32 THE QUEENS COURIER • HEALTH • NOVEMBER 19, 2020 FOR BREAKING NEWS VISIT WWW.QNS.COM
Creativity and Aging
Th e peak years of creativity has been a
subject of inquiry among many developmental
psychologists. Kastenbaum, a social
scientist, believes “the end of life oft en stimulates
that creativity. It’s then when people
who are about to jump into the void
can sometimes be more creative and most
able to transform their situation. At times
like this, people can be tense, actually more
alive.” Creativity can, in fact, triumph over
the debilitation of an aging body as it has
with many individuals.
Th e researcher Simonton has studied the
aged and their creative genius and concludes
that, “Creative productions are not
necessarily tied to chronology but to successive
acts of self-actualization.” A defi -
nition of self-actualization is “the full realization
of one’s creative intellectual and
social potential through one’s internal drive
versus external drive like money, status,
power” (Merriam Webster’s Dictionary).
Th e creative act, as it has been described
in the literature, tends to emerge out of the
energy that is expended by our thoughts,
feelings and imagination. According to
social scientists, the stages of creativity are
preparation, illumination and elaboration.
Th e central activity of all human beings is
to create meaning in our lives. How, you
may ask?
Maintain a personal journal of the day to
day accomplishments and their infl uence
on your thoughts and decisions.
Create a life history that integrates the
healthy memories of past experiences with
family and friends.
Involve yourself with music and poetry.
Music as a universal experience can
be emotionally comforting while off ering
multiple opportunities for creative selfexpression.
It has been documented that the “products”
of creativity are far less important
than the attitudes it produces. Curiosity,
inquisitiveness, wonderment, puzzlement
and craving are those suggested creative
attitudes.
Th e collective power of older persons has
already brought about many changes in
society. Power is in fact the gateway to multiple
resources and recognition.
Th e age equality movement consists of
the many older citizens who are returning
to school. Also, the revolution of older
people in movements such as the Gray
Panthers have made signifi cant changes at
the political and social levels.
It has oft en been heard that the old no
longer can off er anything creative as a result
of a recognizable illness, an aging body, a
slowing of mind and physical movement.
Here are several disclaimers that contradict
these erroneous assumptions.
Cervantes completed part two of Don
Quixote at age 68.
Chevruel began the study of gerontology
at age 90 and published his last scientifi c
paper at age 100.
George Bernard Shaw was 94 when one
of his last plays was fi rst produced.
Benjamin Franklin was a framer of the
Constitution when he was 80.
Golda Meir was 71 when she became
Prime Minister of Israel.
Verdi composed Falstaff at age 80.
Th e world of middle-aged and older
adults is much diff erent now from what it
was 40 years ago. Optimal health, opportunity
and ageism have shift ed markedly
for the better.
Music is a creative act that has kept elders
going. For instance, Pablo Casals, the great
cellist, played each morning into his 90s to
limber his fi ngers that were bound by rheumatoid
arthritis. Music is a remarkable
rejuvenator for those who enjoy its mystical
powers.
Here are several suggestions for a creative
environment. Th ey can act as a visual
as well as an aural benefi t and that enhances
our sense of well-being:
Art – Try pastel, charcoal, oils and
attempt drawing a simple portrait;
Music – Listen to a variety of musical
genre from opera to Broadway and discuss
the feelings they evoke for you and others;
Movement – Attempt performing a simple
dance step that fi ts your mood. If a partnet
is available, begin with a two-step, otherwise
known as the fox trot;
Recreation – Practice regularly scheduled
periods of activity such as daily outdoor
walks preferably with a friend or
acquaintance, watch a long awaited movie
with someone, limit time at the computer,
phone a friend or relative you haven’t
spoken to recently, resolve a confl ict with
someone you love;
Poetry – Recite some poetry, privately
or with a group; discuss with like-minded
“poets” a contemporary poem; try forming
a haiku (Japanese three line poem); “sing a
poem” that can be set to a familiar aria, ballad,
bluegrass, etc.; try memorizing several
ELDER LAW
RONALD FATOULLAH
ESQ, CELA*
lines from your favorite poem.
Creativity is a multi-faceted process that
can only occur if one seizes the various
opportunities that are available.
Here is a mantra for achieving a creative
and happy existence that is within
our reach.
1. Maintain your faith in that which
brings you a greater peace of mind.
2. Maintain an optimistic outlook on life
and share it with others.
3. Engage in activities that promote family
and community harmony.
4. Practice optimal health habits based on
sound and current medical advice.
5. Accept unsolvable limitations and
move on.
6. Off er a kind word or two to those less
fortunate.
7. Volunteers your time to a worthy cause.
In essence, the prospect for living a creative
life is based on two ideas: practice a
continuous spiritual and physical growth,
and learn new things while enjoying the
many benefi ts that it aff ords .
It has been eight months since the start of
this terrible pandemic. Yet I still believe we
will emerge to a brighter tomorrow. I am
reminded of eight grueling weeks of basic
training in the US Air Force. I believed it
would never end. I also believed, at times,
I was fated not to survive. Well I did! We
will come out of this crisis, stronger than
ever before and more determined to enjoy
the creative aspects of a safe and meaningful
life.
Little Orphan Annie sang the message
on Broadway that we all should hear, “Th e
Sun Will Come Out Tomorrow.” It’s coming,
and you can bet on it!
Sheldon Ornstein Ed.D, RN, LNHA
Elder Law Minute TM
Implementation of new Medicaid
rules pushed back to April 1, 2021
BY RONALD FATOULLAH, ESQ. AND
STACEY MESHNICK, ESQ.
Medicaid applications for community
based long-term care will be subject to
a 30-month lookback period, which will
be phased in. Th e implementation of the
changes to the law was originally to begin
on October 1, 2020, was pushed back once
to January 1, 2021 and was just pushed back
again to April 1, 2021. Th e April 1, 2021
implementation date is due to the extension
of the public health emergency. As such, for
those who have a long-term care need, and
those considering Medicaid planning and
applications, it is critical to submit applications
prior to April 1, 2021 if at all possible.
Medicaid will perform a fi nancial review
only looking back to gift s made on or aft er
October 1, 2020. In other words, applications
submitted on May 1, 2021 will have to
provide 7 months of documentation, while
applications submitted on May 1, 2022 will
have to include 19 months of documentation.
Th e lookback will be fully phased in
with Medicaid applications submitted on
or aft er April 1, 2023, and will require 30
months of documentation at that point.
In addition, Medicaid will impose a penalty
period for uncompensated transfers of assets
(gift s) to “non-exempt” individuals. On the
other hand, gift s to exempt individuals, such
as a spouse or disabled child, will not incur a
penalty. Applications will have to provide all
fi nancial documentation, including bank and
brokerage statements, for the lookback period.
Th e Medicaid agency will impose a penalty
that is equal to one month for every $12,844
gift ed for NYC applicants or one month for
every $13,407 gift ed for Long Island applicants.
Th e start date of the penalty period is the
fi rst day the individual is receiving the services
for which he is applying.
Th e lookback applies to home health services,
consumer directed personal assistance
program (CDPAP), personal care services
and Medicaid funded assisted living
program services (ALP). If an individual
owns a home, it is exempt as long as the
value is within the home equity limitation
of $893,000.
Th ere are several outstanding concerns
with regard to the implementation of the
new policy. First, it is likely that there will
now be delays in processing Medicaid applications
given the increased documentation
requirement. Th e current time frames for
approval are 45 days for applications and 90
days if a disability determination is required
to determine eligibility (under 65), except
for “immediate need applications” which
are expedited. However, given that there are
delays under the current system with only
a minimal documentation requirement, we
believe that it is probable that applications
will take longer to process, and therefore
applicants will likely not get services in place
when they need them.
In addition to changes in the fi nancial
documentation requirement, there are
changes to the functional eligibility criteria
for community-based services. Current
recipients of home care will not be subject
to the new requirements, but will be
“grandfathered” under the former rules.
Under the new rules, in order to be eligible
for home care and CDPAP, applicants must
need assistance for physical maneuvering
with at least three activities of daily living
(ADLs). If there is a diagnosis of dementia,
they must require supervision with at
least two ADLs.
Home care and CDPAP services must
be prescribed by a qualifi ed independent
physician selected or approved by the
Department of Health. In addition, a new
standardized task-based assessment tool
will be created to determine hours. Th e tool
will be used to determine how the individual’s
needs can be met with telehealth and
family supports.
Th ose who are considering applying for
long-term community-based benefi ts, such
as a home health attendant, should strongly
consider submitting their Medicaid applications
as soon as possible, but no later than
the end of March, 2021. It is important to
consult with an elder care attorney who can
advise on the best steps for your particular
situation and needs.
Th is is not intended to be individual legal
advice which can only be provided if you
retain our fi rm. If you need legal advice
please contact 1-877-ELDERLAW (1-877-
353-3752).
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