Last fall, while sitting in my family room on a calm Saturday afternoon, I was suddenly hit with a crushing pain in the center of my chest. I was sure that I had twisted some sort of chest muscle, so I sat up straight, hoping that changing position would relieve the pain, but no. Then I leaned forward, still no change. I stood up and walked a few steps, but again, no change. By now, just a few minutes later, the pain had taken my breath away, I was nauseated, and my husband was freaking out. Frankly, so was I.
A few minutes later, after my insistence that he shouldn't, my husband called 911. The paramedics were there within a few minutes. They took an EKG and a blood sample. Turns out, I wasn't having a heart attack, and while I was relieved, the paramedics advised that I should go to the emergency room to find out what was causing the pain.
Pay Attention to Sudden Onset Symptoms
Calling 911 and following up at the emergency room was a good move according to Dr. Nieca Goldberg, medical director of Atria New York City and clinical associate professor of medicine at NYU Grossman School of Medicine. Goldberg says that it's important not to waste time when sudden onset chest pain occurs.
"It's important to get to an ER and you don't want to waste time because you could be diagnosed with a heart attack or other emergency." 
"The most important point is the sudden onset. It's important to get to an ER and you don't want to waste time because you could be diagnosed with a heart attack or other emergency. You can't make the diagnosis about what is causing the symptoms unless you go to an ER where they can do confirmatory testing," says Goldberg.
My symptoms were disturbingly similar to a heart attack, yet, I didn't have a history of heart disease in my family and during my annual checkups, my cholesterol numbers were always excellent.
However, 15 years ago, my older brother died very suddenly, and because there was no autopsy, it was assumed he died of sudden cardiac arrest, but never confirmed. When my pain continued for more than a few minutes, I thought about my brother. If you have a first degree relative who has had a heart attack, you are at higher risk.
So, the question: Is there a way to know if symptoms, such as chest pain and pressure, shortness of breath and nausea are life threatening? The short answer is no — not without further evaluation.
"There is no way of definitively knowing if someone is [or is not] having a heart attack without test results conducted in the ER," Goldberg says.
While the chest pain, shortness of breath and nausea are typical symptoms, Goldberg explains that sometimes women can experience heart attack symptoms differently."Oftentimes, women don't feel the chest discomfort. They can feel it lower and confuse it with stomach issues and some women will have back pain," says Goldberg.
Other Causes of Chest Pain 
Dr. Jim Liu, practicing cardiologist at Ohio State University Wexner Medical Center and assistant professor at the Ohio State University College of Medicine, says that having chest pain doesn't always mean you're having a heart attack and, more commonly, it's related to something other than the heart.
"Usually, I tell my patients when they come in with chest pain that there's a lot in the chest outside of the heart that can cause pain — the lungs, chest muscles, lining of the heart, the esophagus," says Liu.
According to Liu, common examples of heart attack-like conditions include myocarditis, an inflammation of the heart muscle, which can occur from the cold or flu virus. Pericarditis is another inflammation of the lining of the heart which is a very common cause of chest pain. Pneumonia can cause chest pain. Musculoskeletal issues, such as a muscle strain in your chest from working out or a recent trauma, can cause pain, as well as bruised or broken ribs.
"Panic attacks can really mimic a heart attack, and it would be hard to tell based on symptoms alone. If a patient has a history of anxiety or panic attacks, then it could indicate a panic attack. Generally, there isn't nausea with those types of pain, but there may be some shortness of breath," Liu says.
Other issues can cause chest pain; gallstones, pancreatitis, acid reflux, gastritis, collapsed lung, or a rupture of the esophagus are a few that mimic heart attacks and are just as dangerous. Liu says that chest pain happens for a lot of different reasons — including heart attacks — and he explains that personal medical history can play a role in determining what course of action you should take.
"Family history factors, as [does] if the patient smokes or has smoked, high blood pressure, or heart disease in family. If you have a lot of risk factors — think more seriously if you're having chest pains. If it's a heart attack, the pain is not going away on its own. If it's getting worse, the safest thing to do is to seek medical attention," Liu says.
A Visit to the ER
A number of tests are conducted in the ER to determine if a patient is having a heart attack. Initial tests include an EKG and blood work. A blood sample will show if the patient's troponin — an enzyme that only appears in the heart muscle — has risen. When someone is having a heart attack, troponin levels rise.
My troponin level and EKG results were normal. Further tests, including an imaging test, determined that I had gallstones.
Further tests, including an imaging test, determined that I had gallstones. 
Emergency medicine physician Kevin King operates a clinical practice at University Hospital and is an associate professor in emergency medicine at University of Texas Health Science Center San Antonio, Long School of Medicine. I asked him how important it is for patients to visit the ER if they're experiencing symptoms similar to a heart attack.
"Chest pain can represent a lot of things, a heart attack being one. Another thing that we [see is] unstable angina, which is a pre-heart attack syndrome. The heart muscle is hurting because there isn't enough blood flow because one of the vessels is narrowed. If that goes undiagnosed for too long, you'll have a heart attack," King says.
He adds that there are approximately 20 conditions that cause chest pain that are emergencies. He also reiterates that if you have a heart, you can have a heart attack.
"If you're experiencing symptoms that are different and concerning, you should always have that checked out because it's potentially an emergency," King says.
"The bottom line is that we all know what our bodies feel like, and if your body is telling you something is weird, or if you think you're having an emergency, you need to call 911."
I'm glad my husband did just that.


Chest Pain Sent Me to the ER, But It Wasn't a Heart Attack

Sally Benford

Tere Dillard, of Decatur, Ill., has gotten used to taking her 89-year-old father Jim Lee to what she considers pointless tests ordered by his primary care doctor. One was a CT scan for mild dizziness. As caregiver for her dad and his wife Lenora, who's 88, it's not the only time Dillard has experienced what she calls "over-the-top tests."
Tere Dillard and her parents, Lenore and Jim Lee"When I was in the initial appointment with him, I was surprised the doctor didn't look in his ears or listen to his heart," she says. "He basically asked him a couple of questions and then ordered a CT. And I feel like I have to take him when the doctor orders these tests even though I'm sure they're unnecessary because my dad's scared to death."
The same doctor ordered a CT scan for her mother when she complained of a sore throat — although he saw nothing wrong when he looked at her throat.
Ways Ageism Shows Up in Health Care
Dillard is tired of doctors overtreating her parents for what she believes are minor health issues. "I just feel sometimes doctors order tests because the patient is old, they're impressionable and the doctors know that Medicare will pay for it," she says. 
"We know we live in an age of unconscious bias, and people who work in health care aren't immune to that."
Dillard's experience is just one form of rampant ageism in health care, something the Changing the Narrative initiative is trying to remedy through its Age Friendly Health Care Campaign. (Changing the Narrative is a partnership of NextFifty Initiative — a funder of Next Avenue — and Rose Community Foundation.)
"We know we live in an age of unconscious bias, and people who work in health care aren't immune to that," says Janine Vanderburg, founder and director for Changing the Narrative, which is focused on ending all manner of ageism.
Her new campaign aims to bring ageism in health care to the attention of those who need it most: older patients who experience it and the health care providers who interact with them.
Vandenburg has felt this ageism in health care personally.
During a recent pre-op appointment for cataract surgery, Vanderburg, 68, ignored the receptionist's elderspeak, calling her "dear." But she says she couldn't ignore the wording on the doctor's office form asking why she wanted better eyesight.
Janine Vanderburg heads Changing the Narrative's ageism in health care initiative"The form options ranged from 'I want play to golf, to view scenery/take photographs, play cards, sew, do crossword puzzles, see car dashboard and watch movies,' but nowhere did it have an option for working," she recalls. "So, I crossed out 'view scenery/take photographs' and wrote in 'Working/Facilitating Training Sessions, Workshops."
When she pointed out the omission of working as an option, her doctor said, "Oh, we didn't think about that."
Age Discrimination in Health Care
A study in the Journal of Internal Medicine, Vanderburg notes, found that nearly a third of older adults said they frequently experience age discrimination from doctors or hospitals.
Over- and undertreating older patients, disrespecting or demeaning them, minimizing their symptoms, elderspeak and communicating with a family member instead of the patient are among the ways ageism is showing up in doctors' offices, urgent care centers and hospitals across the country. 
Changing the Narrative and other researchers say ageism has serious impacts on older adults' health and on America's health care system.
Better communication with older patients is one way health care providers can begin to reduce ageist tendencies.
A 2018 study by Yale University Professor Becca R. Levy (a Next Avenue Influencer in Aging) and colleagues found that ageism in health care costs the U.S. $63 billion annually.
The number might be even higher today.
"During the pandemic, there were certainly issues that exacerbated ageism in health care, particularly in the long-term care setting — with the high number of deaths in the first months of the pandemic that were due, in part, to the inadequate protective equipment and inadequate protections given to the workers and the residents," Levy says.
Better communication with older patients is one way health care providers can begin to reduce ageist tendencies.
Alexis Kurland, 66, of El Cerrito, Calif., says she's often called "dear" by the nurse in her doctor's office. "I haven't worked up the nerve to ask her to stop using that term with me, so that's my fault. Yet, every time she says it, I cringe," Kurland says.
Levy says older adults often don't recognize ageism as a real threat to the care they're receiving.  
Not Even Seeing the Ageism
"Part of the reason it's so insidious is that people don't even realize that they're experiencing it and they tend to blame it on themselves instead of discrimination or the larger systemic problem of not getting the best possible health care for older people," she notes.
Alexis Kurland thinks she has heard elderspeak from her doctorsPutting a positive spin on aging, however, can reap rewards. An earlier study by Levy and her peers found that people with a positive self-perception of aging lived, on average, 7.6 years longer than those with a negative view. 
Both Levy and Vanderburg are hopeful for changes in health care ageism at the institutional and government levels.
Doing so, according to a recent Changing the Narrative webinar with experts Kris Geerken and Gilliane Lee, means — among other things — training those working in health care on implicit bias, including older people in clinical trials and exposing health care students to older adults during their professional training,
Levy concedes that these types of changes will probably be slow, however.
"Thinking of it in a big structural way is key," she says. "It's great for patients to advocate for themselves, but the hope is that hospital and office settings will give older people agency and voice."
Vanderburg believes older adults need to address health care ageism when it happens.
"We need to advocate for ourselves, and that's what we're training people to do," she says. "Fill out that patient survey, let the provider know they didn't listen or that there's a problem."
Let doctors and other medical staffers know how you'd like to be treated, Vanderburg adds. "After all, we are the leaders we're looking for," she says.


How to Make Health Care Less Ageist

The human body needs a certain amount of salt — or rather, the sodium in salt — to maintain bodily functions such as adequate fluid levels, muscle function and proper pH in our blood. Yet for some, consuming salt can cause high blood pressure, especially as we age, putting us at risk for hypertension and heart disease.
We know that reducing sodium intake is good for overall health and now a new study in the New England Journal of Medicine proves that. 
The study found that by reducing salt (sodium) in the diet and replacing it with salt substitutes containing reduced sodium and increased potassium can lower blood pressure. The rates of stroke and major cardiovascular events in participants were also lower with the salt substitute than with regular salt. The study took place over a five-year period in China — a place known for high salt use —  and focused on people 60 and older with high blood pressure.
Americans Love Sodium
"High blood pressure is a well-known cause of developing heart disease and strokes, says Dr. Nachiket Patel, clinical professor of medicine at University of Arizona Medical School in Phoenix and an interventional cardiologist. "Consuming a lot of salt causes water retention and that causes high blood pressure and it can also decrease the beneficial effects of drugs that lower blood pressure."
The average American consumes 3,400 milligrams of sodium per day, well above the 2,300 milligrams — equal to about a teaspoon — recommended by the American Heart Association.
"As we get older, we are more affected by salt in our diets," Patel says. "Salt, by increasing the blood pressure, can lead to uncontrolled high blood pressure, which causes all kinds of negative effects on the heart."
You Are What You Eat
The major culprit of too much sodium in the American diet? Health and nutrition experts place the blame on processed foods.
Dr. Stuart Ruch, a cardiologist with Berkshire Medical Center in Massachusetts, recommends his patients shop on the perimeter of the grocery store and stay away from the interior aisles.
"I've cut out salt, but I've done other things as well, and my doctor says it's working. It's less about elimination and more about moderation."
"You can cut back on sodium, and you need to get potassium from fresh fruit and vegetables. What I tell patients is, 'If it's in a can or a box, you've got to stop that.' ... We've got to find a way to cut down on all the junk we're putting into our bodies," says Ruch. 
He says the reason salt causes problems for some people is that water inevitably follows sodium, and as the volume of this fluid increases, so does the volume of blood. This means the heart must work harder putting more pressure on blood vessels. Over time, this pressure stiffens the blood vessels, which can lead to high blood pressure, heart attack or stroke.
"There's a lot of variability because some people are really sensitive to salt and some people not so much and we don't really know why. Hypertension tends to be diagnosed more in older people. As we age our vessels get stiffer," Ruch says.
More About Salt Moderation
Allen Raines knew he had to make changes when he had an episode of high blood pressure last year. The 54-year-old from Cincinnati has always been naturally thin, so when he had that health scare, his doctor made several recommendations and one was to reduce his salt intake.
"I've cut out salt, but I've done other things as well, and my doctor says it's working. It's less about elimination and more about moderation," Raines says.
He's the cook in the family and stopped using salt that recipes called for. Instead, he lets his family add salt at the table if they choose. Raines tried salt substitutes initially, but his family didn't care for the taste, so he doesn't cook with them.
"I researched salt substitutes and I don't trust the high potassium levels. It felt a little risky and didn't seem like the route I wanted to go," says Raines. "I'm eating more fruit and vegetables now, getting potassium and sodium naturally. I used to like a sandwich for lunch, heavy with mayonnaise. Now I just use a thin layer."
Patel says: "I think salt substitutes are beneficial with the caveat that you have to work with your doctor. Having high levels of potassium in the body can have very bad effects on the heart. Most people can handle the extra potassium they're ingesting in the salt substitute, provided their kidney function is normal; the patients who have abnormal kidney function have to be very careful of those salt substitutes that are using potassium chloride." 
Fresh vs. Frozen vs. Canned
So how do you know what to look for and where to find high- and low-sodium foods? 
Lauri Wright, director of University of North Florida's Center for Nutrition and Food Security, says going fresh is always best, frozen is better than canned and reading nutrition labels and comparing sodium amounts against similar products is most important when buying processed foods. 
She also advises avoiding snack foods that are loaded with salt and notes that condiments often contain hidden sodium.
"Ketchup can be high in sodium — a tablespoon can have a hundred and fifty milligrams. Watch out for soy sauce and some salsas, salad dressings and dips," says Wright. "Anything pickled is very high is sodium."
"Dishes like chicken parmesan with the marinara, cheese and breading on the chicken can contain almost three thousand milligrams of sodium."
For adding extra flavor naturally, Wright suggests using fresh or dried herbs and spices.
"Play with vinegars and plain mustards to add flavor without heavy sauces. Citrus juices are a nice way to add flavor. Look for herbs and herb blends that state no sodium added," Wright says.
Mildred Pascucci has restricted salt on the advice of her doctor after having pacemaker surgery a few years ago. The 86-year-old cooks with what she calls the "big seven"— garlic, onion, red pepper, basil, oregano, thyme and olive oil.
Pascucci and her husband, who live in Hampstead, N.C., follow the Mediterranean diet, eating a lot of fresh vegetables, pasta and healthy proteins. If she buys canned products, she looks for low-sodium versions.
"I used a lot of salt before because that's how I grew up," says Pascucci. "Salt substitutes didn't work for me, so the best way for me was to just cut it [salt] flat out."
What about dining out? Wright says: skip the cream and cheese sauces and gravies, which are usually loaded with salt, and go for roasted or grilled meat without marinades.
"One important thing you can do is check the restaurant's nutrition information. Dishes like chicken parmesan with the marinara, cheese and breading on the chicken can contain almost three thousand milligrams of sodium," Wright says. "The majority of us need to cut back. Even if it's cutting a half a teaspoon of salt from your daily diet, you're going to see a benefit."


Are Salt Substitutes Really Good for Your Health?

(This post originally appeared on Midcentury Modern.)
In the new movie Hello, My Name is Doris,  Sally Field plays a woman in her sixties who falls in love with the new hunk in her office. The hunk, named John, happens to be half her age, and is played by Max Greenfield (Schmidt on TV's New Girl), whose winning smile reminds me of Ken Olin’s portrayal of Michael on Thirtysomething back in the '90s.
Greenfield’s smile is the best thing about this movie, but it’s not enough to save it. The problem is Field’s character  —  an amalgam of every stereotype of the sad spinsterhood rolled up into one vivid grotesquerie.
She lives in Staten Island, she has a cat, she wears her hair up in a big floppy bow, she’s a hoarder, she’s such a Facebook virgin that when she gets a notification chime, she recoils as if a gun went off, she needs two pairs of glasses to look at a computer screen, and her body language says “I wish I could shrink up into a little ball of fuzz and blend into the rug.”
She’s the one who’s going to snag the hottie.
A Certain Age
I saw the film last spring at the Montclair (N.J.) Film Festival. In the Q&A afterwards, between the film festival’s executive director Tom Hall and director/comedian Michael Showalter, there was a fair amount of congratulation and self-congratulation for Showalter making a film with a leading character who’s “a woman of a certain age.”
That phrase was actually repeated onstage several times, and then by someone in the audience asking a question, and the general consensus seemed to be that anybody who throws a bone to an actress over the age of 40 deserves a Nobel Prize.
The problem, though, is that Sally Field’s character is so cringeworthy (and yes I do get it, she grows over the course of the film) and the comedy so broad that the ratio of laughs to winces was, generously speaking, about 1 to 10.
How broad? Consider one of the movie’s peak scenes, in which Doris learns that John’s favorite band is playing in Williamsburg and decides to go so she’ll run into him. Her concert ensemble  —  presented as a huge laugh  —  is a ridiculous mismatched neon jumpsuit, her hair bow temporarily replaced with an oversized visor. Really, just imagine an outfit Richard Simmons discarded in 1979.
No Laughing Matter
And this outfit, Showalter insisted, was proof of how much he loves and respects this character: “She says a lot with what she wears.”
Looked at another way, Doris has made the cataclysmic character leap from milquetoast to eccentric. Hooray!
Yes, it’s a role for a “woman of a certain age.” Yes, there are wrinkles. Congratulations. But when there are so few portrayals of women in their 60s in Hollywood, we choose to make one that depicts an older woman as not just pathetic, but laughably pathetic? Now that’s sad.
We Can Do Better
A friend I spoke with after the screening made an interesting analogy. It would be like  —  she said  —  a director 50 years ago making a movie about an Uncle Tom figure. Sure, the director could argue, “It’s based on a real character. There reallywas a person exactly like this.” And maybe there was. But does he get credit for making movie about the black experience? Or would a lot of people be, justifiably, offended?
When I got home, it struck me: Amos and Andy. We’ve gotten beyond the limp wrist as a hilarious signifier for a gay person, and the shuffle-and-jive as a hilarious signifier for a black person. Director Michael Showalter said that Sally Field’s character was a real archetype. He’s wrong. It was a stereotype. Like so many others, it’s time to let it go.
https://www.youtube.com/watch?time_continue=2&v=L6vBnnryIug


The Trouble With the New Sally Field Movie

Debbie Galant

Divorce is always sad, but when it turns ugly, it’s terrible. You may remember The War of the Roses, the dark comedy where Kathleen Turner and Michael Douglas start out as a perfect couple and end up destroying their possessions — including their luxurious house and cars — because they can’t agree on who gets what. That movie is unfortunately hitting home for plenty of boomers and Gen X’ers. According to a recent survey by Allianz Life Insurance, two thirds of divorced women feel their divorce created a financial crisis.
Many of my friends have gone to divorce war, but unlike Turner and Douglas, they destroyed their finances (by paying steep legal fees), not their possessions. Divorce doesn’t have to be as financially painful as it so often is, though.
Why Divorce Turns Into War
What drives divorce wars? My hunch is that many are driven by very different assessments by spouses of the impact of their proposed settlements. For example, a husband may think his settlement proposal is incredibly generous while his wife thinks it’s miserably cheap. Without a neutral measurement stick, their fight — with the lawyers' meters running — can go on and on.
As an economist, I’d say that this is where economics can help couples. Its math and computer algorithms can figure out precisely how much each spouse will get to spend now and in the future under any given divorce settlement. And this analysis can take into account all relevant factors, including the division of assets, alimony and child support, child custody and the disposition of the marital home.
How do I know? My company recently released a software tool designed to limit divorce wars (full disclosure: I derive no income from my company). It calculates each spouse’s living standard under any proposed divorce settlement.
John and Sally's Equitable Divorce
Let me illustrate this new technology:
Take John and Sally Doe, both 50, who are untying the knot after 25 years. John earns $200,000; Sally earns $40,000. John and his employer both contribute $6,000 a year to his 401(k). Sally and her employer both contribute $3,000 to hers. John and Sally plan to retire at 65. The couple has one child, Sam, 10. Sam will spend 80 percent of his time with Sally and 20 percent with John. John will cover Sam’s college expenses. The couple own a $450,000 house with a $90,000 mortgage. John proposes that Sally live in their house for eight years, while he picks up three-quarters of the housing cost. Meanwhile, John will buy a condo for $200,000. Sally will buy the same-priced condo when they sell their house, sharing the proceeds 50/50. John also proposes dividing the couple’s $200,000 in regular assets and $1 million in retirement assets in proportion to their labor earnings.
John wants to be fair. He figures that paying for most of Sally’s and Sam’s housing for the next eight years, covering Sam’s college expenses and housing and feeding Sam one-fifth of the time is highly generous. He also believes his and Sally’s living standards will be pretty similar once his much higher tax payments are factored in. So John proposes no alimony or child support.
Is John right? Will he and Sally be able to spend roughly the same amount over the rest of their days?
No, he's wrong. But by playing around with the numbers and the software they can arrive at an agreement that works for both of them.
John’s proposed settlement lets him spend $83,215 annually and Sally spend $23,353 annually (measured in today's dollars) after covering all housing costs and taxes. There are lots of reasons for this big differential, including John’s higher salary, his large asset share and his receipt of higher Social Security benefits.
When Sally points out the large spending (living standard) difference, John offers to split all assets 50/50. Now John’s and Sally’s annual spending amounts become $73,891 and $35,757, respectively.
Sally, who sacrificed her career to put John through law school and raise Sam, digs in her heels. “John, you need to pay alimony and child support,” she says. John agrees to $25,000-a-year in child support until Sam goes to college. Sally runs the computer program again and finds that John’s annual spending would now be $68,783 and hers would be $41,158.
Sally says, “John, sorry, but you wouldn’t be making five times my salary if it weren’t for me. There is no reason I should have a lower living standard going forward. If you pay me $20,555 each year in alimony and agree to the other things you offered, we’ll both get to spend the same amount each year: $54,836.”
John thinks this over and then counters with a $10,000 annual alimony payment, pointing out that his job is far more demanding than Sally’s. Sally, upon reflection, decides this is reasonable and the two hire a single attorney for one hour to draw up the agreement. Sally and John used economics to save their divorce.
How to Divorce Fairly
Couples don’t have to use our software to come up with equitable divorce agreements. You can also get a rough handle on your relative spending levels by comparing each spouse’s disposable lifetime resources.
To arrive at this number, you'd start by calculating your lifetime resources (the present value (how much a future sum of money is worth today) of your future labor, Social Security and other income including alimony and child support plus your current net worth. Next, you'd subtract the present value of your projected taxes, housing costs, expenditures on children and other expenses including alimony and child support payments. The difference is your spendable resources.
Do this for your spouse, too, and then divide by each spouse's maximum remaining lifespan. This is a rough calculation primarily because you'll need to guesstimate your taxes and may misestimate your Social Security benefits, since they may be different in the future than what you expect today.
Next Avenue Editors Also Recommend:
5 Retirement Moves for Recently Divorced CouplesWhy Couples Divorce After Decades of MarriageIs It Time for a National Divorce Law?

How to Keep a Divorce From Wrecking Your Finances

Laurence J. Kotlikoff

Legendary Washington Post Editor Ben Bradlee rose to prominence for exposing the Watergate scandal, for publishing the Pentagon Papers and for guiding the paper to 23 Pulitzer Prizes during his tenure. He died Tuesday at age 93 in his Washington, D.C. home. He had Alzheimer’s disease.
 
In September, Bradlee’s wife, Sally Quinn, spoke to C-SPAN’s Brian Lamb about her husband’s health and her own transitions as a caregiver. She moved from thinking his dementia wouldn’t be so hard, to witnessing its ravages, to facing it realistically and ultimately finding peace with the disease and her role.
(MORE: 11 Inspiring Quotes for Caregivers)
 
“A certain peace has come over me,” she said. “Caretaking has become almost sacred… I don’t think we have ever been as loving with each other as we are now.”


Sally Quinn on Ben Bradlee’s Final Days

Sue Campbell

Every day 10,000 boomers retire. Most of them immediately file for their Social Security retirement benefits. In so doing, they are generally losing tens to hundreds of thousands of dollars in lifetime income.
Taking benefits right away can cost you big time in two ways.
First, you receive much smaller Social Security retirement benefits for the rest of your life. Taking your retirement benefit at 70 — which only 2 percent of us do —means a 76 percent higher check each month (after adjusting for inflation) than taking it at the earliest age possible, 62 — which over 40 percent of us do.
Second, if you take your Social Security retirement benefit before 70, you can lose the opportunity to take another benefit before 70 while letting your retirement benefit grow.
The Sad Story of Joe and Sally
Let me give you an example of what I mean, with Joe and Sally, who just turned 62 and retired. To make things simple, let's assume they earned the same amount annually and that their full Social Security retirement benefit is $3,000 per month.
Joe and Sally head down to their local Social Security office and meet Joan, who encourages them to take their retirement benefit right away because they could otherwise die and end up getting nothing for all their years of contributions.
Joan's words are just what they were thinking. So they file for their retirement benefits and start collecting $1,875 a month from Social Security. This is only 75 percent of the $3,000 benefit they’d get by waiting until Full Retirement Age (66), and less than half the $3,960 they'd receive were they to wait until 70.
Joe and Sally know all those numbers and they are in excellent health. But like Joan said, "Why risk dying and getting nothing? A bird in the hand beats two in the bush."
Now fast forward a day. Joe and Sally are out kayaking on a category 5 river. They've never kayaked in their life and 5 sounds like a low number. It's not. It's the most dangerous river rating. Joe hits the first set of falls and ... well, he's gone. Sally is devastated, but hears at Joe's funeral that she can collect Joe's Social Security retirement benefit as a widow’s benefit and heads straight over to see Joan.
Joan says, "Sorry to hear about Joe. Nuts to try a cat 5 river. But we all make mistakes. Now about widow’s benefits. Here's the deal. Since you took your retirement benefit early, Sally, we're not going to give you two benefits at once. That would be double dipping. But we will give you an excess widow’s benefit, in addition to your retirement benefit. You'll get it every month and it will be adjusted for inflation. Let me calculate what it will be.”
The Vanishing Excess Widow's Social Security Benefit
Joan disappears for a half hour, does the calculation, returns and says: “Well, your monthly excess widow’s benefit will be zero. I just double-checked and it's calculated as the difference between your widow’s benefit and your retirement benefit. Your widow’s benefit is always going to be lower than your retirement benefit because Joe took his retirement benefit early. Had you waited to take your retirement benefit, you'd be able to collect $3,000 per month through age 70 and then collect $3,980 per month thereafter. But you didn't. So sorry. Have a good day."
Sally is thunderstruck. She's not only lost Joe, who she loved deeply, she's also lost a ton of money.
But Sally consoles herself by telling her friend Jane that she's definitely not going to make it past 70 because her sister died at 58. So at least she'll get her own retirement benefits before she joins Joe.
The years roll by. Sally hits 70. And then she makes it to 80, which she really can't believe. And then 90. She tells her doctor: “Every day I wake up and kick myself for taking retirement benefits early."
Her doctor says: "You are as healthy as a horse. My bet is you'll be one of the 3 million centenarians the U.S. Census Department predicted could be around by now. Have a good day."
Why People Claim Social Security Early
What explains Joe and Sally’s behavior?
I think people are strongly superstitious when it comes to longevity. My hunch is that they ignore the possibility and the associated major financial risk that they could live long lives because they fear that thinking about this will jinx them.


Why Most Retirees Lose Thousands in Social Security Benefits

I’m a career coach working with two clients who are 65 and, figuratively speaking, living in a Career Disaster Area.
A massive earthquake called Creative Destruction has hit the career world where they lived for many years. Although creative destruction isn’t new, technological change has caused not just job categories, but entire industries, to disappear or change dramatically. (If you’d like to learn more about Creative Destruction, read my Career Pivot post, "Surviving Creative Destruction in the 2nd Half of Life.")
Can my two clients living in a Career Disaster Area recover? Sure.
Will they ever go back to the good old days? Probably not.
I’ll tell you their stories; you may see yourself in them. (My clients’ names and identities have been altered to protect their privacy.)
Name: Sally
Career Disaster Area: Marketing
Sally, 65, has been the consummate marketing professional. She’s worked in a variety of industries over the span of her career, sometimes freelance and sometimes for some major agencies.
Like many of her peers, Sally took a hit in the Great Recession. Then, her spouse passed away suddenly. So she decided to move across the country to be closer to her children. These days, Sally is trying to reestablish herself in a new city, where the culture and job market are very young and vibrant.
Sally is taking courses in social media and digital marketing, but the skills required to be a productive marketing professional have made tectonic shifts in the direction of technology and analytics.
(I can relate. I spent much of the 1990s working in IBM marketing or in an executive briefing center, which was a marketing and sales support function. I produced presentations, marketing collateral and web content that supported the sale of IBM hardware and software. That world no longer exists. When I made the decision to leave the world of technology marketing 15+ years ago, I left a place that looks NOTHING like it does today.)
Creative destruction has wreaked havoc in the traditional marketing world and most of this transformation has occurred in the last five years. For Sally to shift into this new technological marketing world, she needs to buy some time.
So Sally has shifted her job search away from the traditional corporate world to the world of nonprofits. Most nonprofits can’t afford modern digital marketing, but given enough time, they will.
Sally is currently in the running for a marketing manager position at a nonprofit that focuses on youth. To demonstrate her technology savvy, we discussed how she could suggest removing geo-targeting information from photographs of children before they’re posted on social media platforms like Instagram, Snapchat or Facebook.
I believe that by shifting to the nonprofit world and continuing to upgrade her skills, Sally will be able to find a job and support a cause she truly believes in.
Name: Larry
Career Disaster Area: Engineering
Throughout his career, Larry, a 65-year-old engineer, has worked for some of the top companies that designed and manufactured computers. He was a program and project manager for a huge, multinational and handled multicompany development projects with huge scope and complexity.
That world is disappearing fast. Companies like HP, IBM and others have seen their hardware businesses almost completely disappear. Firms like Sun and DEC have been wiped off the map in a very short period of time.
There are many people like Larry who built their careers around designing large and ever-growing, complex hardware systems. But the hardware market has become commoditized in the last 10 years. The iPhone sitting next to me has more computing power and function than huge computers of just a few years ago.
There have been tectonic shifts in his field, too. Consequently, the market now demands skills in things like mobile app development and cloud computing software.
Recently, Larry interviewed for a position with one of the leading cloud infrastructure companies for a program management job. The first thing he was asked to do: take a coding test.
WHAT?!! A coding test??? This is a program management job!, he thought to himself.
(I relate to Larry, too. I haven’t written a line of code in over 15 years. Could I pass a coding test? Probably not.)
Does it make sense that employers want to see if Larry can code? Probably not. But that’s the world Larry is living in.
Creative destruction of the computer hardware industry has been swift and devastating. Like Sally, Larry could retool; but can he do it fast enough and be accepted in a young, fast-moving market?
It is possible, but Larry also needs to buy some time.
So Larry is now repositioning himself as an IT project manager. IT project managers use all the skills Larry developed over the years, but on much simpler projects. Rather than working on one massive complex assignment, Larry might need to be a project manager of 10, 15 or 20 smaller projects simultaneously. He will not be working on leading projects; his work will be far more operational.
He will be turning the crank, rather than leading the project to design the crank.
At the same time, Larry will be retooling to learn leading edge software tools and technologies.
How to Retool When You're in a Career Disaster Area
People can and do rebuild after a disaster. Sometimes, though, they have to walk away from the disaster scene because it is too risky to stay.
Do you see your industry or profession in decline? If so, you may want to:
Attend a industry conference at your own expenseTake free or inexpensive online courses from providers like Lynda.com, Skillshare.com, Udacity.com, Coursera.org, Edx.org or Udemy.comForm a group of like-minded individuals to help you track industry trendsGet help from an industry veteran to perform a gap analysis so you can learn which skills you need to acquire

When You're Working in a Career Disaster Area

Marc Miller

(This article originally appeared on PBSNewsHour.org.)
Economist Laurence Kotlikoff, well known for his Ask Larry Social Security column and his bestseller, Get What’s Yours: The Secrets to Maxing Out Your Social Security Benefits (co-authored by our Paul Solman and Philip Moeller), advises people on their divorce settlements. This column provides a warning that where you live can make a big difference in your divorce settlement.
 
We Americans love lots of things. We love to fall in love, we love to get married, we “love” to get divorced and we love to move.
Almost all of us fall in love (at the very least with our pets), almost all of us get married, almost half of us who get married get divorced and almost half of us born in one state end up living in another. When our country was formed none of this was true. Marriage was near universal, divorce was unheard of and most people stayed put.
State rights, one of our nation’s founding principles, made sense back then. It makes far less sense today. But your state of residence determines all kinds of things. These include the penalties for crimes you commit, how much you pay in taxes, how much you can collect in welfare, what you can leave your children when you die, where you can buy beer, whether you can smoke pot, whether you can readily get an abortion and the list goes on.
Time to End State-Specific Divorce Laws
And until recently, when the Supreme Court made gay marriage legal throughout the land, where you lived also determined whether you could get married. Now it’s time for our nation to ditch state-specific divorce rules, too.
One of the biggest issues some married couples face when they move across state lines is how they will fare if they get divorced. The answer may be far better or far worse depending on the state and even the county in which you reside.
I say “may,” because if you reach an amicable settlement, that settlement may be legally approved no matter where you live. But if you have a contested divorce and end up leaving it up to a judge, she’ll likely apply state or county guidelines that can be very different depending on the state or country.
Indeed, since only a few states and counties in the country have formal guidelines, the guidelines are mostly those set by the local judge. These judges are, of course, influenced primarily by what other judges in their locality and state are doing.
The Case of Joe and Sally
Let me illustrate the world of divorce trouble in which you can land by picking the wrong state of residence.
Take fictitious Joe and Sally, a 50 year-old couple who have been married since age 25. Most of their marriage was sheer bliss. But since their four kids left home, Joe and Sally’s relationship has gone off the rails. Whether its Joe’s drinking, Sally’s smoking, or a hundred other things that have gone wrong, both want out.
They face a big, conflict-laden question: How much should Joe pay Sally in alimony?
Sally makes $30,000 a year. Joe makes $200,000. They both intend to work through age 67 (the Social Security Full Retirement Age for them). Joe has a three-times larger Social Security retirement benefit coming his way and his 401(k) is five times Sally’s. Apart from a small checking account and house equity, Joe and Sally have no other major assets.
Now suppose Joe and Sally live in Massachusetts. According to its online alimony guideline calculator, Joe will need to pay Sally $59,500 annually in alimony indefinitely, but this appears to really mean until Joe reaches 65 (17 years from now). This is the maximum alimony, which is set at 35 percent of the difference in Joe and Sally’s incomes, but can be set as low as 30 percent of the difference.
If the couple lives in Kansas, however, Sally will, based on its state alimony guidelines, receive only $38,000. That’s a third less!
And she’ll only collect the $38,000 for 8.77 years. So, on the face of it, Kansas’s alimony — discounting for the time value of money — is less than 40 percent of the Massachusetts amount.
The guideline calculators ignore a host of factors, including differences in asset holdings and future pensions, Social Security, and other income.
So if they live in Kansas, Joe can, it seems, walk away with all of his retirement account and Social Security retirement benefit.
Yes, Sally can collect half of Joe’s full retirement benefit as a spousal benefit between her Full Retirement Age and 70. Afterward, she will flip onto her own retirement benefit, which is higher. But the story’s the same for Joe.
He, too, can collect a full (if smaller) spousal benefit off of Sally’s work record before taking his own retirement benefit at 70. The main saving grace for Sally, when it comes to Social Security, arrives the instant Joe dies. If he passes when they are both 90, Sally will receive his retirement benefit in the form of a divorcee widow’s benefit.
Different Divorce Rules in Kansas, Massachusetts and Texas
In short, having been married for a quarter of a century, having raised four children primarily on her own, and having sacrificed her own career for decades, Sally’s reward in Kansas is to live the rest of her life at a far lower living standard than Joe.
Things are better for Sally and worse for Joe in Massachusetts, but it’s not clear that Sally will receive any of Joe’s assets there, since the guidelines appear to be mum on that subject.
If Joe and Sally lived in Texas, the guideline for alimony would be similar to that in Kansas. She would receive slightly more in alimony ($40,000 per year), but for an even shorter duration (only seven years). But Texas is a community property state, unlike Massachusetts and Kansas. So in Texas, Sally would, arguably, have a 50 percent claim on all of the couple’s combined assets, including all their combined retirement accounts. (This is also likely in practice in Massachusetts for a long-term marriage, but certainly not a sure thing.)
Why Leave It to States and Judges?
So here’s my question: Why should Joe and Sally, who may have spent most of their life in Massachusetts before resettling to Kansas, end up with such different post-divorce lifestyles just because they moved to Kansas for better jobs, hurricanes, whatever?
Isn’t it time we have a national divorce law?
After all, this is one nation under God, not 50 states under God, let alone more than 3,000 counties under God.
Moreover, why do we let possibly male-hating or women-hating judges arbitrarily decide what’s fair if the divorce settlement is contested? Do the judges handling divorce cases have any training in personal finance?
And, as I showed in an earlier post, determining a fair divorce (which in long-term marriages requires equal living standards for each spouse going forward) is, in fact, real rocket science — none of which is remotely covered in law school.


Is It Time for a National Divorce Law?

When Sally Connors turned 80, she decided to go for it. Now, Wednesdays are her writing day.
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