Fong Law Group

Does Divorce Affect Social Security Spousal Benefits?

More than 50 million Americans receive Social Security retirement benefits. Most of these recipients are retirees who worked and paid Social Security taxes. But millions of dependents and survivors of retired workers, including spouses and ex-spouses, also receive a monthly benefit from Social Security.

Spouses can collect Social Security benefits based on their fellow spouse’s work records. These benefits are also available to divorced spouses who meet certain criteria, even after their ex-spouse has remarried. Divorced spouses are entitled to survivor benefits as well in some situations.

Social Security Auxiliary Benefits

Social Security provides monthly benefit payments to retired and disabled workers. It also pays dependent benefits and survivor benefits — collectively known as auxiliary benefits — to the spouses, former spouses, children, parents, and widows/widowers of retired, disabled, and deceased workers. In fact, more than 30 percent of new Social Security benefit awards in 2020 were auxiliary benefits.

Retirement benefits make up the lion’s share (78.9 percent) of Social Security payments. Retired workers collect most of these payments (75.1 percent), according to Social Security Administration (SSA) data. But the spouses of retired workers are the second most common recipient of Social Security retirement benefits.

As of March 2024, about 1.8 million spouses of retired workers — most of them women — received Social Security benefits averaging $911 per month. Divorced spouses comprise approximately 12 percent of all spousal benefit awardees.

Social Security benefits are also available to surviving spouses. The survivor’s benefit is based on the deceased spouse’s lifetime earnings.

Survivor benefits make up about 8.6 percent of all Social Security benefits, with monthly payments totaling $8.7 million and an average payment of just over $1,500 per month. Widows and widowers comprise about 65 percent of survivor beneficiaries.

In a 2021 report, the Congressional Research Service notes that spousal and survivor benefits were added to the Social Security system in 1939, when the majority of U.S. households consisted of a single earner, generally the husband.

Despite most women now working full-time — and increasingly out-earning their husbands — women are vulnerable to poverty in old age, says the report. This is attributed to demographic and economic reasons that include a longer average lifespan, lower labor force participation, and an “earnings gap” that can lead to women receiving a lower Social Security benefit than men.

Social Security Spousal Benefits

To address the benefit disparity between men and women, while accounting for women’s now much-higher labor force participation and the increase in the number of divorces, the SSA has over the years modified how it administers Social Security spousal benefits. This includes allowing same-sex spouses to receive spousal benefits in the same way as opposite-sex spouses.

Today, many individuals who qualify for spousal benefits do so based on their spouse’s work records and their own work records.

As a spouse, you can claim Social Security benefits based on your own earnings record. Or you can collect a spousal benefit up to 50 percent of your spouse’s Social Security benefit.

Those who qualify for both do not receive both in full, but they are automatically entitled to whichever benefit is higher, and they can collect on their spouse’s record even if they never worked.

You are eligible to receive Social Security spousal benefits when you turn 62 years old if your spouse is receiving retirement or disability benefits. However, if you choose to receive spousal benefits before you reach full retirement age (age 67 for anyone born in 1960 or later), your benefit amount will be permanently reduced.

These rules don’t apply to some child caregivers. If you are caring for a child younger than 16, or who has a disability and is entitled to receive benefits on your spouse’s record, you can qualify for Social Security spousal benefits at any age. Having a qualifying child in your care also means that you’ll receive your full spouse’s benefit even if you are under full retirement age.

Spouses who do not have a qualifying child in their care and begin receiving benefits before full retirement age can use this calculator to see how much their spousal benefit will be reduced.

Social Security Benefits for Divorced Spouses

As a divorced spouse, you can collect benefits on your ex-spouse’s record, even if the ex-spouse has remarried and the ex-spouse’s new spouse is collecting on the same record.

To qualify for a divorced spouse Social Security benefit, you must meet the following requirements:

• You were married for at least 10 years (although the marriage could have been briefly interrupted by divorce during this period; see below).
• You are currently unmarried.
• You are at least 62 years old.
• Your ex-spouse is eligible for retirement benefits.
• The benefit you are entitled to receive based on your own work record is less than the benefit you would receive based on your ex-spouse’s work record.

If your ex-spouse has not yet applied for retirement benefits but can qualify for them, you can receive benefits on their record, provided you have been divorced for at least two continuous years.

And if you are eligible for both a spouse’s benefit and your own retirement benefit, you may have a choice between the two benefits, depending on your age, explains the SSA.

Any Social Security benefits that you receive on an ex-spouse’s record may be reduced by you continuing to work and/or receiving a pension from a government employer that wasn’t required to withhold Social Security taxes.

Divorced Spouse Benefits and Remarriage

If you remarry, you generally can't receive benefits on your former spouse’s record unless the new marriage ends (by death, divorce, or annulment). In such cases, you can claim benefits on either spouse’s record, as long as each marriage meets eligibly requirements (it lasted at least 10 years, etc.) for divorced spouse benefits.

In limited cases, remarriage does not end benefits obtained on the record of a living former spouse. One of these exceptions applies if you remarry the same person.

A marriage to the same spouse could be interrupted by divorce and remarriage and still qualify for divorced spouse benefits if the remarriage took place no later than the calendar year immediately following the calendar year of the divorce.

According to AARP, remarriage also may not terminate your ex-spouse benefits if your new spouse is receiving survivor benefits, divorced spouse benefits, or childhood disability benefits.

Social Security Survivor Benefits for Divorced Spouses

The divorced spouse of a worker who has passed away could be eligible for Social Security payments equal to a surviving spouse benefit. To receive a survivor benefit as a divorced spouse, your marriage must have lasted 10 years or more and you must meet these other requirements:

• You are at least age 60 (or between 50 and 59 if you have a disability).
• You are not entitled to a Social Security benefit on your own work record that is equal to or higher than a benefit from your deceased ex-spouse.
• You are unmarried (unless you qualify for an exception).

The 10-year marriage requirement does not apply if you are caring for a child under age 16, or who has a disability, and the child qualifies for benefits on your former spouse’s record. The child must also be the natural or legal adopted child of your former spouse.

Survivor benefits are equivalent to the deceased worker’s full Social Security benefit amount. However, there is a maximum family amount—typically between 150 percent and 180 percent of a worker’s full retirement benefit—that survivors can collectively receive each month.

The SSA states that a benefit paid to a surviving divorced spouse will not affect the amount of benefits other surviving family members can receive, unless the ex-spouse is a divorced parent caring for the child of a deceased worker, in which case their benefits could affect the benefits of other survivors.

Divorced widow/widower payments are also subject to these SSA rules:

• If you remarry before age 50 you can't collect survivor benefits unless you divorce.
• If you remarry between ages 50 and 59 you aren’t eligible for survivor benefits.
• If you remarry after age 60 you can still receive survivor benefits based on your former spouse’s record. But if your new spouse is also collecting Social Security benefits, and you would receive a higher amount based on the new spouse’s work record, you will receive the higher amount.

Once you reach full retirement age and are eligible for both a survivor benefit and your own retirement benefit, you can choose to take survivor benefits first, letting your own benefits vest and then switching to retirement benefits later if that benefit is larger.

Surviving divorced spouses cannot apply online for survivor’s benefits. Contact the SSA at 1-800-772-1213 (TTY 1-800-325-0778) to request an in-person appointment at your local Social Security office.

You can use this screening tool to determine your eligibility for the different Social Security benefit programs. You may also benefit from consulting with your elder law attorney. They can help you choose the benefit option that works best for your situation.

Most US Workers Say They Will File for Social Security Early

To secure the maximum amount in monthly Social Security retirement benefits, Americans must wait until full retirement age to start receiving their payouts. Results from a 2023 survey show that most of today’s workers know about this stipulation – and yet the vast majority say they’re willing to file for their Social Security benefits early anyway.

UK-based wealth management company Schroders surveyed 2,000 working Americans to learn more about their readiness for and perspectives on retirement. The results showed that a mere 10 percent of respondents said they plan to hold off until age 70 to take their Social Security benefits. This is the case even though 72 percent of them are aware their payments could be higher if they waited.

Why Are So Many People Willing to Give Up More Income?

Many of the survey participants – roughly 44 percent – said they worry about Social Security running out of funds. Their fears may not be entirely unfounded. The Social Security program has served as a safety net for millions of retirees, providing monthly benefits since 1940. However, based on some projections, timely payments may not be possible beyond 2037.

Another 36 percent of the respondents said they would take benefits earlier because they need the money sooner.

These fears, said Deb Boyden, head of US defined contribution at Schroders, reflect “a crisis of confidence in the Social Security system.”

“Fear about the stability of Social Security has people walking away from money that could improve their quality of life in retirement,” she said.

Other Key Findings

• Nearly half of all survey respondents (49 percent) acknowledged that they do not have any strategies in place for retirement income.

• Less than a quarter (24 percent) of those aged 60 to 67 who are still in the workforce said they believe they’ve accumulated sufficient retirement savings.

• Among respondents aged 45 and older, 69 percent say they fret over money daily – on average, 1.6 hours every day. More than half of this same group (53 percent) said they worry that stress over finances will have a negative impact on their overall health.
   
• Retirees who’d worked with a financial planner had higher average monthly incomes than those who had not sought out the help of an advisor ($5,075 per month versus $3,000 per month). Those who had set up a formal financial plan received nearly twice more per month on average in retirement – about $5,810.

Find more information on the survey results online.

Getting Social Security Checks While Living Overseas

Many retirees look forward to traveling in their retirement. More and more are actually retiring overseas, in part as a way to stretch savings. But what happens to retirees' federal benefits while they are out of the country?

The short answer is that although Social Security benefits are available to retirees in other countries, Medicare is not. In this installment we look at Social Security. 

Medicare vs. Social Security Benefits When Living Abroad

Unlike with Medicare, retirees who decide to move to another country can still receive their Social Security benefits. Once a retiree has been outside the country for 30 days in a row, they are considered outside the U.S., and the rules for collecting benefits apply.

The Social Security Administration (SSA) will send checks to anyone living abroad who is eligible for benefits. However, the SSA is not allowed to send checks to several countries. Retirees who move to Cuba or North Korea cannot receive any checks while they are in either country, but they can get any withheld checks if they go to a country where paychecks can be sent.

In addition, the SSA generally does not send Social Security checks to Cambodia, Vietnam, or areas that were in the former Soviet Union (other than Armenia, Estonia, Latvia, Lithuania, and Russia). However, retirees may be able to apply for an exception. In such cases, retirees may have to agree to certain conditions, such as appearing in person at the U.S. embassy each month, to receive benefits.

Retirees who are U.S. citizens can continue receiving benefits for as long as they live outside the United States. However, citizens of other countries who receive Social Security may have some restrictions on how long they can receive benefits while outside the U.S.

The rules are quite complicated. The Social Security publication Your Payments While You Are Outside the United States explains in detail what restrictions citizens of individual countries face. The SSA also offers a payment screening tool that tells beneficiaries whether they'll be entitled to benefits if they remain outside the country for more than six months.

Retirees may have their checks directly deposited into a bank account in the United States, and direct deposit is available in some other countries as well. Using direct deposit avoids check-cashing and currency-conversion fees.

In countries with a large number of U.S. retirees, American embassies and consulates have individuals who are trained to provide Social Security services, including taking applications.

The countries are: Argentina, Australia, Austria, Belgium, Chile, Costa Rica, Croatia, Denmark, the Dominican Republic, Finland, France, Germany, Greece, Hong Kong, Ireland, Iceland, Israel, Italy, Jamaica, Korea, Japan, Mexico, the Netherlands, New Zealand, Norway, the Philippines, Poland, Portugal, Slovenia, Spain, Sweden, Switzerland, the United Kingdom, and Yemen. Individuals in other countries need to contact the SSA in writing or by phone. For a list of phone numbers, visit the SSA's webpage.

Social Security Taxes

The taxes on overseas Social Security benefits are the same as taxes on benefits for retirees living in the United States. Retirees who file individual tax returns and earn between $25,000 and $34,000 may have to pay taxes on up to 50 percent of benefits. Retirees with income over $34,000 may have to pay taxes on 85 percent of benefits.

Retirees filing jointly with a combined income of between $32,000 and $44,000 may have to pay taxes on 50 percent of their benefits. Joint filers with a combined income of more than $44,000 may have to pay taxes on 85 percent of their benefits. Combined income is the retiree's adjusted gross income plus nontaxable interest plus one-half of the retiree's Social Security benefits.

In addition to U.S. taxes, some foreign countries may tax benefits as well. To find out whether a country imposes taxes on Social Security benefits, contact the country's embassy in the United States.

The SSA provides information and resources on its International Programs webpage for retirees who are moving outside of the U.S.

What About Supplemental Security Income?

The rules for receiving Social Security overseas do not apply to Supplemental Security Income (SSI) benefits. Most recipients of SSI are not entitled to benefits outside the U.S. SSI benefits will stop if a recipient is outside the U.S. for more than 30 days, and benefits won't start up again until the recipient is back in the country for at least 30 days. However, there are exceptions for dependent children of military personnel and students studying abroad.

Is an Independent Living Facility Right for Me?

Housing options and the associated costs are among the top priorities for many seniors. Today, the housing market is unpredictable, while many seniors currently living independently may also have concerns about continuing their lifestyles. Moving to an independent living facility may be the best choice to accomplish your financial goals and maintain your way of life.

What Is an Independent Living Facility?

An independent living facility is a housing arrangement that caters to older people, usually aged 55 and older. These facilities offer a community. Residents can live with people who share common interests while having fun and staying active. Some people may refer to these facilities as 55-and-over communities, active adult communities, or retirement communities.

These environments are different from other long-term care facilities. For example, in nursing homes patients are not likely to live in a private apartment or arrangement. They are usually dependent on medical caregivers. Residents of assisted living facilities, meanwhile, may not require medical care 24-7, but do need assistance with activities of daily living.

In contrast, older adults who live in independent living facilities continue to maintain their independent lifestyles but gain the support of trained staff.

Who Is the Best Fit for Independent Living?

Independent living facilities best serve seniors who do not require constant medical care. If you or your spouse require round-the-clock medical attention, you should consider another living arrangement. However, there are usually 24-hour staff in these types of facilities to respond in case of an emergency.

While independent living facilities are best for more active seniors, they are also beneficial for older adults who do not have the ability or resources to maintain their homes anymore. Independent living facilities remove the need for older people to do household chores and yardwork, which can make their lives that much easier.

Types of Independent Living Facilities

Living arrangements in these facilities can vary. Here are some of the types of housing options an older adult can expect from an independent living facility:

Senior Apartments

A senior can choose to live in an apartment complex that is age-restricted, where most residents are at least 55 years old. Some facilities include recreational programs, community meals, transportation services, and community services in the rent.

Low-Income Housing

If you are a low-income senior, you may be able to find housing complexes that are subsidized by the United States Department of Housing and Urban Development (HUD). Learn more about HUD’s Supportive Housing Program.

Continuing Care Retirement Communities

At a Continuing Care Retirement Community (CCRC), seniors who can care for themselves but have declining health may be a good fit. CCRCs allow a spectrum of arrangements, so when a resident’s health starts to wane, they can easily move from one part of the facility to another that offers more extensive care while remaining in the same complex.

What Should I Look for in an Independent Living Facility?

You should take some time to consider what you want in your living arrangements before making a final decision about where you will spend your time in your older years.

You may want to consider location as a major factor in your decision. Will you be close enough to stay in contact with your network of family and friends, if that is your preference? Or would you like to make a move to a different state or a warmer climate to connect with new people?

What services are you set on having? For example, will you have your own vehicle and, if not, does the facility offer transportation options?

You may want to live in a facility that offers certain amenities. Perhaps you would like to use a gym, take part in classes or workshops, or enjoy other hobbies. Some facilities offer access to more than one on-site dining option. Others may have a movie theater, nail salon, walking trails, or organized trips to nearby museums, concert halls, or casinos.

Of course, cost is more often than not also part of the equation. Compare the costs of several different independent living communities if possible. Confirm whether the cost of the facility includes the services and amenities in which you are interested.

Pricing will also vary greatly across states and cities. For instance, in Connecticut, the average monthly cost for an independent living facility is nearly $3,500. In Mississippi, the average may be less than $2,000 a month.

Also, think about the following before choosing a community:

Your Health and Your Spouse’s Health

The level of care you and your spouse require is one of the biggest questions that you must answer before choosing the best living arrangements. Independent living facilities are not the best option for people who need a great deal of medical care.

Your Mobility

It may be time to make new living arrangements if your mobility has decreased as you have gotten older.

Can You Maintain Your Home?

Moving to an independent living facility can be a good decision for seniors who are looking to downsize from their home.

What Will Your 2024 Social Security Benefits Look Like?

In 2023, recipients of Social Security benefits saw the biggest increase in decades in their monthly checks. Although their payouts will indeed rise again in 2024, the cost-of-living adjustment (COLA) will be more modest – just 3.2 percent, versus the nearly 9 percent boost in 2023.

Does COLA Only Affect Retired Workers?

Each fall, the Social Security Administration (SSA) announces changes to the annual cost-of-living adjustment for the forthcoming year.

Based in part on the consumer price index, the COLA has an impact on Social Security payouts for retirees as well as many seniors and people with disabilities who receive disability benefits.

How Much Can You Expect to Receive?

In early December, the SSA begins notifying Social Security’s roughly 66 million beneficiaries about what their monthly retirement benefits checks will total as of 2024. These notifications go out via snail mail. How much each recipient gets in their monthly payout can vary depending on such factors as one’s age, employment history, and past work earnings.

If you don’t want to wait for your mail to learn the details, you can find out how much more you will be receiving in 2024 by visiting the My Social Security online portal in December. There, not only can you obtain details on what your 2024 benefits increase will look like, but you can also carry out numerous other tasks, including estimating your spouse’s Social Security benefits, reviewing your statements, opting out of some printed mailings, or updating your direct deposit information.

As a result of the latest COLA, the monthly amount retirees will receive in their 2024 Social Security checks will, on average, be $59 higher than in 2023 – about $1,907 (up from $1,848). This equals $22,884 per year for an individual recipient.

What About My 2024 SSI Payments?

If you are among the 7.5 million people who receive Supplemental Security Income (SSI), the announcement regarding COLA will also bring your payouts up by 3.2 percent.

So, in 2024, the maximum monthly SSI benefit will rise from $914 to $943. (Maximum monthly payouts for couples receiving SSI will be $1,415, up from $1,371.) These adjustments begin earlier, on December 29, 2023.

Are These Payout Increases Enough?

Many seniors have concerns about the failure of Social Security payouts in keeping up with rising prices for everything from prescription meds to groceries. They aren’t wrong; a 2023 survey showed that benefits have effectively resulted in a 36 percent loss in buying power since 2000.

Administrators of the survey give an example of the effects: A dozen eggs in 2023 cost $4.21 on average. In 2000, the cost hovered around a dollar – that’s an increase of more than 300 percent.

Get additional details on the 2024 Social Security changes on the SSA website.

An Epidemic: Substance Abuse a Growing Problem Among Seniors

The United States population of aging adults has grown exponentially over the past decade. According to projections published by the U.S. Census Bureau, the number of Americans aged 60 and older increased by 34 percent from 55.7 million to 74.6 million between 2009 and 2019. Unfortunately, amid their growing numbers, more and more seniors are facing a substance use disorder problem that in large part has remained silent.

What Are Substance Use Disorders?

According to the Centers for Disease Control and Prevention, substance use disorders include “treatable, chronic diseases characterized by a problematic pattern of use of a substance or substances leading to impairments in health, social function, and control over substance use.”

Seniors are an overlooked group regarding substance abuse issues, but the problem is growing nationwide. Learning the extent and cause of substance abuse among seniors can help improve outcomes for this population.

Rates of Substance Abuse and Misuse Among Older Adults

Seniors often get disregarded in conversations about substance misuse. Yet according to some estimates, nearly 1 million adults aged 65 and older were reported to be living with an addiction as of 2018. Today, that number could be much higher.

Drug Abuse

Drug abuse among older adults is a dangerous problem, in part because health care providers and caregivers so often overlook it. It may even be diagnosed incorrectly as a health condition related to aging.

Seniors are likely to use one or more prescription medications. Adverse drug interactions between multiple prescriptions, nutritional supplements, and over-the-counter medication can inadvertently harm one’s health.

Misuse of certain prescriptions can also lead to a substance use disorder. Opioids, for example, have been prescribed to millions of people suffering from chronic pain. The proportion of U.S. adults aged 55 and up who have sought treatment for opioid use disorder has been surging over the past two decades; between 2013 and 2015 alone, it jumped more than 50 percent. One 2006 study stated that at least one in four older adults were using prescription drugs that have potential for abuse.

Many seniors are at risk of developing a dependence on nonprescription, over-the-counter, and illicit drugs as well. Meanwhile, research has suggested that American seniors use illicit drugs at a higher rate than older adults from most other countries.  

Alcohol Use

Surveys show that alcohol use among people 65 and older has increased 22 percent over the past two decades. The extent of alcohol abuse remains unknown due to the impact of underreporting. However, seniors in some studies do report binge drinking and at-risk drinking.

People binge drink when they have five or more drinks in one setting. According to one study, more than a tenth of older adults in the U.S. are regular binge drinkers.

Research published by the National Library of Medicine defines at-risk drinking as consuming more than three drinks on one occasion or having more than seven drinks in one week. The prevalence of at-risk drinking among men is estimated at 16 percent and 10.9 percent among women.

Note that the National Institutes of Health offers a series of free worksheets that can help you evaluate your use of alcohol and learn how to make positive changes.

Why Do Seniors Abuse Substances?

Seniors are less likely to abuse substances for a euphoric effect. Older adults typically use drugs and alcohol to self-medicate against the physical and emotional pain that comes with aging.

Some common causes of substance abuse among people aged 65 and older include:

• Loss of a spouse or family member
• Decreased income
• Change in living arrangements
• Trouble sleeping
• A mental and physical decline in health
• Conflicts with family
• Lack of purpose
• Retirement

A senior’s coping style early in life may correlate with late-life substance abuse. People with avoidant coping styles tend to rely on substances to deal with stress and change. If seniors spend their lives avoiding stress or problems, they are more likely to develop a late-life drinking problem than those who cope in other ways.

Social Factors Leading to Substance Abuse Among Older Adults

Various social factors appear to increase the chance of late-life drug and alcohol abuse. The following social factors are among those that may lead to increased substance misuse:

• Unexpected or forced retirement
• Social isolation
• Being divorced, separated, or single
• Lack of religious affiliation
• Affluence or feeling comfortable with the availability of financial resources
• Grief

Physical Factors Leading to Substance Abuse Among Aging Adults

Older adults with substance abuse disorder typically have these physical factors in common:

• Comorbidities
• Chronic medical conditions
• Reduced mobility
• Chronic pain
• Poor health status

Psychiatric Risk Factors Leading to Substance Abuse Among Seniors

Psychiatric risk factors among older adults with substance abuse disorder include:

• History of substance use disorder
• Current or previous mental illness
• Feeling socially isolated
• Having an avoidance coping style

Symptoms of Substance Abuse Among Older Adults

Substance abuse is a serious medical condition. Prompt diagnosis and treatment can help seniors get the help they need to improve their quality of life. Caregivers and medical providers should watch out for the following symptoms of substance misuse:

• Depression and loss of interest in previously enjoyable activities
• Use of a prescription drug more often than what is outlined in the instructions
• Memory problems
• Change in appetite
• Social withdrawal
• Irritability and sadness
• Change in sleeping patterns
• Decline in hygiene

Leading Substance Use Disorders According to Region

Substance misuse is occurring everywhere in the U.S., regardless of age, but certain areas are seeing abuse of specific types of substances. The Agency for Healthcare Research and Quality compiled the following data for 2016 through 2018 about regions nationwide:

• New Jersey and parts of Appalachia have a concentration of opioid-related substance use disorders.
• The Midwest, Appalachia, Rhode Island, and Nevada saw a higher concentration of alcohol dependency issues than other parts of the country.
• Appalachia saw a more-significant-than-average concentration of sedative-related substance use disorders.
• Stimulant-related disorders appeared more in the Midwest, the South, and Appalachia.
• Cannabis-related substance abuse disorders occurred in Mississippi and other Southern states.

Health Impacts of Substance Abuse on Seniors

The health implications of substance abuse disorder are more significant for older people. Older people are more vulnerable than other groups to the effects of drug use on mental health. Seniors who take prescription medication risk negatively impacting their mental state by mixing their medicine with recreational drugs or by abusing alcohol.

Drug and alcohol abuse can also lead to increased fall risk, physical impairment, adverse psychiatric effects, worsening of other physical conditions, and death.

In fact, among people aged 65 and over, certain types of opioid overdose deaths increased by 53 percent between 2019 and 2020 alone. The number of alcohol-related deaths for this age group rose by 18 percent over the same timeframe.

Recovery Options for Older Adults

Whether a senior should receive inpatient or outpatient treatment depends on their needs. Older adults with a substance use disorder may benefit from inpatient treatment if they meet some of these criteria:

• A high likelihood of relapse
• Suicidal thoughts or thoughts of self-harm
• Likelihood of experiencing withdrawal symptoms
• No familial support
• Previous attempts at detox
• Co-occurring severe medical conditions that need continuous monitoring

Seniors may also need the following to get the most out of recovery:

• Careful case management
• Family, group, and individual counseling
• Cognitive behavioral therapy

How Can the Health Care Industry Help Older Adults With Substance Use Disorder?

Much work is needed to decrease the substance abuse rates among older adults. There is a critical need to address this problem.

Primary care physicians are the first line of defense. Education for clinicians should include skill and strategy development to treat substance abuse issues among older adults. Health care workers should know how to identify substance misuse with proper screening and assessments. Understanding co-occurring disorders and the connection between mental illnesses and substance use disorders is also crucial.

If you notice signs of addiction in a loved one, it is essential to get them professional help. In addition to improving their quality of life, you may save them from succumbing to this disease.

An Epidemic: Substance Abuse a Growing Problem Among Seniors

The United States population of aging adults has grown exponentially over the past decade. According to projections published by the U.S. Census Bureau, the number of Americans aged 60 and older increased by 34 percent from 55.7 million to 74.6 million between 2009 and 2019. Unfortunately, amid their growing numbers, more and more seniors are facing a substance use disorder problem that in large part has remained silent.

What Are Substance Use Disorders?

According to the Centers for Disease Control and Prevention, substance use disorders include “treatable, chronic diseases characterized by a problematic pattern of use of a substance or substances leading to impairments in health, social function, and control over substance use.”

Seniors are an overlooked group regarding substance abuse issues, but the problem is growing nationwide. Learning the extent and cause of substance abuse among seniors can help improve outcomes for this population.

Rates of Substance Abuse and Misuse Among Older Adults

Seniors often get disregarded in conversations about substance misuse. Yet according to some estimates, nearly 1 million adults aged 65 and older were reported to be living with an addiction as of 2018. Today, that number could be much higher.

Drug Abuse

Drug abuse among older adults is a dangerous problem, in part because health care providers and caregivers so often overlook it. It may even be diagnosed incorrectly as a health condition related to aging.

Seniors are likely to use one or more prescription medications. Adverse drug interactions between multiple prescriptions, nutritional supplements, and over-the-counter medication can inadvertently harm one’s health.

Misuse of certain prescriptions can also lead to a substance use disorder. Opioids, for example, have been prescribed to millions of people suffering from chronic pain. The proportion of U.S. adults aged 55 and up who have sought treatment for opioid use disorder has been surging over the past two decades; between 2013 and 2015 alone, it jumped more than 50 percent. One 2006 study stated that at least one in four older adults were using prescription drugs that have potential for abuse.

Many seniors are at risk of developing a dependence on nonprescription, over-the-counter, and illicit drugs as well. Meanwhile, research has suggested that American seniors use illicit drugs at a higher rate than older adults from most other countries.  

Alcohol Use

Surveys show that alcohol use among people 65 and older has increased 22 percent over the past two decades. The extent of alcohol abuse remains unknown due to the impact of underreporting. However, seniors in some studies do report binge drinking and at-risk drinking.

People binge drink when they have five or more drinks in one setting. According to one study, more than a tenth of older adults in the U.S. are regular binge drinkers.

Research published by the National Library of Medicine defines at-risk drinking as consuming more than three drinks on one occasion or having more than seven drinks in one week. The prevalence of at-risk drinking among men is estimated at 16 percent and 10.9 percent among women.

Note that the National Institutes of Health offers a series of free worksheets that can help you evaluate your use of alcohol and learn how to make positive changes.

Why Do Seniors Abuse Substances?

Seniors are less likely to abuse substances for a euphoric effect. Older adults typically use drugs and alcohol to self-medicate against the physical and emotional pain that comes with aging.

Some common causes of substance abuse among people aged 65 and older include:

• Loss of a spouse or family member
• Decreased income
• Change in living arrangements
• Trouble sleeping
• A mental and physical decline in health
• Conflicts with family
• Lack of purpose
• Retirement

A senior’s coping style early in life may correlate with late-life substance abuse. People with avoidant coping styles tend to rely on substances to deal with stress and change. If seniors spend their lives avoiding stress or problems, they are more likely to develop a late-life drinking problem than those who cope in other ways.

Social Factors Leading to Substance Abuse Among Older Adults

Various social factors appear to increase the chance of late-life drug and alcohol abuse. The following social factors are among those that may lead to increased substance misuse:

• Unexpected or forced retirement
• Social isolation
• Being divorced, separated, or single
• Lack of religious affiliation
• Affluence or feeling comfortable with the availability of financial resources
• Grief

Physical Factors Leading to Substance Abuse Among Aging Adults

Older adults with substance abuse disorder typically have these physical factors in common:

• Comorbidities
• Chronic medical conditions
• Reduced mobility
• Chronic pain
• Poor health status

Psychiatric Risk Factors Leading to Substance Abuse Among Seniors

Psychiatric risk factors among older adults with substance abuse disorder include:

• History of substance use disorder
• Current or previous mental illness
• Feeling socially isolated
• Having an avoidance coping style

Symptoms of Substance Abuse Among Older Adults

Substance abuse is a serious medical condition. Prompt diagnosis and treatment can help seniors get the help they need to improve their quality of life. Caregivers and medical providers should watch out for the following symptoms of substance misuse:

• Depression and loss of interest in previously enjoyable activities
• Use of a prescription drug more often than what is outlined in the instructions
• Memory problems
• Change in appetite
• Social withdrawal
• Irritability and sadness
• Change in sleeping patterns
• Decline in hygiene

Leading Substance Use Disorders According to Region

Substance misuse is occurring everywhere in the U.S., regardless of age, but certain areas are seeing abuse of specific types of substances. The Agency for Healthcare Research and Quality compiled the following data for 2016 through 2018 about regions nationwide:

• New Jersey and parts of Appalachia have a concentration of opioid-related substance use disorders.
• The Midwest, Appalachia, Rhode Island, and Nevada saw a higher concentration of alcohol dependency issues than other parts of the country.
• Appalachia saw a more-significant-than-average concentration of sedative-related substance use disorders.
• Stimulant-related disorders appeared more in the Midwest, the South, and Appalachia.
• Cannabis-related substance abuse disorders occurred in Mississippi and other Southern states.

Health Impacts of Substance Abuse on Seniors

The health implications of substance abuse disorder are more significant for older people. Older people are more vulnerable than other groups to the effects of drug use on mental health. Seniors who take prescription medication risk negatively impacting their mental state by mixing their medicine with recreational drugs or by abusing alcohol.

Drug and alcohol abuse can also lead to increased fall risk, physical impairment, adverse psychiatric effects, worsening of other physical conditions, and death.

In fact, among people aged 65 and over, certain types of opioid overdose deaths increased by 53 percent between 2019 and 2020 alone. The number of alcohol-related deaths for this age group rose by 18 percent over the same timeframe.

Recovery Options for Older Adults

Whether a senior should receive inpatient or outpatient treatment depends on their needs. Older adults with a substance use disorder may benefit from inpatient treatment if they meet some of these criteria:

• A high likelihood of relapse
• Suicidal thoughts or thoughts of self-harm
• Likelihood of experiencing withdrawal symptoms
• No familial support
• Previous attempts at detox
• Co-occurring severe medical conditions that need continuous monitoring

Seniors may also need the following to get the most out of recovery:

• Careful case management
• Family, group, and individual counseling
• Cognitive behavioral therapy

How Can the Health Care Industry Help Older Adults With Substance Use Disorder?

Much work is needed to decrease the substance abuse rates among older adults. There is a critical need to address this problem.

Primary care physicians are the first line of defense. Education for clinicians should include skill and strategy development to treat substance abuse issues among older adults. Health care workers should know how to identify substance misuse with proper screening and assessments. Understanding co-occurring disorders and the connection between mental illnesses and substance use disorders is also crucial.

If you notice signs of addiction in a loved one, it is essential to get them professional help. In addition to improving their quality of life, you may save them from succumbing to this disease.

Is "Aging in Place" Right for Me?

Most older adults want to remain in their homes and communities as they age rather than move into assisted living facilities or nursing homes.

For those who wish to maintain their independence and continue living at home as they grow older, taking certain steps to protect their physical, mental, and financial welfare is essential.

What Does It Mean to Age in Place?

The Centers for Disease Control and Prevention defines aging in place as a senior’s “ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level.” According to 2021 data from AARP, more than three-quarters of adults 50 and older say they would prefer to age in place.

Health Considerations for Older Americans Aging in Place

Older adults must consider their physical, emotional, and social well-being when deciding where to spend their later years. They may consider adding supplemental services over time to help improve their quality of life.

To ensure that you will have the support you need for safely aging in place, take the following into consideration:

Resources to Manage Chronic Diseases

Disease management is vital for anyone, especially an older person with a chronic illness. Many older people suffer from at least one chronic illness. If a senior has a chronic disease and wants to age in place, they and their caregivers should focus on:

• Ensuring that spaces in the home are safe and easily accessible to make getting around easier;
• Learning about proper nutrition; and
• Increasing access to dental health services. Research has found that proper oral care can help prevent the progression of many chronic diseases.

Eating Well While Aging at Home

Proper nutrition is a vital part of caring for yourself at home. In facing potential changes to your financial situation after retirement, you may need help buying nutritious meals even after budgeting.

If you find yourself in need of meals, community resources may be available. Neighborhood senior centers, places of worship, and charities may provide a hot meal while you make new friends. If you cannot leave your home, some meal delivery services drop off food at your door for little or no cost.

Support for Mobility

Exercise and maintaining your mobility can increase overall physical and mental health even as you grow older. Seniors aging in place need to be able to move around their homes and neighborhoods safely. Aging in place is a much more realistic goal if you can walk for exercise, access transportation to medical appointments and errands, and maintain a safe environment at home, free from increased fall risks.

If you desire to age in place, consider simple changes you can make to your home to promote your safety. Examples of helpful modifications around the house include handrails, temporary ramps, no-slip bath rugs, and assistive seating.

Mental Health, Substance Abuse, and Memory Care Services

There is an increased need among older adults for mental health, substance abuse, and memory care services. An estimated 20 percent of older adults have a mental health disorder, and the total number of seniors with a mental health or memory care diagnosis is likely to increase over time.

Suggestions for addressing mental health concerns among older people include:

• Focusing on preventative care. Seniors and their caregivers should work with their primary care physician to identify warning signs of depression, anxiety, other mood disorders, and memory care problems. Preventative care can help mitigate the progress of these disorders and improve quality of life.
   
• Looking for common signs of a substance abuse problem. This is an often overlooked area of older adult mental health care. Older adults may turn to substances to deal with unresolved childhood problems or to avoid a feeling of loss of meaning and purpose. Some common signs to watch for include reduced hygiene, unexplained bruises, erratic behavior, and the smell of alcohol on their breath.
  
  If you are a senior’s caregiver and suspect substance abuse, you can find resources and support through the Substance Abuse and Mental Health Services Administration (SAMHSA).

The Need for Social Connection Among Aging Adults

Older adults benefit tremendously from social connections and interaction. People over 65 are likely to live alone, so creating a community outside the home is necessary. Feeling a sense of purpose is beneficial to mental and physical health. For seniors looking to create a sense of community and purpose, they may benefit from such activities as:

• Joining an organization or social club

• Volunteering for a cause close to their hearts

• Learning a new hobby

• Attending a religious institution

• Adopting or fostering a pet

• Using technology to stay in touch with friends and family

Wearables and Smart Monitoring Devices

Technology can help us not only remain connected to one another, but also monitor our health and that of our aging loved ones. Many devices make detailed health information readily available at our fingertips. These devices benefit seniors because they can learn more about their health and make the most of doctor’s visits by communicating effectively about their medical needs.

Examples of wearable health and smart-home monitoring devices include:

• Smartwatches and smartphones, which can track your cardiac health, fitness activity, and sleep patterns
• Medical alert bracelets and personal alert necklaces, which can aid in detecting falls or contacting emergency services when necessary
• Contact sensors and smart locks, devices that can alert caregivers when their loved one living at home leaves a window, garage, or door open, or has forgotten to lock them
• Smart plugs, which can automatically turn on and off lights, space heaters, thermostats, security cameras, and more

Money Management While Aging in Place

Money management can also be an area of concern for seniors and caretakers. Seniors want to make sure they have sufficient financial resources to remain in their homes and communities comfortably, eat well, care for their medical needs, and have fun.

Creating a budget with the help of financial counselors and geriatric care managers can benefit someone on a fixed income. There may even be volunteers in your area that offer a similar service. Being aware of how to prevent and avoid common types of scams that target the senior population is equally as important.

How Can Caregivers Help Seniors Age in Place?

Seniors often choose to age in place to remain independent and avoid becoming a burden to their family. Caregivers can support their goal by teaching them to use technology to communicate and track their health, helping them establish a budget, and setting them up with a routine that may include visiting their doctor, running errands, and making time to socialize.

There is nonmedical support that your loved one will need, too. Caregivers may opt to support their aging loved ones by pitching in with or hiring services for lawn care, cleaning, cooking, laundry, or pet care.

Is Aging in Place Right for You?

Careful planning is the best way to accomplish your goal of staying home as you age. If you are considering plans to age in place and want assistance, contact your elder care attorney.

What Is IRMAA and How Does It Affect My Medicare Premiums?

As we near retirement, we may assume that once Medicare kicks in, our medical insurance premiums will be fixed. However, many people may not realize that there are special rules regarding how much they pay for Medicare Parts B and D if they are in a higher income range.

What Is IRMAA?

If the Social Security Administration (SSA) determines you have a higher income, you will have to pay more for your Medicare Part B or Medicare Part D coverage. This surcharge  is referred to as the income-related monthly adjustment amount (IRMAA). It is paid in addition to your monthly premium amount.

Note that Medicare Part B pays for doctor visits, outpatient care, and related services. Medicare Part D is related to your prescription drug coverage.

How Is IRMAA Calculated?

To determine whether you must pay higher Medicare Part B or D premiums, the SSA bases the decision on your most recently filed tax return. Because of timing issues, this can often be your tax return from two years prior, as your most recent one may not yet be filed or in the IRS system.

If the SSA finds that you must pay a higher premium, they use a sliding scale based on your modified adjusted gross income (MAGI) to determine by how much. MAGI equals your total adjusted gross income and any tax-exempt interest income you have received in a tax year.

2023 IRMAA Brackets

The IRMAA 2023 threshold for married couples is $194,000. For any other filing status, the threshold is $97,000.

Once you cross these thresholds, you will pay more for coverage. How much more depends on how much you exceed these numbers. The SSA provides a chart to show you what you can expect in 2023.

The SSA calculates your IRMAA every year. So, while you may be subject to IRMAA for one year, you may not be subject to it the following year. If the SSA determines you will be subject to IRMAA, they inform you of this and its effect on your premium in writing.

How Will IRMAA Affect My Premiums?

Let’s start by understanding how IRMAA may affect your Medicare Part B and D premium. Usually, the split between SSA and you is 75 percent/25 percent. In other words, Medicare pays 75 percent of the premium, and you pay 25 percent. If you exceed the income thresholds, the split changes, and you may pay anywhere from 35 percent to the total cost, depending on your income level.

Again, refer to the SSA’s 2023 chart for your situation. So, for example, if you are filing taxes as a married couple and make between $194,000 and $228,000 in 2023, you will see on the 2023 chart that your Part B premium will increase by $65.90. Your Part D premium will go up by $12.20.

What If I Don’t Think I Should Be Subject to IRMAA?

What happens if your income listed on your most recently available tax return was much higher than what you are currently making or receiving? There is a way for you to inform SSA of the change in your finances.

For example, if you divorced, were laid off, or are making less money and you can document this, you can complete the Medicare Income-Related Monthly Adjustment Amount - Life-Changing Event form. This will inform SSA and ask them to reassess any imposition of IRMAA in your case.

You can also appeal the SSA’s decision where there was a change in your income but not necessarily in the form of a life event. For example, if you filed and IRS accepted an amended tax return for the year that is being used to calculate your IRMAA, you may be able to get the SSA to change its decision. Sometimes the SSA gets erroneous information about you from the IRS, and this may also be a basis to appeal.

There are a few different ways to appeal the SSA’s IRMAA determination. The appeal can be submitted in any of the following ways:

• online,
• in writing by completing a Request for Reconsideration, or
• through your local SSA office.

Speak With a Professional

If you have questions about IRMAA and your particular circumstances, it is best to speak with a professional. Timing matters, so seeking professional guidance as soon as possible after you receive notice of the IRMAA surcharge is essential.

Highlights of How the Omnibus Bill Will Benefit Older Adults

The Senate and House have cleared the passage of a year-end $1.7 trillion appropriations bill that will benefit older adults on a number of fronts.

The bill, which runs more than 4,000 pages and includes a wide variety of legislation, heads to President Biden next for his signoff.

Here is a breakdown of some of the highlights that relate to supporting older Americans:

Health and Housing

• Opt to age at home – The Money Follows the Person (MFP) Program has been helping older adults age in their own home or a community setting, rather than in nursing homes, since 1972. The newly passed bill extends MFP through September 2027.
   
• Age in place safely – The omnibus bill has also doubled funding for the federal government’s Older Adult Home Modification Program from $15 million to $30 million.
  
  For seniors with limited income, this program covers the cost of simple, low-cost home modifications – such as railings and temporary wheelchair ramps – that help them age in place safely.
   
• Provide for your healthy spouse if you are on Medicaid in a nursing home – Medicaid beneficiaries who must reside in a long-term care facility but have a spouse still living at home will continue to see their healthy spouse protected from poverty.
  
  Known as spousal impoverishment rules, these protections ensure that the healthy spouse receives income while their institutionalized spouse keeps their Medicaid eligibility. These protections, which are adjusted each year, will continue to be in place until September 2027.
   
• Continue to see doctors online – Lawmakers have extended access to telehealth services for Medicare enrollees for another two years.
   
• Find affordable housing with support services – The Housing for the Elderly Program has received a billion-dollar bump in funding as well.
  
  This program seeks to aid seniors with very limited income in securing housing that is within their means while also offering supportive services such as assistance with cooking and cleaning.

Retirement Savings

• Contribute more to retirement – For older workers, the omnibus bill raises what are known as “catch-up” contribution limits for retirement savings. Taxpayers ages 60 to 63 will be allowed to contribute an extra $10,000 to their 401(k) starting in 2025.
   
• Access 401(k) funds for emergencies – If you need to take money out of your 401(k) before reaching age 59½, under certain circumstances you will no longer have to pay the 10 percent penalty fee for withdrawing money early. As of the end of 2023, you will be allowed to withdraw up to $1,000 a year for unforeseen emergencies without incurring a penalty.
   
• Wait longer to withdraw money from your retirement accounts – Previously, you were required to begin withdrawing money from your retirement plan account starting at age 72. This mandatory withdrawal is known as a required minimum distribution (RMD).
  
  As of January 1, 2023, the new bill allows you to hold off until age 73 to take funds from these types of private retirement accounts.