Because We Care
Practical tips for family caregivers

Cavities at this age?

As we age we become more prone to tooth decay and infections of the gums. If dental infections go undetected or ignored, the consequences are not small.

Cavities, gum disease, and decay of tooth roots are painful, and expensive to fix. (Medicare does not cover dentistry!) Loss of teeth can result in poor nutrition and social isolation if your loved one is embarrassed. And, gum disease and tooth loss have been linked to serious conditions such as diabetes, heart disease, stroke, and cancer.

Here’s what to look for as potential signs of dental disease.

• Pain. Sore gums and teeth are an indication of infection. If your loved one has dementia, he or she may not be able to tell you about mouth pain. Watch during meals for grimacing or problems with chewing.
• Breath that routinely smells bad. This can indicate an overgrowth of bacteria.
• Filmy or stained teeth. Oral bacteria coat the teeth in a sticky “plaque.” These bacteria produce acids that cause tooth and root decay.
• Gum problems. Swelling and bleeding are signs of infection. Gums naturally recede as we age, exposing the soft roots of our teeth to bacteria that cause infection.
• Dry mouth. Many medications used by older adults reduce saliva. Saliva is nature’s anti-cavity rinse. When saliva or other mouth moisture is limited, cavities are likely.
• Loose teeth. Prolonged root decay and gum disease destabilize teeth. Affected teeth can easily break off altogether.
• Dentures that aren’t used. This may indicate the gums are swollen or painful or that the dentures no longer fit properly.

If you notice any of these symptoms, have your relative see a dentist as soon as possible. If cost is a barrier, look for free or low-cost dental services through www.toothwisdom.org.

Moving sooner is better than later

Sometimes you just know in your bones that you will have to move your loved one from his or her home one day. You may hope to delay that step as long as possible. But if a move is inevitable, it’s best not to wait until poor health forces the issue.

Earlier action means your relative can

• help select the new residence;
• help make decisions about what to keep, give away, and discard.

Most of all, a move while still healthy allows your loved one to create a new social network. Having a family connection in a new town just isn’t enough. It’s too much pressure to expect family members to meet all the elder’s social needs. And, let’s face it, although you may love your family member, you may not like the same kinds of activities. Plus, if there is any family discord (as happens now and then, even in the most loving families), your relative could end up isolated.

Research suggests that activities with friends and a sense of belonging form the basis of a positive outlook in late life. Your parents’ sense of well-being and self-worth are strongly affected by

• their familiarity with local resources (where to shop, find nearby medical services);
• feeling connected in the community; and
• developing friendships with people of their own choosing.

The ideal, then, is to make the move when your relative is energetic enough to be out mingling and making new connections. Support his or her future by doing some research to find

• options for medical services. Which local doctors are on the insurance plan?
• stores of the kind your relative has liked. And transportation to get there.
• hobby clubs and other interest groups. If he or she has enjoyed this in the past.
• a new religious or spiritual home base.

Tax breaks for family caregivers

Before you file this year, ask your tax specialist if you qualify for any of these tax breaks.

Claim your loved one as a “dependent.” This requires that he or she

• is related to you or lived with you all year. A “relative” is anyone in your family, including stepparents and in-laws;
• had a gross income of less than $3950 in 2014. “Income” includes pensions and withdrawals from retirement savings and investments. It does not include Social Security or disability benefits;
• is supported by you. You paid at least 50% of his/her annual expenses. Expenses include food, shelter, clothing, medical care, transportation, recreation, and other basics.

If several relatives shared expenses, you may need to file a multiple support declaration.

Get a tax credit for dependent care. This applies if

• your loved one cannot care for himself or herself;
• you must pay someone to provide care while you work;
• he or she is your dependent or would qualify as your dependent but had too much income or filed a joint return;
• he or she lived with you for more than half the year.

Take a deduction for medical expenses. You can claim this deduction for

• yourself, your spouse, and your dependents;
• anyone who would have qualified as your dependent but had too much income or filed a joint return.

To be eligible for deduction, the expenses must add up to more than 10% of your adjusted gross income if you are younger than age 65, or 7.5% if you are age 65 or older.

In IRS terms, a “medical expense” includes

• dental care, glasses, hearing aids
• bandages, medications
• car mileage related to medical care
• doctor visits, hospitalization, ambulance services
• home improvements, such as grab bars and ramps

And, if a doctor says they are needed for health and safety:

• home care services
• care facility fees