Tom Kelly, author of Cashing in on a Second Home in Mexico, recently told Realty Times that he advocates investing in Mexico real estate, specifically “fly in” resort locations rather than “drive in” locations that are near the border. According to the article, one of the key reasons that Mexico real estate is a smart investment is because of the much lower building costs compared to the US. “Investors can pick up a two-bedroom, two bath fourteen hundred square foot condo unit with a golf course or water view in Mazatlan for $180,000″. You can buy cheap real estate in many Mexican destinations, like Merida for example. “You can still purchase an old colonial under $100,000 and have it redone for pennies on the dollar,” said Jim Mann of Mayan Living Real Estate Company who was interviewed by NuWire Investor on real estate in Merida.

While there are many opportunities that can appreciate well in the future, it is also important to look at several other factors that come into play when investing overseas. Is the infrastructure for utilities sound in the area? How is demand for vacation rentals? Would you feel comfortable living at the location? How is the quality of health care? Are there reputable property management services available? Many of these questions can only be answered by spending some time at the destination you are interested in.

• Accepted dvdrip

John Q movie

• Behind Locked Doors release
  
  Down Periscope psp

Shutter movie Munich film

Imagine a resort-style, 40,000 square foot clubhouse of stunning architectural distinction, that will make meeting for cards, a swim, a wine tasting or a game of billiards an elegant event.

Welcome to Aquabella®. A place that redefines how a community designed for active adults looks, lives and plays. Its debut will cause quite a stir. And give active adults a reason to get very, very excited.

{visit Aquabella.com}

• Munich trailer

2012 Doomsday full movie

The Strangers buy Adventureland rip

Valiant dvd

Coming to America hd buy Futurama: The Beast with a Billion Backs

Flamingo Lakes boasts an exclusive resort setting complete with a conservation area, two golf courses, a tennis academy, equestrian centre, beach club, marina and spa, along with one- and two-storey abodes offering all the comforts of home. “For years, many Canadians have seasoned in Merida, enjoying the low cost of living and the rich cultural environment,” says Carmen Laborin, marketing director. “Now with Flamingo Lakes, they can own a home overlooking a golf course and a wildlife sanctuary.”

The villas will include up to five bedrooms, covered terraces and a swimming pool, while golf-view condominiums will feature up to three bedrooms, starting at US $113,000. Additionally, there will be a variety of services residents can enjoy, including key holding, property maintenance, pool management, gardening, property rental and a comprehensive security system.

“Unlike other parts of the world where the economy has taken a big hit, Mexico’s economy continues to grow,” says Steve O’Malley, principal of MexCan Direct, a Toronto-based real estate agency specializing in Yucatan developments.

“Investing in a stable country like Mexico where health care and the cost of living are inexpensive ensures their savings will last longer and will ultimately create a better quality of life for the home buyer.”

And added to a high quality of life is a rich culture and breathtaking surroundings.

Visitors can enjoy the Mayan ruins, haciendas and cathedrals, as well as modern conveniences such as a theatre, a  Costco and WalMart, a variety of charming restaurants and nearby museums and beaches.

“The quality of life offered in Merida has attracted many Canadians to this beautiful city,” Laborin says.

“Now is the best time to discover Yucatan’s hidden gem and be a part of this active growing community.”

Learn more about Flamingo Lakes by visiting: FlamingoLakes.com Japan Sinks (Nihon chinbotsu) download

Vantage Point download

Joe Versus the Volcano

• Kokoda full

Don’t Be a Menace to South Central While Drinking Your Juice in the Hood dvd

{ SUN MEDIA Inglourious Basterds dvdrip

Jigsaw

Nicole McLaws }

On November 6-8, 2008, International Living is hosting a seminar on “Living and Investing in Mexico”. Sign up for a chance to win free airfare and accommodations. Prizes include:

» airfare
» hotel
» sight seeing
» fishing

The Man Who Would Be King movie download

Sign up Today:

when: Nov. 6–8, 2008
where: Merida, Mexico
cost: $995

Dr. Dolittle: Tail to the Chief movies Ladder 49 movie Japan Sinks (Nihon chinbotsu) movie Name: John Q movies Email: Jurassic Park movies Earth Ride full movie Your email is safe. privacy Thelma & Louise ipod

Dark Streets move

Richard F. Davis

THE REGION KNOWN AS LATIN AMERICA and the Caribbean (LAC), as defined by the World Bank, consists of 41 countries. Emerging from often troubled and dramatic historical challenges, a number of these countries have risen over the last ten years to become attractive and competitive members of a thriving global economy. In fact, recent reports by a respected investment fund adviser show that investment funds focused on the region, particularly Latin America, have outperformed all other regional funds.

One of LAC’s greatest assets is the bountiful real estate that is available for destination resort or retirement development. In many of the countries, particularly those closest to the United States with established air transport corridors, tourism has become one of the most dominant industries. This factor, combined with trends in U.S. tourism and resort investment, has made the region a magnet for new real estate activity.

location, location, location

The September 11, 2001, attacks on the United States led to important changes in Americans’ travel habits and boosted the value of resort and retirement development in the LAC region. As outbound U.S. travel gradually recovered, it became clear that U.S. vacationers preferred to stay closer to home. Trips became shorter, more frequent, and focused on destinations within driving distance or limited to a relatively short, nonstop flight. Furthermore, a broad range of U.S. travelers developed a preference for resort locations offering many leisure experience~ within a secure community environment. Because these vacationers were spending less on travel and returning more often to resorts closer to the United States, they were willing to invest in those communities. Noting this trend, a number of LAC countries took aggressive steps-such as streamlining the establishment of business and investments and providing for sophisticated financial markets, state-of-the-art technologies, investment incentives, and property rights protection-to transform themselves into U.S. traveler- and investor-friendly destinations.

Those that succeeded, most notably Panama, Costa Rica, and the Dominican Republic, have joined Mexico as the “hot spots” of the current era. Because of their size, the amount of available land, their proximity to the United States, and their well-served air col1idors from many U.S. locations, these four LAC countries have the most potential in the region for growth in resort and retirement development.

Mexico continues to be the premier destination for U.S. investors looking for resort and retirement real estate in the region, largely due to its proximity to the United States, whose citizens constitute the largest tourist market in the world. Mexico has done an impressive job of reforming its legal, business, and tax systems to modernize and compete effectively with resort, tourism, and retirement destinations in the United States and throughout LAC. Today, Mexico offers world-class resort community projects with top-quality golf and other amenities expected in a high-end resort. Mayakoba in the Riviera Maya, for example, offers a collection of the world’s finest luxury resorts interconnected with lagoons, waterways, and beaches to create an environment unique by any standard; and a renowned Four Seasons Resort in Punta Mita near Puerto Vallarta on Mexico’s Pacific Coast, is sited along pristine white sand beaches and natural islands. Like most modem destination resorts in the LAC region, these projects are mixed use and include different types and styles of for-sale private residences, hotel, and retail uses, as well as amenities, within a secure, easily accessible campus.

While Mexico remains ahead of the pack with a sophisticated real estate development industry that functions much like that of the United States, Panama has advanced its development activity significantly. Established long ago as ~ major corporate and money center around the operational and trade contributions of the Panama Canal, Panama has advanced, sophisticated legal and business infrastructure and services and one of the best investment incentive packages in the region.

Costa Rica, known for its environmental protection laws and “green” sensitivity, also offers an ease of legal compliance and operations, a strong banking sector, and state-of-the-art real estate and technology services.

The Dominican Republic, the youngest of the group with respect to large-scale real estate development, has become one of the most aggressive in seeking and, promoting foreign investment in resort and retirement real estate. Major destination areas with mixed-use projects-almost all of which are oceanfront properties-in Puerto Plata, Punta Cana, and outward from Santo Domingo, as well as an almost completely dollarized economy and significant U.S. influence have fueled tremendous growth in this country.

Real Estate Products

The LAC region in general, and these four countries in particular, cater to the luxury real estate sector and mass tourism. The largest demand for real estate investment within these countries is in the luxury sector, fueled by wealthy baby boomers who can buy into the new, secure, mixed-use destination resorts being developed throughout the region and can travel back and forth multiple times per year. Mass tourism is focused more on tourist hotels and transient businesses without many of the services provided in the larger, more prevalent mixed-use resorts. Panama and Mexico are also attracting a significant amount of retirement development.

In addition to Mexico’s Mayakoba

• Joe Versus the Volcano download

and Punta Mita, the Trump Ocean Club in Panama City is a fine example of a luxury sector project. Located on the Punta Pacifica Peninsula, it features a high-end hotel, condominium residences, pools, spa, beach and yacht club, pier, restaurants, and a casino, all within a 68-story, architecturally unique building. The new Santa Fe project, outside of Panama City, is an almost l,000-acre (2,833-ha), master-planned community in a more traditional low-rise style with a variety of residential products, hotels, private clubs, spas, golf courses, equestrian facilities, retail activity, and its own medical center. The developer of the project is Latin Ventures, a joint venture between a U.S. developer and a Panamanian family.

Located in Costa Rica’s Guanacaste Province on a slender Pacific isthmus fringed by gold-sand beaches, the luxury Four Seasons Resort at the Peninsula Papagayo includes 165 rooms and suites in a natural environment, swimming pools, a spa, a signature golf course, and for-sale real estate. In 2009, a Mandarin Oriental hotel will also open in Guanacaste Province. This 130-room beach resort will serve as the cornerstone of a gated residential development called Rancho
Manzanillo with a signature championship golf course, a gigantic spa, multilevel outdoor swimming pools, and what is advertised as “the best part of all,” treehouse

suites nestled high in the canopy of guanacaste trees.

The Dominican Republic’s Cap Cana is one of the most exciting new major destination resorts in the region. Situated on more than five miles (eight km) of coastline on Juanillo Beach-one of the country’s most scenic beaches-Cap Cana will feature multiple luxury hotels as part of a master plan that includes the largest inland, megayacht marina in the Caribbean; three championship golf courses; beach, yacht, golf, and country clubs; restaurants; a spa; tennis courts; pools; deep-sea fishing; a casino; and more. Within Cap Cana will be the no-room Ritz Carlton Resort located on Juanillo Beach with its own enormous spa, a private beach club, five restaurants and lounges, and 194 privately owned, beachfront residences. All of this is scheduled to open in 2010.

These and other similar projects will include luxury private residence clubs (a form of fractional common-interest ownership in condominiums and villas organized and regulated as timeshare plans) and other forms of timeshare fractional ownership such as vacation clubs, nontimeshare

Dr. Dolittle: Tail to the Chief movie full

• Invasion of the Body Snatchers

, nonproprietary destination clubs, and the newest product-a nontimeshare destination club. The last is organized as a club corporation owned by its members; the corporation owns all of its real estate and offers the same nontimeshare

access to a variety of resort accommodations as traditional destination resorts do. Such forms of common ownership provide more flexibility in scheduling use, and easier legal compliance with more formal rules in non-U.S.jurisdictions.

Luma, in Nuevo Vallarta, Mexico, is a combination luxury resort and retirement community for active adults 50 years old and over. Developed by Front Porch, a leading developer of retirement communities in the United States, in partnership with Grupo Krone

House on Haunted Hill rip

, a Mexican-based housing and land development company, Luma is said to be the first American-developed, full-ownership, active adult, beachfront community in Mexico. Comprising seven towers built to maximize ocean and mountain views and surrounded by lush gardens, with an on-site restaurant, a bar, and social gathering spots distinctly designed for an active retirement community, Luma has plans to combine the best of a resort lifestyle with amenities and facilities aimed at older Americans. Given the demographic density of wealthy baby boomers and “shadow boomers” entering retirement over the next few years, luxury retirement resorts may be the “next big thing.”

The Condemned dvd
Projects similar to Luma are in planning stages throughout the LAC region and are expected to proliferate, particularly in Mexico, Panama, Costa Rica, and the Dominican Republic. Panama has offered affordable, service-free condominiums for retirement housing for years, while emerging both in Mexico and Panama are middle-level retirement projects located in campus environments and close to major urban centers that provide health care and other services to retirees.

Luma (left) in Nuevo Vallarta, Mexico, is a combination luxury resort and retirement community for active adults 50 years old
and over. Its spacious condominiums will feature 11- to 13-foothigh <3- to 4-m) ceilings, glass walls, and terraces with sweeping ocean and mountain views (below).

Legal and Business Issues

The five most important areas of real estate investment and development to know about in the region are: ownership structure, titles, taxation, marketing regulations, and sales and closing procedures. The legal system for the four hot spot countries discussed is based on the civil law system. Developed from legislation and codes, rather than from cases and precedent as in the United States, the legal system requires more formality in documentation and general legal procedures.

• Dark Streets full

> Ownership Structure. Many foreign countries restrict or regulate landownership by noncitizens or companies owned by noncitizens. Although some of the most popular countries have such restrictions, they provide a number of legal methods that permit foreigners to receive and hold the full benefits and burdens of real estate ownership.
It is common practice to structure ownership to comply with restrictions on foreign ownership and investment, isolate the risks of ownership, and simplify tax reporting through a local entity, such as a corporation or the local counterpart of a limited liability company.

> Title. The title system in the four countries is operated exclusively by state and local government and requires the registration of title to all real estate at property registries. This system can be more efficient than the method used in the United States to record and track title to land. Conveyance deeds and documents must contain very detailed legal descriptions and, for property tax purposes, must often be accompanied by cadastra (maps/land surveys). These features make due diligence investigation of title quite efficient compared with other systems.
State governments also appoint well-established, highly regarded lawyers as notarios or notaries. They manage the property registries and are responsible for reviewing and confirming compliance with laws governing the transfer of real estate before a conveyancing document is presented to a public registry
may select a notary from the jurisdiction in which the property is located. In recent years, U.S.-based title companies have proliferated in the LAC market, offering a variety of title insurance products in a similar form to those offered in the United States.

> Taxation. There are additional taxes in the LAC region that differ from those in the United States. All the taxes and tax equivalent charges involved in real estate transactions in the region can be planned for and managed through legal structures and negotiations to reach a cost that is roughly equivalent to that of doing business in the United States. However, a detailed analysis of those tax systems is beyond the scope of this article. Early tax
planning, before making final decisions on legal structure and ownership, nevertheless, is critical for success.

> Marketing Regulation. Most of the LAC countries in high demand have laws governing the marketing of real estate developments and for-sale property such as planned communities, condominiums, and fractional or timeshare interests. An important step in the planning process is to look at the country’s laws and comply with them before launching any real estate sales there.
The United States has very complex, strict laws regulating real estate sales to U.S. residents-laws that may apply to offers or sales of non-U.S. property wherever they are made. Careful attention should be given to compliance with or exemption from U.S. laws regulating real estate sales and licensing before soliciting potential U.S. real estate buyers in the United States or abroad.

> Sales and Closing Procedures. The procedure for completing the purchase and
sale of real property or “deeded” interests is strongly traditional and technical in LAC countries. Generally, escrows are not used; rather, the buyer pays the full price under the terms of a purchase contract before receiving the instrument of conveyance. Absent a method of simultaneous closing, such as the escrow used in the United States, it is customary for all parties to the transaction to appear at the notario’s offices to execute all documents necessary to convey title, and provide all funds to cover the purchase price, as well as funds for fees and registration, to the notario. Escrow use is growing slowly in the LAC region, and escrows can be arranged in the United States, if the parties agree.

Article and photos by Jan Morgan

The Coastline of Progreso, Mexico. Hard Target hd

Toward the end of 2003 my husband Fred and I decided to move to Mexico. It was not something we had spent years contemplating. It happened that we were talking about our daughter’s plan to move to Mexico and perhaps teach English. We were excited, because we felt it allowed us a new place to vacation.

After three years she still had not made the move. On a cold evening in October my husband said, “You know, we could do that. We could move to Mexico.” And so it started.

We veered into a local Barnes and Noble before going home and bought our first book on retiring to Mexico. The selection was limited, to say the least. Thank goodness for the Internet.

I started scanning the Web and accumulating lots of great information. I found a place to live for the first six months, and started the “winding-down” process at home.

Eight months later we had sold or given away most of our furniture, put the rest in storage, attended numerous going-away parties, and set out on our new adventure.

Seeking a New Life

We were no different from many Americans who seek a new life after retirement. We wanted to learn a new language by immersing ourselves in it. We wanted to experience living in a new culture. We were eager to test ourselves and see what we could do with limited international experience and language skills. The information we picked up along the way may help you if you are considering a move to Mexico.

Before You Go: The Internet is full of great information, so take advantage of it. Learn some Spanish, as much as you can. Buy maps of the regions you are going to and familiarize yourself with the adjacent towns, sights to see, etc.

When You Get There: Be respectful of your new country—remember, you are a guest. Don’t automatically switch to new foods you have not eaten before; take it slow to avoid traveler’s distress. To avoid some illnesses, wash your hands often or carry antibacterial hand cleaner, so you don’t pick up germs you’re not ready to handle yet. Wear sunscreen, comfortable shoes, appropriate clothing. Save your short shorts and scanty blouses for the tourist beaches.

Visas: You will need a visa for Mexico, no matter how long you are staying. Requirements change, so check with your Mexican Consulate or immigration office.

The (FM-T) Tourist Visa is for visitors and valid anywhere from 30 to 180 days. If you plan to be in Mexico for six months, ask the officer at immigration to give you the 180-day visa so that you don’t have to worry about renewal. You will need proof of citizenship—either a passport or a certified copy of your birth certificate accompanied by a photo ID.

You can obtain a blank FM-T form at any Mexican consulate, at the travel agency issuing your ticket, at the airline counter, or even on the plane while en route. If you come across the border by car or bus, you can obtain one at the border office.

A tourist visa is just a permit to enter the country as a visitor. While you are in Mexico you cannot work, and the amount of personal belongings you can bring with you is limited.

If you plan to live in Mexico as a resident immigrant longer than six months, you should apply for an FM-3 visa. It is needed to open a bank account and set up utilities. It is renewable each year in the city in which you are residing. It does not permit you to work. You must apply in person for an FM-3 visa from a Mexican consulate in one of several U.S. cities or at a city in Mexico.

Get a list outlining what you need to receive an FM-3 visa from the immigration office or consulate. Requirements include proof of minimum income.

An FM-2 visa is for people who wish to make Mexico their permanent home. It is best to find a good Mexican attorney to help you through the process.

After renewing an FM-2 consecutively for five years, you become eligible for permanent residency. Once approved, you have most of the rights of a Mexican citizen.

Yucatan, Mexico; Children wait outside their home with their burro.

Traveling with Children: If you are traveling with children, you need their birth certificates or passports. If both parents are not traveling with the child, a notarized letter of permission from the absent parent or notarized guardianship papers will be necessary.

Banking: You will not need to bring a lot of U.S. dollars or traveler’s checks with you, just an ATM card. However, it is always smart to arrive in Mexico with at least $100 worth of pesos in your pocket for taxis, etc.

Language:

• Blank Check rip

You will need basic Spanish to live in Mexico. We have electronic translators that we keep with us so we can always look up a word when we need to.

Expatriates and locals alike visit Progreso’s fishmonger.

Cars in Mexico: Mexican law is very strict about bringing cars into Mexico, and if you bring a car in, you are responsible for taking that same car out. There is a “free zone” of about 20 kilometers south of the U.S. border where these guidelines do not apply.

Leviathan dvdrip The Last Castle video

Beyond the free zone owners of personal vehicles must present a valid U.S. driver’s license with a photo or an international driving permit (available at most auto clubs); valid tourist card, passport, or visa; the original certificate of title (if you do not have title to the car you must present a notarized letter of permission from the lien holder authorizing temporary importation of the car, or from the rental agency, or your company); valid state license plates; credit card in the owner’s name to pay the vehicle permit fee (usually between $10 and $35 dollars).

The title holder, driver, and credit card owner must be one and the same. The title holder must be in the vehicle at all times, and if another person is authorized by the title holder to drive the car his or her name must be put on the car permit by the official at the border. To avoid hefty fines, do not lend the car to anyone else.

Jurassic Park movies

A car permit is valid for up to six months. Your tourist visa will be stamped to reflect that you brought a car into the country. Keep these documents in a safe place, because you have to turn them back in when you leave the country. If your permit expires, the authorities can confiscate your car. If you have an FM-3 visa, your permit must be renewed with you visa.

Car Insurance: Your U.S. or Canadian car insurance will not be recognized in Mexico. Be prepared to buy Mexican car insurance when you cross the border if you haven’t already purchased it. Several companies sell Mexican car insurance

.

In case of accident, Mexican law requires that your car be held until damages are paid or until you guarantee proper payment via an insurance policy.

Free Willy 2: The Adventure Home full Good Boy!

The Little Shop of Horrors movie full

(say-NO-tay) in Spanish or dzonot in Mayan. The Yucatan Peninsula is a flat, thick shelf of limestone with thousands of miles of underground, water-filled caves interconnected by rivers. When the roof of one of these caves collapses, it produces a sinkhole or natural well, filled with fresh water. The most famous cenote is the sacred cenote at Chichen Itza, but hundreds of cenotes large and small dot the Yucatan. Some cenotes are hidden deep in the jungle and others are inside larger caves. Some have been reliable sources of drinking water for centuries, which is why many Maya villages and ancient cities are located nearby.

During a recent visit to Hacienda Chichen Sideways on dvd , we learned of a small Maya pueblo called Yokdzonot, only a few minutes drive from Chichen Itza, where a group of citizens had formed an association that has spent two years converting their abandoned cenote into a project of sustainable tourism. The video below is our report of their efforts. For more information about this project, visit Yucatan Adventure.

Apr. 17, 2008 (McClatchy-Tribune Regional News delivered by Newstex) –
Two Midlands retirement communities will become laboratories for new high-technology solutions to enable older adults to live longer in their own homes and deal more effectively with the challenges that come with age.

The University of South Carolina signed an agreement with the Fraunhofer Institute for Software Engineering of Kaiserslautern, Germany, and Columbia’s Palmetto Health System to jointly develop technological responses to aging issues. The Lutheran Homes of South Carolina and Still Hopes Episcopal Retirement Community have agreed to test and help develop new products and services for the elderly.

The Lowman Homes at White Rock will equip one of its assisted living cottages with the products developed through the SeniorSmart Center. The goal will be to test commercial viability of the new products and speed their marketability.

“Our residents are pleased,” said Thomas Brown, president of Lutheran Homes of South Carolina, which operates Lowman Homes. “South Carolina’s older adults are interested in staying active. We want to help them achieve this goal.”

Danny Sanford, chief executive officer of Still Hopes Episcopal Retirement Community, said that as America’s elder population explodes, devising ways for more of them to live in their own homes will be cheaper for society, and reduce the need to build hundreds of new nursing homes.

USC already had a major commitment in its SeniorSmart Center to develop mobility, activity, rehabilitation and transportation technology for the elderly. The center will be the academic home of two of the endowed chairs, which were created to attract top researchers in the field to move their research to South Carolina. A third endowed chair will work with the center from Clemson University.

Research will focus on three areas:

– Making the home safer for older adults, with technological systems that help monitor their needs and assist with daily activities that become more difficult with age.

– Examining and promoting mobility outside the home by improving transportation safety and driving responses for older adults.

– And studying brain health to slow or prevent the onset of diseases such as Alzheimer’s and Parkinson’s.

The Medical University of South Carolina and Greenville Hospital System University Medical Center also will participate in the research through their membership in the Health Sciences South Carolina consortium.

Dr. Paul Eleazer, director of geriatrics at the USC School of Medicine and the SeniorSmart Center’s director, said the center will eventually comprise 10 to 20 researchers who aim to keep older residents independent and engaged in their communities.

Eleazer said the center will bring together many disciplines from medicine to engineering and social work to craft solutions to the problems of aging.

Such combinations of skills could, for example, produce a refrigerator that senses outdated food, or smart cups that monitor the fluid intake of older adults who are prone to dehydration.

Dieter Rombach, who heads the Fraunhofer Institute for Software Engineering, said improving the quality of life is particularly urgent for Germany, which has the oldest average age of any industrialized country. He said the number of Germans over age 65 is expected to double by 2025.

Rombach said South Carolina offered unique conditions for collaboration with a growing retired population, and the partnership of hospitals, retirement homes and universities.

USC President Andrew Sorensen said Fraunhofer Institute is particularly good at commercializing new products. It developed the software for, and holds the patent on the MP3 digital music software used by most digital music players.

Reach Hammond at (803) 771-8474.

Courtesy of AARP.org

.

PCU movie download Thank You, Mr. Moto film Reservoir Dogs film

Hearts in Atlantis the movie

Rambo release

Interstate 60 psp Crossing Over

HealthDay News - More than one-third of elderly patients on Medicare take a companion with them for routine medical visits.

And patients who are accompanied on such visits tend to be more satisfied with the visit, according to a study published in the July 14 issue of the Archives of Internal Medicine.

“I think it’s a fabulous idea [to have companions on medical visits],” said senior study author Debra L. Roter, a professor of health behavior and society at Johns Hopkins Bloomberg School of Public Health in Baltimore. “And we have a very good notion of interventions now, ideas that can help companions and patients prepare for their visit in a more proactive and effective way. The consequences seem to be especially valuable for those elderly people that we generally think of as most vulnerable, those who are the sickest, the oldest and the least well-educated. Those are the people who seem to benefit the most by having somebody with them.”

A previous study led by Roter had also indicated that it was common for older adults to take someone with them on medical visits, usually a spouse or adult child.

“We found that companions actually do lots of very helpful things for the patient, but our study was only one, and it was relatively small,” Roter said.

She and a colleague decided to do analyze a larger population of 12,000 community-dwelling Medicare beneficiaries aged 65 and older who had participated in a 2004 survey. Roter had actually written several of the questions for that earlier survey.

Many of the findings dovetailed with the earlier, smaller study.

Here, 38.6 percent of participants said they were usually accompanied on routine medical visits. Those accompanied were usually older, less educated, and in poorer health.

Companions could be spouses (53.3 percent), adult children (31.9 percent), other relatives (6.8 percent), roommates, friends or neighbors (5.2 percent), non-relatives (2.8 percent) or nurses, nurses aids, legal or financial officers (under 1 percent).

More than 60 percent of companions helped with doctor-patient communications by writing down instructions (44.1 percent), giving information on the patients’ medical conditions or needs (41.6 percent), asking questions (41.1 percent) or explaining doctors’ instructions (29.7 percent).

Patients who were accompanied on visits were 15 percent more satisfied with their doctor’s technical skills, 19 percent more satisfied with the doctors’ information-giving, and 18 percent more satisfied with their personal skills compared with unaccompanied patients.

“This tells us that this is a national phenomenon,” Roter said. “These patient companions are commonly very active, so they don’t just stay in the waiting room. They come into the exam room with the patients, and they’re active in the communication process in a helpful way.”

Study author Jennifer L. Wolff, an assistant professor of health policy and management at Bloomberg, hopes the findings will lead to more research on better ways to use companion visits to advantage.

“This study is important in terms of thinking about the role of the visit companion, both within the encounter and also outside the encounter,” she said. “We don’t have a very good understanding of roles that family caregivers play in medical processes. It would be very exciting to relate this to safety issues, for example, adverse drug reactions or issues around adherence to medications. Theoretically, it makes sense that when an older adult has a family caregiver who is actively engaged in the health-care process, there could be some beneficial outcomes.”

Another expert agreed but offered a note of caution.

“This has pushed the science to the next level by quantifying the findings, and by doing this for more people,” said Marcia G. Ory, a professor of social and behavioral health with the Texas A&M Health Science Center School of Rural Public Health in College Station. “It’s also looking at the functions of the companions.”

“There are implications for clinicians, for companion visitors as well as for the older patient him or herself,” Ory added. “Physicians need to know how to appropriately interact with the [companion visitor]. The companion visitor needs to understand what their role is. It’s also important for the message to go to the patient that the patient is ultimately responsible for their own health care, but they don’t do it in a vacuum. They live in families.”

“In the past, we’ve ignored the third party, but we don’t want the pendulum to swing and ignore older patients,” Ory said. “It’s that delicate balance that will get us the best quality of care.”

More information

Visit the National Family Caregivers Association The City Is Mine trailer for more on this topic.

One of the greatest pieces of  legislation in the world  to help seniors, the disabled, spouses and dependants to live in dignity.

“It’s hard to remember now, but before Social Security, nearly half of America’s seniors lived in poverty. After a lifetime of playing by the rules and working hard, there was no guarantee of a secure retirement.

Mysterious Mr. Moto hd

They believed that lifting our seniors out of poverty is a reflection of our nation’s core values.” Season of the Witch psp

• buy Frankenstein

Out Cold

Command Performance full

• The Lion King 1½ divx

http://www.dailykos.com/storyonly/2008/8/14/153010/252/534/567971

“On this anniversary of Social Security, let’s reaffirm our commitment to ensuring that Social Security remains a safety net that seniors can count on today, tomorrow, and always. It is impossible to fully measure Social Security’s value for its recipients, as well as for those who look after and love them. Nearly 13 million seniors depend on it each month to keep from falling into poverty, and millions more depend on survivor and disability benefits to protect their retirement.”  Barack Obama

“Social Security is a disgrace.”  John McCain

Eight Men Out full movie

All the best.  Bob