Aging

Death with Dignity: Hospice Care

Published on: March 14, 2023 | by Ettinger Law Firm

The recent announcement by 98 year old Jimmy Carter, our long-lived president, that he was opting for hospice care at home instead of additional medical intervention, is in keeping with the trend towards dying with dignity. Hospice care arises when an illness is either no longer responding to medical treatment, no medical treatment is available, or the patient has decided they want to transition from treatments intended to prolong quantity of life to treatments intended to improve quality of life.

One of the great misconceptions about hospice care is that it is the cessation of medical care. Dr. Sunita Puri, author of “That Good Night: Life and Medicine in the Eleventh Hour” defines hospice care as “intensive comfort-focused care, provided with the goal of minimizing the physical, emotional and spiritual suffering that patients and their families experience when somebody has possibly six months or less to live.” While hospice can usually take place at home it can also be in a facility and is paid for by Medicare Hospice Benefit.

The hospice “team” consists of (1) a nurse to assess and manage pain and provide hands-on-care, (2) a social worker, to offer emotional support and help with planning, (3) a physician to interface with the patient’s primary physician and consult on pain and symptom management and make house calls, (4) a hospice aide to help with personal care needs, such as bathing, (5) clergy to offer spiritual support, (6) volunteers to help in a variety of ways, and (7) a bereavement specialist to provide grief and loss counseling.

Battling the Epidemic of Loneliness

Published on: February 28, 2023 | by Ettinger Law Firm

According to former Surgeon General Vivek H. Murthy, MD, loneliness poses real threats to both mental and physical health, including depression and anxiety, addictions, heart disease and dementia. His book “Together” reveals that loneliness affects about one-quarter of adult Americans, and “The reality is that loneliness is a natural signal that our body gives us, similar to hunger, thirst. And that’s how important human connection is.” Such is the public health crisis, that in the UK the government has appointed a Minister of Loneliness to help combat the problem.

One of the best ways to overcome loneliness is to volunteer. AARP Foundation Experience Corps reports that 85% of volunteers felt their lives had improved through their volunteering efforts.

Here are some suggestions and resources gleaned from Val Walker’s ground-breaking book “400 Friends and No One to Call” subtitled “Breaking Through Isolation and Building Community.”

Book Review: Let’s Talk About Death, by Michael Hebb

Published on: February 9, 2023 | by Ettinger Law Firm

In his invitation and guide to life’s most important conversation, as he puts it, author Michael Hebb seeks to address the fact that “the way we die in the modern age is broken.” Almost unique to American culture, the denial of death has ripple effects in depleting our skills to discuss death and to process the loss of a loved one.

Perhaps this is why (1) although 80% of Americans say they want to die at home, only 20% do, and (2) the leading cause of bankruptcy in the United States is the cost of end-of-life care. Most people do not want extreme measures that only prolong suffering leading to death. However, so few of us have talked to our families about our wishes nor have we been asked, leading to the medicalization of end-of-life.

Given the right framework, these conversations can be liberating and even transforming — bringing people together and reminding us what really matters. While death is often tragic and terrible, there are opportunities to learn and grow — by making us more aware of life’s precious gift, making us kinder and bringing us closer to one another.

Better Sleep for Seniors

Published on: January 26, 2023 | by Ettinger Law Firm

While sleep is essential for mental and physical health, aging presents some sleep challenges. About half of all seniors report a sleep problem such as taking longer to fall asleep, shorter sleep, waking up often and napping more and longer. As we age, our body clock deteriorates and melatonin (a sleep inducing chemical) levels decline. To increase the amount and quality of sleep, the three main factors are (1) routine, (2) sleeping environment, and (3) diet and exercise.

Routine: A consistent evening routine works best for sleeping. Going to bed at the same time and “winding down” makes a considerable difference. Avoid uses of electronic devices such as smartphones and television as they emit “blue light” which inhibits melatonin production and can upset body rhythms. Blue light blocking lenses may avoid this problem.

Sleeping Environment: Cooling down the bedroom can lead to better sleep. If the thermostat is out of your control, a fan will help. Light should be just enough to allow you not to trip and fall should you need to get out of bed. Darkness options are blackout blinds or curtains and covering any electronics that emit light. An eye mask can work wonders too. Outside noises or partners who snore can disturb sleep. Consider “white noise” machines or spa-like recordings to help you sleep. Like the eye mask for light, consider ear plugs for noise. While a firm, comfortable mattress and quality pillows with breathable fabrics are essential, there are other high-tech options that may assist, such as mattress and pillows that adjust their temperature as yours changes. Many people report a weighted blanket works wonders.

Strength Training for Seniors

Published on: January 12, 2023 | by Ettinger Law Firm

About a year ago, your writer found that he was having trouble doing the yard work and carrying the trash to the curb. I was getting weaker with age and realized that this trend was only going to go in one direction. So I decided to reverse the decline with strength training. Putting in just three hours a week, I am now stronger than I was thirty years ago.

The British Journal of Sports Medicine reports that just thirty to sixty minutes a week of strength or “resistance” training leads to a ten to twenty percent decrease in heart disease, cancer and mortality. It also increases cognitive function and decreases anxiety and depression. Better yet, you can carry in the groceries or climb the stairs without getting exhausted!

Strength training doesn’t mean you have to go to the gym and start lifting heavy weights. Just doing push-ups, planks, squats, walking up stairs, etc. are all forms of resistance training. You don’t even have to change your clothing, so long as you have enough room to move.

Eight Good Reasons to Plan Your Estate

Published on: December 23, 2022 | by Ettinger Law Firm

1. Makes sure your estate goes to whom you want, when you want, the way you want. Most estate plans leave the assets to the next generation outright (i.e., in their hands) in equal shares. However, with a little bit of thought on your part, and some guidance from an experienced elder law estate planning attorney, you may dramatically improve the way your estate is ultimately distributed. For example, you may delay large bequests until children or grandchildren are older or give it to them in stages so that they have the chance to make some mistakes with the money without jeopardizing the whole inheritance. Similarly, you may place conditions on receipt of money such as “only upon graduation with a bachelor’s degree” or “only to be used to purchase an annuity to provide a lifetime income for the beneficiary”. The possibilities, of course, are endless.
1. Allows you to give back to the people and places that have helped you. Again, most people leave their assets to their children in equal shares. Yet time and again we see children who really don’t need the money or, unfortunately, don’t deserve it. Even when they do need and deserve it, there is a place for remembering those people and institutions who have helped make you what you are today.
1. It proves stewardship by showing your family that you cared enough to plan for them. When you put time, thought and effort into planning your affairs it sends a powerful message to your loved ones. You are saying that you handled the matter with care and diligence. This will reflect itself in how the money is received, invested and spent by your heirs.

Keeping The Lights On

Published on: November 17, 2022 | by Ettinger Law Firm

Adapted from author Doug Armey, the following are keys to keeping your brain “lit” as you age.

Flow. A sedentary life causes brain deterioration. Blood flow to the brain keeps oxygen in your brain cells which gives them life. Keep moving, walking and get some exercise.
Energize. Junk food clogs your arteries and lowers energy, causing a sedentary lifestyle. Healthy food gives energy to your body and brain. Refuel and brighten the lights.

Book Review: John Leland’s “Happiness is a Choice You Make”

Published on: October 21, 2022 | by Ettinger Law Firm

In his book, subtitled “Lessons From a Year Among the Oldest Old”, journalist John Leland takes us on a journey into uncharted territory. Mr. Leland spent a year with six elderly New Yorkers, exploring their lives.

He divides the book into the first six chapters chronicling the years spent with each of the six — John, 97, living in the same Manhattan apartment for forty-six years, the last six of them alone after the death of his partner; Fred, 87, a World War II vet and retired civil servant living in a three-story walk up; Helen, 90, living in The Hebrew Home in the Bronx, dating Howie, living down the hall; Ping, 89, providing an Asian perspective, living in a rent-controlled apartment with a Medicaid paid home attendant for seven hours a day; Ruth, a feisty 90, in assisted living in Sheepshead Bay, Brooklyn and, finally, Jonas, 92, an active filmmaker and writer.

Along with the author, we live the lives of these six people from getting up in the morning to going to bed at night. “How did they get through the day, and what were their hopes for the morrow? How did they manage their medications, their children, and their changing bodies…” Further, says Mr. Leland “All had lost something: mobility, vision, spouses, children, peers, memory but few had lost everything.” What the author found was that the “oldest old” are not a different species, as so many people see them, but rather much the same as you and me — getting up each morning with wants and needs and doing the best they can with what they have. Nevertheless, older people report a greater sense of well-being and fewer negative emotions than younger people. “Experience helps older people moderate their expectations and makes them more resilient when things don’t go as hoped.” We learn the many ways his six seniors chose to be happy.