Coming of Age Magazine Issue IX

ISSUE 9| SUMMER 2021

WHO WILL TELL YOUR STORY? A look at the process of writing a eulogy.

THE FAMILY AND THE FACILITY THAT WESTCHESTER HAS TRUSTED FOR NEARLY 40 YEARS WHEN IT COMES TIME TO FACE LIFE’S MOST DIFFICULT MOMENTS. FAMILIES HAVE TRAVELED THE EXTRA MILE TO CALL UPON US, KNOWING FULL WELL WE WILL DO THE SAME FOR THEM.

767 E. Boston Post Road Mamaroneck, NY 10543 (914) 698-5968

134 Hamilton Avenue Greenwich, CT 06830 (203) 869-5968

EDITOR'S NOTE

R

estaurants are open, the masks are off (kind of), the airports are crowded… it would appear as if life was back to normal; although we are left to wonder what normal now means. Irreparable damage has been incurred over this past year and change. Our children have been alienated from their schools and peers. They have come to accept their virtual reality as the norm. Our seniors have been alienated from families, literally in fear of giving or receiving a hug from their grandchildren. They have missed out on birthdays, sporting events, holidays, random visits… moments and memories that time will not allow them to have back.

One day, we will recognize the true aftermath and damage that was inflicted during this time and realize that COVID, the virus itself, was the least of it.

There is only one direction we can travel and that is forward. So here we go, onward and upward. It’s time to pick up the pieces and move past the fear. It’s time to sit at a table and gather with family and friends; time to have kids regularly in-person for school, time to hug one another and not live in fear of standing 6-feet apart.

""Whatever your

We’ve proven our susceptibility to government control. They got us good, everyone. So many restrictions here in our great state have been lifted, not coinciding with scientific data necessarily, but rather, politics.

It begs the question, what was all the fear for?

I hope this issue provides you with some hopefulness moving forward. With legal, medical, health/fitness and other experts, you will be equipped with some great tools to afford you some great peace of mind.

Rebuilding a life will be much more difficult for some than others. Those who opted for deeper isolation must now be reintroduced into society.

The things we took for granted like walking into a store or restaurant have become foreign to so many.

Others, who may have experienced a loss over this past year must now enter the new world minus the one they loved. The moral of this story is that everyone is fighting a battle and we are all united by our respective struggles.

struggle, hold on to hope…

however you can."

Whatever your struggle, hold on to hope…however you can.

Jen

Sincerely,

COMING OF AGE | 01

COMING OF AGE

CONTENTS

4 6 How To Get Rid of the Concierge Medicine Raise your level of care. "COVID - 19" (pounds)

10 Aphasia Do you have it?

1 EDITOR'S NOTE: Jennifer Graziano

Editor: Jennifer Graziano Contributing Authors: Aubrey Bauer Salvatore Di Costanzo, Esq. Adriana Greco Dwayne July Dr. Michelle Maidenberg Dr. Kim Nichols Dr. Jeffrey Puglisi Richard Sgaglio Publisher: Jennifer Lanser JL Harbrook

27 What will be said about you?

Think of it as "your story"' 17 Are you ready to travel?

Where are people going?

Copyright © 2021 All rights reserved. No part of this publication including, but not limited to text and photographs, may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher. For permission requests write to the publisher addressed.

COMING OF AGE | 02

19 Video documenting your final thoughts For families dealing with terminal illness 13 Love the skin you're in Getting through menopause 23 Legal Information Power of Attorney and Trusts

Has the pandemic added an unwanted 10-15 lbs. or did it just make you realize that you need to get in shape and you don't know where to start?

Here are 5 pitfalls when you make the decision to start a fitness program.

FIVE THINGS TO AVOID WHEN STARTING A FITNESS PROGRAM

BY DWAYNE JULY

1 04

STARTING OUT TOO HARD

In the age of social media, we have information at our fingertips.

This can be a gift, but it can also be a curse. We may admire certain people and their physiques, however, that doesn’t mean that we should do the same program they are currently doing.

The reason is that you don't want to start a training program that's too advanced for your fitness level. That is how you may get hurt or how you may feel

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defeated too early. Instead, focus on where you currently are in terms of fitness and strive to make small improvements every day.

EGO LIFTING

Have you ever seen someone lifting a weight that they can’t control at all and over time they get hurt? Yes? Ok please don’t do it. Find a moderate weight (even if that weight is only 7 lbs) that you can lift with good form for the designated number of reps. Over time and with discipline and patience you can increase the weight that you are lifting.

3 4 5

CHANGING UP YOUR PROGRAM TOO OFTEN

This has become one of the biggest issues in the fitness industry because of the term muscle confusion. People don't fully understand what that means so they change up their program too often. This practice does not give the body the ability to adapt to the work and, as a result, prevents the body from actually seeing a quantifiable change in physique and strength.

NOT BEING CONSISTENT

The results that you will be looking to achieve will come through regular and consistent activity. Stick to your program and avoid frequent stops and starts.

Consistency will also diminish the soreness that you inevitably feel when you first start.

NOT HYDRATING

Ensure you drink plenty of water before, during, and after exercise. Particularly, if you are exercising in warm conditions or for long periods, it's a must. Dehydration will result in a drop in performance and severe dehydration can be dangerous.

It's time to lose that COVID 19 lbs! Get in touch about crafting your own personalized and successful plan chat on Facebook @Fitbyjuly or call (203) 900.1166

COMING OF AGE | 05

Concierge Medicine— Having the Time to Care

More is more.

Time to focus on your health.

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“Dr. Puglisi, it was so nice to be able to reach you quickly and easily. Thank you for taking the time to address the medical problem I have.”

Over the past seven years, I’ve heard this accolade from my patients countless times as they describe their physical symptom or medical situation that required urgent attention.

In a high-volume traditional practice, the aforementioned medical problem might be lost in an electronic medical record portal message or buried in a phone tree somewhere or get handled by a covering doctor or physician assistant that doesn’t know the patient - or worse yet may prescribe a therapy that’s expedient because they have twenty other calls to get to that day.

In this type of traditional practice setting, excellent doctors and other healthcare practitioners are unable to be their best because of the constraints on their time and the inability to put the patient’s needs first.

It’s been nearly 20 years that I’ve worked in Internal Medicine in Greenwich, CT. Early in my career, our practice was similar to these volume-based practices and I did my best to provide optimal care for the patients that put their trust in me and my partners. Despite our best efforts, it was exceedingly difficult to provide the level of care they needed in our traditional medical practice.

We tried our best, stayed late every day, and had countless meetings to see how we could achieve the right patient experience for them.

That’s when we learned about an annual fee model, called Concierge Medicine. Too often in the early days (some 20 years ago), this type of practice was misconstrued as “elitist care” and dismissed as a way for a doctor to work less and make more money.

However, hundreds of doctors I know throughout the country who have shifted to a concierge model have done so to save more lives and provide the type of personal care that they’d expect for their own family members. At the same time, this approach has prevented physician burnout and improved their mental and physical wellness.

Longer term benefits are that these doctors are staying in practice for a lifetime rather than retiring early or shifting to another career choice, which ultimately benefits the patients even more.

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discuss emotional well-being, review their lab results, do a thorough physical exam, understand life stressors, help strategize about their preventive health for the upcoming year, and most importantly treat every patient like family.

Being part of our concierge practice, each patient has the ability to contact us and our staff directly and easily when the need arises.

Most can get office visits, phone calls, or emails handling their issue within a short amount of time. The annual fee model works. In fact, recent national concierge practice data show decreased rates of cardiovascular events in individuals at risk for these diseases. It gives people peace of mind that the doctor who knows them the best is available to help them when an issue arises and that preventive medicine truly works when the doctor has the time to spend with patients.

At Glenville Medical Concierge Care, my practice in Greenwich, CT, our mantra is that “your commitment to wellness doesn’t happen by chance, it happens by choice”. Our patients are motivated to stay in good health. We offer 90-minute annual physicals to assess cardiovascular risks, talk about their family history,

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Many people are shocked to learn that the average age of my patient panel is early 50s.

We care for patients from late teenage years to over one hundred years old. I always joked that a patient of mine who passed away at 103 years old, played more golf during that year than I did—and it was an absolutely true statement.

He was an inspiration to me and my life is better because of the bond we shared together during the past two decades.

As a founding member of the Greenwich Hospital Wellness Committee, a group designed to help prevent physician burnout, we always encourage our colleagues to try and look inward and reflect regularly on how they are doing physically and emotionally. Prior to my concierge practice transition, I wasn’t taking care of my health and I felt deeply unfulfilled knowing that the medical care I was providing was not at the level I wanted.

Thankfully, my partners Dr. Judy Shea and Dr. Steve Mickley agreed that the move to an annual fee-based membership model was the best change we could make for our patients and ourselves.

We are in year seven and not only do we all agree that the shift was unbelievably worthwhile, but we added Dr. Ralph Cipriani three years ago (an Infectious Disease doctor

and Internist). Now we are delighted to announce that our fifth doctor will join us in August—Dr. Erika Krauss from Westchester County, NY where she’s practiced for the past twenty years. Dr. Krauss brings with her an incredible intellect, amazing medical skills, and additional training in functional/holistic medicine and nutrition. Our practice will only become stronger from her addition and we can’t wait for new patients to meet her and benefit from her warm personality and passion for patient care.

In closing, anyone who cares about their health and wants to join a team that fully believes the value proposition of Concierge Medicine is all about having the time to partner together to achieve optimal wellness, then please reach out to a concierge doctor in your area or call our

practice to learn more. My goals for the future are to continue working nationally with groups like Specialdocs and ROAMD and the team at the Concierge Medicine Today Journal to hopefully have employers and insurance companies defray the cost of these annual fee practices. Once that occurs, it will allow other physicians to shift to smaller patient-panel practices like ours and encourage younger doctors to do the same when they graduate their residency programs. This will finally afford patients the chance to have the doctor they trust be able to care for them in the way they deserve.

YOU

COMING OF AGE | 09 Issue 30 | 234

APHASIA IN AMERICA

BY RICHARD SGAGLI0 VICE PRESIDENT, THE OSBORN

WWW.THEOSBORN.ORG

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STATISTICS 2020 According to the National Aphasia Association, 2 million people in the United States have aphasia,

However, 84.5% of Americans state that they’ve never heard the term aphasia.

WHAT IS APHASIA? Aphasia is a language disorder that occurs when someone experiences brain damage. The brain has two halves or hemispheres. Language skills are carried out in the left half of the brain. Damage on that side may lead to language problems. Damage on the right side of the brain may cause other problems, like poor attention or memory issues.

Aphasia may make it hard for someone to understand, speak, read, or write. It does not make them less intelligent or cause problems with the way they think.

Brain damage can also cause other problems along with aphasia. People may have muscle weakness in and around the mouth, called dysarthria.

They may have trouble getting the muscles of the mouth to move the right

84.5% way to say words. This is called apraxia.

They can also experience associated swallowing problems, which is called dysphagia.

SIGNS OF APHASIA Aphasia can lead to a number of different problems. Someone may have trouble speaking, reading, and writing.

People with Aphasia may experience the following: Cannot think of the words they want to say Say the wrong word without realizing it Change the order of compound words Use words that sound like gibberish Have a hard time creating sentences Use single words rather than sentences Create sentences that include nonwords and real words

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COMPREHENSION People with Aphasia may experience the following: Not understand what others are saying Have trouble understanding conversations in groups Be unable to understand humor or sarcasm

READING AND WRITING People with Aphasia may experience the following: Difficulty reading and comprehending magazines, books, and computer screens Unable to spell and put words together to write complete sentences Difficulty using numbers or doing math such as counting

CAUSES OF APHASIA Aphasia is most often caused by a stroke (brain bleed) but can occur as a result of any type of brain damage. This includes a traumatic brain injury, brain tumors, and certain types of dementia.

TESTING FOR APHASIA People should see a doctor if they have trouble speaking or understanding what people say. A doctor will determine if there is a medical cause for the problem.

A speech-language pathologist, or SLP, will test their speech and language skills.

The SLP will test how well someone: Understands words, questions, directions, and stories Says words and sentences Reads and writes

TREATMENTS FOR APHASIA Many people who suffer from Aphasia following a brain injury will find it most beneficial to work with a Speech/Language Pathologist (SLP). This can be done individually or in a small group. Some people with aphasia find it helpful to join a support group because it is a way of connecting to others who are experiencing the same type of communication challenge.

TIPS FOR COMMUNICATING WITH A PERSON WHO HAS APHASIA These tips may make it easier for you to understand and talk with those with aphasia.

1. Make and keep eye contact 2. .Watch body language 3. Talk in a quiet place 4. Keep your voice at a normal level 5. Keep the words simple but do use not baby talk 6. Use shorter sentences 7. Give them time to speak 8. Try using drawings, gestures, writing, and facial expressions 9. Ask them to draw, write, or point when having trouble talking 10. Ask "yes" and "no" questions

Aphasia is a difficult and frustrating disorder for those who have it – it’s also caused by some other medical issue which adds to its complexity. If someone you care about has aphasia, please be patient and kind. It will go a long way in helping them recover. Other Resources: Aphasia Hope National Aphasia Association American Stroke Association

The information in the above article is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

EMBRACE YOUR AGE: HOW TO LOVE THE SKIN YOU’RE IN DURING MENOPAUSE

BY DR. KIM NICHOLS, M.D On average, 27 million women experience menopause each year. With menopause comes a new set of skincare concerns and struggles, from dry skin and hormonal acne to hair loss and wrinkles. And yet, in the beauty and skincare industries menopause and skincare has been so often overlooked. At NicholsMD of Greenwich [in Greenwich, CT] my goal is to make every woman look and feel their best at every age.

Skin: Wrinkles and Laxity As a board-certified dermatologist and expert in hair, skin, and nails, I strongly believe that aging is not something to fear. As a result, I enjoy treating common problems that arise as women reach menopause. Because the face has a high concentration of estrogen receptors, dramatic changes in hormone levels have direct impacts on women’s skin. Decreased estrogen levels often lead to slower cell turnover and decreased collagen production, which in turn causes sagging, wrinkles, and jowls.

For those wanting to restore firmer, more youthful skin, I recommend Ultherapy. It is one of the most popular treatments at my practice, averaging one to three patients per day I personally do Ultherapy .as maintenance to keep my own face, neck, and decolletage lifted and firm. Ultherapy uses focused ultrasound to stimulate collagen production deep within the skin without the downtime of an

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invasive treatment. For women looking to prevent wrinkles during perimenopausal and menopausal stages, I always recommend injectables such as BotoxÒ, DysportÒ, and XeominÒ to soften expressions that create deeper fine lines.

Skin: Age Spots & Sun-Damage Further, over time the abuse of sunbathing begins to show in age spots and discoloration all over the body. The most important thing to do is get routine full-body skin exams and cancer screenings, as well as protect your skin with ample SPF and sun-protective clothing. While past sun damage can’t be undone, sun protection will stop additional damage from occurring. In addition, I offer a variety of laser treatments to help reduce the appearance of photodamage and discoloration.

Skin: Dullness & Dryness Another common issue to treat is dry, dehydrated, and dull skin. When skin becomes estrogen-deficient, it becomes harder to absorb the nutrients in moisturizer and skincare regimens.

And there is nothing more frustrating than when products you invest time and money in suddenly stop working. When patients come in with this concern, I typically suggest the Complete Emepelle System, a two-step skincare line that is designed specifically to revitalize the natural function of estrogen deficient skin. These products use MEP TechnologyÒ to help keep skin hydrated, even, and bright by restoring lost collagen, without acting as a hormone replacement.

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Hair: Thinning and Facial Hair Growth Skin isn’t the only thing that is negatively affected by decreasing estrogen levels.

Hair also tends to start thinning during perimenopausal and menopausal stages of life. To strengthen and help stimulate hair regrowth, I advise her patients to consider PRP (plateletrich plasma) injections. Using each patient’s natural growth factors found in their platelet-rich plasma, these injections help reactivate inactive hair follicles, triggering hair regrowth. On the opposite end of the spectrum, while women tend to lose hair on their heads during these stages of life, it is also common to experience an increase in unwanted facial hair. When this occurs, I offer both laser hair removal and dermaplaning at her practice in Greenwich, CT.

Body: Feminine Health Aside from the visible aging concerns most women have as they reach menopause, the natural aging process and decrease in estrogen can also sometimes lead to unexpected and embarrassing physical conditions such as urinary incontinence, vaginal laxity, dryness, and recurring infections. These symptoms hinder feminine confidence, as well as the ability to fully enjoy intimate moments. However, at NicholsMD of Greenwich, Dr. Nichols believe every woman deserves to be confident to live her best life at every age. When women open up about this, the treatment offered to her patients is feminine rejuvenation with the CO2RE® Intima laser. This non-surgical treatment helps to relieve these symptoms related to vaginal wellness and enhance sexual functioning – restoring confidence that is so often lost as women age.

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Post Pandemic Travel Trends

BY ADRIANNA GRECO

COMING OF AGE | 17

Pent up demand for travel is

so they can obtain a “pass” to

very real. So much so that

enter. Turks & Caicos has been

destinations and cruises for

our "GO TO" suggestion for

2022 are already heavily

our clients this winter and

booked. Inquiries for summer

spring. It has pristine beaches,

and year end festive travel are

wonderful hospitality, luxurious

pouring in. EVERYONE is ready

hotels. and gladly welcomed

to come out of their cocoon,

guests with open arms.

and go away!

We recently learned that the Safety is their top priority with

EU is set open its borders to

ease of entry and exit being

vaccinated U.S. travelers this

the second factor influencing

summer. This news thrills us

where people are deciding to

and should be exciting to each

go. Many hotels, cruise lines

of you as well. It means that a

and airports have made Covid

return to normalcy is in our

testing super easy with

very near future.

performing tests on site, in designated areas, so that

Established in 1994,

guests can easily board flights

Crossroads II Travel Inc, has a

back to the U.S.

staff of experienced professionals ready to guide

Several Caribbean Islands

you out of the pandemic into

were the first of International

your dream trip. Now more

destinations to welcome ready

than ever, you should rely on

and willing travelers. These

an experienced travel

countries still require negative

professional to assist in your

tests to enter. Many tourism

future travel arrangements, so

boards across the globe made

dust off those passports and

it simple for passengers to

contact us today.

upload results to websites

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THE INSPIRATION BEHIND THRU MY EYES: CREATING VIDEO LEGACIES FOR INDIVIDUALS WITH LIFE-THREATENING ILLNESSES

BY DR. MICHELLE MAIDENBERG I met 40-year-old Dede at the gym I attend. Her blazing blue eyes (thus the name “Thru My Eyes") and beautiful red hair were striking. After my exercise regimen, we were standing at the mirror getting ready for work. We got into conversations about children, and I expressed that I had four children and she disclosed that she had a daughter who was seven at the time.

Through our encounters at the mirror, she eventually shared that she always dreamt of having many children but because of her bout with breast cancer and her extensive treatment, at the time, she accepted that she could not have any more children. She described her daughter as being her “true miracle” because she and her doctors believed she would never conceive. She expressed how thankful she was to be in remission and spoke of her journey of discovery and evolution toward committing to live a present and purposeful life.

Approximately a year later, we stood by the mirror and Dede shared with me that cancer had returned. She was going to receive aggressive treatment and understood that she was “in the fight” of her life.

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My heart sank as I watched her hair fall out,

discussing important milestones for her

she became progressively weaker and

daughter so that she could be left with

eventually could not make it to the gym any

anecdotes and critical lessons for life. She

longer. A fighter she was. She worked out

asked if she could consult with me about

until she absolutely couldn’t anymore.

developmentally appropriate topics to cover. I helped her come up with a structure

I once asked her, how do you do it and

from which she wanted to be videotaped.

Written by Dr. Michelle Maidenberg

muster up enough strength to come to the

20

gym and remain so generous and positive. I

A few women at the gym did research on

will never forget her answer as it is forever

who might offer such a service. At the

burnished in my mind. She said during her

hospital, they had a videographer who came

last bout with cancer that she made the

to the hospital only if a patient requested it.

decision to live every moment of the rest of

They had to be videotaped at the hospital,

her life with appreciation and joy and

they had to pay for it, and they would be

planned to carry that out no matter what

videotaped without any support or

her demise. I marveled at her courage and

guidance. A few friends chipped in and we

motivation.

were able to get the videographer to come

Further along in her illness, she approached me about wanting to videotape herself

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to Dede’s house to videotape.

Out of this experience, I was committed to

sharing the most intimate details of their

making this service for families readily

extraordinary lives. Examples of these

available, effortless, supportive, and

moments include a 37-year-old woman who

empowering. I felt it should be offered at very

spoke directly into the camera and reassured

minimal cost, or at no cost to families who

her young son that he does not need to be

have limited financial resources so that all

concerned about forgetting her because he has

families, despite their socioeconomic status

this video footage which he could watch as

can benefit. Additionally, in order to preserve

often as he wanted. Another instance was

the dignity and integrity of each individual and

when a couple stopped the taping and took a

family, the videotaping should be

moment to embrace and sobbed lovingly in

accomplished in the comfort of a person’s

each other’s arms. I cried with them.

home with the guidance of a licensed mental health professional who can offer emotional

This 501c3 non-profit organization has been

support and provide a script from which to

fully operational since 2010. We videotaped

guide the interview, based on the topics they

over 300 clients and are offering our services

personally elect to discuss.

nationally. I have gratitude that Dede had the

I explain to families that videotaping is similar

organization and that we continue to provide

to taking out a life insurance policy. We take it

this service to families to enrich their lives

out in the hopes that we never have to rely on

through such a traumatic and challenging

it, but it is comforting to know that it’s there. If

time. Clients always express gratitude that

the individual goes into remission or

they see the process through and

rehabilitates, it is a gift to the individual and

communicate how meaningful and therapeutic

family.

it was and will continue to be into the future

opportunity to witness the initial growth of the

for them and their families. To view

Words cannot truly describe the experience of

testimonies on the website, please see:

conducting interviews where people are

www.thrumyeyes.org.

COMING OF AGE | 21

Do they know?

If you want to be buried or cremated?

If you want a visitation for those who knew and loved you?

If you have a favorite photo,.. song,.. or prayer?

If you have a special way you'd like to be remembered?

Perhaps you should tell them...

Pre-arranging a funeral allows you to make choices and selections so that your loved ones are not left to guess, but rather, are able to grieve.

Don't assume your family will make the same choices you'd prefer. Let your voice be heard and your wishes known.

Cut off this portion of the page and send it to either address below for a licensed, trusted, knowledgeable, funeral director to help you learn about pre-planning and to have your voice be heard.

We are not sales people, we are family.

767 E. Boston Post Road Mamaroneck, NY 10543 (914) 698-5968 Name

www.coxandgraziano.com

Phone preferred method of contact:

134 Hamilton Avenue Greenwich, CT 06830 (203) 869-5968 eMail

eMail

Phone

Legal Info...

significant changes in

y e n r o t t a f o r e pow Substantial Conformity

On December 15th, 2020, Governor Cuomo signed into law legislation substantially amending the New York General Obligations Law, which is the law that governs powers of attorney in New York. Effective June 13th, 2021, the new law, among other things, modifies the form of a power of attorney. The new form must be used beginning June 13th, 2021, however, a power of attorney drafted prior to the effective date is still valid. This article provides a brief overview of the key changes made by the new legislation.

One of the nuances of the old law was that the form of the power of attorney signed by the principal (meaning you) needed to exactly match the wording of the form provided by the statute. For the unwary, a slight alteration to the form, in the wrong place, may have resulted in the form being considered a “non-statutory” form, thereby losing the protections of the statute. Under the new law, the form signed by the principal only needs to “substantially conform” to the wording of the form found in the statute. This leniency makes it much easier to rely on the statutory provisions benefiting powers of attorney, for instance, imposing sanctions on those who unreasonably refuse to accept the power of attorney (as discussed below).

Elimination of Statutory Gifts Rider A very cumbersome aspect of the old statute centered around the statutory gifts rider. The statutory gifts rider was necessary, and required, to allow your agent to exercise any power that might change your beneficial interest. For instance, to transfer your assets to a family member or to change beneficiary designations on your accounts, a statutory gifts rider would be necessary.

The statutory gifts rider was complex, but it was also often improperly implemented. For instance, for the statutory gifts rider to be effective, a box on the power of attorney needed to be initialed. Moreover, the statutory gifts rider needed to be signed at the same time as the power of attorney otherwise it was invalid.

The new law eliminates the statutory gifts rider. While this may appear to simplify things, great care must be taken to incorporate those modifications ordinarily found in a statutory gifts rider into the new power of attorney form. This is not a straightforward assignment and counsel must be sought.

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Acceptance and Reliance by Others A practical issue with powers of attorney is that many financial institutions might refuse to honor the form simply because it is not the form prescribed by their legal department. It has always been unlawful to unreasonably refuse to honor a valid statutory short form power of attorney, however, there were no consequences to doing so. Now, to encourage acceptance of the form, the new law imposes sanctions, such as legal fees, on those who unreasonably refuse to accept a valid statutory short form power of attorney. And to further encourage acceptance, a third party who reasonably accepts a power of attorney form properly v acknowledged and witnessed shall not be held liable for any unauthorized transactions by agent.

Signing At the Direction of Another Salvatore M. Di Costanzo is a partner with the firm of Maker, Fragale & Di Costanzo, LLP located in Rye, New York, and Yorktown Heights, New York. Mr. Di Costanzo is an attorney and accountant whose main area of practice is elder law and special needs planning. He is a member of the National Academy of Elder Law Attorneys and a frequent author and lecturer on current elder law and special needs topics.

Since 2013 Mr. Di Costanzo has been selected each year by the rating service, Super Lawyers as a New York Metro leading elder law attorney.

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Here is an interesting tidbit. In New York, one can direct another to sign a Last Will and Testament on one’s behalf. Similarly, the new law allows a power of attorney to be signed on behalf of the principal by someone other than the agent, in the principal’s presence and at the direction of the principal.

There are several other technical changes made by the new legislation that requires the expertise of counsel who regularly practices in this area. The consequences of having an improper power of attorney may lead to an unanticipated guardianship proceeding which is where a judge will appoint someone to handle your affairs. The implementation of the new law is an opportune time to meet with us and review your overall estate plan.

Mr. Di Costanzo can be reached at (914) 925-1010 or via email at smd@mfd-law.com.

Visit his practice specific website at www.plantodayfortomorrow.com

In New York, one can direct another to sign a Last Will and Testament on one's behalf.

FROM THE DESK OF SALVATORE M. DI COSTANZO, ESQ. In my practice, repetition inspires action. Sometimes, people need to hear the same advice repeatedly before they act. Since one of the most important planning techniques implemented by an elder law attorney is the Medicaid Trust, it is prudent to repeat this writing every now and again. Perhaps this will be the impetus you need to act.

THE PURPOSE OF THE TRUST It is irrefutable that there is a possibility that you may require nursing home care or home care someday. The next logical question would be “How am I to pay for my care?” There are limited options.

For many, privately paying is cost-prohibitive, as the average monthly cost of a nursing home exceeds $12,000 a month. In home care cases, it could be as much as $10,000 a month. Long-term care insurance is an option, but many people cannot afford the premiums or cannot qualify due to age or health. Medicare is limited, in fact, it only covers the first 100 days in a nursing home.

That leaves Medicaid as your only viable alternative. Those who intend on relying on Medicaid as the payor of their nursing home or home care costs are regularly introduced to the Medicaid Trust as a mechanism to obtain Medicaid eligibility without losing their assets, turpis.

THE MECHANICS OF THE TRUST You are the creator of the trust. Usually, one or more of the children are the trustees. The children are usually the beneficiaries of the trust after your death; however, you can name anyone as the beneficiary. The trust is irrevocable. However, there are provisions under New York State law that allow for the revocation or amendment of an irrevocable trust and our trusts are drafted in such a manner to allow for changed circumstances.

You are entitled to receive the income of the trust, if any. This means that you are

entitled to receive the interest, dividends, etc. generated from that any trust assets.

You are not entitled to take the principal out of the trust. After five years from the date the assets are transferred to the Trust, the assets of the Trust can no longer be considered by Medicaid when applying for nursing home Medicaid. Recently, a new

look-back period has been instituted for community Medicaid (care at home). The look-back period for community Medicaid is two and one-half years.

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PROVISIONS PERTAINING TO THE HOUSE The Medicaid Trust is largely drafted with the intent to transfer your house and/or other assets to the Trust. The Trust provides that you have the right to live in the property of the trust. This means that you cannot be kicked out of your house. You are still considered the owner of the house for purposes of maintaining the house, payment of real estate taxes, the STAR exemption, the Veteran’s Exemption and any other tax benefits attached to the house.

The house can be sold at any time, but only with your consent. A new house can be purchased with the proceeds of the sale from the first house.

SPECIAL POWERS RETAINED BY THE CREATOR Many clients are concerned about losing control. However, a properly prepared trust affords the creator a great deal of control as permissible by Medicaid rules, regulations and case law. For instance, you have the power to change the trustees of the Trust. Consider for a moment a child named as a trustee that becomes a hooligan. You can remove and replace the trustee with someone else. Another scenario might be where you want to sell the house, but the trustee will not sign the contract. All you need to do is remove and replace the trustee.

You also have the power to change the beneficiaries of the trust. Assume for a moment that your three children are the beneficiaries of the trust and one child gets divorced. You can change the beneficiaries to your remaining children to avoid having your assets become subjected to the divorce proceeding.

This is a summary of the salient provision of a Medicaid Trust. It should not be dismissed for lack of understanding. Contact me by using the information below:

PHONE: (914) 925-1010 EMAIL: SMD@MFD-LAW.COM WEBSITE: WWW.PLANTODAYFORTOMORROW.COM

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WHAT WILL BE YOUR STORY?

BY AUBREY BAUER

WHEN YOU HEAR THE WORD EULOGY, WHAT’S THE FIRST THING THAT POPS INTO YOUR HEAD?

If you’re like most people, you probably think of a dimlit funeral parlor, with a person in dark attire standing at a podium, mourners gathered around with tissues held to their faces. And there’s the lonesome casket, itself profusely decorated in overly-aromatic flowers, sitting serenely nearby in the darkest corner of the room.

In your mind’s eye, the person giving the eulogy is trying very hard not to cry, while those in the pews below need not try so hard to hold back the tears. This is the traditional funeral service, and the traditional eulogy: an attempt to illustrate an entire life in the span of a few minutes while placing much of the emphasis on the fact that this loved one is no longer with us. Most of us have attended a funeral service like this for a loved one at least once in our lives.

Perhaps we’ve also attended a not-so-traditional funeral service, such as a celebration of life. These services attempt to place the focus on who the deceased was in life, during happier times, and not so much on the fact that they have died. Eulogies can be spoken at celebrations of life, too, of course. But they do not necessarily have to meet the expectation of the morose person standing at the podium, doing their best to hold it together. Eulogies don’t even have to occur in a funeral parlor or in a place of worship. They can happen in a home, in a garden, at the beach, on a boat, over Zoom. By today’s standards, they are 100% customizable.

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When I first got into eulogy writing, I had some experience in the funeral industry. I’d already graduated from mortuary school, and had worked in a few different funeral homes and mortuaries by the time I started my business. Living in the south, most of the funerals I’d attended had been what you would call a traditional Christian service. But when Eulogies

by Aubrey started to really grow, by the power of the Internet, it began to reach places that I’ve never even been to within the US and indeed, around the world. It began to reach cultures and religions I had little experience with. It began to reach people and personalities that I had never encountered. It began to require of me a different way of thinking and approaching these precious families who were in need of their own kind of eulogy in honor of their loved one.

While there is nothing wrong with it, as it turns out, not everyone has a desire for the picture-perfect sadness of the traditional eulogy or funeral speech. Depending on the family you are serving, there is a spectrum of emotion that needs to be captured and described: sadness and loss

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included, yes…there’s really no way around that, and perhaps here shouldn’t be, especially depending on the circumstances of the loss. But there is also joy, adventure, mystery, romance, and even a touch of humor in a life well-lived. Personalization is paramount. It’s a final act of storytelling, and when done right, it can be a beautiful thing.

So I ask you: When the time comes, what will your story say? For just a moment, let’s not consider it a eulogy. Let’s not consider your family background or what’s expected of you, per se. Let’s not consider your age demographic and what your peers have determined will take place at their funerals. Let’s consider you, let’s consider your life’s story. Let’s consider all of the emotions that have gone into the life you have lived.

Let’s consider the sadness, the loss, the joy, the adventure, the mystery, the romance.

And let’s certainly consider the fact that your life’s story is not over yet.

What will be your story?

Don't consider it a eulogy, consider it a life's story that certainly is not over yet.

“When the time comes what will your story say.”