48 THE QUEENS COURIER • HEALTH • SEPTEMBER 6, 2018 FOR BREAKING NEWS VISIT WWW.QNS.COM
Tactile Stimulation and the AD Patient
BY DR. SHELDON ORNSTEIN
Th e need for tactile stimulation or
touch, continues throughout our lives.
Older adults may experience less touch
because they have fewer contacts in their
immediate environment, compared to
the younger person.
As the senses of sight and sound
decrease, touch becomes an increasingly
important means of communicating.
Touch then becomes a vital vehicle for
expressing emotions and a way to make
meaningful contact with others.
Here are some thoughts to keep in
mind when using touch with an individual
who has been diagnosed with
Alzheimer's disease (AD).
1. Respect the dignity, cultural and
social background of this individual.
How? Touching with dignity means
touching as one adult to another. It also
means respecting the AD patient’s need
for privacy and obtaining permission to
2. Begin the use of touch gradually,
constantly assessing the person’s reaction.
How? Use touch frequently! It is
amazing how even those with the most
advanced AD, respond positively to this
familiar, over-learned action.
3. Beware of the emotional
How? Do so gently but
not hesitantly, and above
all, touch with a sense of
compassion and caring. As
with verbal communication,
how you communicate
with touch is as important
as what you say.
4. Beware of where you
How? Use conventional approaches
and activities that involve touch, e.g.
dancing, handshaking, taking an arm
while walking to a group activity, grooming,
haircare, manicure, etc.
5. Encourage the appropriate use
of touch between peers. Use activities
which encourage touch and incorporate
approaches to touch that caretakers perform
daily for the AD patient.
6. Use the diff erent types of touch to
either calm or stimulate as necessary.
How? A fi rm or pressure touch is reassuring
or calming. A light touch can be
stimulating i.e. gently touching with fi nger
tips, the brush of some soft fabric, etc.
7. Make sure the AD person is aware of
your presence before you touch.
8. Be careful on fragile older skin which
may tear or shear much more
9. Be sensitive and responsive
to appropriate touch
from the individual with AD
to you as their caregiver.
How? Th e off er of appropriate
touch by the AD
patient to you the caregiver,
is a gift that needs to be
accepted. Individuals with
AD have needs to nurture
and care for others and is their way of
10. Be careful that caring touch will not
take on a sexual interpretation.
How? Because of diffi culties with interpreting
the environment, persons with
AD may misinterpret touch. If the person’s
response in anyway suggests that
the touch was interpreted as a sexual
overture, do not use that approach.
11. Touch from the non-human environment
should be encouraged. Th at can
provide stimulating, appropriate materials
and furnishings that off er a variety of
pleasing touch experiences.
How? Encourage visitation from family
pets which provides a living responsive
touch experience and a non-threatening
opportunity for the person to express
aff ection and nurturing.
A fi nal thought for the caregiver –
Caregiving, whether it be performed by
a paid professional caregiver or family
member, is doubly diffi cult when it
comes to the AD individual.
Th e eleven points in this article can
be of benefi t when performed with sincerity,
compassion and regularity. I
wish to emphasize this belief, because
the application of therapeutic touch
may not always be immediately successful.
“Expectations may be high at fi rst but
you have to remember that expectations
are a part of life and seems to be
ingrained in our thinking. You can lessen
your expectations a little bit about things
that are supposed to be, and instead
just accept what is.” Th is was expressed
by Richard Carlson in his book, “Don’t
Sweat the Small Stuff .”
Dr. Sheldon Ornstein is a registered
professional nurse with a doctoral degree
in nursing organization. He has specialized
in the care of older adults and has
published many articles on the subject.
He has done post-graduate work in gerontology
and has taught at several universities.
In 2013, he was inducted into
the Nursing Hall of Fame at Teachers
College, Columbia University.
The Elder Law Minute TM
To Keep or Not to Keep?
BY RONALD A. FATOULLAH, ESQ.
AND JOSEPH BRENINGSTALL
Clients oft en ask us which documents,
records, and papers they need to keep in
their homes. When determining which
documents to shred and which ones to
keep, it is important to point out that one
should always be careful to destroy any
documents that may include sensitive
personal information before discarding
them. Th ose who ascribe to the notion of
“better safe than sorry” always have the
option of scanning their documents and
storing them electronically.
With that introduction, we can divide
documents into three separate categories:
those that can be discarded aft er a
short while, those that should be kept
either in paper or electronic form for a
longer or indefi nite period of time, and
those where the original copies should be
kept in a safe place. Examples of documents
that can be discarded aft er a short
while include ATM receipts, bank deposit
slips and receipts for small purchases;
these should be kept anywhere from one
to three months. Documents that should
be kept for a slightly longer period of
time include pay stubs, monthly mortgage
statements, utility bills and expired
insurance information; these should be
kept for about one year. Electronic or
paper copies of tax returns, investment
statements, medical bills and claims,
bank statements, mortgage and loan documents
(aft er the loan term has concluded)
should be kept for approximately
seven years (although the increased popularity
of online banking has obfuscated
the need for paper statements for many
Th ere are several documents that
should be kept in some form indefi nitely,
and there are documents for which the
paper form is either strongly preferred
or required. Documents that should be
kept indefi nitely include medical records,
education records, pension plan documents,
retirement plan records, medical
and burial instructions, deeds, bills
of sale, and home improvement documentation.
Offi cial government documents
such as birth and death certifi -
cates, marriage licenses, divorce papers,
passports, Social Security cards, military
discharge papers, and business licenses
should always be kept in their original
It is crucial that documents which
may be required for Medicaid planning
be retained, and many estate planning
documents should be held indefi nitely
in their original form. Important estate
planning documents include the last will
and testament, powers of attorney, living
wills, healthcare proxies and various
forms of trusts. While many of these
documents can be replicated from a digital
fi le or physical copy, it may be diffi
cult, time consuming and expensive
to reproduce them. Additionally, many
fi nancial institutions require an original
copy of a power of attorney and will
not accept photocopies. It is oft en advisable
for the attorney who supervised the
execution of a will to retain the original
will in a fi reproof fi le. Th e reason for this
is that if the client takes his original will
and it cannot be located aft er the client
dies, there is a rebuttable presumption
that the will was destroyed and thereby
revoked. However, when the attorney
holds the original will, if anything should
happen to the will the attorney can submit
an affi davit to the court and the will
would still be admitted to probate.
Medicaid is a means-tested program,
so documentation regarding pensions,
Social Security benefi ts and fi nancial
accounts are scrutinized for the fi ve
years preceding the application. Th e
nuanced requirements that the Social
Security Administration has implemented
with regard to Medicaid eligibility
can be quite confusing and overwhelming.
Th us, it is important to consult with
an experienced elder law attorney when
planning for Medicaid.
Ronald A. Fatoullah, Esq. is the founder
of Ronald Fatoullah & Associates,
a law fi rm that concentrates in elder
law, estate planning, Medicaid planning,
guardianships, estate administration,
trusts, wills, and real estate. Joseph
Breningstall is a law clerk with the fi rm.
Th e law fi rm can be reached at 718-
261-1700, 516-466-4422, or toll-free at
1-877-ELDER-LAW or 1-877-ESTATES.
Mr. Fatoullah is also a partner with
Advice Period, a wealth management
fi rm that provides a continuum of fi nancial
and investment advice for individuals
and businesses, and he can be reached