Advance Directives Need to Be Accessible

July 8th, 2014

When drafting advance directives, a common problem for many people is making these documents easily accessible for their loved ones.

What is an advance directive? A legal document in which a person specifies what arrangements should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity. There are different ways of creating advance directives, including a living will, a durable power of attorney and also a health care proxy.

People may feel that their advance directive should be kept with their attorney or in a safe deposit box. However, decisions about medical treatment often need to be made quickly, so it is important that an advance directive be not only safe, but easy to get to.

If an individual’s advance directive appoints another person as health care proxy, then that person should have a copy of the document, or know where it is kept. If a patient is incapacitated, then it is important that the health care proxy be able to present the document to medical personnel.

It may also be wise to keep a copy of the document in electronic form, stored in such a way that it is accessible from a smartphone or other device. Such electronic copies have the same legal authority as the original paper document, and they can be accessed more easily. Ask your attorney what they recommend for digital or cloud storage for these documents to ensure the security of your private information. Learn more about our services within elder law and advance directives by clicking here.

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Traveling with an Older Adult

June 25th, 2014

By Susan Yubas, founder of FYI Senior Living Solutions, Inc.

As we prepare for a trip with older members of our family, we want the plans we make to be as uncomplicated and stress free as possible.  “Ha, ha,” you laugh.  Travel is complicated and stressful on its own these days, let alone when you are traveling with an older adult who may be frail.

Here are some tips to ease the way:

  • Review your travel plans with their personal physician so you know if there are any special needs you should be aware of and plan for in advance of your arrival.
  • Make sure you know the health insurance company’s requirements for out of network or emergency care – sometimes a family definition of emergency is different from that of the insurer.  Bring a copy of insurance cards with you on the trip.
  • Bring a current medication list and medications in their original pharmacy bottles.  Carry the medications with you – never pack them in checked luggage or in a place that you cannot get to easily.
  • If an older adult has difficulty walking long distances or easily gets short of breath, arrange for a wheelchair.  It is important that you do this well in advance of arrival at the airport as having the wheelchair available at curbside will allow you to navigate security and get to the gate more easily and safely.
  • Familiarize yourself with available medical resources at your destination in advance.
  • If you will be traveling quite a distance, you may want to consider travel insurance that includes medical transport and/or trained personnel to accompany you to a care destination should the need for urgent care arise.
  • Be flexible with your schedule and enjoy your trip!

Susan Yubas is a Certified Senior Advisor and the founder of FYI Senior Living Solutions, Inc.  She will help you articulate your goals,identify issues you may not have considered and direct you to appropriate professionals to help you implement what is needed.


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Planning Considerations when your Elderly Parent Moves in

June 17th, 2014

Have you considered having an elderly parent move in with you? Many people face this decision because of financial circumstances or because their parents need assistance with daily activities. Living with an aging parent can provide an opportunity to reconnect in a positive way but it also demands life style changes. Proper planning can make the difference in ensuring that this transition is smooth.

  • Communication is key. When adult children of elderly parents think about how they intent to care for them, it is important to broach the subject with their parents early on to gauge their feelings. There are situations in which older people in which older people do not want to face the fact that they need help and may be resistant to leaving their home or accepting the care they need. However, even in these cases, any accommodations that can be made to the parents’ own preferences will make the transition easier for everyone.
  • Advance planning is crucial, especially regarding financial matters. Remodeling may be necessary to make one’s home senior-friendly. For instance, if changes need to be made to permit wheelchair access or to add or remodel a bedroom or bathroom, then these costs need to be planned for. If part of the plan is to rely on proceeds from the sale of the parents’ home, then this too requires arrangements to be made well advance.
  • What types of care are covered? It is important to consider what care one’s parents may need as they grow older, and how to pay for it. When making the decision to have an elderly parent move in to one’s own home rather than an assisted living facility or nursing facility, one needs to consider whether an in-home caregiver will need to be hired. If so, that cost needs to be included as one considers the financial planning aspect of the move. Is there a long-term care insurance policy? What Medicare or Medicaid coverage is in place? Take the time to learn what type of care may or may not be covered. Do not assume that providing care oneself is the least expensive option. Time taken away from work and incidental care-giving costs can add up and needs to be planned for.
  • Communicate with Siblings. It is important to communicate with siblings regarding the cost of care. If an elderly parent is moving in with one sibling, then there should be clear communication with the other siblings about how they intent to contribute to their parents’ care.

Caregiving has financial and emotional costs that may not be recognized by others if they are not expressed. In addition to getting help from one’s siblings, if possible, adults caring for elderly parents should take full advantage of any services that are available to seniors and their caregivers in the area.


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Horses May Help In Alleviating Alzheimer’s Symptoms

June 13th, 2014

A small pilot study indicates that equine therapy – spending time grooming, feeding and walking with horses – eases symptoms of Alzheimer’s dementia, making patients calmer and happier.

Equine therapy is used today for children and teenagers with emotional and developmental disorders, and the new study indicates that it may also be useful for older adults with Alzheimer’s disease.

Researchers at Ohio State University studied 16 people with Alzheimer’s disease who participated in activities at an adult senior daycare center. Eight of the seniors who volunteered for the study were taken to an equine education center while the other eight pursued other activities at the center. The clients visited the farm once a week for four consecutive weeks, grooming, walking and feeding the horses under the supervision of caregivers.

The researchers found that the patients who interacted with horses showed an immediate positive mood change and were less likely to resist care or become agitated later in the day.


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Avoiding Medicare Mistakes

June 3rd, 2014

Americans approaching retirement age are usually aware of the basic facts about Medicare. However, people sometimes make assumptions that can lead to pitfalls. It is important to know what to do and when, because mistakes can cause penalties.

One mistake some people make is assuming that they will not qualify for Medicare because they have not worked long enough. The waiver of premiums for Part A (hospital insurance) is based on the payment of Medicare taxes by applicants or their spouses for at least 10 years. However, for those who do not qualify for a waiver of Part A premiums, they still have the option to enroll in Part A and pay premiums.  Additionally, one does not need work credits to be eligible for Medicare Part B (physicians’ services) and Part D (prescription drugs).

A common mistake that people may make for different reasons is failing to sign up for Medicare at the right time. To avoid late penalties, one must sign up for Medicare during their designated Initial Enrollment Period.  Your Initial Enrollment Period is a seven-month period beginning three months before the month you turn 65 and ending three months after the month you turn 65.  This is true even if your “full retirement age” for Social Security retirement benefits is age 66

Sometimes people hear about the Medicare “Open Enrollment Period” in the fall of each year and believe that this is when they should first sign up for Medicare. Actually, Open Enrollment is when people who are already receiving Medicare may change their Medicare coverage or plan for the following year. First-time Medicare enrollees must sign up during the three month period before and after they turn 65.  One legitimate reason to delay signing up for Part B is if you continue to have health coverage from an employer after age 65; in this case you can delay enrollment in Part B with no penalty.

Finally, it would be a mistake to decide not to sign up for Part D just because you do not currently take any prescription medications. An unforeseen medical condition could necessitate expensive prescriptions, and having a Part D plan can be crucial.


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Senior Crime Busters: A Proactive Elder Fraud & Crime Prevention Program

May 14th, 2014

Seniors are often targeted for identity theft, telemarketing and sweepstakes fraud, and home improvement rip-offs. And with so many seniors using the Internet, online scams are an increasing concern.

That’s why Westchester County launched Senior Crime Busters, a proactive elder fraud and crime prevention program that teaches seniors how to recognize potential scams before they happen, and how to avoid becoming a victim in the first place. To learn more about this program, visit the Westchester County Senior Citizens website or click here.

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May 2014 is Older Americans Month

May 5th, 2014

May 2014 is Older Americans Month, with the theme of “Safe Today, Healthy Tomorrow.”

Older Americans Month, once known as Senior Citizens Month, has been celebrated since 1963, and is a time to honor older Americans for their contributions and achievements, and raise awareness of issues of importance to seniors.

In New York, a ceremony will be held on Tuesday, May 6 in Albany, to mark Senior Citizens’ Day and Older Americans Month. Older citizens from across the state will be honored by the New York State Office for the Aging, focusing on those who have shared their expertise with their communities through volunteer work.

This year the theme of Older Americans Month is a focus on safety. Seniors are at a much greater risk of unintentional injury than the rest of the population. Falls and other accidents account for millions of injuries and over 30,000 deaths each year.

There are many small changes that older Americans can make to promote safety. These include having one’s vision checked on a regular basis, staying aware of medications that may cause unsteadiness, installing handrails in bathrooms or wearing shoes with non-slip soles to prevent falls, and setting the household water heater to 120 degrees to prevent burns. Seniors should also be aware that daytime driving under good weather conditions is safest, and it is important to avoid distractions while driving.

The Administration for Community Living, which helps seniors live in their homes and participate in their community, has additional resources available at


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Avoiding Caregiver Burnout

April 21st, 2014

By Bernard A. Krooks, Certified Elder Law Attorney

Being a caregiver for an elderly family member can be very demanding, both physically and emotionally. It is no surprise that many caregivers experience burnout. Caregivers often feel pressure to assume additional responsibility as time passes and neglect to take time out for themselves. Here are a few key tips to avoid burnout:

Ask Family Members for Help

When an aging parent needs care, one adult child may assume a greater share of the work than their adult siblings. This may be intentional or unavoidable, if other siblings work full-time or live farther away from the parent. Often, the imbalance is not acknowledged or even understood. It may be that those siblings who are not the primary caregivers simply do not know how much work is involved. In this situation, it can be important to have a family meeting.  The primary caregiver can use such a gathering to inform other family members of the details of their parent’s condition, and what is needed in terms of care. Once the caregiver explains in detail the amount of work that is involved, a perfect opportunity arises to ask other family members to contribute and help.

Try a Support Group

Being a caregiver can be very isolating. One may spend a great deal of time alone with the elderly parent.  Other relatives and friends, who are not caregivers, may not appreciate the amount of work involved and may not understand the caregiver’s frustration or exhaustion. Getting together in a support group is an excellent way to share resources and talk about day-to-day experiences with other caregivers in similar circumstances. Caregivers may be reluctant to attend a support group because of time constraints or because they downplay the significance of their work. However, most people have a positive experience when they attend support groups.                                                                                                   

Use Respite Care

Many people are working as unpaid caregivers for an elderly family member in part because professional in-home assistance can be unaffordable. Respite care can be a good alternative to full- or part-time help, providing planned, short-term breaks for the caregiver. For example, a break of a few hours once a week can have a beneficial effect on the caregiver’s emotional well-being. When making choices about care, families sometimes look at the option of hiring in-home care as an “all or nothing” undertaking, but respite care can be the perfect in-between alternative, allowing a family member to provide primary care, but take necessary breaks.

These tips have a common theme: one should not face these challenges alone. Instead, get help from family members and from community resources.

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Emergency Rooms and the Elderly Patient

April 17th, 2014

Emergency rooms are designed for fast treatment of serious or life-threatening conditions.  Elderly patients suffering from chronic illnesses may not always be able to convey important medical information to treating professionals.  This is particularly true of those suffering from Alzheimer’s disease or dementia. Additionally, elderly patients may not be able to properly communicate information about their prescribed medications. These factors mean that quick treatment is not always the most effective treatment.

hospitalPatients coming to hospital emergency rooms receive treatment and are sent home with detailed instructions about arranging their own follow-up care. This approach is grounded in the efficient use of limited resources. For many elderly patients, this approach may not be ideal because more thorough evaluation is necessary.

Specialists in geriatric medicine and emergency room care have taken steps to address the problem. Recently, the Society for Academic Emergency Medicine (SAEM) published a set of guidelines to help emergency departments provide better care for elderly patients.

The purpose is to “provide a standardized set of guidelines that can effectively improve the care of the geriatric population and which is feasible to implement in the ED. These guidelines create a template for staffing, equipment, education, policies and procedures, follow-up care, and performance improvement measures.”  (Society for Academic Emergency Medicine, 2014)

Elderly-Man-With Doctor

The guidelines include better training for hospital staff to recognize certain factors that play a role in providing care to the elderly. For instance, older patients may need more assistance getting prescriptions filled, and may need for transportation to be arranged for follow-up medical visits. The guidelines also recommend sound-absorbing materials and non-slip flooring in emergency rooms to reduce noise and prevent accidents.

Recommended changes also include printing discharge instructions in a large font size, and making sure that emergency rooms communicate important information to the patient’s family and any outpatient caregivers, including nursing homes. Emergency departments should also develop relationships with providers of resources that patients can use for follow-up care regarding mobility, safety assessments, prescription assistance and education, and home health care assistance. The guidelines stress that much depends on educating hospital staff about the needs of elderly patients.

Similar changes have been made in regard to pediatric and cardiac emergency care, but changes to help the elderly have not come as quickly. Nevertheless, progress is being made. Today over 50 medical centers have made such improvements, as opposed to ten years ago, when there were no such features.


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Society for Academic Emergency Medicine. (2014). Geriatric Emergency Department Guidelines. Retrieved from


Glossary of New York Estate Administration Terms

April 8th, 2014

If you are preparing your will, or if you have been named as executor in a will, you may be encountering some unfamiliar terminology. It is important to know the meaning of the terms used in the administration of estates, so that you can begin to understand how wills are probated and what the responsibilities of a fiduciary are. This glossary defines some of the terms that are used in the administration of estates in New York State. More information can be found at the website of the Public Administrator of New York County.


  • Administrator: A fiduciary appointed to administer the estate of a decedent who died without a will.
  • Decedent: A person who has died.
  • Distributee: A person entitled to take some or all of the property of a decedent who died intestate. Also called an heir.
  • Domicile: The permanent place where a decedent lived. If a decedent lived in more than one place, then the domicile is where the person intended to return.
  • Estate: The total property of a decedent.
  • Executor: A fiduciary who is named in a will to administer the estate of a decedent.
  • Fiduciary: Also called a personal representative, a person appointed by the Surrogate’s Court to administer or manage the estate of a decedent. A fiduciary may be an executor if named to that position in a will, or an administrator if appointed to administer the estate of a decedent who died intestate.
  • Intestate: Describes a person who died without a will.
  • Personal Representative: Another term for a fiduciary.
  • Probate: The process by which the Surrogate’s Court recognizes the validity of a will. When a will is recognized as valid, it is admitted to probate, and the executor is usually appointed to administer the estate.
  • Public Administrator: The Office of the Public Administrator administers estates in each New York county, and is the default fiduciary, administering estates when no one else is available, such as when a decedent dies intestate and there are no distributees, or the distributees are ineligible to serve as administrator.
  • Surrogate’s Court: The New York county courts that oversee the estates of decedents. In other states, these may be called probate courts.


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