Category: Elder Law and Advocacy
Clear ResultsFamily Law
New York Medical Aid in Dying Will Become Law After Decade-Long Debate
After more than a decade of legislative debate, New York is poised to join a growing number of jurisdictions recognizing a terminally ill patient’s right to medical aid in dying. Governor Kathy Hochul recently reached an agreement with the New York State Senate on the Medical Aid in Dying Act (“MAID”), clearing the final obstacles to enactment. The bill, which had already passed the Assembly following a lengthy and emotional debate, will be signed into law later this month with agreed-upon amendments and will take effect six months after signing. Once implemented, New York will become the eleventh U.S. state, along with the District of Columbia, to codify medical aid in dying for eligible terminally ill adults. Overview of the Medical Aid in Dying Act The MAID Act permits mentally competent adults diagnosed with a terminal illness and a prognosis of six months or less to receive a prescription for life-ending medication. Eligibility is conditioned on strict procedural safeguards designed to ensure voluntariness, capacity, and the absence of coercion. A qualifying patient must personally request medical aid in dying both in writing and orally. Two physicians must independently confirm the terminal diagnosis, prognosis, and the patient’s capacity to make an informed decision. While terminal diagnosis and prognosis are generally clinical determinations, assessments of capacity have historically been among the most contested issues in New York health care and elder law. The law also requires that the request be witnessed by two individuals. Certain parties are expressly prohibited from serving as witnesses, including relatives, individuals entitled to inherit from the patient, health care facility employees, treating physicians, and the patient’s health care proxy or agent under a power of attorney. Additional Guardrails Agreed Upon by the Governor and Legislature As originally passed, the MAID Act included multiple protections for patients and health care providers, including provisions ensuring that participation is voluntary for both physicians and religiously affiliated institutions. As part of the Governor’s agreement with legislative leadership, a series of additional guardrails will be enacted to further safeguard patient autonomy and ensure responsible implementation. These additional protections include a mandatory five-day waiting period between the issuance and filling of a prescription for life-ending medication and a requirement that a patient’s oral request be recorded by video or audio. The agreement also mandates a mental health evaluation by a licensed psychologist or psychiatrist for all patients seeking medical aid in dying. To further guard against undue influence, the law will prohibit anyone who may benefit financially from a patient’s death from serving as a witness or interpreter to the oral request. Medical aid in dying will be limited to New York residents, and the initial physician evaluation must be conducted in person. Religiously oriented home hospice providers will be permitted to opt out of offering medical aid in dying altogether. The agreement also clarifies enforcement, specifying that violations of the statute constitute professional misconduct under the New York Education Law. The six-month delayed effective date is intended to give the Department of Health time to promulgate implementing regulations and allow healthcare facilities to develop compliant policies, procedures, and staff training. Implications and Ongoing Debate Supporters of the MAID Act argue that it provides a compassionate option for terminally ill individuals seeking autonomy and dignity at the end of life. Advocacy organizations point to polling indicating broad public support among New Yorkers. Opponents, including certain religious and disability rights groups, continue to raise concerns about potential pressure on vulnerable populations and the broader ethical implications of physician-assisted death. Although enactment of the MAID Act represents a significant shift in New York law, it is unlikely to settle the debate. Questions surrounding end-of-life decision-making, professional responsibility, and the role of government in matters of life and death will continue to evolve as the law is implemented and tested in practice.
January 16, 2026
Estates and Trusts
Holiday Harmony for the Sandwich Generation: Boundaries, Delegation, and Self-Care
The holidays arrive each year with that familiar blend of anticipation, nostalgia, and — if we are being honest — a fair amount of anxiety. For members of the Sandwich Generation, that pressure can feel magnified. You are balancing end-of-year school events, office deadlines, holiday parties, travel plans, gift lists, and meal planning while simultaneously managing the medical appointments, emotional needs, and household logistics of aging parents. The season that promises joy often demands more than anyone can give. In the middle of it all, I, like most people, find myself longing for the simpler holidays of childhood, when someone else did the worrying. Yet here we are, stuck in the middle, holding together the needs of multiple generations. If this is your role, you are not failing when it feels overwhelming. You are doing complex emotional and logistical work, and the holidays simply spotlight that reality. This is precisely why remembering three core principles — boundaries, delegation, and self-care — is not just helpful, but essential. These are not indulgences or luxuries, they are survival skills. Boundary-Setting: A Gift to Yourself and Everyone Else The holidays tend to activate our instinct to say “yes”: yes to hosting, yes to attending, yes to keeping every tradition alive. Sandwich Generation members feel even more pressure during the holiday season, as they often operate with already limited bandwidth. Without firm and healthy boundaries, the season can shift quickly from meaningful to unmanageable. Setting boundaries does not make you less generous or less committed to your family; it can mean the difference between sustainable and not. When you clearly identify what you can realistically handle — whether that means declining to host this year, catering instead of cooking, limiting travel, or being upfront about needing to leave an event early — you are honoring your own humanity and limitations. Boundaries also spare your loved ones the silent resentment, not-so-silent commentary, or exhaustion that builds when you push beyond your limits. If set up properly, boundaries can actually improve relationships: they create predictability, reduce friction, and allow you to remain emotionally present. Saying “no” or “not this year” is not a rejection of a person or tradition; it is an act of respect for your energy, your time, and your wellbeing. Delegation: Letting Others Step Into Their Roles Many Sandwich Generation caregivers take pride in being the one who manages everything. This “can do” attitude is essential on many days and certainly comes from a good place. Trying to do all things generally reflects a desire to protect, shepherd, and smooth the path for those who rely on you. But during the holidays, the instinct to take on everything can often become unsustainable. Delegation becomes not merely practical, but vital. And despite what many fear, delegation is not a sign that you are incapable or weak. It is a sign that you recognize the importance of shared responsibility. Whether it means asking siblings to manage a parent’s appointment, inviting older children to take over part of the holiday meal, hiring someone to help with errands, or letting a friend wrap gifts, delegation strengthens your support system. Almost equally important, delegation also allows others to feel invested and helpful: family members and friends often want to contribute but simply do not know how. When you provide concrete tasks, you offer them a pathway to meaningful participation. You are also creating space for your own rest, which ultimately benefits everyone around you. Self-Care: The Foundation That Holds It All Together Pop culture often portrays self-care during the holidays as lighting a candle as you sink into a beautifully drawn bath larger than a bedroom or escaping to a snowy holiday getaway in a picturesque New England village. And while these images reflect the perfect picture, true self-care for the Sandwich Generation often runs deeper and less ideal. Images of self-care instead should be reframed to reclaim the internal resources the season tends to drain. Self-care can be simple: scheduling a quiet hour early in the morning before anyone else wakes up, maintaining your own medical appointments rather than postponing them to accommodate others, stepping outside for a walk, closing your office door for an hour, and giving yourself permission not to attend every gathering. Most importantly, self-care is not something you earn only when everything else is done. It is a non-negotiable part of ensuring you can keep caring for the people who depend on you. Neglecting yourself does not make you more devoted; it makes you depleted. When you protect your own emotional and physical well-being, you are building the resilience the holidays demand and ensuring that you can keep going when the holiday chaos is over. Finding Your Own Pace in a Season of Expectations Being a member of the Sandwich Generation during the holidays means carrying the weight of competing needs — your desire to ensure a magical holiday season for your children and your parents’ needs for care and stability, all while trying to maintain your own sense of center. It is no small task. And yet, with boundaries, delegation, and self-care, you can consciously shape a season that honors both your family and yourself. This year, allow yourself to rewrite some of the holiday scripts. Create new traditions that fit the realities of your life now. Let go of unnecessary pressure and focus on presence instead of perfection. It is possible to protect your energy, share the load, and still create a meaningful season for multiple generations — without losing yourself in the process. The holidays will always be full, but they do not have to deplete you physically and emotionally. By embracing these three principles, permit yourself to experience the season with the steadiness, clarity, and compassion you deserve.
December 15, 2025
Estates and Trusts
Protecting Aging Loved Ones from Predatory Partners
As individuals age, they often face unique emotional and financial vulnerabilities that can make them susceptible to exploitation. In recent years, I have noticed a troubling uptick in cases related to one of the more concerning forms of elder abuse, which is at the hands of a predatory spouse or romantic partner. This type of elder abuse often results in a gain of undue influence over an aging individual, leading to manipulation, financial exploitation, coerced changes to estate planning documents, and, in one case, the administration of medication to compromise my elderly client. This type of exploitation is often subtle, masked by the appearance of affection or companionship, and it can have devastating legal and financial consequences for the older adult and their family. Elder exploitation by a spouse or intimate partner typically begins with efforts to isolate the older adult from family members, long-time friends, or trusted advisors. Warning signs may include sudden changes in behavior and secrecy surrounding financial matters, and can result in unexplained transfers of money or property, or the execution of new estate planning documents, beneficiary designations, or a deed transferred to favor the new partner. In many cases, the older adult may not recognize the manipulation taking place or may be reluctant to acknowledge it out of fear, embarrassment, or emotional dependency. Legal Protections and Preventive Measures Proactive legal planning remains the most effective method to protect aging loved ones from predatory relationships. Establishing a comprehensive estate plan is essential. A plan should include a durable power of attorney that appoints a trusted and financially responsible individual — other than the romantic partner — to manage financial affairs upon incapacity. A health care proxy and related HIPAA release ensure that medical decisions reflect the aging loved one’s wishes, rather than the influence of a manipulative partner. In my practice, I encourage the use of revocable living trusts, which further safeguard the individual by centralizing the management and creating a layer of oversight for those assets. Trusts can be drafted so that a trusted individual or an adult child can serve as a co-trustee with the aging loved one, ensuring that they maintain their autonomy while not being subjected to undue influence or decisions that do not benefit them. In some instances, irrevocable trusts can offer additional protection by restricting direct access to funds and preventing third parties from exerting control over assets intended for the elder’s or their family’s benefit. When marriage is contemplated, a prenuptial agreement is vital to protect an individual’s assets and family inheritances. Such agreements can define the financial boundaries of the relationship and prevent disputes or exploitation later. If marriage has already occurred, in some cases, a postnuptial agreement may still provide meaningful protection and clarify financial rights and obligations. Families should also remain vigilant regarding changes to financial advisors, brokerage houses, deeds, joint accounts, and beneficiary designations. If sudden or unexplained modifications occur, or if there is evidence of undue influence or incapacity, immediate legal action may be necessary. In severe cases, guardianship proceedings can be initiated to protect the older adult from further exploitation and to restore financial control to a court-appointed fiduciary. While the risks of exploitation can be significant, it is still critical to approach these matters with kindness and sensitivity to the elder’s autonomy and dignity. The goal of legal intervention should not be to limit the independence of your aging loved one, but to preserve it by preventing exploitation. Thoughtful legal planning involving the aging loved one will provide a structure that allows aging individuals to maintain control over their affairs while minimizing the risk of coercion or manipulation. Timing is Everything Once exploitation has occurred, legal remedies are often complex, time-sensitive, and emotionally fraught: early intervention is key. Families who notice signs of isolation, undue influence or financial abuse should consult with an experienced elder law or estate planning attorney promptly. A knowledgeable attorney can review existing documents, recommend protective legal mechanisms, and, where appropriate, initiate proceedings to safeguard the elder’s assets and welfare. Protecting aging loved ones from predatory spouses or partners requires vigilance, communication, and sound legal planning. By taking proactive steps — establishing comprehensive estate documents, creating appropriate trusts, and, when necessary, pursuing legal recourse — families can ensure that their loved ones’ financial security and personal dignity are preserved. In the end, these legal safeguards not only protect assets but also uphold the fundamental right of every individual to age with safety, with respect, and in peace of mind.
November 21, 2025
Elder Law and Advocacy
Guiding Families and Caregivers Dealing with Dementia: Medicare’s New GUIDE Program
If you are caring for a loved one with Alzheimer’s disease or another form of dementia, you already know how overwhelming the journey can be. Between doctor visits, medications, daily routines, and the emotional toll on the family, it can feel totally overwhelming, patching together resources and support. Medicare has finally recognized just how hard this journey is for the patient and the caregiver and recently launched the GUIDE Program (Guiding an Improved Dementia Experience). The GUIDE program was developed by the Centers for Medicare & Medicaid Services, and its purpose is to provide comprehensive and coordinated care for people living with Alzheimer’s disease and dementia, while also offering much-needed support for the caregiver, who shoulders most of the day-to-day responsibilities. GUIDE was designed to improve the quality of life, enabling individuals to stay in their homes and communities longer while also reducing the strain on families by integrating medical, social, and community resources into a cohesive plan. Instead of leaving families to figure things out alone, GUIDE now offers a way to connect you with a care team and a dedicated dementia care navigator. When you enroll in GUIDE, the program starts with a thorough assessment of your loved one’s needs, as well as yours, as a caregiver. From there, the care team works to create a plan that covers both medical and day-to-day support. Every participant in the program is connected with a dementia care “navigator,” someone who helps coordinate services and create individualized care plans, which are updated as needs evolve. That plan might include help with managing medications, guidance on connecting to community services like transportation or meal programs, or even just having someone to call when you need advice. GUIDE also includes education and coaching for the caregiver so that they can feel more confident in their caregiving role. The care team also manages transitions and offers around-the-clock access to provide guidance in moments of crisis. The best part of the GUIDE program is that it is free. To participate, your loved one must be enrolled in traditional Medicare and have a formal diagnosis of dementia. They cannot already be in hospice care, living in a nursing facility, or enrolled in certain other programs, such as Medicare Advantage or PACE. GUIDE’s focus is on people living and remaining in the community, where support is often the most fragmented and where families typically struggle to navigate a confusing array of resources. What makes this program especially unique is that it puts caregivers at the center of the care plan. Medicare has long covered medical services, but this is one of the first times it has stepped in to consider long-term care and recognize and support the unpaid family members and friends who provide most of the hands-on care. GUIDE acknowledges what caregivers already know: that supporting the caregiver is essential to supporting the person with dementia. Since the program is still new, not every provider is currently offering it. To determine if GUIDE is an option for your family, you should check with your loved one’s primary care physician or reach out to your local Alzheimer’s Association chapter. While GUIDE is just beginning, it has the potential to make a real difference for families. Instead of feeling alone in the maze of dementia care, families will have someone helping to coordinate, guide, and support. For caregivers in the Sandwich Generation who are often stretched to their limits, that extra layer of help means less stress, fewer crises, and more time to focus on what really matters: spending meaningful moments with the person they love.
October 7, 2025
Elder Law and Advocacy
Why Caregiving Matters More Than Ever in America
When Bradley Cooper released his new PBS documentary “Caregiving,” he didn’t just share a deeply personal narrative, he opened the door to a long-overdue national reckoning. His story of bathing his father, of holding his hand through cancer, of navigating a healthcare labyrinth with little support resonates because it is all of our stories. Whether we realize it yet or not. Caregiving is the invisible thread that holds my clients — the wealthy and not so wealthy — their families, and their communities together. This essential labor, both paid and unpaid, is finally stepping into the spotlight, demanding recognition, reform, and real support. The Growing Crisis The statistics are irrefutable: for the first time ever, Americans aged 65 and older are set to outnumber their children by 2034. Currently, 23 million care for older adults exceeding the 21 million caring for kids. It is important to note, however, that caregiving occurs at all ages and contributions. No one is immune from caregiving. Financial caregiving responsibilities can begin much earlier for a younger demographic if they are in a better financial position than their aging family members. Added to that, those who are having children later in life now care for their aging parents whom they presumed could help them raise their own young children. Unpaid family caregivers contribute nearly $600 billion worth of labor to the US economy annually, which is larger than the United States Department of Defense budget and a figure soon to hit $900 billion the next decade. Families, who represent the unpaid caregivers, absorb this enormous emotional, financial, and physical burden. As this author has written about in the past, caregivers generally must reduce work hours, give up career opportunities, or quit jobs entirely. These sacrifices lead to lost income, strained mental health, and mounting caregiving debt. Beyond the individual cost, caregiving faces much broader challenges, including the underfunding of resources, a fragmented health care system, policy neglect, and a lack of labor protections for professional caregivers. Millions of Americans, especially women, people of color, and low-income individuals are making impossible choices: career or care. Income or loved one. Sleep or safety. And while the dialogue surrounding caregiving has traditionally been viewed as a women’s or senior issue, it is clear that caregiving now touches every demographic and tax bracket. In fact, the recognition of today’s “Sandwich Generation,” adults caring for aging parents while raising kids, has been a topic of conversation, mostly because of the extreme pressure this generation feels with its caregiving responsibilities: even Gen Z is stepping in as caregivers, often for grandparents and disabled siblings. Most fall into caregiving during a crisis — an accident, a diagnosis, or a fall. Without a plan, the emotional, legal, and financial toll compounds quickly and sometimes in ways that cannot be controlled. Planning in advance provides options that planning during or after a crisis simply does not. The culmination of these issues leaves us all without robust systemic support, defining caregiving as a personal crisis rather than a shared responsibility. However, there is hope, and the way to hold onto that hope is through planning. Take Action Clarify wishes. Encourage your aging loved ones to clarify their wishes. Advance healthcare directives provide caregivers guidance and reduce stress of healthcare and end of life decision making. Ensure your Will or Trust is in place and up-to-date reflecting the beneficiaries chosen by the aging loved one, not by the state. Consider creating an ethical will to share with your family describing your hopes and wishes for their future and lessons you wish to impart long after you are gone. Protect assets. If your loved one’s assets are not infinite, it’s imperative to meet with an elder law attorney who can assess whether or not your loved one will qualify for Medicaid or Veterans benefits in the future to pay for long-term care. Determine if asset protection trusts can help your loved one qualify for benefits or resources in their area. If you still have time, speak with an insurance professional about qualifying for long-term care insurance. Organize roles. Nothing is more important than setting a plan in place. This means determining now who can help your aging loved one and contribute to their caregiving. Dividing and conquering roles like organizing medication, cooking meals, providing transportation to appointments, and managing finances can help caregivers avoid burnout and ensure that talents among all caregivers are utilized. Technology is even being developed to address the need such as software like Hero Generation which can make organization for the caregiver easier. Preserve dignity. Talk to your aging loved one about where they want to live as they age and, perhaps more importantly, where they do not want to live as they age. If your loved one is faced with a life-limiting condition, start the dialogue about what their idea of a “good death” looks like by consulting with organizations like Befriending Death or your local hospice agency. Thoughtful planning keeps care centered around the person’s needs, values, religious, and spiritual beliefs, not just the logistics of the end of their life. As caregivers, there is so much we can do beyond providing the care. We must acknowledge the heavy lift of caregiving: talking about it with family, co-workers, and friends to create community around the experience. We must offer respite to our friends who are caregivers and vote for public policies that support and expand care. And of course, elevate the conversation and share resources to make sure that it is easier for those who come after us. Roslyn Carter wisely said that “...there are only four kinds of people in the world: those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who will need caregivers." Caregiving is love in action and planning for it is essential. Wherever you are in your own caregiving or care receiving journey, ensuring a plan is in place is essential.
July 23, 2025
Elder Law and Advocacy
Elder Abuse Exposed: Understanding the Crisis and Lessons from Stan Lee’s Story
Elder abuse is a widespread issue that impacts millions of elderly individuals worldwide. It often manifests in different forms, including physical abuse, emotional or psychological mistreatment, neglect, and, most commonly, financial exploitation. Vulnerable older adults—particularly those experiencing cognitive decline, frailty, or social isolation—are particularly at risk. Among the most high-profile cases of elder abuse in recent years involves Stan Lee, the legendary creator of Marvel Comics. Understanding Elder Abuse Elder abuse can happen anywhere, including in homes, nursing facilities, or even public spaces. A common factor among these cases is that the abuser is generally someone trusted by the elder, such as caregivers, significant others, or family members. In fact, statistics reflect that nearly 60% of financial abuse is committed by a spouse, significant other, or family member. According to the World Health Organization (WHO), one in six people aged 60 and older has experienced some form of abuse in community settings within the past year. The actual numbers are likely much higher, as many cases of elder abuse go unreported due to fear or shame. Stan Lee: A Victim of Elder Abuse Stan Lee, the co-creator of iconic superheroes like Spider-Man, the X-Men, the Avengers, and many other beloved superheroes, passed away in 2018 at the age of 95. His final years were overshadowed by a deeply troubling elder abuse scandal. After losing his wife and advocate of 70 years, Lee's physical and mental health deteriorated significantly, leaving him increasingly dependent on others to manage his personal, financial, and creative affairs. Allegations emerged that Lee fell victim to financial and emotional abuse at the hands of his former business manager, who had become a trusted confidant. As with most elder abuse cases, the manager allegedly isolated Lee from his family and longtime associates, seized control of his finances, misappropriated millions in assets, coerced him into public appearances, and restricted access to family members and those who had supported Lee for decades. Furthermore, this manager even relocated Lee into a new home without informing his only child. The Financial Exploitation of Elders Lee's case is not an isolated incident; financial exploitation is the most common form of elder abuse. While Lee's situation is noteworthy due to the unusual occurrence of financial exploitation among wealthy individuals with significant assets, elders of all economic backgrounds—especially those with diminished mental capacity—are at risk of manipulation and exploitation. In Lee's case, the exploitation was particularly egregious, given his status as a global pop culture icon with a multimillion-dollar estate. Although Lee experienced rapid exploitation within a year following his wife's death, most financial abuse unfolds slowly and subtly. It is important to keep in mind that this financial abuse can manifest as forgery, coercion in managing finances under the guise of assistance, or through more sophisticated and deceptive schemes involving multiple perpetrators. Sadly, statistics indicate that abuse and exploitation disproportionately affect elders with more modest means—those least equipped to handle economic setbacks in their later years. Alarmingly, nonwhite elders are particularly vulnerable, with reports showing they are 200% more likely to suffer from elder abuse compared to their white counterparts. Legal Protections and Reporting Cases like Lee's illustrate the urgent need for improved legal protections and reporting mechanisms for elder abuse. Although laws aimed at combating elder abuse exist, enforcement is frequently lacking. Most elderly individuals lack the capacity to seek help, which is often what makes them vulnerable in the first place. Alarmingly, those who might normally report such abuse are often perpetrators themselves. These factors, combined with the shame and fear associated with reporting, severely hinder the prosecution of these crimes. While many elder abuse units exist within law enforcement, significant gaps remain in the system due to a lack of resources and, from my perspective, a lack of empathy for senior victims. What We Can Learn from Stan Lee's Story The tragic story of Stan Lee's elder abuse serves as a powerful reminder that even the most celebrated individuals can fall victim to exploitation in their later years. It underscores the critical need for planning ahead and vigilance from both loved ones and legal authorities to protect vulnerable elders from abuse. For those caring for elderly loved ones, staying engaged, monitoring financial activities, and advocating for their well-being is essential. Preparation for potential incapacity can also help prevent victimization. Aging loved ones should have the proper legal documentation in place, such as a Power of Attorney and Trust instruments, which empower them to designate trusted individuals prior to their incapacity. Proper legal authority and the appointment of reliable individuals in positions of trust reduce the risk of exploitation by bad actors. Preparing for potential incapacity can also help prevent victimization. Aging loved ones should have essential legal documentation in place, such as a Power of Attorney and Trust instruments, which empower them to designate trusted individuals before they become incapacitated. Proper legal authority and the selection of reliable individuals in positions of trust reduce the risk of exploitation by bad actors. Despite the flashy headlines of Mr. Lee's case, elder abuse remains a largely hidden crisis. Greater societal acknowledgment of its existence, coupled with stronger legal protections, will better ensure that our elderly population can live with dignity and security. Protecting elders from exploitation is a moral imperative that requires collective awareness, legal guidance, and action. Whether famous or not, senior adults deserve respect, care, and protection in the twilight of their lives, allowing them to age with dignity.
October 2, 2024
Elder Law and Advocacy
Embracing Diversity in Senior Living
The Rise of LGBTQ Senior Housing As our society progresses towards greater inclusivity, the needs of the aging LGBTQ community have gained significant and deserved attention. One crucial aspect is the development of LGBTQ-specific senior housing, which offers a supportive and understanding environment for older adults who identify as LGBTQ. The importance of focusing on housing for the aging LGBTQ population cannot be overstated, as the challenges faced by this senior community often go unnoticed. Therefore, during this Pride Month, I am glad to shed light on why such communities are vital for fostering dignity and well-being among LGBTQ seniors. Understanding the Need for LGBTQ-Specific Senior Housing Historical Discrimination and Isolation: Over 800,000 elders reside in senior housing in the United States, with almost 8% identifying as LGBTQ. The number is likely higher, as many older LGBTQ seniors do not identify openly for a myriad of reasons. Most LGBTQ seniors have faced lifelong discrimination; one study indicated that 33% of seniors felt that they had to hide their sexual identity if they moved to senior housing. SAGE reports that a staggering 48% of same-sex older couples applying for senior housing faced discrimination. In addition to discrimination, SAGE also reports that LGBTQ seniors are twice as likely to live and age alone compared to their cis-gender peers. According to AARP, this isolation is often because LGBTQ seniors are twice as likely to live and age alone and four times less likely to have children, an essential support network for seniors. Dedicated LGBTQ housing helps mitigate these concerns by providing a space where residents can live openly and authentically, preventing the isolation that forces many back into the proverbial closet as they age. Health Disparities: The American Psychology Association has found that LGBTQ seniors are disproportionately affected by physical and mental health conditions due to a lifetime of unique stressors associated with being a minority. The cost of healthcare for LGBTQ seniors is also more costly as they do not enjoy the same health insurance opportunities as their cis-gender married peers. As a result, health insurance is more expensive. Additionally, the lack of cultural competency in the healthcare system means that LGBTQ elders are more likely to delay getting the necessary care, treatment, and prescriptions, often resorting to emergency rooms more frequently than the general population. These factors, combined with a lack of familial support, can significantly impact the health of LGBTQ seniors. LGBTQ-specific housing with built-in care, which is the model for all senior housing, helps to even the playing field and mitigate these disparities. It provides LGBTQ seniors with access to healthcare providers who are properly trained and familiar with the unique issues that impact LGBTQ seniors at a greater rate. Safety and Comfort: Members of the LGBTQ population often create families of “choice” rather than blood relation due to historical discrimination and rejection by their families of origin. As a result, LGBTQ seniors heavily rely on aging friends and non-biologically related caregivers. Additionally, LGBTQ seniors are more likely than their cis counterparts to be HIV positive and have complicated medical histories, particularly as they age. According to a recent study published in the Journal of the American Geriatrics Society, the combination of non-biologically related caregivers and complex medical needs places LGBTQ seniors at a significantly increased risk for mistreatment in later life. As their health and capacity decline, their partners and chosen family pass away, and the complications of HIV status (including HIV-related dementia) or neglected health issues increase. This study pointed out that even with limited information available, 22.1% of LGBTQ adults over age 60 reported being harmed, hurt, or neglected by a caregiver, 25.7% reported knowing someone who had been mistreated, and over 60% had experienced psychological abuse. The figures are startling and understandably cause concern among LGBTQ seniors about encountering prejudice from both staff and fellow residents. Having an LGBTQ-focused senior facility will ensure that residents feel and are safe, even if they lack the capacity to advocate for themselves. Properly trained staff will create a safe and welcoming atmosphere where all residents can feel respected and valued. The Good News in LGBTQ Senior Housing Thankfully, LGBTQ senior housing developments are incorporating inclusive design principles and services tailored to the needs of LGBTQ seniors. These facilities feature gender-neutral bathrooms, staff trained in LGBTQ competency, and events celebrating LGBTQ culture and history. SAGE has spearheaded this movement with its National LGBTQ Housing Initiative, which helps identify safe housing options for the LGBTQ population. Prominent Examples of LGBTQ Senior Housing: New York City: Stonewall House in Brooklyn, named after the historic Stonewall riots in Manhattan’s West Village, is known as a “beacon of inclusivity.” This development provides affordable senior housing in NYC, with a mission to offer a strong sense of community for LGBTQ seniors. Los Angeles: The Triangle Square Apartments, the first affordable housing project for LGBTQ seniors in the U.S., is a unique and pioneering initiative. It offers a variety of amenities and support services tailored to the LGBTQ community, exemplifying societal progress and inclusivity. Recently taken over by the Los Angeles LGBTQ Center, its commitment to the community has been further enhanced. Philadelphia: The John C. Anderson Apartments in Center City is an affordable housing development that provides not only housing but also integrates social services and community activities designed to meet the unique needs of LGBTQ seniors. Senior housing is more than just a place to live; it is a haven of acceptance, dignity, and support. As awareness of the specific needs of LGBTQ seniors grows, so too will the number and quality of housing options available to them. By continuing to advocate for and invest in these communities, we can ensure that LGBTQ seniors enjoy their golden years with the respect and care they deserve. Embracing diversity in senior living not only enriches the lives of LGBTQ individuals but also strengthens our society as a whole.
June 21, 2024
Elder Law and Advocacy
Aging in Place: NYFSC’s Home Sharing Program Offers a Unique Housing Solution for NYC’s Aging Population
The housing crunch in New York City is real. Exorbitant rents and climbing interest rates have led many further into debt, all but ruled out homeownership for most, and forced countless seniors to reconsider their plan to “age in place” in the space they have called home for decades. New York City’s Foundation for Senior Citizens (“NYFSC”) may have a solution in its established “Home Sharing Program.” What Is It?: NYFSC’s free Home Sharing Program has been in existence for the last 30 years. Its mission is to help link senior or adult “hosts” with unused private spaces in their homes or apartments with appropriate adult “guests.” The hosts and guests share their abode and the related expenses and perhaps forge a friendship along the way. The only age requirement is that both must be over the age of 18, and either the guest or host must be 60 or older. How Does It Work?: The NYC program (and similar programs in other cities) has a comprehensive screening process to match hosts with the right guests. Social workers provide a formal intake to screen applicants to consider lifestyle, work schedule, and collective needs for socialization. The host and the guest must have three solid professional recommendations and endorsements to ensure they are suitable candidates. The housing coordinators also assist with negotiating home-sharing and financial specifics to ensure the arrangement works for both parties. What are the Benefits?: Home or apartment sharing can provide homeowners and tenants additional income by renting out spare rooms and space. This is particularly helpful in expensive cities like NYC with high housing costs. The cost of long-term care is multiplying each year. Likewise, the guest’s contribution can ensure that a senior who no longer can afford to reside in their home can remain now that the guest is sharing the carrying charges of the home or apartment. Similarly, guests who find themselves out of options due to unaffordable rents might be able to find the perfect housing arrangement in a neighborhood that they thought was out of their reach. In addition to the obvious financial benefits, coordinated housing can foster a sense of community by connecting people who may not have otherwise interacted. When they work well, such arrangements can lead to the formation of relationships and mutual support between hosts and guests. This is particularly useful for seniors who tend to become more isolated as they age. Beyond companionship, there is a real opportunity, particularly in NYC, for cultural exchange and a richer understanding of different lifestyles and backgrounds, which can, in turn, contribute to a more diverse and interconnected community. In addition to building community and an exchange of cultures, an intergenerational arrangement may provide both parties the opportunity to give and receive advice from someone who is further on in life. Learn More: Certainly, this option is not for everyone, but perhaps it is an option that might work for those who wish to age in place as they age. For more information about this program or similar programs in your town or city, contact your local county office on Aging.
January 31, 2024
Elder Law and Advocacy
LGBTQ+: NY’s Goal of Aging Without Discrimination
It is no surprise to LGBTQ+ individuals and their allies that nine out of ten of those who identify as LGBTQ+ fear discrimination in medical settings. According to SAGE, LGBTQ+ people are two times as likely to age alone and four times less likely to have children who might otherwise serve as caregivers and advocates. This means the LGBTQ+ population is even more vulnerable as they age. As a result, and at long last, Governor Hochul signed a law that is intended to address this discrimination related to the medical care received by the LGBTQ+ community in the home care and nursing home setting. Beginning in June 2023, New York State will require that all home health aides, certified nurses’ aides and personal care aides – essentially the backbone of a senior’s long-term care team– will receive training focused on providing care to patients of diverse sexual orientations, expressions and gender identities. This ambitious and much-needed law includes several components that will be included in the training program. Much of the training relates to the education of the caregivers to provide comprehensive explanations of various terms related to the LGBTQ+ community and provides an understanding of why patients with diverse sexual orientations and gender identities or expressions may conceal their identities. The goal of the training is, of course, to incorporate the concerns of these patients and ensure that they receive “person” directed care and to address the unique healthcare needs of LGBTQ+ patients. In light of the nearly 400 anti-LGBTQ+ legislative actions pending in the states across the country, it’s heartening that New York is taking the lead to combat this discrimination, especially for the most vulnerable in the LGBTQ+ population.
March 29, 2023
Elder Law and Advocacy
Significant Increase in New York Medicaid Income and Resource Limits to Protect Individuals 65 and Over and Disabled Adults
In the past, Medicaid recipients who received MAGI Medicaid benefits (individuals under the age of 65) could lose their Medicaid benefits when they reached age 65. Once an individual reached 65, he had to reapply for non-MAGI Medicaid benefits with strict income and resource limits. In 2022, Medicaid’s monthly income limit was $934 for an individual and $1,367 for a couple; the resource limit was $16,800 for an individual and $28,133 for a couple. As a result, an individual with a monthly income of $1,500 and assets totaling $25,000 would lose his Medicaid benefits when he turned 65 because he was over the income and resource limits. While his income and resource had no significant increase, he has suffered a significant loss of benefit. Governor Hochul recently expanded coverage for older New Yorkers and disabled adults by increasing the income limits to match the income limits of MAGI Medicaid recipients under the Affordable Care Act, which takes effect this year. As a result of this expansion, the same individual with a monthly income of $1,500 and savings of $25,000 would not lose his benefits once he turned 65. Starting January 1, 2023, the monthly income limit for a single individual is $1,563 (a significant increase from $934), and for a couple, $2,106 (from $1,367 in 2022). The 2023 resource limit for an individual is $28,133 (up from $16,800 in 2022), and for a couple, $37,902 (up from $28,133 in 2022). For those already receiving Medicaid benefits and utilizing pooled income trusts to protect their excess income, they may continue with their current spend-down plan until Recertification. The increased income limits will apply upon the Medicaid recipients’ renewal. Those Medicaid recipients who prefer not to await rebudgeting upon Recertification may request a rebudgeting of income with the local Department of Social Services or, in New York City, Human Resources Administration. It is important to note that this expansion not only protects those who are currently receiving Medicaid benefits but also allows low-income New Yorkers who have been unable to qualify for non-MAGI Medicaid benefits in the past due to the strict income and resource limits to apply now and qualify for the benefits they need. If you or your loved ones have questions about how these recent significant changes may impact you, please feel free to contact me with any questions and to discuss your options.
January 20, 2023
