.

Remedy: None. Give it away to any place or person who will take it.

No. 5: Heavy, Dark, Antique Furniture

There is still a market for this sort of furniture, and that market, in the fashionable areas of the U.S., is most often the secondhand shop. You’ll receive less than a quarter of purchase price if you sell on consignment in one. Unless your furniture is mid-century modern, there’s a good chance you will have to pay someone to take it off your hands.

Remedy: Donate it and take a non-cash charitable contribution using fair market valuation. Use reporting services such as P4A.com to find where this class of furniture sells.

No. 4: Persian Rugs

The modern tranquility aimed for in the décor of the 20- to 30-somethings does not lend itself to a collection of multicolored (and sometimes threadbare) Persian rugs.

Remedy: The high-end market is still collecting in certain parts of the U.S. (think Martha’s Vineyard), but unless the rug is rare, it is one of the hardest things to sell these days. If you think the value of the rug is below $2,000, it will be a hard sell. Like antique furniture, it may be best to donate.

No. 3: Linens

Go ahead, offer to send your daughter five boxes of hand-embroidered pillowcases, guest towels, napkins, and table linens. She might not even own an iron or ironing board, and she definitely doesn’t set that kind of table.

Remedy: Source those needlewomen who make handmade Christening clothes, wedding dresses, and quinceañera gowns. Also, often you can donate linens to costume shops of theaters and deduct the donation. A site like P4a.com has auction results to establish the fair market value of such objects.

No. 2: Sterling Silver Flatware and Crystal Wine Services

Unless the scrap value for silver is high enough for a meltdown, matching sets of sterling flatware are hard to sell because they rarely go for “antique” value. Formal entertaining is not a priority these days. And of course, sterling must be hand-washed and dried. Can you see your kids choosing to use the silver? Same goes for crystal: The sets you have are too precious, and the wine they hold is too small a portion. Period.

Remedy: Sites like Replacements.com offer matching services for folks who DO enjoy silver flatware and have recognized patterns. Because they sell per piece, and therefore buy per piece, sellers get a rather good price. Sell your whole silver service; it will be “pieced out.”

Unless your crystal is Lalique, Moser, Steuben, Baccarat or another great name, you will not be able to sell your “nice set.” Give “unknown maker” sets away, fast.

No. 1: Fine Porcelain Dinnerware

Your grown children may not want to store four sets of fancy porcelain dinnerware, and frankly don’t see the glory in unpacking it once a year for a holiday or event.

This is the saddest story I have to tell my clients: your grown kids and grown grandkids DO NOT want and will NEVER want five or more fine china services. They don’t even want one. They do not see the logic. They don’t want porcelain tea sets or dessert, fish, or fruit services either. Ask yourself, when was the last time you witnessed your grown son using a saucer?

Remedy: Like silverware, china is something to consider for sale to a replacement matching service like Replacements.com. Know your pattern to get a quote from one. Because such replacement companies buy per piece, the aggregate of the selling price is always more than a bulk sale at a consignment store, which might be your only other option.

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(This article was provided through The OpEd Project, whose mission is to increase the range of voices and quality of ideas we hear in the world.)

While a new study last month suggested exercise is the best way to prevent falls in people over 65, there’s another, surprisingly simple, but often overlooked way to reduce the risk of falling: a hearing test.

In 2012, researchers determined that even a mild hearing loss tripled the risk of an accidental fall; the risk increased by 140 percent for every 10 decibels of increased hearing loss in people over 40.

The study’s author, Johns Hopkins Associate Professor of Otolaryngology Frank Lin, theorized that hearing loss puts a larger cognitive load on the brain, which may reduce brain resources for balance.  If this seems unlikely, just try putting foam earplugs in: Although they create the equivalent of a 40-decibel hearing loss (considered mild), just tell me this doesn’t affect how you experience and move around in the world.

Hearing Loss: ‘A Silent Problem’

In addition to increasing the risk of falls, hearing loss is linked to diabetes, cognitive decline, multiple sclerosis, rheumatoid arthritis, depression and more. But unlike vision, hearing loss remains a silent problem. The reasoning behind this is multifaceted, but largely related to myths and stigma.

For instance, in my 25 years fitting hearing aids, I’ve often heard patients say their hearing aids make their natural hearing ability worse. But this is not the case. The brain is so hungry to get the stimuli, the hearing-impaired person just notices the “before” and “after” effect. The brain loves to have all of the aural information it had been missing, and the wearer has much better awareness of what it hadn’t been hearing once hearing aids are in place.

Hearing loss also carries a stigma that vision loss doesn’t — despite the inevitability of both senses declining with age. Glasses, unlike hearing aids, are a cool fashion accessory. Personally, I’ve had glasses since I was 4; my sister painted a flower garden on my lens when I needed an eyepatch. Now, nearing 50, I own several pairs of glasses in different shapes and colors to match my outfits. Hearing aids, on the other hand, are associated with age and infirmity.

Not Enough Attention From Medical Profession

It doesn’t help that the medical profession sometimes forgets about the importance of hearing. For instance, in 2013, the Centers for Disease Control acknowledged that diabetes affects hearing, but failed to mention until very recently that annual hearing exams should be required for those diagnosed with diabetes. Vision, on the other hand, has been a recommended test for diabetes for years.

If our vision changes, it’s often quite obvious to us. We hold the newspaper farther away or we can’t read street signs. Hearing loss can be much more subtle. We ask people to repeat themselves more or tell people they’re mumbling or get more tired trying to follow a conversation. That’s especially true in a noisy situation because we use more cognitive function to figure out what is being said. These changes happen over time, so many don’t realize it is happening.

The Need for Baseline Hearing Tests

Everyone needs a diagnostic hearing exam on a regular basis to provide a baseline to measure changes in our bodies. Without such a baseline, it becomes difficult to evaluate the impact of many things that may affect hearing — from chronic diseases like diabetes to medical treatments like chemotherapy to accidents. Without a diagnostic test on record, it can be difficult to prove that hearing changed.

Most commercial health insurance covers hearing exams, although some plans require a referral from a primary physician. Medicare, however, can be more complicated: It covers hearing exams related to medical issues (with a physician referral), including diabetes and vertigo, but not routine exams or for exams for hearing aids.

Many people need to be their own advocate in requesting hearing exams; seven in 10 adults who had a physical in the last year say it didn’t include a hearing test, according to the nonprofit Better Hearing Institute.

As our population ages, and more attention is focused on the impact of age, annual hearing evaluations must become the norm for adults — not the exception.

By Judy Huch

Judy Huch, Au.D., is the founder of the nonprofit Grace Hearing Center in Tucson and serves on the Arizona Commission for the Deaf and Hard of Hearing. She is an OpEd Project Public Voices Fellow.

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Whether you’ve been sidelined by a sports injury, an accident or a surgery, the loss of fitness that often follows can be seriously frustrating. Luckily, there are things you can do to help minimize your downtime, maintain your fitness and recover as smoothly as possible.

To round up the best tips and guidelines, I interviewed an active 50-something with firsthand experience and an expert on orthopedic recovery. Despite their different perspectives, they had similar advice to share.

Get Off the Couch

“The biggest thing for people to remember is try to stay as active as they can. A lot of people just don’t realize there are a lot of things that they can do, says Jasmine Marcus, a physical therapist who practices in Ithaca, N.Y. She recommends working with your care team as early as possible to map out exactly which activities you can do and when.

This line of questioning should start even before you go into surgery or at the time of triage care in the case of an injury. That’s exactly what Julie Sprau, a busy 57-year-old attorney from St. Louis Park, Minn., did prior to her hip replacement surgery.

“In the weeks leading up to surgery, I got a list of gym exercises from my doctor,” she says. “They were focused on building as much strength and mobility in my hip joint, to give me the best chance at a quick recovery.”

Don’t Overdo It

According to Marcus and Sprau, it’s important to be specific. Ask directly about activities you routinely do, whether they are household chores or sports. Even more important: don’t return to activity too quickly.

“I followed my doctor’s orders one hundred percent,” says Sprau, who didn’t put an ounce of weight on her affected leg until her doctor said she could.

Said Marcus: “As you start to recover and do more, check in with your care team and make sure what you’re doing is safe and appropriate. If you haven’t been exercising for a while because of the injury or surgery, make sure you don’t do too much too soon, because that can easily lead to re-injury.”

Nourish Your Body and Mind

Getting injured or recovering from surgery can be frustrating and even depressing, but you’ll only compound the negative impacts if you turn to junk food and alcohol to cheer you up. Instead, make it your mission to use what you eat and drink to fuel your body’s recovery.

Eating whole foods should be your top priority, according to the 2015 meta-analysis “Nutritional Support for Exercise-Induced Injuries,” published in the New Zealand journal Sports Medicine. Studies have shown that boosting intake of foods high in zinc, vitamins A and C and Omega-3 fatty acids can result in quicker healing.

Also, despite the typical drop in activity following an injury, the healing process burns quite a few calories, so restricting intake isn’t always a good idea. It’s especially important to get enough lean protein, to eat foods high in fiber and avoid dairy and other foods that can cause constipation, a common side effect of many pain medications.

It’s equally important to nurture your mental health. Rather than succumb to frustration, use the down time to enjoy sedentary activities like knitting or reading. This would also be a great period to experiment with meditation; at least one study has shown a negative correlation between stress levels and the speed of healing.

Get Creative

Immediately following an injury or surgery, it might seem like there’s nothing you can do, and for the first week or two, this may be the case. But before long, you can, and should, do whatever you’re able to do.

“Usually, patients are safe to continue exercising their uninvolved body parts,” Marcus says. “This can mean working out their core and arms in the event of a leg injury or switching from walking and running to biking to decrease weight bearing.

“There’s also a growing body of research that shows that an injured limb loses less strength if you continue exercising the opposite limb,” she continues. “For example, if you break your right arm, but continue exercising with your left arm, your right arm will be better off in the long run.”

You may have to get a little creative where exercise is concerned.

“I wanted to bench [press],” Sprau says, “but I couldn’t extend my hip the way I normally would lying on the bench. So, my trainer set up a couple of boxes next to the bench and I rested my legs on them. Of course, I wasn’t able to lift as heavy, but it was enough for me to maintain some strength and mobility in my upper body.”

Exercises to Help Reclaim Your Functionality

In addition to exercising unaffected muscle groups, consider incorporating the exercises below to strengthen key core and stabilizer muscles, improve movement quality and possibly prevent injuries from recurring. Just be sure to discuss specific exercises with your medical care team prior to any activity.

Click on the name of the exercise for a link to instructions and a photo or video demonstration.

Balance stands: In addition to improving balance, this exercise engages the core and dozens of stabilizer muscles in the upper and lower leg, foot and ankle.

Clamshells: Weak hips can be the culprit for some knee and lower back injuries. Do this simple exercise to strengthen key hip movers.

Back extensions: Like weak hips, weak lower back muscles can compromise the lower and mid-back and contribute to poor form when walking or running.

Planks: The Plank, in any of its many varieties, is one of the best total core exercises. If you’re new to planks, start on your knees or even against a wall.

Hip hinge: The hip hinge is an important precursor movement for many strength exercises and activities of daily life. Unfortunately, weak hip flexors and tight hamstrings, caused by too much sitting, have made our bodies forget how to do this basic movement.

Injuries and surgeries can be a real drag, but by doing what you can when the time is right, and focusing on a few key exercises, you’ll be ready to tackle life at full speed again in no time.

By Rashelle Brown

Rashelle Brown is a Certified Personal Trainer and health coach who has been writing about health and fitness since 2010. Her work has appeared in IDEA Fitness Journal and on the popular health web sites livestrong.com and eHow.com. She is a regular contributor for Active.com and NextAvenue and in 2015 published her first book, Reboot Your Body: Unlocking the Genetic Secrets to Permanent Weight Loss (Turner Publishing). Learn more at WellCuratedLife.com.@RashelleBrown1

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As so many medical professionals, policymakers and nonprofits continue to sound the alarm about the impending tsunami of Americans with Alzheimer’s disease and other dementias, the U.S. still has no affordable long-term care system to handle the situation.

In her new book Dementia Reimagined: Building a Life of Joy and Dignity from Beginning to End, Dr. Tia Powell joins those sounding the alarm, but she calls for a much greater focus on developing care programs and facilities for people with dementia that preserve their dignity and ability to experience joy in life.

The professor of psychiatry and bioethics at the Albert Einstein College of Medicine in New York says it’s time to stop focusing only on finding a cure for dementia, as if that will save us from having to pay for care. It’s too late for that, she says. No magic pill or other preventative

Credit: Adobe

intervention is anywhere on the horizon that would be available in time to make a difference for the 10,000 boomers turning 65 every day.

Powell’s book, released this month, blends a fascinating history of how dementia has been viewed in the U.S. with her thoughts on what compassionate care for people with dementia might look like. She also includes her own experience helping to care for her mother who had dementia and died a few years ago.

In a recent interview with Next Avenue, Powell talked about what she learned from researching and writing her book:

Edie Grossfield: You wrote that you expect some people will take issue with your suggestion that we need to shift more research funding from finding a cure for dementia to developing compassionate care for people with the disease. Can you elaborate?

Credit: © Ethan Hill 2018

Dr. Tia Powell: I don’t want people to stop looking for a cure. Dementia is a serious illness, it is a fatal illness and we don’t have a cure, so I’m all for finding a cure. But that has been the overwhelming majority of the research we’ve done.

If we find a cure, it’s not going to be in time for the baby boomer generation. We will have millions and millions of people who need care. And although I think there are good people working on that, there has been pretty modest funding for thinking about what would good care look like? How can we pay for that? How can we make it accessible to people all across the country? What are the things that people with dementia and their caregivers really say they need and want?

You also expressed concern about some researchers and pharmaceutical companies focused on a preventative drug for people who have high levels of amyloid plaque in their brains — that being one theory about the cause of Alzheimer’s. You said that since research has shown high levels of amyloid doesn’t mean a person will get Alzheimer’s, such a drug would mean big bucks for ‘Big Pharma’ with little benefit for most of the people who take it. What are your thoughts on this research today?

I hope that particular dream is fading. We just had in the last couple of weeks another major failureof a big, hundreds-of-millions-of-dollars clinical trial trying to decrease amyloid as a way of preventing and treating dementia, and it failed again, just like the ones I’ve described in the book. I’m hoping it’s going to be the nail in the coffin for looking just at amyloid. It’s not that amyloid is good for you, but there’s something really important that we don’t understand, and it really looks like just decreasing amyloid or even preventing its buildup — I don’t think that’s going to be the ticket.

What are your hopes for developing care for people with Alzheimer’s and other dementias?

A lot of people who don’t even have dementia yet are absolutely terrified. They think that this is more frightening than cancer, than AIDS. And that’s partly because we haven’t done enough to reassure them. I think we can reassure people. I think you can have a life with dementia that has joy in it, and we need to make sure that’s not an empty promise, but an actual one. I think it can be. And since a lot of us are going to have dementia, and probably me, too … I think we should do more to make sure that people with dementia don’t have to be so terrified of it.

What is one example of the kind of care you hope we’ll see more of?

A lot of older buildings that are nursing homes had no easy access to the outdoors. In some cases, people might go literally years without ever feeling the outside air. And now, there are places that think we can do better than that. They’ve said even if somebody is in a wheelchair, why don’t we get one that they can operate by themselves? Why don’t we set up our facility so that the access is easy so the person can just present themselves at the door, the door will open automatically and they will be in, basically, a kind of walled garden? They can walk or roll about as much as they want, and end up back at the door. You can’t get lost. So, it’s that simple freedom that can make an enormous difference in somebody’s life.

Toward the end of the book, you wrote that you think you have a good chance of getting dementia when you’re older because both your mother and grandmother had it. Is that one of the reasons why you wanted to write the book?

The book is, in a sense, an enormous thought experiment for me to figure out: Can I make my peace with that? And if I’m going to have dementia, I’d like to have some joy in that life. I would like to be happy, because that’s really the point of life. So, I better think about how to be happy with dementia — and what would that look like and how would I do that.

What was it like for you to do that exercise?

I think it was very useful. It was very comforting to try and think about that. So, I thought that I would offer it as a suggestion (to readers of the book) because, as we know, a lot of people in middle age and up are really worried about ‘Oh man, what if I get dementia? It’s just the most horrible thing in the world.’

I’d like to at least tease them with the idea that maybe it doesn’t have to be so horrible. What could you think about, what could you bring with you into the stage of dementia that might make you happy? How could you remodel the world around you? So, if you wish there was a community garden where little kids come and plant bulbs, it may be great for older people with dementia to maybe sit and watch the little kids putting in the bulbs. Maybe you could work on that. It would be a great thing to do.

Hope for Simple Joy

In the last paragraph of her book, Powell described what she hopes she could still enjoy as a person with dementia.

She wrote: Even toward the end, I hope still to have some joy. I may not get there, but I’d like to see again one of my familiar places: the dancing world of Central Park on a perfect day. Leaves shimmer overhead in a light breeze. Midair Frisbees fly while dogs and people arc gracefully up to seize them for the ether. On the ground, a young couple on a picnic blanket, Motown on their boombox. Their wobbly first child stands, resplendent in a dinosaur-print onesie, his small hands in the large ones of his seated father. He cannot walk yet, but he dances, bobbing his padded bottom up and down. His face is the portrait of happiness, with the sun, his parents’ love, the breeze, the music all radiating through him. If I could be there again, trees, breeze, flying dogs and dancing babies, that would be enough. I’ll be seeing you.

The last paragraph of your book is beautiful, but also sad, as you talk about what you hope to be able to still enjoy if you have dementia.

It is a little sad, but it’s also about gratitude and feeling happy for the things that you have loved in life, and really hoping to find at least some of those things that you can still be happy about as you go forward and step into the future. What could you take with you that would still be a happy thing?

By Edie Grossfield

Edie has been a journalist for more than 20 years, reporting and editing for newspapers and magazines. She also worked in communications for a large health care organization. She holds a bachelor’s degree in communications and media and a master’s degree in journalism, both from the University of Wisconsin in Madison. Reach her by email at egrossfield@nextavenue.org.

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That’s when I froze.

The gym’s central area buzzed with the alien whir of treadmills. The reverb thud of heavy objects landing on industrial carpet. The banter of fit people in workout gear. Everyone moved like they knew what they were doing.

Suddenly every stream of self-consciousness I‘d ever felt — standing alone unpicked for dodgeball at school, entering a party knowing no one, revealing my bathing suit on the beach — blended into a foamy river of doubt roaring in my ears.

I was a fish out of water in old Gap stretch pants. Instead of hopping on a bike, I beelined back to the locker room. Safe inside a bathroom stall, I burst into silent tears.

Calling In Reinforcement: a Trainer

A month earlier, I’d joined this fitness center in a bid to overcome my lifelong gymtimidation — fear and intimidation about gyms. Unless you count YMCA aerobics in my 20s (hair scrunchie, “feel the burn” and all), I’d slid through adulthood sadly fitness-free. So, I hired trainer Tracy Van Thuyne of Old Town Athletic Club in Fort Collins, Colo., to handhold me past my awkwardness.

It was unnerving enough to try new things in the shelter of her patience and encouragement. But working out without her, between our appointments? A bust.

After confessing my cop-out to her at our next session, she looked me square in the eyes. “First off, you already did the most important part of any workout: Walking in that front door.”

She added, “And you’re not the only one who feels that way!” Another client, she said, once seized up and fled when a man started using the chest press next to her. “He wasn’t even her age or paying any attention to her,” Tracy said. Also, my walking buddy confided that she’d abandoned the free perk of her company gym when the super-fit young trainers grew impatient that she couldn’t remember how to set the machines.

Three-quarters of women want to exercise more but are held back by fear of being judged or not being good at it, according to research by Sport England. In a smaller study by Fitrated, women avoided the gym twice as often as men, mainly due to anxiety or fear. These included fears of being judged about their weight, form, improper equipment use, not looking fit enough, even their clothing choice.

Becoming ‘Almost a Gym Rat’

So how, within three months, did I transform from gymtimidated newbie to “almost a gym rat” (my amazed daughter’s words)?

I learned these confidence-boosters:

Find a place that feels comfortable. For a small word, “gym” packs big variety, from low-cost community centers to large enterprises like the Planet Fitness chain (helpfully promoting itself as a “judgement-free zone”). Most gyms offer free or low-risk trial periods. If you don’t like one vibe, sample another. I chose my small, privately owned gym for its free classes, trainers, handy hours and 1-mile walk from my house.

Invest in a helper. Working with a trainer had three key benefits.

First, my appointments just got me there — huge at the start.

Second, Tracy and I worked for weeks on form, so I learned how to do basic moves properly, lowering my odds of injury and providing a solid foundation.

Third, Tracy crafted a series of workouts, shooting video of me with my phone as she talked me through them. This way, I have the video handy if I forget what to do when I’m working out on my own.

Yes, it costs money to hire a trainer. When I first started, I signed up for an introductory package of eight one-hour sessions for $350. But as investments go, this one will pay off for years, since it’s my health. (And compared to what I spend on my hair…) Some gyms offer trainer consults when you join; I bought a discounted package of Tracy’s services to start. Now we check in monthly so I can keep learning.

Find the right support for you. Tracy understood that my confidence needed strengthening as much as my muscles. You might prefer a trainer used to working with women, or older adults. If your first choice doesn’t seem tuned into your needs (mind and body), another will.

Promise to give it time. It takes an average of 66 days to form a new habit, slightly longer for exercise. That makes it easy for gymtimidation to creep in! Even if you don’t look different on the outside, remind yourself that your muscles, heart and brain improve each time you show up. I started out going once or twice a week. Now, I’m there six times a week for different types of exercise — resistance training, yoga and high-intensity interval training.

Practice when it’s not crowded. On Saturdays and Sundays before 8 a.m., my gym is virtually empty. I can watch my videos and practice anything new with less inhibition.

Look for models of inspiration rather than intimidation. Instead of focusing on the massive men deadlifting 200 pounds while I grunted over 20, I began admiring the stout sparkplug who showed up daily and the white-haired treadmill jogger. Now that I (somewhat) know what I’m doing, I mainly focus on, well, doing it. Truth is, nobody’s thinking much about me, or you.

Splurge on the right clothes. Not essential. But when my 20-something daughters dragged me into stores selling made-for-movement “athleisure” wear, I discovered pants and tops that made me feel like the fit person I hoped to be. Shallow, maybe, but it helped.

The other day, after an interval workout on the bike — yes, I mustered the courage to try it, and the elliptical, too — I saw Tracy training another client. “I think you’d better write your gymtimidation article before you don’t have it any more,” she said with a grin.

She doesn’t even know I once actually left the gym when I saw her there, overcome with discomfort at being watched by someone who knew me. Now, I just show up. I plow through. And after, I feel great — which keeps me walking through that door again and again.

Next Avenue Editors Also Recommend:

• How to Find the Perfect Fitness Trainer
• The Benefits of Exercise: Now, Next Week, Next Month
• How to Keep Your Muscles in Good ‘Functional’ Shape

In many families, holiday or other event gatherings are a collaborative effort. Someone brings the main dish, someone else brings a salad and another person shows up with dessert.

Maybe it’s time, experts say, to assign one dinner guest to keep an eye on your family member who has Alzheimer’s disease or other dementia. Otherwise, that relative may end up sitting alone, staring into the distance, as others mingle after the meal.

“Most people with early or middle-stage Alzheimer’s enjoy being social, and many would enjoy eating a holiday dinner with the family,” says Dr. Suzanne Schindler, a neurologist and a professor at Washington University School of Medicine in St. Louis.

Consider What the Person with Dementia Would Enjoy

When planning the event, Schindler says, it’s important to take these individuals’ needs and wants into consideration. What would they like? What would make them happy? Maybe your mom likes to dance. Encourage the younger children to ask her to dance for a bit. Does your dad enjoy singing? A family sing-along after dinner may be in order.

Someone with mobility issues may prefer to visit quietly with one person at a time, reminiscing about previous holidays. A family photo album may spark that conversation. Sometimes, just sitting together, observing others at the gathering, may be enough.

“You want the person to be engaged, but not too much or too little,” Schindler says. Too little might be seating the person at the back of a room. Too much might be seating the person in the middle of a noisy crowd or in the path of active children.

What topics should be avoided? Current events may be troubling for someone with short-term memory loss. Schindler also cautions against correcting those with dementia, who may say things that are inaccurate, or calling them out for being repetitious. She recommends avoiding any confrontations.

Don’t Make Assumptions About Alzheimer’s

An estimated 5.7 million Americans are living with Alzheimer’s. Yet, many people still are not well informed about this debilitating disease, for which there is no cure. Simply acknowledging that a family member has Alzheimer’s often is emotionally difficult for many people. Beyond sadness, some experience fears that they, too, may develop the disease, though experts say that age is a far greater risk factor than genetics.

Monica Moreno, senior director of care and support for the Alzheimer’s Association, endorses Schindler’s suggestion that before families gather, they talk openly about a loved one’s level of disease, what to expect and how they can help.

“Many people hear the word ‘Alzheimer’s’ and they think of someone who can’t communicate or doesn’t know what’s happening around them,’ Moreno says. “That’s not always the case. Alzheimer’s affects everyone differently, and that’s why we shouldn’t make assumptions.”

Moreno offers these general tips:

• Consider holding the gathering at brunch or lunch, because some people with dementia experience fatigue or confusion later in the day.
• Interact directly with the person, rather than his or her caretaker, at the event.
• Be a good and patient listener, because some people may need longer to formulate their responses to questions.
• Invite the person to participate in a non-stressful way, perhaps by helping set the table or fold napkins, depending on his or her level of function.
• Provide a quiet place where the person can spend some down time if needed.

Moreno also recommends keeping your sense of humor, which lightens the mood for everyone and can ease communications. And keep in mind that a specific tip or strategy that doesn’t work one day may well work the next.

The Alzheimer’s Association’s website offers more advice on how to communicate with individuals in the early, middle and late stages of the disease, including a short video.

Try to Interpret Unexpected Behaviors

If your loved one with dementia becomes distressed during a gathering, Moreno recommends trying to redirect him or her. “Change the topic … or invite someone else to join your conversation,” she says. If that doesn’t work, try to understand any behaviors you may witness, because all behaviors are a form of communication.

“A person may try to get up and leave. By doing this, what is he or she saying? Perhaps they need a drink or to go to the bathroom, or perhaps they feel anxious or over-stimulated because the noise level is too loud. It’s helpful to know what triggers may bring on different behaviors,” Moreno says.

And if things get out of control, the Alzheimer’s Association has a Helpline staffed by clinicians who can offer support all day, every day. The number is 800-272-3900.

Have Realistic Expectations as Circumstances Change

As a person’s dementia progresses, his or her ability to interact with other people will change as well. The family will have to adjust to that, and there might come a time when a big gathering is just too much for a loved one with dementia.

For example, my friend Elizabeth wasn’t at her family’s Thanksgiving dinner this year. I wrote about her two years ago  when at 68, she was the youngest person living in a memory care unit after a diagnosis of Alzheimer’s. Now she is in a skilled nursing unit, and Michael, her husband, tells me it’s not easy to keep Elizabeth engaged when he visits every day.

“Elizabeth will not initiate any conversation, and it’s often difficult to even get a reaction to what I say,” Michael says. “We almost always go for a walk on the grounds. We look at the trees and the beautiful fall leaves, and I talk about them. That always provides a good distraction.”

Elizabeth’s and Michael’s family gatherings have always been large. They have three children with families of their own, plus Elizabeth has eight living siblings and Michael has two, all with families. “I don’t bring Elizabeth home for the holidays,” he says. “The crowd would be too much.”

By Patricia Corrigan

Patricia Corrigan is a journalist and the author of numerous books, including a guide to San Francisco that expresses her great joy in her adopted city. Visit her blog here.

Next Avenue Editors Also Recommend:

• 5 Calming Techniques for Caregivers
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(In 2008, National Geographic writer Dan Buettner published his bestselling book, The Blue Zones: 9 Lessons for Living Longer From the People Who’ve Lived the Longest, about the five “longevity pockets” around the world. For this weekly series, Next Avenue Money and Work & Purpose editor Richard Eisenberg, a Gerontological Society of America Journalists in Aging Fellow, takes a different look at the Blue Zones — places where there’s a high concentration of people living past 90 without chronic illnesses. Rather than focusing on the residents’ diets, he reports on how the oldest people in the Blue Zones make their money last and what Americans and America can learn from this. This installment, Part 2, is about the Blue Zones of Okinawa, Japan; Sardinia, Italy and Ikaria, Greece. Part I, which you can read here, was about The Nicoya Peninsula of Costa Rica.)

The Blue Zone of Okinawa, Japan

An archipelago of 150 small, rural islands south of mainland Japan, Okinawa is best known to Americans for two things: Its horrific World War II battle and the “Okinawa Diet.” That plant-based diet (big on sweet potatoes) is believed to be a key reason for the residents’ exceptional longevity. I was curious to learn how the centenarians and nonagenarians there make their money last and spoke with several experts who know them well and have spent a good deal of time with them.

Okinawa, the subtropical area sometimes called the Japanese Hawaii, has roughly 25 centenarians per 100,000 inhabitants — and they’re mostly healthy centenarians. Rates of heart disease, strokes, prostate cancer and dementia are far lower than for people their age elsewhere. Frequent walking, as well as physical labor from agricultural work, fishing and gardening, keeps them in good shape.

But two other factors help explain why, as Francesc Miralles (co-author of Ikigai: The Japanese Secret to a Long and Happy Life), told me, the oldest Okinawans “don’t worry about money” — even though they live in one of the poorer parts of Japan.

One is ikigai (pronounced EYE-kih-guy). Loosely translated as the happiness of always being busy, Buettner said it’s more about having a reason to get up in the morning. Miralles believes ikigai is why Okinawa’s centenarians “are free of stress.” Dr. Craig Willcox, a gerontologist and co-principal investigator of the Okinawa Centenarian Study, described them to me as “happy-go-lucky,” confident that “it will all work out in the end.”

In Okinawa, people often work into their 90s. But work isn’t the only reason for their ikigai. Nearly all the oldest Okinawans also take enormous pleasure in the vegetable and medicinal gardens they maintain outside their small houses. Many continue earning income selling what they grow.

The other key factor helping make Okinawans’ money last is one I found especially fascinating: the financial and personal safety net known as a “moai” (pronounced mo-AHY).

It’s a group of about 20 close-knit older friends who look out for each other. They typically get together every afternoon to talk and play games. Moai participants also contribute about $40 to $50 a month to their communal pot. When one has a money emergency, he or she can pull money out, which reduces financial stress. It’s something older Americans might want to create to help lessen their anxiety about outliving their money.

The moai is especially important because Okinawans’ incomes and assets are small. Annual incomes are almost half of those in Tokyo, and assets are only a third as large as for people in Japan overall, said Takaoh Miyagawa, a retirement researcher at the Japanese insurance company AEGON Sony Life.

The community moai is a stand-in for the kind of care and assistance family members provide in other Blue Zones. “People in Okinawa usually don’t have relatives in their village,” said Miralles. “And some don’t have children. The relationships with their neighbors are like family.”

As one Okinawa centenarian from Ogimi (nicknamed “the Village of Longevity”) told Miralles and his co-author Hector Garcia: “Getting together with my friends is my most important ikigai.” (You can watch the intriguing video, above, that Miralles and Garcia made of their interviews with Blue Zone Okinawans; be sure to turn on the subtitles.)

A low cost of living also helps keep the oldest Okinawans afloat financially.

“They don’t need to spend very much,” said Miralles. While an apartment in Tokyo might cost $3,000 a month, an Okinawan house runs closer to $300 a month, Miralles noted. Due to their vitality, the oldest Okinawans “don’t take as many medicines as in the U.S.” said Buettner. And they generally don’t buy on credit, either, avoiding interest charges.

Japan’s government-provided health care — including its 19-year-old long-term care program — helps avoid costly out-of-pocket medical expenses. “Japan has quite a good long-term health care system,” said Willcox. Everyone over 40 pays in and anyone can draw money out for home care or institutional care, when necessary, starting at 65. In America, by contrast, the Medicare health system for people 65 and older generally doesn’t cover long-term care.

The Blue Zone of Sardinia, Italy

Roughly 120 miles west of mainland Italy lies the isolated, rugged Blue Zone island of Sardinia, Italy. It’s actually the first place that was labeled a Blue Zone, which happened in 2000 when demographers drew a blue circle on a map around this low-income area peppered with male centenarians. Unlike the other Blue Zones, researchers found that in Sardinia, it’s mostly the men who live especially long, healthy lives. So it’s the men who’ve been the prime subjects of analysts of the Ikarian Blue Zone. No one yet knows exactly why older women there generally don’t share the same characteristics as the men.

Like the Blue Zones of Nicoya Peninsula, Costa Rica; Okinawa, Japan and Ikaria, Greece, the oldest (and often quite healthy) residents of Sardinia are often able to make their money last due to: government-provided universal health care and pensions; a low cost of living and income from produce they grow in their gardens.

Experts who have studied and talked with these Sardinians told me that they’re especially frugal, too. If they do own cars, the vehicles are about 20 years old. Few older Sardinians save or invest regularly, as we in America are frequently told to do. Their wealth typically accrues from owning farm property, animals and equipment.

“If you asked them, ‘Would you rather have another 10 sheep or X dollars in the bank, they’ll probably pick the sheep,” said Paul Hitchcott, a University of Pisa Research Fellow who has studied Sardinia’s centenarians. “That is wealth for them. It means safety and security.”

Belgian demographer Michel Poulain, who helped coined the term Blue Zones, told me: “I have never heard of anyone [there] who wanted to save and put money in the bank.”

The 2018 study of 160 of Sardinia’s oldest residents done by Hitchcott and fellow researchers found its men to be resilient and upbeat. “We noticed they seemed to be better cognitively and with lower levels of depression,” said Hitchcott. “People who are depressed are more likely to die sooner.”

As in the Blue Zones of Costa Rica and Greece, children of the centenarians and nonagenarians (usually daughters, as in Costa Rica and Greece) here frequently provide unpaid caregiving. Often, the oldest Sardinians live in their children’s homes.

There are no long-term care facilities in Sardinia. “It would bring shame to a family to put an aging parent in a nursing home in Sardinia,” Buettner told me.

Community support of the Sardinian Blue Zoners is very strong here, too. “People are literally on their doorstep who’ve got their back,” said Hitchcott. “There’s an incredibly rich network of close family members and friends who are very much out looking after each other.”

Spending time there, Hitchcott said, reminded him of the TV show Cheers. “Everybody knows your name — and your family and your ancestors and your children,” he joked.

Most of the male centenarians spent their working lives as shepherds and farmers. Some, Poulain said, stop working at around 50 because they can’t continue doing the difficult, physical labor. “Then they take on another job, like bus driver,” he noted.

Others continue working in fields and farms for decades, as elder advisers. Buettner told me that in Sardinia, 80-, 90- and 100-year olds “meet with farmers to help them deal with pests and bad weather.”

Said Hitchcott: “They don’t retire; they kind of get promoted.”

The Blue Zone of Ikaria, Greece

Dubbed “The Island Where People Forget to Die,” the Blue Zone of Ikaria, Greece (pronounced ih-kir-EE-a), is a small (pop. 8,300), rocky collection of villages, 30 miles off the coast of Turkey, in the North Aegean Sea.

People in Ikaria, I learned, reach age 90 at 2 ½ times the rate they do in America; the average life expectancy in Greece overall is 80. They eat a version of the Mediterranean diet and frequently climb up and down the island’s 20 steep hills, giving them exercise and strength. One study found that 60% of Ikarians over 90 are physically active.

In Ikaria, people tend to live eight to 10 years longer than elsewhere before succumbing to cancer or cardiovascular disease, if they ever get either. Researchers of the oldest Ikarians have found their blood pressure is low and they’re less likely to suffer from depression than others their age elsewhere. Only 20% of Ikarians over 80 have dementia (compared to 50% in Athens).

But, Ikaria researchers told me, this island — whose residents are often subsistence farmers — is much different from the rest of Greece in other, surprising ways, too.

“It’s a really weird place,” Platon Tinios, a Piraeus University economist who studied the oldest Ikarians, told me. Howie Litwin, head of the Israel Gerontological Data Center, who has spent time in Ikaria, said: “Ikaria is a mind-blowing experience for someone used to an urban, tense atmosphere.”

Here, stress is practically non-existent. Practically everyone takes a midday nap. And, Litwin said, “Time is a different entity on this island.” As an example, Tinios said, “One village has reversed day and night; shops open at 11 at night and people go to sleep at 8 in the morning.”

It’s also a left-wing island. The Greek government exiled 13,000 communists and radicals to Ikaria in the 1940s and 1950s, which is why some call the place “Red Rock.” Many of those exiles are among the oldest-old living there.

“The old people in Ikaria are from a very unique brand of people who struggled in the early parts of their lives,” said Litwin. “They’re used to fairly harsh conditions and, as a result, it affected their way of life and it positively affected their longevity.”

Their don’t-worry-be-happy attitude goes a long way in explaining why the nonagenarians and centenarians in Ikaria rarely worry about running out of money. That’s an attitude I found is typical in all five Blue Zones.

In Ikaria, “they don’t pay attention to money or artificial things,” said Dr. Christina Chrysohoou, an Athens cardiologist who has studied the health of the oldest Ikarians. “They live poor, but happily.”

The oldest in Ikaria are frugal, partly because of where they live. “They don’t have places to spend money,” said Chrysohoou. And, said Litwin, “They’re not governed by a drive for status symbols.”

They’re anything but prodigious savers, though. “Greece is not a saving culture,” said Tinios. “People don’t think old age is something they have to save for.”

Instead, the oldest Ikarians rely on modest government pensions, the Greek National Health Service for their medical bills, property they own and assistance from extended family members.

Unlike in Japan, there is no national long-term care system from the government. Due to Greece’s high unemployment and economic troubles, Tinios said, the government thinks it “has other things to worry about.” Here, though, local municipalities pitch in, partly through a home-care program — often underfunded, due to Greece’s financial woes — called Help at Home.

In Ikaria, caregiving provided for the oldest inhabitants by their children, nieces and nephews, is de rigueur, however. Often, Ikarians in their 80s, 90s and 100s live with their caregiving daughters, or with a child and grandchildren. In this way, “Ikaria resembles how Greece used to be 50 or 60 years ago,” said Chrysohoou.

Liz Mestheneos, a founding member of the Hellas 50 initiative to support Greeks over 50, describes the implicit understanding this way: “It’s a two-way process. They helped their children when they needed it, now their children help them. It’s a family savings bank.”

(This is the second part of the three-part Next Avenue series: Blue Zones: How the World’s Oldest People Make Their Money Last. It describes the Blue Zones of Okinawa, Japan; Sardinia, Italy and Ikaria, Greece. Part I focused on the Blue Zone of the Nicoya Peninsula in Costa Rica. Part III is about how the oldest people of America’s only Blue Zone, in Loma Linda, Calif., make their money last. This article was written with the support of a journalism fellowship from the Gerontological Society of America, Journalists Network on Generations and The Commonwealth Fund.)