Aging with Grace

Aging in Place, right here on Long Island

A New York Times article published today indicated that one of the best places to retire was right here on Long Island! A study cited  the town of North Hempstead as one of the nation's best for seniors  due to accessibility to top-notch health care, recreation, proximity to New York City and amenities extended to the town's seniors.

The article even provides the example of The Amsterdam at Harborside, a state-of-the-art community in Port Washington, right on Roslyn Harbor. If the senior chooses not to remain in his home but wants to stay in the area, a place like the Amsterdam offers residents the opportunity to purchase an apartment in the community and if more skilled care is needed, assisted living and nursing care is available to its residents right on the grounds so that relocating is never necessary and spouses stay together. Construction on the Amsterdam should be completed in about a year or so.

Another town not mentioned in the article but in the vicinity, is the village of Sea Cliff which has a Senior Action Committee formed 30 years ago. The Senior Action Committee created a number of programs that assist its seniors in remaining in their own homes with the support of the community. The free senior services in Sea Cliff include, for example, free transportation to doctor's appointments, free blood-pressure testing once a month, and even free visits and telephone calls to make sure that everything is well with the home-bound senior.

If you or a family member is a senior and hoping to live out your days in your own home or at least stay in the Long Island vicinity, call your local town hall to find out what amenities are offered to seniors in the town, village or within the county: you might be surprised!

Alzheimer's Disease

We all do it. Rushing around in our daily lives, oblivious to those around us. Sometimes I don't even look people in the eye when I speak with them -- or worse, when they are speaking to me.

This video was part of Newsday's series on Alzheimer's Disease and the lives it ravages. The husband in the video, Mr. Schreibman, is such an inspiration: patient, loving, and kind to his wife suffering from Alzheimers.  All the while he is taking care of her--and himself--in the midst of this horrible disease that eventually took her from him after 70 years of togetherness.  People like this inspire me and they are all around us. The next time you are at the grocery store or at the gas station and you see a senior citizen, stop for a moment, look them in the eye and be kind. You never know what, or who, is waiting for them at home. Or worse, who is no longer there. The fact remains: it's not easy getting old and we all will.

Until Medical Bills Do Us Part

Although it's hard to agree with Mr. Beck on most issues, this recent editorial in the New York Times is one that's right on the mark.

Healthcare in this country is in shambles if our citizens are forced to divorce spouses they love to avoid total impoverishment when they need medical care. 

If you or someone you know is living through the scenario that Mr. Beck has illustrated, it is imperative to see an elder law attorney in your state. Government entitlements, despite the fact that most are Federal, differ greatly from state to state so it is important to know what your own state's health care programs entail (here is a list of local Medicaid offices in New York State) Fortunately, in New York, spouses are not forced to divorce each other to obtain the health care they need. Unfortunately, for the citizens of other States in the tri-state area, such a scenario is not uncommon.

A good place to find an elder law attorney in your State who can help protect you from financial ruin due to health care costs is the National Academy of Elder Law Attorneys. 

Role Reversal: Inspiration from the Parkinson's Patient

I speak to various groups thirsty for knowledge on elder law topics quite often. This weekend, however, I was truly inspired by those seeking information and knowledge from me. I was invited to speak at the co-sponsored NYU Langone Parkinson and Movement Disorder Center and the Manhattan Jewish Community Center's Sunday series for Parkinson's patients and their families.  The partnership between NYU and JCC is truly unique when it comes to helping the Parkinson's patient and those who love him (or her). The two organizations formed a partnership in which an approach of overall wellness for the Parkinson's patient is the mission.  The NYU/JCC Parkinson program offers not only world renowned phsyicians like Dr. Allesanddro DiRocca and Dr. Scott Hirsch but also clinicians, therapists, and medical researchers who take an overall approach of the mental and physical wellness of the Parkinson patient. The NYU/JCC program even offers its patients classes in movement and fitness such as yoga, tai chi, and pilates designed specifically for the Parkinson patient.

What was so inspiring to me today, though, is the journey that the patient and his loved ones are forced to take together after such a devastating diagnosis.  As a practitioner, it is easy to forget the humanity behind the diagnosis--any diagnosis. Sometimes the logistics of a Power of Attorney or Health Care Proxy allow us, the practitioner, to forget about the person listening to our lecture.  I just wanted to say thank you to all of the attendees who reminded me of the person and their personal journeys.  Their humanity, their dignity, their struggle, and their fight for wellness and knowledge was truly an inspiration to me.

As an aside, if you or your loved one has recently been diagnosed with Parkinson's Disease, a good place to start looking for answers is the National Parkinson Foundation; in the New York City area, check out NYU Parkinson and Movement Disorder Center, and NYU/JCC Parkinson Wellness Program.

The Exhausting Dementia Diagnosis

Dementia can take many forms: memory loss, disorientation, personality change(s), anger, and fear are all common characteristics. Many of my clients and their caretaking family members grumble about another frustrating characteristic: sleep deprivation. As an elder law practitioner, I have heard this phenomenon referred to as the "sundowners' syndrome". Simply put, the unpleasant characteristics of listlessness, confusion, and fear peak as the sun goes down. As a result, it becomes more and more difficult, and even dangerous, to allow those afflicted with full-swing dementia to remain alone in their homes.  The solution generally seems to be to move mom or dad into the caretaker's house: unfortunately, the caretaker-children are subject to a "rude-awakening", no pun intended. The senior is safer, certainly, but the sleeplessness, mania and confusion in the middle of the night generally continues. The Hebrew Home for the Aged in Riverdale has a "day" care program at night for those with sundowners' syndrome.  ElderServe at Night is truly unique as most programs serve dementia and Alzheimers seniors, only during the day. ElderServe gives the dementia senior the socialization he needs during the hours he need it. The senior can paint, play cards, and even dance the night away (compliments of the live music of any one of the local musicians who visit the center provide) -- all the while the rest of the world and the caregivers enjoy their much-needed and well-earned, sleep.

In Appreciation of our Veterans: Aid and Attendance

This past Memorial Day got me thinking about our nation’s veterans; particularly the older veterans that I have the privilege of meeting in my field of Elder Law.  As you know, there has been plenty of media attention paid to the United States Department of Veterans Affairs or the “VA” regarding what it does, or perhaps what it does not do, for those it’s supposed to assist. In fact, the care for veterans returning from Iraq and Afghanistan was said to be so indefensible that the Chief of the VA under the Bush Administration quit. Regardless of your politics, there is one program that the VA offers, which deserves more attention as it can greatly improve the quality of life of many of our nation’s truly deserving veterans. The program is called “Aid and Attendance” and unfortunately, many veterans know nothing about it. 

The Aid and Attendance program is referred to as a “Special Pension” in VA terms which means that it is truly a “pension” and not dependent upon the veteran’s “service-related” injury or condition. In short, most veterans who apply for the Aid and Attendance program will qualify. Furthermore, the pension is not only for the veteran himself, but also for his spouse (or the veteran’s surviving spouse) who requires assistance.

The requirements basically, are that the veteran (or his spouse, or both the veteran and his spouse) require additional help with activities of daily living; defined as eating, bathing, dressing, mobilizing, cooking, cleaning, etc (check out this site for a thorough list; in pdf format ). 

In addition to the assistance with activities of daily living, the veteran must also meet certain financial requirements, as well.  If the veteran and/or his spouse qualifies and is entitled to this extra assistance with the aforementioned activities, he is awarded an extra pension of up to $1632 per month; the spouse of a veteran can qualify for up to $1,055 per month; and the veteran and his spouse who both require assistance can receive up to $1,949 per month.  The monies can be used for homecare services, nursing home care or even assisted living facilities, who provide assistance with activities of daily living. 

Suffice it to say, the program is extremely underutilized by our nation’s veterans and could mean the difference between a veteran being forced to move into a state funded nursing home or living out his days in his own home or in an assisted living facility, in dignity.  

For an excellent resource that outlines the requirements in more detail (and that was far more helpful than the United States Department of Veteran’s Affairs own website,) please visit VeteranAid.org, a non-profit set up for veterans and their families to inform them about the Aid and Attendance program. If you find the application process as cumbersome as dealing with the VA, you can even hire an Aid and Attendant Consultant to offer you advice on how to file the claim. (True to its reputation of less-than-helpful to the veterans it is designed to assist, the VA has made it a crime to actually hire someone to submit the claim on behalf of the veteran. But, I digress…)

Advice to Children

I field plenty of telephone calls from my clients’ children who are just as overwhelmed with the logistics of their aging parents’ elder law plan as their parents seem to be.  In addition to worrying about their moms and dads, they still have young children, jobs, and mortgages to contend with; not to mention the baggage and decades’ old triggers that we all seem to have in the relationships that we share with our parents!

I saw this New York Times article regarding the other matters that face the children of my clients and it resonated.  Advice on how to cope with issues other than the legal ones can come from the most unexpected and unsolicited places.  Listen up to those around you and if you have some words of wisdom on how to cope with matters of aging parents, dispense the advice freely and kindly.

The Memory Loss Initiative

Many family members who contact me seeking legal advice for their loved one are also often grappling their loved one's memory impairment condition. I found this amazing project on-line called "The Memory Loss Initiative" sponsored by StoryCorps (a non-profit organization that honors and celebrates life by listening.)  The Memory Loss Initiative encourages those with Dementia, Alzheimers, etc. to record their memories by allowing a loved-one to interview them.  Interviews can be conducted anywhere and the interview is recorded, free of charge, by StoryCorps and the family receives the recording.  With the family's consent, the recording is broadcast on NPR and housed in the Library of Congress.

Home Sweet Home Revisited

In May of 2007, I posted this entry linking to a New York Times article regarding life in a nursing home and a (geographically distant) alternative to nursing home life in Tupelo, Mississippi. Although the alternative featured offered a glimmer of hope to some of my NYC metropolitan elder law clients, Mississippi is too far south of downtown Brooklyn to be a realistic option for most native New Yorkers. Thankfully, the New York Times published this article about an alternative right here in New York City.  Finally, it seems, someone listened: there is a NYC alternative to institutional living and bingo.

Social Security

In the 2005 State of the Union Address, our former president tried to convince us of the dire need to "privatize" the Social Security Administration's pension fund. Thankfully, he was unsuccessful.  If we heeded our former fearless leader's advice, the Social Security fund as we know it would have been obliterated in recent months and would (likely) be barely limping along, like the rest of the financial world. Saul Friedman of Long Island Newsday published this article, "GRAY MATTERS: Show me the money? It's easy: Social Security isn't in trouble", outlining the laurels of old-faithful, Social Security. The gist: Social Security, compared to the rest of the American financial outlets, is doing just fine.