Author: Kacie Cotter-Harrigan

Today is Valentine’s Day, and I wish I had something Valentines-y to share with you — but I have something even better! “Unforgettable in every way” crooned Nat King Cole in his romantic hit, and I’m going to share with you just how to be unforgettable … as the host of a birthday party for a child.

I need to start out by saying that we don’t do birthday parties for our boys where we invite their friends, and this is one hundred percent because of my limitations as a person and a mother. I can’t even come up with a scenario where I’d feel capable of hosting the birthday boy’s friends for a party, even a small one. We do, however, have a family party for each of the boys for their birthdays; it’s really just one of our normal Sunday dinners (we have dinner each Sunday night with whoever of our extended family can make it) that’s been “birthday-fied” by allowing the birthday boy to choose the menu, and having birthday cake for dessert. My boys have been brought up knowing we don’t do friend parties, and as a result they get really excited for their family party (which I’ve heard them telling their friends about — “I’m having my birthday party this weekend!” — and I’m always worried it will be misunderstood as a *friend party*! To all of the parents of my boys’ friends, please know I would never not invite your children! And I’m ever so grateful that you continue to invite my boys to your children’s parties, even though we can’t reciprocate!)

I think the menu is really the most exciting part of the party for my boys — it’s not every day they can choose what everyone eats! They ask for their favorite foods, and I’m totally committed to allowing them free rein here (within reason, though my parameters are broad). Whether they want to do something easy, like order in pizza, or something more complicated, like for me to make a certain dish, I do what I can to deliver. And when they’re too young to ask for something specific, I try to figure out what their current favorite food is and build a meal around it.

Hands down, our most memorable party was the one we had for our No. 5 when he was turning two. 

Hands down, his favorite food at that time was liverwurst (just liverwurst, no bread).

This particular boy has always been the pickiest of picky eaters. Historically, he’s hated all breads, sauces, gravies, and cheese, which takes away a lot of options that are crowd- and kid-friendly, like pizza. How such a boy ended up loving liverwurst, I’ll never know, but love it he did, and since I like it as well, I didn’t think it would be hard to figure out a liverwurst-themed menu.

I was pretty thrilled with how it turned out! I got those small loaves of pumpernickel bread, and I buttered and grilled half of them with cheese, so those that eat liverwurst had a choice of cold sandwich or hot, and those that didn’t like liverwurst (including the rest of my boys) could have grilled cheeses. I sautéed onions, which I thought went well with both liverwurst and with grilled cheese for those with a more adult palate. I offered other things as well — chips and veggies and dip — and of course there was cake. I was terribly impressed with myself.

To this day, six years later, every time one of the boys’ birthdays is coming up, it’s not unusual for a family member to ask what food the birthday boy has requested, because they’re bracing themselves to hear “liverwurst.” Bracing themselves! As if the liverwurst party was that bad! As if they were forced to eat something they didn’t like! As if there weren’t lots of other tasty non-liverwurst options!

Anyway, doesn’t everyone want to throw the kind of party that’s talked about for years afterward? I didn’t know that was a goal of mine, but I’m totally owning it. Yes, I threw a liverwurst party and I’m not sorry. The birthday boy loved it, which was the whole point. And now you know how to throw an unforgettable party! (But I will admit that if you’re looking to throw a Valentine’s Day party, liverwurst might not be your best option.)

Kate and her husband have seven sons ages 15, 13, 11, 9, 8, 5, and 1. Follow her at www.facebook.com/kmtowne23, or email her at kmtowne23@gmail.com.

Osteoporosis affects 55 percent of the people aged 50 and older in the United States. 

Osteoporosis is diagnosed when a person has decreased bone mineral density. This diagnosis literally means “porous bone.” Therefore, instead of a bone being filled with a strong matrix inside, it is more sponge-like, causing it to become weak. 

Although there are many diseases and medications that can increase your risk of Osteoporosis, the most common cause is due to the body’s hormonal changes. With decreased production of estrogen and progesterone in post-menopausal women, there is an increased rate of bone resorption and no change in the rate of bone formation, leading to weaker bones. 

A majority of treatment today focuses on the change in hormone levels and acts to decrease the number of osteoclasts (i.e. cells that break down bone) to decrease the rate of bone breakdown. However, this method can often lead to secondary bone mineral loss because it interferes with the body’s natural responses. 

Normally, when there are increased osteoclasts, the body will produce increased osteoblasts (i.e. cells that make more bone) in order to maintain balance. Therefore, although the medication decreases the body’s rate of breaking down bone, it can also interfere with the body’s ability to build new bone. 

The most common areas of Osteoporosis include the spine and the hips, and it is important to be aware that not all those diagnosed with decreased bone mineral density will have pain. However, due to the fragility of the bones, there is a very high risk of fractures. Worldwide, 1 in 3 women and 1 in 5 men over the age of 50 will experience at least one osteoporotic fracture. 

As physical therapists, we are educated on Wolf’s Law, which states that a bone will adapt to the loads under which it is placed. This means the more force put through a bone, the stronger it will become, due to increased osteoblast activity.

There is substantial research showing that strength training leads to increased bone mineral density. The exercises in the studies talk about performing fewer repetitions with heavier weights. Heavier meaning weights that are “almost” maximal for someone to be able to lift. Most women over the age of 50 are not lifting heavy enough weights, if it all. In order to see changes in bone mineral density on a DEXA scan, the technology used to measure bone density, it takes about 6-8 months of heavy, consistent loading. 

That is why FysioFit PT has developed a specialized program for individuals with Osteoporosis to teach foundational lifting patterns as well as provide progressive loading in a comfortable, small-group setting. The lifting component focuses on three major, functional lifts. These include the squat, overhead press, and deadlift. These movements were chosen since they are seen throughout our day-to-day activities including lifting things over our heads or picking up heavy groceries or laundry baskets.  Often times, we perform these movements without thinking or moving with correct form, causing increased stress through our backs. By learning the proper lifting techniques from our PTs, there is a significant reduction in future injury risk. The FysioFit program is not only designed-by but also led by doctors of physical therapy. This ensures correct form with each lift as well as the ability to modify when needed on an individual basis. 

Each class starts with a movement prep, which differs from a generalized warm-up that you see with most fitness classes. These are carefully selected movements that will help to activate the correct muscles and introduce the proper movement patterns to complete the lift for that day. In order to maximize the load put through the bones, we often use a weighted vest to directly load the spine with these various movements. A weighted vest will distribute load primarily through the spine and hips. Although dumbbells are great too, they won’t have as big of an impact through the spine and hips. 

Our Phase 1: Foundations class has been a big success this past winter season. We expect to have another foundation class starting in Spring 2020.  In addition, a lot of our participants will continue with Phase 2 to continue to progress in weight used as well as building confidence to perform these exercises on their own. Our program does not have to be performed as an alternative to medical treatment but rather in conjunction with for best results. In addition to strength training for building bone density, our program also focuses on loading using a yoga program. The yoga program was designed to also load the spine and hips as well as improve balance, stability, and posture. These are very important for those with Osteoporosis to decrease the risk of falls as well as improve posture to reduce the risk of compression fractures in the spine. To learn more about the yoga portion of the program, read Dr. Sarah Avery’s article on www.FysiofitPT.com. 

Our comprehensive, research-based program is truly one of a kind. We cap our classes to 4 people to ensure more individualized attention as well as start the program with an evaluation of each person’s past medical history, strength, and body mobility. The program focuses on your goals and our job is to guide you there! For more information call us at 518-306-6894 or email us at Fysiofit@gmail.com. 

On December 20, 2019, the President signed into law the Setting Every Community Up for Retirement Enhancement (SECURE) Act.  The SECURE Act was passed by significant bi-partisan majorities in both the House and the Senate, and it includes some of the most significant changes to retirement plans in several years.

Elimination of the “Stretch IRA”
Although there is no such thing as a “stretch IRA”, this term is often used to describe the fact that the recipient of an inherited IRA could stretch out their distributions over their lifetime, thereby potentially allowing many years of tax deferred growth. For example, if a 28 year old grandson received an inherited IRA from his deceased grandmother, he could have potentially “stretched” out distributions from the IRA until he was into his eighties. 

Under the SECURE Act, that has all changed.  Now, that grandson must take the IRA distributions out over ten years.  There are some exceptions for some beneficiaries, including:  spouses, the disabled or chronically ill, individuals who are not more than ten years younger than the deceased IRA owner, and minor children.  The exception for minor children expires when they become legal adults.  At that point, the child must take the distributions out over the next ten years.  The beginning of that ten year period, however, can be delayed up to the age of 26, if the child is still in school.

In addition to the exemption for certain beneficiaries, the application of the new ten year rule on distributions will not apply to governmental plans, such as 403(b) and 457 plans, until January 1, 2022.

Change of the time period when RMDs start
Under the prior law, if you had an IRA, you needed to start taking out required minimum distributions (RMDs) in the year you turned 70 ½.  Under the new law, you can delay taking RMDs until you are 72.  If you do not need the income at 70 ½, this allows you to keep the IRA growing tax free until you reach 72.

IRA contributions no longer prohibited after age 70 ½
Under the prior law, if you were still working at age 70 ½ and earning compensation, you could no longer contribute to a traditional IRA after you reached 70 ½.  Under the new law, this prohibition is lifted and you can continue to contribute to your IRA.

New qualified birth or adoption expense exception
Generally speaking, if you take a distribution from your IRA before you are 59 ½, you will be subject to a 10% early withdrawal penalty.  Under the new law, you may take a penalty-free distribution of up to $5,000 after you have a child or adopt a child.  This distribution applies individually, so if both parents have an IRA, they could withdraw penalty-free up to $10,000.  In addition, you may restore those funds later back into your IRA without regard to annual contribution limits.

Important changes for employers
The SECURE Act includes several new provisions to encourage employers to set up retirement plans for their employees.  Employers may now take advantage of “safe harbor” provisions, which will encourage the use of annuities in retirement plans.  If the employer abides by these provisions, they will be insulated from legal liability if the insurance company providing the annuity to the employee later becomes unable to meet its obligations to the employee.

These safe harbor provisions are meant to encourage a greater use of annuities in retirement planning.  While everyone’s retirement plans and goals are different, the advantage of annuities is that they provide a set amount of monthly income in retirement, akin to a pension payment.  As a result, the chance of the employee running out of money in retirement is potentially reduced.

The SECURE Act also provides increased tax credits for small businesses that establish retirement plans, as well as new or increased tax credits for those that auto enroll their employees in retirement plans.  Another welcome change is greater access to retirement plans for part-time employees.

Under the prior law, employers could exclude part-time employees from participating in a 401(k) plan if they worked less than 1,000 hours in a year.  Now, if the employee works at least 500 hours in a year for at least three consecutive years, they will be able to participate.  This provision starts in 2021, so the first eligible employees will be able to participate in an employer provided 401(k) plan in 2024.

Additional changes not related to retirement plans
The SECURE Act also includes several changes to the law not related to retirement plans.  Included in those changes are new modifications regarding 529 plans.  Under the new law, 529 plan funds can now be used to pay off qualified student loan debt up to $10,000.  This limit is a per-person lifetime limit, but the law allows additional similar payments of up to $10,000 each for the siblings of the 529 beneficiary.

As with all significant changes in the law, the SECURE Act presents challenges and opportunities.  In order to successfully navigate the new retirement landscape, it is advisable to consult with an experienced professional, such as an estate planning attorney, accountant, or financial advisor.

Matthew J. Dorsey, Esq. is a Partner with O’Connell and Aronowitz, 1 Court St., Saratoga Springs.  Over his twenty-three years of practice, he has focused in the areas of elder law, estate planning, and estate administration. Mr. Dorsey can be reached at 518-584-5205, mdorsey@oalaw.com and www.oalaw.com. 

In today’s confusing and complex health care environment, it is important for every one of us to make our goals and wishes for our care expressed and understood.  Where appropriate, this should be done in a manner that ensures those wishes will be respected.  This applies to people of all ages and all states of health.  None of us knows when we might become incapacitated due to an accident or sudden illness. 

Why do I need a Health Care Proxy?
New York State provides the Health Care Proxy, a document that allows you to appoint a Proxy decision-maker should you loose decision-making capacity.  Proxy forms are available at most physician offices, and on-line.  The form allows you to designate another adult as your Proxy, as well as to name an Alternate.  A critical factor in designating your Proxy is his or her understanding of what in fact you would want.  Be sure to discuss your underlying values and health care wishes and preferences.  The Holiday Season is a great time for these conversations among family and close friends.  Legal and medical advice is helpful in completing the form, but not required.  Carefully choose your proxy, complete the form, have it witnessed, and make sure your health care providers, including the Hospital, have it in their records.  Most States recognize and honor the New York document. Since the status of and access to your Proxy may change due to moving, sickness, disability, new phone service, or death, it is advisable to update your Health Care Proxy every year.

When Serious Illness Advances, Do My Preferences Matter?
If you have a very advanced serious illness, perhaps with only a year or two to live, New York State provides an actual medical order called the MOLST – Medical Order for Life-Sustaining Treatment.  This form allows your physician to order care that is aligned with your wishes should your heart stop.  The order covers resuscitation wishes for when you have stopped breathing, as well as other care guidelines and instructions.  Both you and your physician sign the MOLST.  Signing a MOLST is not a snap activity.  It is the culmination of thoughtful conversations about What Matters Most to you as your illness becomes terminal, and what your Goals of Care and Treatment Preferences are.  It will most certainly guide your end-of-life care when that time comes. While the Health Care Proxy is an advance directive, the MOLST is an actual medical order.  MOLST’s are available in most medical offices.

When Should I Receive “Palliative Care?”
When facing serious illness, it is also important to remember palliative care and Hospice.  Palliative care is a type of medical care while Hospice is a formalized healthcare program fully covered by most insurances.  Palliative care is patient-centered care that focuses on quality of life and care of the whole person: physical, social, emotional, and spiritual.  The World Health Organization advises that palliative care should begin at the point of diagnosis of a serious illness, and be incorporated with all other care.  That means that palliative care becomes an extra layer of care and support, even while you are undergoing cure-oriented or disease-modifying treatments.  So don’t think that palliative care means Hospice – it doesn’t.

The application of palliative care before Hospice is one of the greatest needs today as progressive chronic illnesses are becoming epidemic and home care supports for seriously ill persons are increasingly inadequate.  Palliative care has trained and certified specialists right here in Saratoga County, and it is also delivered by any physician in what is called “primary” or “generalist” palliative care.  Congress last month passed legislation enabling more training in palliative care for medical students across the county.

When Should I Choose Hospice?
Hospice is a program of care at the end-of-life, appropriate when cure-oriented and disease-modifying treatments are no longer effective.  It is available when your life expectancy is 6 months or less if the disease runs its normal course.  So up-front discussions and planning with your doctor is critical.  Actually, records show that many patients elect Hospice very close to the actual day of death.  Hospice family members frequently say they wish they had brought Hospice in sooner.  Dying is a normal part of living (none of us will get out of here alive!), and Hospice neither hastens nor postpones the dying process. 

Surveys show that the vast majority of Americans want to be cared for at home, and when the time comes, to die at home.  But the majority of Americans still do not do so.  Many find themselves in circumstances they swore they would avoid.  So take the steps today to ensure that your wishes are known and respected:  Have a current Health Care Proxy document on file with all your providers; speak with your doctor about a MOLST if your illness is very advanced; add Palliative Care to your treatment plan for a serious illness; and consider Hospice with your doctor as your life expectancy becomes short term.

Phil Di Sorbo is a hospice and palliative care consultant on 233 Lake Avenue in Saratoga Springs.  He served as Executive Director of Community Hospice for 26 years, including the founding of Hospice of Saratoga in 1987.  He worked in hospice and palliative care capacities statewide, nationally, and in Africa.  He is currently active in expanding palliative care into mainstream healthcare earlier than end-of-life, working with area health systems.  He offers a navigation counseling service for seriously ill persons and their families, and can be reached at 518-755-1806 and pdisorbo@fairpoint.net.

At the end of last year Congress passed the SECURE Act. As is often the case with Congress, the acronym belies the content of the Act, in many respects, as it contains some provisions that are not altogether helpful to many individuals. Let’s review some of the major provisions (good and bad) of the Act.

Stretch IRAs: 
For IRAs inherited prior to Jan 1, 2020, non-spouse non-trust beneficiaries, need to take a Required Minimum Distribution (RMD) from inherited IRAs each year based on their life expectancy, for the remainder of their life. The younger a beneficiary, the smaller the distribution, as a percentage of the balance. This meant that most of the IRA balance could remain tax-deferred until the beneficiary needed it.

The new rule requires that IRAs inherited on or after Jan 1, 2020 (with few exceptions) must be completely withdrawn within only ten years. This provision will require most beneficiaries to empty inherited IRAs, which are fully taxable, during some of their highest earning years. The net effect will be a tax increase on these individuals by forcing beneficiaries to recognize more income and by forcing many into a higher tax bracket.

Beneficiary IRAs that predate the new Act taking effect are grandfathered in under the old rules. 

Required Minimum Distributions (RMDs):
Under the previous law, an individual must begin taking distributions from their own IRA by the end of the year in which they turned 70.5. The new law pushes that date out to their 72nd year.  However, anyone who attained age 70.5 before Jan 1, 2020 is still subject to the old rule, and must continue taking RMDs. Anyone turning 70.5 on or after Jan 1, 2020 can now wait until age 72. Unlike Inherited IRAs, your own IRA RMD is still based on a lifetime schedule.

IRA Contributions:
The new Act updates IRA contribution rules to bring them in-line with other retirement accounts. Beginning tax year 2020, you can now make IRA contributions beyond the age of 70.5, as long as you have earned income equal to or greater than the contribution amount. You cannot, however, make a prior year contribution for tax year 2019 under this rule. 

Withdrawals:
The Act allows for penalty-free withdrawals from IRAs of up to $5,000 in the event of a birth or adoption. 

The greatest impact of the Act will be to force withdrawals from Inherited IRAs over an accelerated period and during a time in which many beneficiaries will already be subject to higher taxes due to being in their highest earning years. That being said, you can still employ strategies to help mitigate taxes during this period. One option may be to increase contributions to your employer-sponsored plans (401k, 403b, etc), which could help offset the taxable income you’d be forced to receive from the IRA.

Again, these changes are beginning tax year 2020 (on or after Jan 1, 2020), and Inherited IRAs and other IRA RMDs schedules which predate, are unaffected. 

As always, work closely with your independent financial advisor to better understand how the Act may affect your individual circumstances, and to devise a strategy to manage the tax burden where possible. 

Stephen Kyne, CFP is a Partner at Sterling Manor Financial, LLC in Saratoga Springs, and Rhinebeck.
Securities offered through Cadaret, Grant & Co., Inc. Member FINRA/SIPC. Advisory services offered through Sterling Manor Financial, LLC, or Cadaret Grant & Co., Inc., SEC registered investment advisors. Sterling Manor Financial and Cadaret Grant are separate entities.