FOR BREAKING NEWS VISIT WWW.QNS.COM DECEMBER 5, 2019 • HEALTH • THE QUEENS COURIER 49
health
Elder Law Minute TM
Let’s not leave the elder orphan behind
BY RONALD A. FATOULLAH, ESQ.
AND DEBBY ROSENFELD, ESQ.
Th e “elder orphan” is a phrase that
ELDER LAW
recently came up in a conversation with a
colleague. It essentially applies to an elderly
person who has no spouse (is either widowed
Falls and Aging
Th e following article deals with falls,
their causes, consequences, and the
actions that an elderly individual can
take to minimize that fall and its devastating
results.
Th ere is a psychological fear of falling,
particularly in the elderly population
– a fear that can be a more pervasive
problem than even the experience of
the fall itself.
Mr. Jones, a hypothetical eightyfi
ve year old individual, tripped one
day for no apparent reason, and suffered
a shoulder contusion and a mild
concussion. Aft er an examination and
X-rays, he was released from the emergency
room with the attending physician’s
warning of, “be more careful, you
are an old man.” Mr. Jones took seriously
the doctor’s mantra and over time, slowed
his pace of walking and carefully watched
the ground to see that there was nothing
to trip him once again. He slowly shuffl ed
rather than perform his normal gait, all of
which was happening at a gradual pace.
His family soon realized he was not leaving
his home as oft en as he used to.
Fear, whether expressed by a physician’s
casual remark or the fear of experiencing
another fall, could become an
obsession and a limiting factor in one’s
daily activities.
According to the researcher (Kaufman
1990), 13% of falls are due to various
aspects of aging, 37% are related to environmental
hazards, and 50% result from
pathological problems.
Th e following is a list of common environmental
hazards that can be found in
the home and contribute to accidents
and falls:
Inadequate or missing safety rails, particularly
in the bathroom.
Poorly designed or unstable furniture.
High beds/chairs.
Floor surfaces that are glossy and highly
waxed.
Wet, greasy, icy surfaces outdoors.
Inadequate lighting.
Loose rugs and fl oor mats.
General clutter.
Exposed electrical cords.
Loose or uneven stair treads.
Th ere are several potential consequences
that can occur as a result of a
disabling fall: dehydration, pneumonia,
pressure sores, loss of independence, permanent
disability. I hasten to add that any
repeated fall becomes a major precipitant
and can lead to a long-term admission, or
even a necessary protected setting.
What are the recommendations for
preventive action?
Adhere to routine vision and hearing
testing.
Seek an understanding of medications
taken. Medications are prescribed for
their therapeutic value, but can also have
side eff ects that may aff ect balance and
equilibrium.
Limit alcohol intake especially when
taking prescriptive medications.
Rise slowly from bed/chair to avoid a
sudden drop in blood pressure.
Watch for wet or slippery surfaces
when outdoors.
Wear appropriate footwear.
Use assistive devices where and when
appropriate.
Consult a physician if feeling unsteady,
dizzy or ill.
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.
Advanced age, with all of its many virtues,
can still produce painful changes
in muscles and joints, particularly of the
back and legs. Strength and fl exibility can
also decrease markedly either from an
infl ammatory process or simply a more
sedentary lifestyle.
Even though we can’t always prevent
those so-called ravages, we can certainly
do things through lifestyle choices.
It is therefore incumbent on all of us in
the aging population to stay alert and fi t
physically to the advancing frailties they
may encounter, and deal with those frailties
in a timely manner, no matter how
insignifi cant they fi rst appear.
Sheldon Ornstein Ed.D, RN, LNHA
or divorced) and no children who
can be depended on in a diffi cult time or
an emergency. Even though we oft en consult
with couples who have large families
and many children, siblings and friends,
we oft en face the exact opposite - people
who come to see us who do not have many
other people in their lives. Being independent
and attachment-free might be enticing
when one is young and vital, but as a
person confronts the aging process, having
no one to depend on can be daunting and
overwhelming.
While the label “elder orphan” has a
negative and sad connotation, there are
some things we can do as elder law attorneys
to help alleviate this type of predicament.
While this might sound basic,
when a person consults with our fi rm,
we always obtain a complete family set
up in the course of our inquiries. Once a
person acknowledges that he/she has no
spouse, signifi cant other or children, it is
a helpful segue to the conversation that
must be conducted. We discuss the necessity
for advance directives; powers of attorney,
health care proxies and living wills are
important documents for an individual to
have in case he/she becomes incapacitated.
Th is is an impetus for the client to really
delve into which people can be depended
on in an emergency. Th is person might
not be “family” but rather a good friend or
trusted neighbor. Although this exchange
might be a painful one, it is helpful to a
person who must confront the choice of
who to delegate as a decision maker. Many
times, the client has come back to us with
names of friends or distant relatives who
have happily agreed to help out in a time
of need. Ultimately, this gives our clients a
sense of relief and comfort.
For those individuals who have diffi culty
designating anyone, another option is to
refer them to a geriatric care manager. A
geriatric care manager (“GCM”) is usually
a licensed nurse or social worker who specializes
in geriatrics who can help an elderly
individual by identifying his/her needs and
fi nding ways to meet those needs. Many
GCMs are bonded and can help a person
with bill paying and money management.
Th e GCM can also arrange for someone
to help with doctor’s appointments, visits
and general health management. Th e best
option is not to wait for an emergency but
to develop a relationship with a GCM when
one is still vital and independent. A GCM
can meet a client as frequently as every
day of the week or as infrequently as once
every few months. Having a relationship
with a GCM allows for someone to step in
and manage the elderly person’s aff airs in
a fl uid manner without terrible or damaging
delays.
One fi nal option is for the elderly person
to consider a more community-based living
arrangement once he/she feels the need
for some help in managing day to day living.
A continuing care retirement community
is a residential alternative for adults
that off ers, under one contract, an independent
living unit (an apartment or cottage),
residential amenities and access to a continuum
of long term care services, as the
residents’ health and social needs change
over time. Another alternative is an assisted
living facility where room and board are
covered and various levels of care are available
depending on the residents’ needs.
Choosing this type of residence ensures the
elderly person a network of people that he/
she can rely upon in an emergency.
As with most things, planning in advance
is the best advice to off er anyone who
faces this kind of concern. Ultimately, there
is much that can be done for an elderly
orphan to make him/her feel that family
is there.
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. Debby Rosenfeld, Esq. is a
senior staff attorney at the fi rm. Th e law
fi rm can be reached at 718-261-1700, 516-
466-4422, or toll free at 1-877-ELDERLAW
or 1-877-ESTATES. Mr. Fatoullah is
also a partner advisor 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 at 424-256-7273.
RONALD FATOULLAH
ESQ, CELA*
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