Research Your Health DNA
Did your maternal grandmother have diabetes? Did your father have colon cancer? It pays to know your family history and how it can affect your own health and wellness. For instance, a screening colonoscopy is done at 50 years old, but if your father had colon cancer at 49, then you must have a screening at 39. Not just cancers, but knowing family history of things like heart disease and keeping a record of it will help your physician make the right decisions for your health. Researching your health DNA is a critical activity to understanding the health risks that might be passed down to you, and putting a strategy in place to avoid the pitfalls of generations past…
Regional Nurse
Dept. Of Developmental Svcs: Boston, MA
According to Menninger (2002), a study of the drinking habits of 3500 elderly people living in the community demonstrated that 16% of men drank one or more drinks daily and 15% of women drank one or more drinks daily. The findings of this study are alarming to say the least. In nursing home populations, 49% met the criteria for lifetime alcohol abuse or dependence and 18% met the criteria for current alcohol abuse or dependence (Menninger, 2002).
Why there isn’t concern about the severity of alcohol abuse in the aging population can be linked to the limitations of diagnostic testing. The Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM IV) definition of the substance abuse includes a criterion for tolerance that isn’t appropriate for the elderly population. (The DSM-V since being implemented in 2013 has modified some of the criteria with updated language.) Elders do not spend a large amount of time in activities related to substance abuse because they are more sensitive to the effects of alcohol; therefore, they require low amounts. This is due to physiological changes experienced as older adults’ age. Also, the physiological effects of dependence and withdrawal may not be seen in elders who develop alcohol dependence late in life. Policymakers and researchers must be mindful of the fact that elders are not immune to the effects of alcohol. The current practice used to identify the problem and issue of substance abuse must include an effective method that will enable clinicians to accurately assess the signs and symptoms of substance abuse in the elderly.
The alcohol problems of older adults are frequently misidentified. A study showed that alcoholism in elderly patients was accurately diagnosed at a rate of 37% compared to 60% of the younger alcoholic patients (Menninger, 2002). This stems from the current barriers that exist to identify the problem. The stereotypes of the “typical” alcoholic still exist; therefore, a physician may not assume that a middle class elder would have issues regarding substance abuse. Furthermore, physicians may be more tolerant of drinking due to the stressors of aging. Physicians and family members lack of knowledge about treatment resources and attitude towards the diagnosis is also a problem. In addition, fewer social warning signs are seen in older adults with alcoholism. Lastly, problems related to alcohol abuse can be masked by mental illness and medication use.
The cost of treating chronic disease associated with long term alcohol abuse far out way the cost of implementing effective treatment. Currently, there is lack of general evidence-based treatment approaches for the treatment of substance abuse in the elderly. Much of what is currently recommended is used to treat younger populations.
Policymakers, clinicians, and researchers must work together to establish new protocols that address the issue of substance abuse in the aging population. Screenings for alcoholism must be done at regular physicals and at times of life transitions. A standardized diagnostic screening tool should be used nationwide for data collection for continued research. Also, a recommended course of treatment might include participation in AA meetings that have an age-matched cohort to provide mutual support, allow for peer bonding, and promote peer sobriety networks (Bogunovic, 2012).
References
Bogunovic, O. (2012) Substance Abuse in Aging and Elderly Adults. Aging and Geriatric Psychiatry, (8) 39-40.
Menninger, J. (2002) Assessment and treatment of alcoholism and substance-related disorders in the elderly. Bulletin of the Menninger Clinic 66 (2), 166-183.
Respect and Build Credit
Credit can are powerful financial tools. They can help you establish a credit history. They give you payment flexibility and protect you from needing to carry cash. They also come with rewards programs, allowing you to earn points, miles or cash-back for your regular, everyday purchases. However, for some people, credit cards can be negatively powerful as they allow those who don’t follow a budget to spend above their means and rack up massive amounts of debt. While “planned debt” (such as borrowing to remodel your home or making a large purchase such as a car) is something most of us plan for and build into our monthly budgets, “unnecessary debt” and the interest payments that go with it should be avoided at all cost.
Realtor® and Investor
Aesthetic Properties, LLC
Yes, the usual belief is correct that the better qualifications you have, the lower your interest rate will be. However, mortgages are available for almost everyone; it’s the interest rates or the down payments that vary. Even if you borrow all or a portion, lenders involved in financing any dollar amount toward a home purchase will most likely require mortgage pre-approval.
Before speaking with a lender, know what the monthly dollar amount you feel comfortable with paying is. Also estimate property taxes, insurance, utilities, maintenance, and other payments that would be tied to your home purchase. Knowing this will make it easier for you to discuss with a lender a monthly payment amount and the total value of home that you can afford. There are a number of factors in terms of finding the best mortgage.
Answering these questions can allow you to eliminate loan programs that do not fit your financial home buying goals:
What type of market are you in? Is the cost of living more expensive due to the market? What is your credit history and score? Are interest rates fluctuating? What are the lenders loan origination fees? Does the lender accept down payment and closing cost assistance from outside sources? Do you want a fixed or variable mortgage rate, where monthly payments are either consistent or varied? Does the lender offer interest rate discounts?
Most lenders can pre-qualify you for a mortgage over the phone or via online. Based on general questions about your income, debt, assets, and credit history, lenders can estimate how much mortgage you qualify for. However, being pre-qualified and pre-approved are two different things. Pre-approval means that you have applied for a mortgage; you have filled out the mortgage application, received your credit report, and verified your employment, assets, etc. In order to verify, lenders will require you to submit pay stubs, W-2s, federal tax returns, bank statements of all types, and your credit report. When you are pre-approved, you know exactly what the maximum loan amount will be, preliminary loan terms, and have options such as negotiating interest rates with the lender.
A mortgage pre-approval also helps in submitting contract offers on a home. Mortgage pre-approval does count for much if you are competing with other buyers who are not pre-approved. When you are pre-approved, you and the seller know exactly how much house you can afford. It gives you credibility as an interested buyer and lets the seller know immediately that you will qualify for a loan to buy their property. Lender pre-approval also indicates to real estate agents that you’ve had a documented and verified conversation with a lender about finance arrangements for a home purchase. Already having this conversation makes a realtor’s job smooth sailing when completing and negotiating offers on your behalf. Moreover, obtaining lender pre-approval can speed up the buying process by having the right parties in place once your offer to purchase is accepted by sellers. This really helps where they are provisions in your offer that require you act within a certain number days such as obtaining lender approval of the property. Lender property approval is obtained through a property appraisal. Most lender’s use third-party property appraisers who usually have long waiting lists. Thus, causing a delay and risking your offer to purchase to fall through. In addition, it’s important to be pre-approved by a legitimate lender. Legitimate lenders include: banks, mortgage bankers, credit unions, savings and loan associations, mortgage brokers, and online lenders. Some lenders to avoid: those that do not have the required resources in place such as timely property appraisals and quick turn-around loan underwriting, those that do not have open disclosure and communication throughout the pre-approval and closing process, those who lose forms or misplace documents, those who gather information from you in an unorganized manner, those who are not informed about interest rates, points or costs, and those who cannot provide you with the accurate and timely information.
If you are not able to obtain a pre-approval, work closely with a professional credit repairer to address your credit report. This step is vital as it allows you to work with a professional to identify items that caused you not to obtain pre-approval. This process could take months as you work to distinguish credit worthy of pre-approval. However, do not be discouraged. In the meanwhile, continue to work on your credit and look at your savings and down payment for your future home purchase. Work on your savings by determining a reasonable downpayment that you can save for your new home once credit is repaired. Avoid spending sprees using credit if you are going through credit repair. Right now is the time to eliminate debt and work on building a good credit history. Determining how much money you will have available for down payment and closing costs affects almost every aspect of buying a home. Once credit repair is completed, your mortgage still requires lender pre-approval and is subject to a final evaluation of your financial situation.
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