Senior Living Guide Queens Chronicle 03-19-20

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• Changing medical needs • Staying fit and healthy • Future planning

Providing for Long-term Care Finding Skilled Nursing Care

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Baby Boomers – those born from 1945 to 1964

Page 17 QUEENS CHRONICLE, Thursday, March 19, 2020

SPRING 2020

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CONTENTS

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PARTICIPATING ADVERTISERS Catholic Cemeteries Chapin Home for the Aging Donna Furey, Esq. Elder Care Services Flushing House Law Offices of Frank Bruno Jr. Main Street Radiology Margaret Tietz Nursing & Rehab Center Middle Village Adult Center Ozanam Hall of Queens St. Michael’s Cemetery

• Baby Boomers– those born from 1945 to 1964 . . . . . . . . . Page 20 • Providing for Long-term Care . . . . . . . Page 22 • Finding Skilled Nursing Care. . . . . . . . . Page 26 Publisher - Mark Weidler Section Editor - Peter C. Mastrosimone Section Coordinator - Debrah Gordon

THE TRUTH ABOUT MEDICAID Many seniors don’t know that Medicaid is there to help them too, or believe that the process to get benefits is inflexible and uncaring. With our guidance and support, there’s no reason why seniors can’t become eligible and receive the benefits they need and are entitled to.

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The Truth is: ANYONE can become Medicaid eligible

C M SQ page 19 Y K Page 19 QUEENS CHRONICLE, Thursday, March 19, 2020

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Margaret Tietz Center is centrally located near the Queens communities of Kew Gardens Hills, Hillcrest & Jamaica Estates. Only 20 minutes from Crown Heights, Manhattan & the Five Towns.

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QUEENS CHRONICLE, Thursday, March 19, 2020 Page 20

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Senior Living Guide

Diet and exercise: changing with the times

by Michael Gannon Editor

As kids, many baby boomers may have chosen frosted cereal while watching Saturday morning cartoons. In a college dorm it was pizza and macaroni and cheese — the real stuff from the box with the orange powder — while lounging around studying for midterms and finals.

But experts say that even the wealthiest, best-educated generation needs to make concessions to age when it comes to diet and exercise.

“Proper nutrition is vital as you age to maintain your health, weight and energy levels,” said Amanda Graffeo, a registered dietitian and nutritionist at Jamaica Hospital Medical Center’s Medisys outpatient clinic.

“You need proper nutrition to keep your organs functioning, for strong bones and lean muscle mass.”

And while Graffeo said osteoporosis, which makes the bones brittle, is a concern in itself, it is not the only one.

“Strong bones and lean muscle mass are important because as we age we are at increased risk for falls because of increased balance and stability issues,” she said.

Calcium and vitamin D, she said, are important.

Fatty fish such as salmon are high in vitamin D, while Greek yogurt and low-fat milk and cheeses supply calcium. Dark green vegetables such as kale contain it as well.

Graffeo said yellow fruits and vegetables such as sweet potatoes, carrots and cantaloupe help offset the effects of vision, which can start to decline as people age.

She also said proper hydration and sufficient fiber in one’s diet aid in overall health and nutrition. They also help keeping a person regular as their digestive systems slow

Little things that people can change or add to their diet and exercise regimens can play a big role in helping people stay healthy and active as they get older. down over time.

“Fiber helps with digestion and weight,” she said. “I recommend three or four servings of fiber a day such as whole grain bread, brown rice, quinoa — make sure it says ‘whole grain.’”

Drinking water, she said, sometimes must be a conscious effort.

“You lose sensitivity,” she said. “Your senses of smell and taste decline. You may not sense thirst anymore.” Graffeo said she recommends seniors keep water bottles with

Fish, nuts, whole grains, fruit and vegetables can help with everything from proper weight to avoiding falls and high blood pressure.

them, using sugar-free additives such as Crystal Light for flavor.

Seniors should be aware that as the sense of taste decreases, they might be less able to taste salt that already is in or on certain foods, and begin adding more than they should for a healthy diet.

“That can lead to high blood pressure,” she said, adding that other spices, herbs and seasonings can be flavorful substitutes.

Omega 3 fatty acids, which fight some types of cancer, heart disease and rheumatoid arthritis, can be found in tuna, salmon, walnuts, flax and chia seeds.

A balanced meal should include protein from lean meat, fish, beans, legumes, nuts, nut butter and fruit; plus carbohydrates from grains, bread and cereal.

“And you should have five servings a day of fruits and vegetables,” Graffeo said.

A key to a healthy diet, she said, is being a careful, educated shopper.

“Look for whole grains — look at the labels,” she said. “To avoid high blood pressure, look for products that have less than five grams of sodium and saturated fat per serving.”

And while medical needs change and increase as people get older, Graffeo stresses not neglecting continuing dental care.

“As we age, teeth can break or our jaws can be come painful,” she said. “That can affect what we eat. Some people lose weight and they realize they just needed their teeth fixed.”

Exercise, Graffeo said, goes hand-inhand with a healthy diet.

“That helps with strength, balance and mobility,” she said. “But make sure a physician has cleared you to exercise.”

She said 30 minutes per day is recom-

mended, even if someone wants to break that down to three 10-minute sessions a day.

The U.S. Centers for Disease Control and Prevention on its website says it is important that older adults pick activities they enjoy and that match their abilities.

“That will help ensure that you stick with them,” the CDC said.

The agency says physical activity has immediate health benefits “including better sleep and less anxiety. It also helps reduce your risk of getting serious illnesses such as hea r t d isea se, t y pe I I d iabet es a nd depression.”

The website recommends trying a variety of activities as a way to make exercise more enjoyable and reduce the risk of injury.

“Regular physical activity is still safe and good for you even if you have problems doing normal daily activities, such as climbing stairs or walking,” according to the CDC. “Lots of things count. And it all adds up. Find what works for you.”

The web page said that if an illness or injury requires a senior to stop exercising for a period of time to be sure to start again at a lower level and slowly work back up to a normal level of activity.

To get to and stay at a healthy weight, the CDC recommends the equivalent of 150 minutes per week, such as 30 minutes a day, five days a week of moderate-intensity aerobic activity.

“Keep in mind that you may need to do more activity or reduce the number of calories you eat to get to your desired weight,” the government cautions.

While Graffeo cited dietary tools for helping mobility and balance, the CDC says “multicomponent” is essential as well.

A senior couple taking a walk in the park, in the agency’s example, is combining aerobic activity with balance training and muscle-strengthening.

“As part of their weekly physical activity, older adults should do multicomponent physical activity to improve physical function and decrease the risk of falls or injury from a fall.”

The CDC says even little things like walking, lifting weights and balance training by incorporating walking backwards or sideways or by standing on one foot — with a wall or something to hold or lean on nearby — can be done in the home or in a group setting.

Balance activities, the site continues, can improve the ability to resist forces within or outside of the body that cause falls.

“Fall prevention programs that include balance training and other exercises to improve activities of daily living can also significantly reduce the risk of injury, such as bone fractures, if a fall does occur.”

Strengthening muscles of the back, abdomen and legs also improves balance.

The full article on CDC recommendations for physical activity and other information for seniors can be found online at cdc.gov/physicalactivity/basics/adding-pa/ Q activities-olderadults.htm.

C M SQ page 21 Y K Page 21 QUEENS CHRONICLE, Thursday, March 19, 2020

Chapin Home for the Aging Serving the New York City, Long Island community at its Jamaica Hills location since 1869.

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Chapin’s 150 years of nonprofit mission-driven history has been to provide those who have come to Chapin a true Home‚ where they may find serenity and security.

QUEENS CHRONICLE, Thursday, March 19, 2020 Page 22

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Senior Living Guide

Covering the cost of long-term care

by Mark Lord Chronicle Contributor

Eating a healthy diet, remaining physically active, seeking regular healthcare, maintaining a busy social life ... these are all suggestions for delaying or even preventing the need for long-term care.

But what would happen if you ever became ser iously ill or disabled?

According to the National Institute on Aging, “You can never know for sure if you will need long-term care.”

For many, it’s an understandably unpleasant subject to consider. But all the experts seem to agree on one thing: The best time to think about needing long-term care is before you need it.

Elder law at tor ney Ronald Fatoullah, who has a local office in Kew Gardens, advises that the time “to start to get the ball rolling” is around age 45. One of the biggest pitfalls, he says, is that, ver y often, people “just don’t have a plan.”

So, what, exactly, is meant by Long-term care insurance may cover the cost of a nursing home, assisted living facility, adult day care services and more. “long-term care” ? It involves a variety of services designed to ernment health insurance pro- afford them, you could lose all the have someone go over it with you,” meet a person’s health or personal g rams, such as Medicaid. (It money you’ve invested in the pol- he said. “It may cost a little up care needs for a period of time. should be noted that Medicare icy); and your income (as AARP front but it can save you a lot of Such services help individuals does not cover long-term care but suggests, “You must first exhaust money and aggravation later on.”

He a dv ised , “Do a lot of live as independently and safely may cover some costs of short- almost all your resources and as possible when they can no lon- term care in a nursing home fol- meet Medicaid’s other eligibility research,” and suggested finding a case manager to work with you. A requirements.”) ger perform everyday activities lowing a hospital stay.)

Long-term care policies may good place to do so is through the A not he r opt ion is pr ivat e on their own.

One of the primary concerns financing, such as long-term care cover the cost of a nursing home, New York City Department for the with obtaining long-term care is insurance. Certain individuals residence in an assisted living Aging, he said.

DFTA works with case managethe expense. According to the may receive veterans’ benefits that facility, adult day care services, can go toward home care, home modification ment agencies to provide in-home NIA, Americans long-term care. and care coordination. According care for people 60 and up. Case spend billions of Services are also to AARP, most policies have a management social workers generdollars a year on e almost always a v a i l a b l e limit to the amount of benefits ally begin with a telephone assessvarious related ment. They will evaluate your bent h r o u g h t h e you can receive. ser vices. How can protect “Deciding whether long-term efits, and discuss issues such as Old e r A m e r ithey pay for care insurance is right for you can home-delivered meals, personal cans Act. their care about half T h e A A R P take a significant amount of time care, housekeeping needs and depends on their the assets.” we b s i t e i n d i - and research but mak ing the counseling. financial situaAccording to LongTermCare. cates t h a t effort will be time well spent,” tion and the — elder law attorney gov, part of the U.S. Department of “Medicare will AARP says. kinds of services Ronald Fatoullah Fatoullah points out that a lot Health and Human Services, most c ove r a shor t they require. stay in a nursing of people are not buying insur- long-term care is not medical care, Of ten, individuals rely on a variety of pay- home or a limited amount of at- ance because it can be prohibi- but rather assistance with the basic ment sources. Chief among those home care, but only under very tively expensive and rates tend to personal tasks of everyday life, known as “activities of daily livare their own personal funds, strict conditions. To help cover keep going up.

Simply put, “a lot of people ing.” Those include eating, bathincluding pensions, savings and potential long-term care expenses, ing, dressing and using the toilet, income from stocks. Much home- some people choose to buy long- can’t afford it,” he said.

And Barry Klitsberg, president as well as housework, taking medibased care is paid out of pocket. term care insurance.”

The site suggests that since no of the Queens Interagency Coun- cations, shopping for food and Similarly, one’s personal funds often are used to participate in one can predict one’s future needs, cil on Aging, points out, “The clothing and using the telephone.

The duration and level of longadult day service programs and you might want to look into a poli- older you are [when you take out the insurance], the more expen- term care varies from person to other community-based services cy with flexible options. person and changes over time.

Among the factors to consider sive it will be.” provided by local organizations.

Klitsberg indicated that there Such services typically come first Professional care in assisted liv- are your age and health (policies ing facilities and continuing care cost less if purchased when you are a lot of different plans, noting from unpaid caregivers, such as retirement communities is almost are younger and in good health); that “they’re not uniform,” making family and friends. Paid caregivers the premiums, which often go up it all the more important to talk to might include nurses, home health always paid out of pocket.

Some people may turn to gov- over time (if you are unable to an advisor. “You really need to or home care aides and therapists.

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“W

Further assistance may come from adult day services in an individual’s neighborhood.

As people age, they may need a variety of other long-term care assistance, such as nursing homes (which offer the most comprehensive range of services, including nursing care and 24-hour supervision) and assisted living communities.

According to LongTermCare. gov, Medicare will only pay longterm care if you require skilled services or rehabilitative care.

Medicare will cover such services in a nursing home for a maximum of 100 days and at home, if you are also receiving skilled in-home services. Medicare does not pay for nonskilled assistance.

To qualify for Medicaid, your income must be below a certain level and you must meet minimum state eligibility requirements, the site indicates.

According to Fatoullah, your total assets can add up to no more than $15,750 in order for you to qualify for Medicaid.

“The cost for a nursing home is astronomical,” Fatoullah said.

“Most middle class people can’t afford it, or they go bankrupt.” An average cost for a nursing home is $16,000 per month, he said.

He suggested that elder law attorneys, such as himself, can often protect all or some of an individual’s assets, but early planning is key. “We almost always can protect about half the assets,” he said.

But, he pointed out, “Each case is different. There are so many Q moving pieces.”

Barry Klitsberg, president of the Queens Interagency Council on Aging, says it is important to speak with an advisor when considering long-term care insurance because policies differ. FILE PHOTO BY MARK LORD

C M SQ page 23 Y K Page 23 QUEENS CHRONICLE, Thursday, March 19, 2020

Understanding Medicaid: Frequently Asked Questions What is the difference between Medicare and Medicaid?

Medicare is a privilege an individual is entitled to receive upon reaching the age of 65 or upon being certified disabled, providing they have worked for at least 10 years and contributed into the Social Security System.

Medicaid is for the poor or impoverished; therefore, eligibility is based upon income and resources levels. Meeting the eligibility requirements will secure Medicaid eligibility.

What is Medicaid medical assistance?

Medicaid is a joint federal and state funded program, run by the state and local counties, providing medical insurance, home-care services (assisting with all activities of daily living) and nursing home medical assistance to the poor, elderly or disabled.

However, individuals requiring homecare services or nursing home medical assistance, in addition to financial requirements, also will need to have a medical need for these services.

Who can apply for Medicaid?

Medicaid is for anyone who meets the income and resources restrictions.

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What is an MLTC? MLTC stands for Managed Long-Term Care. One example: When an applicant has been approved for Medicaid home-care services, the applicant has to choose one MLTC from several approved Medicaid plans. Upon joining an MLTC a coordinator will be assigned and this coordinator will be the point person between the applicant/recipient and the MLTC.

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Chapin is a nonprofit, missiondriven 220–bed skilled Nursing Home and Rehabilitation facility serving the New York City and Long Island community at its Jamaica Hills location since 1869.

We are proud to celebrate our sesquicentennial anniversary.

Over the last 150 years Chapin has evolved into the highest-quality (CMS 5 Star Rating) skilled nursing facility that continues to embrace the humanity of our residents.

Chapin Home’s guiding principle throughout its history has been to provide the aging men and women who have come to live here, a true home‚ where they may find the serenity and security that have always been envisioned as essential and appropriate to the latter part of life.

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QUEENS CHRONICLE, Thursday, March 19, 2020 Page 24

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COMMUNITY MEDICAID BASICS FOR THE ELDERLY

By John Samaras, Esq., Associate at the Law Office of Donna Furey A common misconception exists that, as an elderly person, one must “give up everything” in order to receive Medicaid benefits. However, this is not the case and it is likely that you may be able to achieve Medicaid assistance with some proper planning.

There are two main types of Medicaid for the elderly: Community Medicaid and Institutional Medicaid. Community Medicaid is when an individual wants to remain at home while receiving medical assistance in the form of health care aides.

Institutional Medicaid is when an individual cannot stay home and needs to reside in a nursing home.

If an individual is seeking Community Medicaid, they must: (1) be a New York State resident, (2) have at least 3 activities of daily living they cannot perform, (3) be above the age of 65, (4) not have income in excess of $875 per month and (5) not have “resources” in excess of $15,750.

Medicaid looks at whether the individual can perform “Activities of Daily Living” without assistance. Activities of Daily Living include but are not limited to dressing, toileting, showering, cooking, shopping, etc. Depending on how many activities a person cannot perform on their own, they will receive different levels of care.

If an individual applying for Community Medicaid has income above $875 plus $20 for personal monthly needs, they have two options: [1] pay their any income above $895 to Medicaid, or [2] join a pooled trust. The income sent to the pooled trust

can be used to pay monthly bills in your name.

A pooled trust is a not-for-profit organization approved by New York State that enables a person who has excess income to qualify for Medicaid.

Any income remaining in the pooled trust after the person passes away, goes to the pooled trust.

Finally, the individual applying for Community Medicaid may only have $15,750 of available resources. This resource limit does not include personal property, such as furniture, jewelry and cars. When calculating your resources, Medicaid does not include the value of your IRAs and 401ks.

However, Medicaid will be entitled to the Required Minimum Distribution (which will count towards your income).

In the event only one spouse is seeking Medicaid assistance, then the Community Spouse (spouse not seeking Medicaid) may have resources between $74,820 to $126,420. With proper Medicaid planning, it is possible to lower your available resources below the limit while also achieving your estate planning goals.

This has merely been a primer on Community Medicaid. The laws surrounding Medicaid are nuanced and extensive. There is no one plan that will fit everyone’s needs, which is why it is important to speak with an elder law attorney in order to create a plan that is specifically tailored to your needs.

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OTHER LOCATIONS

Main Street Radiology is a private, outpatient radiology practice operated

by Radiology Associates of Main Street. We have provided quality diagnostic imaging services to Queens since 1966.

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Page 25 QUEENS CHRONICLE, Thursday, March 19, 2020

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QUEENS CHRONICLE, Thursday, March 19, 2020 Page 26

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Senior Living Guide

Making the right nursing home choice

by Katherine Donlevy Associate Editor

Queens has the second-largest older adult population of any county in the state, following Brooklyn, according to a 2019 Center for an Urban Future study, which recorded more than 353,500 residents over the age of 65.

With the borough growing older, it’s no surprise it is home to a plethora of senior citizen homes and rehabilitation centers, but how does one find the most skilled nursing for their aging loved one? The decision can be overwhelming with so many choices available, but the best option for your loved one’s specific needs can be narrowed down after considering a few key points.

Rating reviews Linda Spiegel, the director of public affairs for Margaret Tietz Nursing and Rehabilitation Center in Jamaica, recom mends that researching reviews on nearby nursing homes should be the searcher’s first consideration.

“There are state websites to see what the rating is,” said Spiegel, suggesting Nursing Home Compare through medicare.gov/ nursinghomecompare as a top source. “A five-star rating is the best, and they also post an audit online so you can see whether they received any deficiency.”

The site ranks the nursing homes based on health inspections, staffing, quality measures and overall rating from 1 to 5 stars. Margaret Tietz, along with every other senior citizen care and rehabilitation center in the state, is subject to annual inspections to ensure that t hey kee p w it h st ate st a nd a rd s a nd guidelines.

Other sites offer reviews and ratings similar to Nursing Home Compare, but some come with more specific details about a home, such as nursinghomerating.org’s statistic tracker.

The website keeps count of available beds, whether the home is a Continuing Care Retirement Community or a Special Focus Facility, whether it is fully sprinklered and more.

Spiegel, who has worked for the care center for over 30 years, says that through this type of research one can easily weed out which type of facility offers programs that cater to a loved one’s specific needs, which is important when considering the difference between short-term and long-term care facilities and ones that offer both.

“Short-term patients are still considered patients, and many facilities have large shortterm components,” explained Spiegel. “Many facilities take on short-term rehab because they’re vying for the same beds, and the seniors return to assisted living, which are like senior hotels.”

Assisted living facilities offer housekeeping service, meals and on-site doctors, but residents maintain the freedom to come and go as they would in their home.

“If you’re medically compromised that’s not an option for you. When they improve, sometimes rehab stays turn into long-term care, and we’ll try to keep them with us.

Some people stay with us a few years,” continued Speigel.

There are multiple nursing homes across Queens, and choosing the perfect one for your aging loved one may feel overwhelming, but the choice may become easier after considering a few key points when evaluating different centers.

Paying a visit After compiling a list of nursing homes and rehabilitation centers, Spiegel says, the next step is the most important one: visiting each facility to get a firsthand look at what it has to offer.

“We have so many choices [of nursing homes], the best thing for people to do is see the rating and then visit the facility,” Spiegel said. “Go in there, see it, meet the personnel ... the rating is important, but going to see the equipment and speaking to the therapist to see if the condition of your loved one can be met appropriately is vital.”

A visit is a good chance to evaluate the conditions your loved one will be exposed to every day during his or her stay, so pay attention to the details: • Are there programs to keep residents active during their down time?

• Is there natural lighting, or an option to spend time outside the facility?

• Are residents given privacy, even if they do share a room?

• Does the facility look well kept and clean?

• What do the visiting hours look like?

• Is safety a priority of the facility, such as providing handrails and clearly marking exit signs?

• Is the menu flexible and does it offer an array of options?

• Does the facility honor religious practices of its residents?

“Everyone has their own needs and each facility has a responsibility to meet those needs and be flexible,” said Spiegel. “It’s very important to know that they have care plans so you know you’re loved one is taken care of ... When you’re elderly and fragile you need that help.”

Spiegel also mentioned the importance of how comfortable the facility can make the resident feel, a tough thing to do when they’re living with doctors and nurses.

“Most of our residents are over 80, and we do as much as we can to get them back to their status and back home,” Speigel said referring to short-term care patients. “Everyone wants to be home if they can be. We outline goals and see if they can be met safely. That’s primary.”

Speaking with staff When paying a visit to the facility, make sure to sit down and meet with those who

potentially could be interacting with your loved one on a daily basis.

“Families considering senior living should speak with the key leadership when visiting, including the executive director, events and activities director and healthcare and nursing management to get a picture of care and service approaches,” said John Hartmayer, senior vice president of Atria Senior Living, which has locations in Forest Hills and Kew Gardens.

Facilities typically have a wide-ranging staff that your loved one will encounter in his or her everyday life. Although it may be impossible to meet the entire staff, it would be wise to sit down and speak with as many representatives as possible before making any important decisions. Nursing homes usually have health teams consisting of physicians, nurses, therapists, dieticians, social workers and service workers, as well as admissions department teams, recreational directors, volunteers and more.

“It’s also important for searching families to ask providers about quality, including their internal quality measures, not to mention the tenure of its leadership team and longevity of its staff,” said Hartmayer.

Setting goals with the staff for your loved one is critical — can the facility aid, and provide the means, for your loved one to get the care he or she needs?

Hartmayer and the Atria community believe that creating a comfortable and positive environment leads to accomplishment and healing, and that the environment is a direct reflection of the staff.

“A growing body of research shows that those who live in a caring, connected environment enjoy greater health and well-being than those who are isolated,” Atria’s mission states, a vital aspect to consider when choosQ ing a nursing home.

Many homes conduct rehabilitation sessions, but considering what other kinds of programming are available is an important consideration when choosing a center.

C M SQ page 27 Y K Page 27 QUEENS CHRONICLE, Thursday, March 19, 2020

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ELDER LAW WILLS and TRUSTS ESTATE PLANNING MEDICAID PLANNING PROBATE ADMINISTRATION OF ESTATES SPECIAL NEEDS REAL ESTATE Donna received her law degree from St. John’s University of Law.

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