How to find a new doctor

June 24, 2015  
Filed under Savvy Senior

Dear Savvy Senior,
What resources can you recommend to help me find and research some doctors in my area?
—Shopping for Doctors

Dear Shopping,
Thanks to the Internet, finding and researching doctors is a lot easier than it use to be. Today, there’s a wide variety of websites you can turn to that provide databases of U.S. doctors, their professional medical histories and ratings and reviews from past patients on a number of criteria. Here are some of the best sites available, along with a few additional tips that can help you find the right doctors.
Locating Tips
To help you locate doctors in your area, a good first step, and one that doesn’t require a computer, is to ask for a referral. Contact other doctors, nurses or health care professionals that you know for names of doctors or practices that they like and trust.
You should also call your insurance provider, or visit its website directory to get a list of potential candidates. If you or your parents are Medicare beneficiaries, you can use the Physician Compare tool at medicare.gov/physiciancompare. This will let you find doctors by name, medical specialty or by geographic location that accept original Medicare. You can also get this information by calling Medicare at 800-633-4227.
Once you find a few doctors, you need to call their offices to verify that they still accept your insurance, and ask whether they are accepting new patients.
Research Tools
There are lots of online resources available to help you get more information.
For example, you can find out if a doctor is board certified at the American Board of Medical Specialties at certificationmatters.org or call 866-275-2267. To learn about malpractice claims and disciplinary action, use your state medical board—see fsmb.org/state-medical-boards/contacts.
Here are some other good websites that can help you find and/or research doctors in your area for free.
Healthgrades.com: This comprehensive easy-to-use site provides doctor’s information on education and training, hospital affiliations, board certification, awards and recognitions, professional misconduct, disciplinary action and malpractice records, office locations and insurance plans. It also offers a 5-star rating scale from past patients on a number of issues like communication and listening skills, wait time, time spent with the patient, office friendliness and more.
Vitals.com: Provides background information on doctor’s awards, expertise, hospital affiliations and insurance, as well as patient ratings on measures such as bedside manner, follow-up, promptness, accuracy of diagnosis, and average wait time. There’s also a patient comment section.
RateMDs.com: Provides information on training as well as patient ratings on staff, punctuality, helpfulness and knowledge. Patients can also post questions and answers about doctors and get doctor’s ratings based on patient reviews.
Look Up Tool: If you want to find out how many times a doctor did a particular service and what they charge for it, go to data.cms.gov and click on “Medicare Physician and Other Supplier Look-up Tool” at the top of the page.
AngiesList.com: If you don’t mind spending a little money ($20/per year), Angie’s List is a membership service that provides doctor reviews using an A through F scale.
When searching for a doctor, it’s wise to check out several of these sites so you can get a bigger sampling and a better feel of how previous patients are rating a particular doctor.
Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

Warren Kimble Retrospective

June 24, 2015  
Filed under Arts & Entertainment

Fans of American folk art will be happy to know that a new exhibit, “Warren Kimble All-American Artist: An Eclectic Retrospective,” is on display through mid-October at the Henry Sheldon Museum in Middlebury.
The exhibit highlights the career of the internationally-known Brandon-based artist, who came to prominence for his folk art, but since has concentrated on diverse themes, inspired in part by his residencies at the Vermont Studio Center in Johnson. These themes include his “Sunshine” series, his “Widows of War” paintings and sculpture and more recent “House of Cards” and “Into the Box,” which featured open faced boxes with found objects and architectural assemblages.
In addition, Kimble and his wife Lorraine have agreed to display their personal collection of folk art by other artists, which will be located throughout the Sheldon’s historic rooms, providing a unique opportunity to enter the private world of Warren Kimble.
The Sheldon Museum exhibit runs through Oct. 18. The museum is located at One Park Street in downtown Middlebury across from the Ilsley Library. Museum hours: Tues.-Sat. 10 a.m. – 5 p.m.; Sun. 1-5 p.m.; Admission is $5 for adults; $3 youth (6-18); $4.50 seniors; $12 family.. For more information, call 388-2117 or visit www.HenrySheldonMuseum.org.

News

June 24, 2015  
Filed under News

Converse Home Recognized for Resident Satisfaction
The Converse Home in Burlington recently received the Excellence in Action award from My InnerView by National Research Corporation. This honor recognizes long term care and senior living communities that achieve the highest levels of satisfaction excellence, as demonstrated by overall resident and family satisfaction scores that fall within the top 10 percent of the My InnerView product database. This is the second year that the Converse Home has received this award.
The Converse Home has been a part of the Burlington community for over 128 years and provides assisted living and memory care services for older adults.

Maple Leaf Treatment Center Expands Efforts to Help Opiate Addicts in Chittenden County
William Young, executive director of the recently re-named Maple Leaf Treatment Center, has announced that Maple Leaf has completed a two-year effort to restructure and strengthen programming to address and meet the changing needs of people struggling with addiction. Last year, 345 people from Chittenden County were served by Maple Leaf.
“People with opiate addiction now make up nearly 80 percent of people seeking admission at Maple Leaf, an increase of approximately 60 percent in the last three years, while those addicted to alcohol continue to turn to us for treatment.”
“Our primary goal is to offer effective treatment,” said Dr. Iacuzzi, clinical director at Maple Leaf. “Our new programs reflect current research and address the often crippling impact of trauma in our patient’s lives. They provide more gender-specific treatment and offer more individualized care with evidence-based best practices to all of our clients, including large numbers of people addicted to opiates, many with both addiction and mental health disorders.”
To emphasize these programming changes while honoring its past, the Board has updated the facility’s name to Maple Leaf Treatment Center. “We’ve served more than 32,000 Vermonters since 1956,” said Young. But for those who don’t know us, the name was confusing. Our new name better reflects what we do.”
People struggling with addiction may call Maple Leaf admissions at 802-899-2911 (toll free 800-254-5659) or access the web site atwww.mapleleaf.org.

How to Avoid Online Dating Scams
With romance scammers using the Internet to rob Americans of an estimated $82 million in the last half of 2014, AARP’s Fraud Watch Network has called on the online dating industry to institute new safeguards to better protect their users. AARP is also inviting its members and the general public to become involved in the campaign by signing an online petition.
“Individual scammers and highly organized groups attempt to steal hearts and wallets from online dating site users every day,” said Doug Shadel, a Fraud Watch Network expert who also serves as AARP Washington state director. “The sites don’t yet do enough to protect their members from known scammers. Our petition asks the companies to take commonsense steps to help put a stop to the scammers’ abilities to prey on the unsuspecting.”
Specific anti-fraud measures the Fraud Watch Network urges the online dating sites to implement include:
Employ algorithms to detect suspicious language patterns used by scammers
Search for fake profiles across multiple dating websites
Issue alerts to any member who has been in contact with someone using a fraudulent profile
Educate members with tips on how to avoid romance scammers
As part of its current campaign, the AARP Fraud Watch Network has posted tips to advise dating site members how to avoid online scams.
One handy tip: Before you engage with anyone on a dating site, use Google’s “search by image” feature to see if that person’s image shows up in other places using a different name. If an email from a potential suitor seems suspicious, cut and paste it into Google and see if the words pop up on any romance scam sites. Consumers can learn more by visiting www.aarp.org.

Top 5 Free Medical Apps for Seniors

June 24, 2015  
Filed under Health & Wellness

In the past year, the Smartphone market has seen more than a 15 percent adoption rate by people in the 55+ category (Nielsen). As adoption rates continue to grow, it is only a matter of time before the app world will recognize the need to develop more mobile apps geared toward the senior market.
Apps for the senior market may vary by category, but health and wellness apps show the most growth since they are universally important to the majority of the senior market.
The following list of top health and medical apps for seniors are budget-friendly and provide high quality health care:
Urgent Care
This app is free to download on iPhone and Android devices, features a symptom checker and gives you access to a healthcare professional. The interactive symptom checker allows you to look up common health symptoms and remedies at no additional cost. The greatest benefit of this app is its ability to connect you to a live, registered nurse who can escalate to a board-certified doctor, 24/7. The cost is only $3.99 per call, so this app is a great alternative if you are unable to visit your regular doctor’s office.
Calorie Counter and Diet Tracker
One of the highest rated calorie tracking apps on the market, this app gives you access to over 2 million foods from the calorie counter feature and the barcode scanner lets you easily find information on foods in the grocery store. The app even allows you to monitor goals, track exercises and receive reports to help you stay on track. The free app is available on both iPhone and Android devices.
Digifit iCardio
The ultimate cardio workout companion featuring multi-sport heart rate monitoring is available on iPhone and Android. It has the ability to track indoor and outdoor activities that include running, rowing, spinning and other cardio exercises. When used outdoors, it can map workouts with GPS as well as record time, distance and speed. The customizable voice feedback will even communicate your progress.
Best Self Help Quotes
This app, available only on the iPhone, features over 500 inspirational quotes for success, personal improvement, wisdom and spiritual growth. The app also allows you to save favorite quotes, send quotes via email/SMS and share on Facebook.
MedCoach
This medication reminder app is currently available to download for free on iPhone and Android devices. This easy-to-use app sends dosage reminders as needed and tracks your prescription schedule. The app also has the ability to link to a pharmacy for quick and easy refills.
—GreatCall.com

Vermont Ranked Healthiest State For Seniors

June 24, 2015  
Filed under Health & Wellness

Vermont is the healthiest state for seniors, rising from fourth place last year, according to the third edition of United Health Foundation’s America’s Health Rankings Senior Report, “A Call to Action for Individuals and Their Communities.”
“Vermont’s seniors should be congratulated for doing a lot of things well to stay healthy, such as low rates of physical inactivity, hospital readmissions, and half of all our seniors rank their health as either very good or excellent,” said Health Commissioner Harry Chen. “As always, there are also areas we need to improve such as a high prevalence of chronic drinking, low hospice care use and a high rate of falls.”
Vermont ranks among the top 10 states in 21 of 43 overall measurements that include behaviors, community and environment, policy, clinical care and outcomes. New Hampshire ranks second, improving one spot from last year. Minnesota fell to third after being ranked first for two years in a row, while Hawaii (4) and Utah (5) round out the top five states. Louisiana ranks 50th as the least healthy state for older adults, followed by Mississippi (49), Kentucky (48), Arkansas (47) and Oklahoma (46).
Vermont’s strengths include low intensive care unit (ICU) use and ready availability of home-delivered meals. This is due, in part, to the efforts of the state’s area agencies on aging, according to Susan Wehry, outgoing commissioner of the Department of Disabilities, Aging & Independent Living. Vermont also has the nation’s best Supplemental Nutrition Assistance Program (SNAP) enrollment, which demonstrates that seniors are aware of and using the program.
“Increasing participation in the supplemental nutrition program for those over 60 who live in poverty has been a top priority of the Agency of Human Services, and to now rank number one for participation is a huge accomplishment,” Wehry said. “I’m grateful to all our partners who helped us achieve this milestone. Vermont has always been a tight-knit community state. We take care of each other and we take care of our seniors.”
The departments of Health and Disabilities, Aging & Independent Living began collaboration on a screening and brief intervention, referral substance abuse project targeting older adults to help address chronic drinking among seniors in Vermont.
Nationally, the report shows that seniors are improving in key care trends, pointing to a health system that may be working better for seniors, according to the United Health Foundation.
“It is heartening to see seniors’ health is improving, but our societal challenge remains finding ways to encourage more seniors to be more active,” said Rhonda Randall, senior adviser to United Health Foundation, and chief medical officer and executive vice president, UnitedHealthcare Retiree Solutions. “Strong community support is an essential part of promoting positive health among seniors. We must work together —across states, communities and our own families—to encourage all seniors to find ways to be as active as they’re able to be.”
Chen said the fact that more seniors nationwide received the flu vaccine compared to last year—rising from 60.1 percent of seniors in 2014 to 62.8 percent this year—is encouraging, because they are particularly susceptible to flu and flu-related complications.
“Every Vermont senior should get vaccinated against the flu,” Chen said. Vermont ranked 18th for flu vaccines for seniors at 65 percent.
To read the full report, visit www.americashealthrankings.org/reports/senior.

Joy Abounds at Queen City Memory Café

June 24, 2015  
Filed under Health & Wellness

By Carrie Shamel

When I heard that Burlington was starting a Memory Café, I was excited and curious. I was not sure what to expect, but I hoped to see that it would bring together those affected by memory challenges and their loved ones to share times of joy and meaning as opposed to the stressors that can come with care giving.
When I walked into the Thayer House last fall for the inaugural cafe, I was rewarded by a world of songs and smiles. I joined the circle of participants and we sang away (out of tune or not!) to familiar songs, as a guest played the guitar. The age range was impressive: from those in their 30s up into their 90s. As we continued to sing and laugh, I realized that in this setting, all barriers of age and memory were removed. No one cared who was “young” or who was “old,” who could walk or needed a walker or who could recall if it was 2014 or 1999. We were in harmony.
The music came to an end, but the conversation and connection continued over coffee and snacks. It seemed everyone had made a new friend, and people were reluctant to leave the café.
I was not surprised to see the same faces return a month later, along with some new faces, as well. The Queen City Memory Café meets the third Saturday of each month from 10 a.m. to 12 p.m. at the Thayer House in Burlington off North Avenue. It is open to the public and free of charge. It is designed to be an engaging community for people with memory challenges and their caregivers and friends. The café does not provide physical care, but provides a warm and supportive ambiance.
In the time since the café began, a wide variety of offerings have occurred, from poetry writing and reading, to storytelling, to holiday celebrating and drumming. In January, a talented musician came to the café, with a host of various types of drums. Another participant gifted us with a wide range of instruments and her own set of talents. Many of us, including myself, were reluctant to pick up an instrument, as we were fearful of making a mistake, not having played before. However, the musician skillfully encouraged us to try, and one by one you saw hands hitting drums, shaking maracas and playing a washboard. As minutes passed, and with little instruction, the sound intensified and you could see confidence growing in each face.
As there were some new folks to the group, some of us had been strangers prior to this day. But in drumming collectively, we made a powerful song that unlocked our souls and drew us together. How wonderful it was to see a diverse group of people creating joyous sounds together. It reminded me for the 100th time that regardless of age or ability you can have fun, make connections and learn new things.
I look forward to future months with more participants joining us. We are looking ahead to learning to do comedy, summer picnicking, some blissful singing and much more. Memory cafes are also in full swing in Montpelier and St. Albans. For more information, contact Jessie Cornell at the Alzheimer’s Association of Vermont at jlcornell@alz.org.
Carrie Shamel is a Social Worker at the Visiting Nurse Association of Chittenden and Grand Isle Counties. She has a Certificate in Gerontology and 10 years of experience supporting caregivers of persons with memory challenges.

First U.S. Center to Study Lyme Disease Launched

June 24, 2015  
Filed under Health & Wellness

Fundamental research into the causes and cures of post-treatment Lyme disease syndrome now has its first home base at a major U.S. medical research center with the launch of the Johns Hopkins Lyme Disease Clinical Research Center. Inaugurated on May 12, 2015, with a major gift from the Lyme Disease Research Foundation, the center plans an ambitious research program targeting this increasingly common disease, which costs the U.S. economy up to $1.3 billion per year in treatment costs alone.
First discovered in Lyme, Connecticut, 40 years ago, Lyme disease has spread rapidly throughout the East Coast and Midwest. It now afflicts more than 300,000 people per year, becoming the sixth most common reportable infectious disease in the U.S.
“If you live anywhere from Maine to Virginia, it’s almost impossible for Lyme disease not to affect someone you know, someone in your family or yourself,” says center founder and director John Aucott, M.D., a Johns Hopkins internist. Aucott, an assistant professor of medicine at Johns Hopkins, has spent more than a decade studying the disease’s potentially crippling effects.
When a tiny tick infected with the bacterium Borrellia burgdorferi bites a human, that person may develop symptoms that seem flu-like, such as swollen glands, fatigue, body aches and rashes. Most people respond well to antibiotics. But about one out of every five or six patients develops a debilitating condition called post-treatment Lyme disease syndrome, marked by extreme fatigue, musculoskeletal pain, arthritis-like pain in the joints and cognitive, neurological and cardiac symptoms.
“This syndrome is not fatal, but it is life-altering,” says Aucott. “People who come down with Lyme disease are active people who have the bad luck to be bitten by an infected tick while they’re out hiking, camping or mowing the grass. It can happen to anyone anywhere there are trees, deer and the ticks that they carry.”
As director of the new clinical research center, housed at Johns Hopkins Bayview Medical Center, Aucott has received an initial grant to lead the first prospective controlled study in the U.S. to examine the impact of Lyme disease on patients’ immune systems and their long-term health. Known as SLICE (Study of Lyme Disease Immunology and Clinical Events), the study aims to understand why some patients develop post-treatment Lyme disease syndrome lasting months or years, while others do not.
The Lyme Disease Research Foundation has also helped establish repositories of blood and tissue samples from patients with Lyme disease at Johns Hopkins, providing researchers with opportunities to collaborate in the search for disease biomarkers that could lead to improved diagnostics and treatment.

The Johns Hopkins Lyme Disease Clinical Research Center will act as a hub for catalyzing the exploration of Lyme disease.  

The Natural Route to Good Health

June 24, 2015  
Filed under Health & Wellness

Local physicians tout benefits of naturopathic medicine
By Adam White

Take two of these and call me in the morning. “
It’s become somewhat of a punchline, but what it says about modern medicine is no joke. The mentality that “there’s a pill for that” drives not only treatment, but patients’ expectations of care – and the consequences can range from prolonged suffering to full-blown dependency and addiction.
“We’re way over-drugged in our society, no doubt,” said Dr. Michelle Haff of Avalon Natural Medicine in Burlington. “I’ve read that in the last three years, deaths from overdosing on painkillers exceed deaths from car accidents. It’s obviously a huge problem.”
Breaking that cycle requires alternative forms of care, and one that stands at the forefront is naturopathic medicine, which uses natural substances and therapies to treat a person as a whole. Naturopathy also encourages a process of self-healing, rather than merely connecting the dots between symptoms and drugs.
“Good health doesn’t come out of a pill bottle,” said Dr. Lorilee Schoenbeck of Mountain View Natural Medicine in South Burlington.
The root of care
The foundation of naturopathic medicine lies in helping patients establish a natural level of wellness. This is largely accomplished through lifestyle choices and patterns including diet, levels of exercise and activity and other “controllable” factors.
The idea is that wellness is an ongoing process rather than a status quo that only needs to be addressed when it is disrupted.
“We treat a vast majority of conditions that conventional primary care physicians treat, but our aim is to treat them early,” said Schoenbeck, using a preventative screening such as a pap smear as an example. “We look at preventive care as something that starts 20 to 30 years before that. “We try to treat things before they manifest themselves clinically.”
But modern medicine may be working against itself when it comes to making prevention a universal tactic embraced by patients. Health care is often prohibitively expensive, and visits to doctors and especially hospitals are time consuming and disruptive to people’s schedules. As a result, the prevailing mindset becomes, “If it ain’t broke, don’t fix it.”
“Most people are reactive,” Haff said. “They don’t go to the doctor unless something is wrong.”
Reversing that trend has been made easier by one somewhat unique facet of naturopathic medicine: Its practitioners serve as primary care physicians for their patients, providing all the same services that a conventional PCP does.
“A lot of times, I’m the only doctor people see,” Haff said. “Whether they have a cold, need a pap smear or physical, or need a prescription filled, I’m doing all of it.
“For a lot of people, it feels just like a conventional doctor’s visit. We can prescribe meds. We also conduct the same types of lab tests and physical exams, and use the same kinds of imaging – CT scans, MRIs, Ultrasounds.”
Community of colleagues
Naturopathic practices are also seeing an increase in the number of referrals from conventional doctors, thanks in part to a gradual shift in perception.
“There are still skeptics of the conventional side when it comes to naturopathic medicine, with very little understanding of what we do,” said Dr. Molly Fleming of Health Resolutions in Burlington. “But I’d say there were more skeptics in the past – pockets of the profession who were less open-minded and didn’t want to have anything to do with us. I think now there are more doctors that know, and we make referrals back and forth.”
The other route by which patients make their way to naturopathic medicine is by reaching the end of their proverbial rope in regard to finding wellness, or even relief.
“Quite often, our patients have seen conventional doctors – started with their primary care physicians, were referred to a specialist – but nothing has helped,” Haff said.
But what can this alternative practice provide that hundreds of years of conventional medicine can’t? The answer lies within the very root of its name – nature.
Naturopathic doctors use extracts and supplements commonly derived from plants and other natural sources, rather than substances that come out of laboratories. Those remedies are often combined with techniques such as acupuncture and chiropractic adjustments, with an aim of treating the patient as a whole rather than just one problematic area.
Diet is a significant factor in the process, as well. Patients will often experience pain without realizing that its cause can be traced to the foods they eat, and how their bodies process those foods.
“At the top of our treatment list is nutrition and intestinal health,”
Haff said. “That’s usually the first thing we treat. People may come to us with a symptom such as back pain, but it’s all related – inflammation in the gut, or the entire body, which manifests itself in different ways.”
A natural fit
The rise in popularity of naturopathic medicine in Vermont isn’t surprising, given the way people here view nature and their relationship to it. From the whole foods movement to conservation and environmental responsibility, Vermonters are inherently in-tune with the natural world and how it is incorporated into their lives.
“The population that Vermont attracts tends to be more holistically-minded people,” Haff said, adding that in her previous practice in Arizona she had to perfect an “elevator speech” – a five-minute summary of what naturopathic medicine is all about.
“I don’t encounter that situation as much here,” she said.
But the flipside is that Vermonters are also notoriously self-sufficient, with a can-do attitude that extends to taking care of their bodies. That can be especially problematic when combined with a wariness of drug-based treatments.
“Because this is Vermont, we see people who have not been going to doctors at all, and have been deferring their care,” Schoenbeck said.
“Others have been treating themselves, naturally. For those patients who self-select, naturopathic care is often a good fit as a first line of treatment.”
Having that choice is also important due to the state’s widely-publicized problem with opiate addiction, which state health officials and politicians alike have admitted has reached an epidemic level. Patients who begin taking medications under a physician’s treatment plan – only to become addicted – can face difficulties with pain management in the future, even after they have dealt with their addictions.
“Nowadays there is a very large addicted population, and they need different options for pain,” Fleming said. “Imagine someone who has gotten sober, through quite a bit of effort, and then they injure themselves and are in a lot of pain.”
The non-toxic and non-addictive alternatives offered through naturopathic medicine can, in those situations, provide the only safe route through that pain. “That was my real motivation going into this: People need options,” Fleming said.
Taking advantage of the naturopathic approach is made easier by the fact that it is now recognized not only by the rest of the medical community, but by insurance companies as well. Haff said her services at Avalon are covered by insurance as both a primary care physician and a specialist, which gives patients extra incentive to try them.
“When it doesn’t cost people anything other than their time, I think that makes it much more appealing,” Haff said.
The accessibility of naturopathic medicine should only grow in the future. Schoenbeck is on the board of the American Association of Naturopathic Physicians, and in early May went to Washington, D.C., with 150 other physicians and medical students for more than 200 meetings with legislators to push for increased recognition. She said the group received a “very good reception.”
“The triple aim of health care reform is lowered costs, better outcomes and better patient satisfaction,” Schoenbeck said. “We think we do those things pretty well, and patient satisfaction surveys confirm that.
“We think naturopathic medicine is an important part of solving our nation’s healthcare crisis.”

Quebec City Visitors in for Real Treat

June 3, 2015  
Filed under Travel

By John Blanchette

As I flew into Quebec City in late March, I thought of my father, who was French Canadian and born in the small town of Chateauguay in the province of Quebec. He was proud of his heritage and every few years would drive us 300 miles from our Massachusetts home, across into Vermont, through upstate New York, around Lake Champlain and across the St. Lawrence River to visit his boyhood home. I loved visiting the farm where he was born and, remarkably, the shed where he was actually born was still standing on the property.
We would feed the livestock and chickens, milk the cows, make cheese, tend the fields and dine on vegetables, eat the honey from the hives on our morning toast and marvel at the imperial quarts of milk delivered by horse-drawn carts through the streets of Montreal and Quebec City. They were bigger than those in the United States, with a bulging neck that would collect the cream for the adults’ coffee.
Then there was the delicious honey butter that came in crocks and also graced the toast when we dined with our big-city relatives in Montreal. The distinctive flavor of fresh-pressed cider from Macintosh apples and the maple syrup and candies have a special place in my memory.
My father loved hockey and golf, the major Canadian pastimes. He was good at them both and played on the Boston University team before World War II interrupted his education. The last time I had visited the city I was 16. College would interrupt my return for many more years.
When I landed, the city had just gone through a very mild winter and the previous week’s temperatures had reached into the 70s. Alas, when I arrived, temperatures plunged into the teens and brave new buds were shivering in the cold along with me. It even snowed on my final day in the city.
My memories of Quebec City were dim. I remembered wandering the narrow and enchanting streets of Old Town (Vieux-Quebec), now a UNESCO World Heritage Site composed of Basse-Ville (Lower Town) and High Town (Haute-Ville). The period architecture dates back 400 years and reminds one of Europe, especially with the sounds of French floating in the air.
I remembered the Marche, where the local farmers sold their goods on the weekends, and the immensity and utterly stunning beauty of Hotel Frontenac, perched above the city wall (the only one still standing in North America) next to the cannons and gunnery placements that guarded this narrowing of the St. Lawrence River. This area was crucial in the fighting between the English and French for control of the Canadian Territory and entry into the Great Lakes and mid-America. According to local lore, it is the most photographed hotel in the world.
The British may have won the battle that ceded them the country, but they could not pry the language or the heritage from French Canada. The name Quebec is not French, however. It is derived from the Algonquin language and means “narrowing of the river.”
Mayor Regis Lebeaume has made revitalization of the working-class St-Roch neighborhood a priority, pouring money into redevelopment. New galleries, restaurants, clubs and shops have turned it into one of the chicest locations in town. Cirque du Soleil has set up headquarters here and offers free shows in the summer. St-Roch Church is the largest in Quebec City and the focal point of the community.
The best way to get a full view of this city of just over 500,000 is to take the ferry across the St. Lawrence River to Levis. The ancient skyline reveals itself upon the promontory, and Hotel Frontenac’s full majesty is impressive. When I returned to the dock, I took a walking tour of Old Town, both lower and upper. For only $1.50 it’s possible to ride on the Funiculaire up to Haute-Ville, a relatively compact town that can be covered in a few hours at a leisurely pace. The buildings and town squares are distinct and lovely, and the narrow lanes make for great window shopping.
The Musee des Beaux-Arts is on the grounds of the Plains of Abraham battlefield (1759) that determined British dominion over Canada and the end of French colonization. In the 1763 Treaty of Paris, the territory was officially ceded to England for good.
I enjoyed La Korrigane brewpub on Dorchester Street (www.korrigane.ca), where I asked for the five-glass taster so I could enjoy the range of beers from a fresh blueberry lager to a dark chocolate stout. And speaking of chocolate, the sweetest part of the city tour is a visit to 634 rue Saint-Jean and the Chocolate Museum (www.chocomusee.com).
One of the more unusual shops was Benjo (www.benjo.ca), a toy store on steroids with a staff of grown-up 10-year-olds who love teasing the customers. Here a zany train ride takes visitors around the store and through the tunnel into a back-room fantasy land. I was also surprised by the employee-operated flying sharks and darting toy helicopters as well as the 5-foot robot who loved to squirt water on shoppers.
The hockey-mad city is building a $400 million sports complex to try and lure a new club to replace the Nordics, who left for Denver a few years ago.
About seven miles northeast of Quebec City are the thundering Montmorency Falls, named by explorer Samuel de Champlain for his patron, the Duke of Montmorency. At 227 feet tall, the falls are the tallest in North America and nearly 100 feet higher than Niagara Falls, but far narrower. For the brave of heart, there is a footbridge that spans the falls with spectacular views. In winter, snowboarders make use of the spray from the falls that coats the nearby rocks with continuously falling powder snow. There are also a number of excellent ski resorts within an hour of town.
Visiting Quebec City again after so many years brought back a flood of memories to me, and first-time visitors are in for a real treat.
WHEN YOU GO
For lodging options, restaurant information, shopping tips, event listings, guidebooks, brochures and maps, contact the Quebec City Tourist Office 877-783-1608 or www.quebecregion.com.
I stayed at the new TRYP Quebec Hotel PUR (www.tryphotels.com) in the St-Roch District. Pur is the French word for pure, and architect Caroline Lajoie has created a quality atmosphere that is innovative, minimalist, sleek and open. My favorite area was the spa, with a dry sauna, a large lap pool and exercise room.
Table, Bar Gastronomique is run by inventive young chef Francois Prive. The restaurant kitchen is in the center of the room surrounded by well-spaced tables that allow easy conversation. Food is eclectic, seasonal, creative and often on small plates.
— CNS

If You Have a 401(k), Do You Need an IRA, Too?

June 3, 2015  
Filed under Money

By Carrie Schwab-Pomerantz

If you have a 401(k), does it make sense to open an individual retirement account, too?
A 401(k) or another employer-sponsored retirement plan — if you’re lucky enough to have one — can be considered the backbone of your retirement savings. Contributions are easy because they automatically come out of your paycheck. Also, you may get an upfront tax deduction, and annual contribution limits are sizable — $18,000 for tax year 2015, plus a $6,000 catch-up for those who are 50 or older (both up $500 over 2014 limits).
That means, depending on your age, you could contribute up to $24,000 in 2015. And if you get an employer match, that’s extra savings in your pocket. Add tax-deferred growth of earnings and what’s not to like?
But as positive as all this is, there’s a good case for having an IRA in addition to your 401(k). An IRA not only gives you the ability to save even mor, but also may give you more investment choices than you have in your employer-sponsored plan. And if you have a Roth IRA, there’s also the potential for tax-free income down the road.
But the type of IRA that makes sense for you personally will depend on your filing status and your income, so there’s a bit more to consider.
Tips for Choosing the Type of IRA That’s Right for You
There are two types of IRAs: a traditional tax-deductible IRA and a Roth IRA. For 2014 and 2015, the annual contribution limit for both is $5,500, with a $1,000 catch-up if you’re 50 or older.
However, each IRA does have an income ceiling, which will determine whether one or the other is right for you.
Traditional tax-deductible IRA. For someone who doesn’t have a 401(k)or similar plan, a traditional IRA is fully tax-deductible. Upfront tax deductibility and tax-deferred growth of earnings are two of the pluses of this type of IRA. However, if you participate in an employer-sponsored retirement plan — such as a 401(k) — tax deductibility is phased out at certain income levels. For tax year 2015, the levels are $61,000-$71,000 for single filers and $98,000-$118,000 for married people filing jointly.
Roth IRA. With a Roth IRA, you don’t get any upfront tax deduction, but you do get tax-free growth, plus tax-free withdrawals at age 59 1/2, as long as you’ve held the account for five years. And there’s no restriction if you participate in an employer plan. However, there are income limits that determine whether you’re eligible to open and contribute to a Roth. In 2015, the limits are $116,000-$131,000 for single filers and $183,000-$193,000 for married people filing jointly.
There are a couple of other things to consider when choosing between IRAs, the main one being whether you believe you’ll be in a higher or lower tax bracket when you retire. That’s because withdrawals from a traditional IRA are taxed at ordinary income tax rates at the time of withdrawal; qualified Roth withdrawals, as I mentioned, are tax-free. Also, there’s no required minimum distribution for a Roth, but with a traditional IRA, you’ll have to begin taking an RMD at age 70 1/2.
A Roth 401(k) — Another Option Worth Considering
Whether or not you choose to open an IRA, if your employer offers a Roth 401(k), you might also consider adding this to your retirement savings strategy. There are no income limits to participate in a Roth 401(k), and you can have both types of 401(k) accounts at the same time. Having both doesn’t mean you can contribute more than the total annual 401(k) contribution limit, but you can split your contributions between the two, giving you a combination of both taxable and tax-free withdrawals come retirement time.
Making Your 401(k) and IRA Work Together
The goal of all this is to give you the greatest opportunity to save, with the greatest flexibility. So my thought would be to first contribute enough to your 401(k) to capture the maximum company match. Then, if you’re eligible — and especially if your 401(k) has limited investment options — open either a traditional or a Roth IRA and contribute the annual maximum. Next, if you can, put more money in your company plan until you max it out. And if you get to the point where you can save even more (kudos!), put that money in a taxable brokerage account.
The bottom line is you can’t really save too much, only too little. So use all the savings and investing vehicles available to you, including both an IRA and your 401(k), to save as much as you can, as early as you can — and, at the same time, get the maximum tax break. You won’t regret it.
— CNS
Carrie Schwab-Pomerantz, Certified Financial Planner, is president of the Charles Schwab Foundation and author of “The Charles Schwab Guide to Finances After Fifty,” available in bookstores nationwide.

Next Page »