If you have a headache, you’re not alone. Nine out of ten Americans suffer from headaches. 

Some are occasional, some frequent, some are dull and throbbing, and some cause debilitating pain and nausea. What do you do when you suffer from a pounding headache? Do you grit your teeth and carry on? Lie down? Pop a pill and hope the pain goes away? There is a better alternative.

Research shows that spinal manipulation – one of the primary treatments provided by Doctors of Chiropractic – may be an effective treatment option for tension headaches and headaches that originate in the neck. A 2014 report in the Journal of Manipulative and Physiological Therapeutics (JMPT) found that chiropractic care improved outcomes for the treatment of acute and chronic neck pain and increased benefit was shown in several instances where a multimodal approach to neck pain had been used.

Headache Triggers

Headaches have many causes, or “triggers.” These may include  foods, environmental stimuli (noises, lights, stress, etc.) and/or behaviors (insomnia, excessive exercise, blood sugar changes, etc.) Ninety-five percent of headaches are primary headaches, such as tension, migraine, or cluster headaches. These types of headaches are not caused by disease; the headache itself is the primary concern.

The greatest majority of primary headaches are associated with muscle tension in the neck. Today, Americans engage in more sedentary activities than in the past, and more hours are spent in one fixed position or posture (such as sitting in front of a computer). This can increase joint irritation and muscle tension in the neck, upper back, and scalp, causing your head to ache.

What Can You Do?

The American Chiropractic Association (ACA) offers the following suggestions to prevent headaches:

•  If you spend a large amount of time in one fixed position, such as in front of a computer, on a sewing machine, typing or reading, take a break and stretch every 30 minutes to one hour. The stretches should take your head and neck through a comfortable range of motion.
• Low-impact exercise may help relieve the pain associated with primary headaches. However, if you are prone to dull, throbbing headaches, avoid heavy exercise. Engage in such activities as walking and low-impact aerobics.
• Avoid teeth clenching. The upper teeth should never touch the lowers, except when swallowing. This results in stress at the temporomandibular joints (TMJ) – the two joints that connect your jaw to your skull – leading to TMJ irritation and a form of tension headaches.
• Drink at least eight 8-ounce glasses of water a day to help avoid dehydration, which can lead to headaches.

What Can a Doctor of Chiropractic Do?

Your Doctor of Chiropractic may do one or more of the following if you suffer from a primary headache:

• Perform spinal manipulation or chiropractic adjustments to improve spinal function and alleviate the stress on your system.
• Provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins.
• Offer advice on posture, ergonomics (work postures), exercises, and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.

Doctors of Chiropractic undergo extensive training to help their patients in many ways beyond just treatment for low back pain. They know how tension in the spine relates to problems in other parts of the body, and they can take steps to relieve those problems.

Dr. Matt Smith has been a Chiropractor in Saratoga Springs for 35 years. He and his daughter Dr. Kevy Smith Minogue can be reached at 518-587-2064 or at www.MySaratogaChiropractor.com

We have a lot of laundry in our house.

There are school and play clothes, underwear and socks, towels and washcloths. (I should note that we are constantly looking for socks, yelling that we have no socks, and arguing about who took whose socks.)

There are work clothes that generally needed to be treated more carefully.

There’s sports laundry: items needed for practices, and different items needed for games and matches, which also change based on whether the game or match is home or away. 

Seasonal clothes: bathing suits and beach towels that need to be washed in the summer; snow clothes that have to be washed or at least dried on a nearly daily basis in the winter.

Masks: we have about a thousand of them, though it seems that only ten or so can be found at any one time. We have small ones for small faces and big ones for big faces; it’s not a guarantee that the ten that can be found are the right mix of small and big.

We have clothes that started out clean but have “somehow” ended up on the floor. We have clothes that were neatly folded and sorted in a laundry basket or in piles on the couch and I look away for a minute or I have to do something else for a minute, or, I do admit, sometimes for a day or two, and “someone” ends up jumping on the piles, dumping out the basket, or throwing items around the room (why do toddlers/preschoolers like to do this?); the formerly clean items then get walked on or kicked under the couch or, as once happened, are found hanging from the curtain rod, and since I can’t always distinguish the clothes on the floor that were dirty from the clothes on the floor that were just cleaned, they all have to go in the wash.

Every night, I ask the boys to gather up whatever clothes they want washed for the next day so I can run at least one load. I often have to put in a second load to make sure everyone has what they need. I usually have to run the dryer at least twice per load, because there are usually some damp things after one cycle. 

I do it at night because it’s often the case that people want things washed that they’ve worn to their practice that doesn’t get out until 8:15, for example. Also, because getting the laundry process going makes me tired, so it’s not until the eleventh hour that I find the will to deal with everyone yelling about how they don’t want to get up to find their laundry at that minute (no one ever wants to get up to get their laundry, but everyone always wants things washed for the next day). I often put the first load of laundry in as late as 10:00; if I have to run another, it goes in at 11:30; sometimes I run out of time to finish the dryer so I run it first thing in the morning before school.

People have offered to help me with laundry. My mom is always telling me she’d be happy to do some if I wanted to bring it to her house. My husband often runs a load of the boys’ things and/or puts away what’s in the dryer or what’s been sitting in a pile on the couch, and he’s always done his own as well, which cuts down on what I have to do. My biggest boy really wants me to let him do his own laundry (I know I have to let this happen, and soon). 

But the thing is, I’m one of those people who, if I don’t touch every single piece that goes through the laundry, I have no idea where anything is, and since everyone’s always asking me where things are, I need to know where things are. I’m also one of those people who loses my steam to get a job done if I’m faced with any kind of obstacle-if I’ve summoned the mental and physical strength to do the laundry and I find that someone’s already using the washer machine, there’s a good chance I’ll fizzle. My husband has gotten pretty good at anticipating when I won’t freak out that he needs to use the washer, but that is a learned skill that took years of marriage-I know for sure that my son would not have the same awareness. “Set a laundry schedule!” some of you are surely thinking, and that would be my thought, too, if I wasn’t dealing with someone (me) who is a slave to infrequent bursts of energy-I find it nearly impossible to get a task done if I’m not in the right frame of mind, and my “right frames of mind” often refuse to conform to a schedule.

I am my own worst enemy. But also, on the whole, I don’t really mind doing the laundry. In our house that is rarely tidy and orderly, there’s something satisfying and even soothing about taking a nice, warm, clean load of laundry out of the dryer. I get a great measure of satisfaction out of sorting, folding, and putting away all the clothes where they go-this step is the one that gets dropped most often (people are often scrounging through a dryerful of clothes to find what they need because I haven’t gotten to dealing with it yet), but it doesn’t get dropped as often as so many of the other tasks I wish I would do more often, because I like doing it. I like having my process, I like being able to do it when and how I like without anyone getting in my way, I like knowing where people’s things are when they ask, and I like making sure my kids have clean clothes. As with so many things, blessings and burdens go hand in hand.

Kate and her husband have seven sons ages 17, 15, 13, 11, 10, 7, and 3. Email her at kmtowne23@gmail.com.

Today is the third article in our series exploring the foundations of fitness. 

My last article reviewed the principle of stability. Improving stability will help you sharpen your ability to adapt to new activities, maintain balance, and react to new movements. Today, we will look at mobility and why it may be important to your fitness.

Mobility is our body’s ability to move freely, efficiently, and under control. Mobility allows us to move correctly and effectively with minimal restriction or difficulty. It is a crucial part of our fitness affecting all individuals and activities. 

A mobile joint taken through its full range of motion daily will be a healthier joint. We must incorporate it into our daily activities or sport, like the person who has to get down to play with grandkids and then reach overhead into the cupboard. If we don’t perform our mobility positions daily, it won’t be easy to do those movements when the time comes, basically, “use it or lose it.”

Over the last few years, mobility and stretching have been controversial in the fitness world—claims about what works and what doesn’t seem to change week to week. 

This controversy raises the questions:
• What stretching or mobility routine is the best? 
• How long should I hold a stretch for? 
• Should I stretch before or after participating in an activity? 
• Do I even need to stretch? 
• Does stretching help prevent injury?

Unfortunately, there is no one right answer, and there is no one-size-fits-all program.

Three myths about your mobility:

1. Stretching Reduces injury
The evidence for stretching reducing injury is inconclusive. Prepping your body with some active movements/stretches can only be a good thing. 

2. Stretching Improves Athletic Performance
Dynamic stretching and sport-specific warmup movements are ideal. Try to keep your warmup around 5-15 minutes.

Static stretching (i.e., stretching held for more than 30 seconds) has been shown to reduce strength, power, and performance! 

3. Stretching Improves Body Composition
Stretching does not make muscles appear longer and leaner. Lean-looking muscles come from diet and activity…NOT stretching. 

There are no detrimental or harmful effects of stretching. 

• Taking our joints through their entire available range of motion helps lubricate them and move the surrounding tissue and joint fluid. 
• You will improve your range of motion after stretching, but it will be temporary. Stretching simply does change the physical length of tissue.
• There is a strong mind-body connection and stress-relieving properties achieved with some forms of mobility/stretch training. 
• Mobility work with specific injuries or post-surgery can be helpful to decrease pain and sensitivity. 
• Particular movements or athletic positions that require a specific amount of joint motion can benefit from targeted mobility work.

How do we train mobility efficiently and effectively?

Remember, there isn’t a one size fits all program. But what I call “strength stretching” and dynamic warmups will serve you best in the most time-efficient manner. Strength stretching (aka loaded stretching) is a method to help simultaneously lengthen tissue (muscle, joints, ligaments) while developing strength and control through the full range of motion. 

This way of performing mobility differs from traditional stretching by incorporating a weight over a more extended period. Strength stretching provides the benefits of strengthening and stretching at the same time! 

Below are a couple of examples of ‘strength stretches’ you can perform. 

Calf raises to heel drop: 
Stand tall with your knees straight and heels hanging off of a bottom stair or a solid piece of wood. Hold onto the wall or railing for support. Start with your heels below the surface you’re standing on. Rise up, pushing your toes into the object that you are standing on. 

Slowly lower yourself (over 5-10 seconds) until your heels feel tight or restricted. Perform 2-3 sets of 5-10 reps three times per week. 

You can make this less challenging by standing on a shorter surface or with more hand support. To make this harder, try on one foot or hold a weight in one hand.

Deep chair squats:
Find a chair, sofa, or stool that is relatively low. Load up a backpack with several weights/books. (Start with 5-20 pounds). 

Next, drive your heels into the ground, lean slightly forward, and quickly rise out of the chair. You may need to use your hands a bit to help yourself up. After coming to a tall standing posture, slowly, with control, lower yourself down into the chair over 5 seconds. 

Repeat 2-3 sets of 8-12 more repetitions per session three times per week. 

Remember to always perform the movements in a range that you feel under control over and go slowly. Also, it is normal to have some post-stretch soreness. 

Mobility is a vital component of long-term fitness that helps you freely and efficiently for an active, healthy life. Any movement is better than no movement, so find a routine you like and stick with it! 

In my following two articles, we will be looking at power and strength and how you can participate and improve in each area!

Dr. Robert Rehberger PT, DPT, OCS, is a physical therapist at Goodemote Physical Therapy. He is a Board-Certified Orthopedic Specialist and a Board Certified Spine Fellow. 

Call 518-306-6894 to set up an appointment with one of our highly trained PTs. 

The end of another year is rapidly approaching, and just as you cross items off your checklist and prepare your home for the winter, it’s also important to complete maintenance items to prepare your finances to close-out 2021.

The first order of business is to make sure you’ve made the Required Minimum Distribution (RMD) from your IRAs and other retirement plans for the year. Congress gave a reprieve in 2020, but did not extent that for 2021. If you’re age 72 or older, or have certain inherited retirement accounts, you will need to make minimum distribution by year’s end. The penalty for non-compliance is 50% of the amount you should have distributed, so you’ll want to steer clear of that!

If, like many, you don’t need the RMD to make ends meet, and would prefer not to take any distribution at all, consider donating it to a charity of your choice. The IRS allows you to distribute funds directly from your IRA to a charity, and not pay taxes on the distribution, even if you aren’t eligible to itemize deductions on your federal taxes. 

It’s important to note that distributions must go DIRECTLY from your IRA to the charity. In other words, you cannot distribute to yourself, and then write a check to the charity. This can be a great option even if you aren’t subject to RMDs, but are charitably inclined and not eligible to itemize deductions!

The next piece of financial housekeeping will be to begin to gather documents you’ll be needing just after the new year to prepare your taxes. Compile receipts for medical bills, tuition payments, child care and charitable contributions, among others.

While many of us will no longer be able to itemize deductions due to recent tax law changes, there are credits for things like child care and education expenses which you may still be eligible for. For those with large medical bills, mortgage interest, or who have been particularly philanthropic this year, you may still be able to itemize, so it is important to have those receipts handy.

Of note: many families which are accustomed to, and depend on, large tax refunds in the spring may be shocked to find out that those checks may be much smaller than they are used to. This is because Congress changed how child tax credits are paid this year. 

Usually, this credit is received at tax time, for the prior year. This year, however, families have been receiving checks each month. No doubt this extra income has been helpful, especially for lower-income families. We feel, though, that the government has done a TERRIBLE job of communicating to these families that their refunds will be lower as a result, and wonder at the net impact on these families’ finances.

When it comes to planning for your retirement, this is the perfect time to evaluate your contribution levels to your retirement plans at work. If you have the ability, and you’re not yet contributing to the maximum levels allowed, consider topping these accounts off to take advantage of the possible tax deduction this year, as well as the ability to simply squirrel as much away for the future as possible. Even if you can’t contribute to the maximum, be sure to at least contribute enough to take advantage of any employer matching contributions. 

You may not be aware, but once you reach age 50, you are eligible for higher contribution levels than in prior years. So, if you’ve turned 50 this year, consider increasing your contributions. For 401(k) and 403(b) plans, you can contribute an additional $6,500 to a max of $26,000 from $19,500 for those under 50. For SIMPLE plans, you get to contribute an additional $3,000, up to a max of $16,500. Take advantage of this opportunity to catch-up on contributions you may not have been able to make when you were younger. 

The end of the year is a perfect time to review your various forms of insurance, including your home and auto. Take note of various coverage limits and deductibles. If you can, consider a higher deductible in order to save on premium expenses. 

Ensure that your homeowners coverage amounts reflect the value of your home. Your home has probably appreciated since you purchased it, but have you increased your coverage limits to keep pace? 

An often-overlooked task is to review your beneficiary declarations each year. Families grow, as new members are added, and shrink with death and divorce, which means that beneficiary and Transfer-on-Death declarations can easily become outdated and no longer reflect your true wishes. 

Since these declarations are a matter of contract, they will overrule what your Will may say. So, even if you’ve updated your will to exclude an ex-spouse, but you left them as beneficiary on your IRA, your new spouse won’t be able to inherit those assets, but the ex will, and it can’t be challenged in probate.

Your Certified Financial Planner® professional is perfectly suited to help you mark most of these items off your list. Review your beneficiaries, gather tax documents, maximize funding of your various retirement plans, take required distributions, and review your insurance coverage with your advisor each year, to help ensure that your financial plan is well-tuned as you prepare to turn the page on 2021.

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.

Every time I hear the song “I’ll Be Home for Christmas,” I wonder about the “presents on the tree” part. On the tree? What does that mean? How would that work? I finally googled it recently and discovered that, indeed, presents used to be hung on the tree or nestled in its branches, but they were small things like dolls and cookies, and for a time there were even containers sold for the express purpose of hanging on the tree with small gifts inside. A holdover from that time is the animal crackers box with its string — it was originally made that way as a Christmas promotion, specifically to be hung on the tree! (If you want to read more, check on the great article “Hanging Gifts ON the Tree” at www.twelvedays.com/blogs/news/7040100-hanging-gifts-on-the-tree.)

Of course, my mind immediately went to “how on earth would that work with small children in the house??” but then I reminded myself that it’s not actually a thing we need to worry so much about anymore anyway, which is just another in a long list of ways my children are growing up and our household is looking so different from how it did even just last year.

Not only are “presents on the tree” not as terrifying an idea as it would have been previously, but even the location of our Christmas tree is evidence of the absence of babies and toddlers. For the vast majority of the last seventeen years, figuring out where to put our Christmas tree has been a no-brainer: it goes in the room that the little ones aren’t allowed in. 

In our first house, where my oldest two came home to after being born, we had a front room that the front door opened into, and a back sunroom that my grandmother had added on when she’d lived there. The back room was the kids’ playroom and our general living room; the front room was for the nice loveseat and the Christmas tree.

In our current house, where we’ve lived ever since we moved from my grandmother’s house, we also have a front room that our front door opens into, and my ideal is that it stays nice, like a sitting room or parlor, where we and guests can sit in relative peace and order (it almost never works out that way, but the intention is there). All the rest of the first floor is living space, where my children have free rein, but I always had a baby gate in the doorway into the front room when I had very small little ones so that there was some effort to keep it nice. Clearly, it was the only place for the Christmas tree.

It’s a perfect room for it too — it has a nice big window that looks out onto the street, which is ideal for a Christmas tree, and every year I sigh with happiness when I drive up to our house at night and see the pretty Christmas tree in the front window.

But this year, I’m not sure where the tree should go! Because of the shutdown and everyone working and schooling from home, it became very obvious to me that we didn’t have adequate workspaces for everyone, so Santa generously brought desks for the boys last year. Figuring out where to put them was a task, let me tell you. But we figured it out, and it’s been great, except that two of the desks are in our already very small front room — the “nice” room — and now there’s no room for the Christmas tree.

I’m sure I could figure out some way of reconfiguring the room for the month or less that we’d have the Christmas tree up, but I’ve actually been thinking about doing something different — I’ve been thinking about maybe putting it in the TV room, which is also in the front of the house, on the other side of a wall from the “nice” front room. It also has a window that looks out on the street — a much smaller window, but still. And this is the big thing, the thing that made me think to write about it for this column: my youngest is three, and while there will definitely be a learning curve for him about what he can and cannot do in regard to a Christmas tree in his living space, I actually think it’s not impossible like it would have been even last year, or any of the other previous almost seventeen years. 

Look how far we’ve come!

There are so many things about these kids growing up that make me sad, like how more than half of them are now wise to the ways of Christmas. I have always loved helping create the mystery and magic of Christmas, and while it’s still wonderful with big boys, and I still do have three little ones who are wide eyed with wonder, and I will always do what I can to help with the mystery and magic, there was something so special about all of our children watching the sky for Santa’s sleigh. But there are also a lot of things about the kids growing up that I’m not hating at all, like having the freedom to put the Christmas tree in a different spot. Look at us with our gateless house and our Christmas tree in our TV room! We could probably even hang some presents on the tree without worrying that Mr. Three-Year-Old would ruin it all. (Well … maybe not just yet.) A very Merry Christmas and Happy New Year to you all!

Kate and her husband have seven sons ages 17, 15, 13, 11, 9, 7, and 3. Follow her at www.facebook.com/kmtowne23, or email her at kmtowne23@gmail.com.

Article 81 of the Mental Hygiene Law outlines the legal provisions relating to guardianship of adults who are no longer able to handle their personal and/or financial affairs.  Adults suffering from chronic mental illness, such as bipolar disorder or schizophrenia, arguably cannot handle their personal or financial affairs, but they are not the most common subjects of Article 81 proceedings.

More commonly, Article 81 proceedings are brought with regard to older individuals suffering from Alzheimer’s Disease or other forms of dementia.  The proceedings are usually brought by family members, including spouses or children.

Those who suffer from mental illness may have functional deficits, which can sometimes lead to limitations presenting a danger to their welfare.  In contrast to an older individual suffering from Alzheimer’s Disease, the functional deficits of a mentally ill person can be intermittent.  As soon as the individual suffering from mental illness is getting proper treatment, i.e. consistent medication and/or therapy, the functional deficits may be manageable.

As a result, an Article 81 guardianship proceeding may be an inappropriate means of legal help for loved ones who seek assistance with a mentally ill friend or family member.  If this is the case, then what options exist under our current law to address the need?

One option to consider is Article 9.60 of the Mental Hygiene Law.  Article 9.60 is known as Kendra’s Law.  In January of 1999, Andrew Goldstein, a man with a long history of mental illness, pushed Kendra Webdale into the path of an oncoming subway train in Manhattan, causing her death.  Kendra was a 32 year-old journalist, originally from Fredonia, New York.  Prior to this tragedy, Mr. Goldstein had been in and out of mental health facilities, typically for short periods. Article 9.60 of the Mental Hygiene Law (MHL 9.60) was passed in honor of Kendra’s memory.

MHL 9.60 applies to adults who suffer from mental illness who are unlikely to survive safely in the community without supervision.  These individuals must have a history of lack of compliance with treatment for mental illness that resulted in: a) two inpatient hospitalizations in a mental health facility in the last three years, or b) one or more acts of serious violent behavior towards themselves or others in the last four years, or c) one or more threats or attempts at serious physical harm against themselves or others in the last four years.

The ultimate goal of MHL 9.60 is to bring mental health services to bear in critical cases to prevent another tragedy, like the death of Kendra Webdale.  MHL 9.60 proceedings are most commonly brought by county mental health authorities, but the statute does permit the proceeding to be brought by close family members and adults who live with the mentally ill individual.

The MHL 9.60 statute is titled “Assisted outpatient treatment,” which is often shortened to “AOT.”  As its name implies, the goal of the law is to put together a plan of outpatient treatment for the individual that can be made part of a judicial order.  For the proceeding to go forward, the petition must be accompanied by a statement by a physician that because of their examination of the individual or based on other factors, they believe the individual would benefit from AOT.

The judge hearing the case must find by “clear and convincing evidence” that AOT services are appropriate and that there is no “appropriate and feasible less restrictive alternative.”  If the judge so finds, he or she can order that the individual take appropriate medications and abide by a treatment plan designed to assist with their condition.  The treatment plan may include things like case management services, individual or group therapy, and alcohol or substance abuse treatment.  The court can order the AOT services plan to be in place for up to one year.

If the individual receiving AOT services fails to comply with the plan set forth for their treatment, MHL 9.60 provides a mechanism for him or her to be taken into custody and evaluated by appropriate medical professionals.  The law allows for the individual to be held for up to seventy-two hours, and potentially longer, based on the circumstances.

If someone who struggles with mental illness is not a good candidate for guardianship under Mental Hygiene Law Article 81, there may be tools that can be brought to bear under Mental Hygiene Law Article 9.60.  MHL 9.60 does not appoint a guardian for the individual, but rather mandates a program of assisted outpatient services to the mentally ill individual – which may help save their life, or potentially the life of another.

Matthew J. Dorsey, Esq. is a Partner with O’Connell and Aronowitz, 1 Court St, Saratoga Springs.  Over his 24 years of practice, he has focused in the areas of elder law, guardianship, estate planning, and estate administration.  Mr. Dorsey can be reached at 518-584-5205, mdorsey@oalaw.com, and www.oalaw.com. 

Article 81 of the Mental Hygiene Law outlines the legal provisions relating to guardianship of adults who are no longer able to handle their personal and/or financial affairs.  Adults suffering from chronic mental illness, such as bipolar disorder or schizophrenia, arguably cannot handle their personal or financial affairs, but they are not the most common subjects of Article 81 proceedings.

More commonly, Article 81 proceedings are brought with regard to older individuals suffering from Alzheimer’s Disease or other forms of dementia.  The proceedings are usually brought by family members, including spouses or children.

Those who suffer from mental illness may have functional deficits, which can sometimes lead to limitations presenting a danger to their welfare.  In contrast to an older individual suffering from Alzheimer’s Disease, the functional deficits of a mentally ill person can be intermittent.  As soon as the individual suffering from mental illness is getting proper treatment, i.e. consistent medication and/or therapy, the functional deficits may be manageable.

As a result, an Article 81 guardianship proceeding may be an inappropriate means of legal help for loved ones who seek assistance with a mentally ill friend or family member.  If this is the case, then what options exist under our current law to address the need?

One option to consider is Article 9.60 of the Mental Hygiene Law.  Article 9.60 is known as Kendra’s Law.  In January of 1999, Andrew Goldstein, a man with a long history of mental illness, pushed Kendra Webdale into the path of an oncoming subway train in Manhattan, causing her death.  Kendra was a 32 year-old journalist, originally from Fredonia, New York.  Prior to this tragedy, Mr. Goldstein had been in and out of mental health facilities, typically for short periods. Article 9.60 of the Mental Hygiene Law (MHL 9.60) was passed in honor of Kendra’s memory.

MHL 9.60 applies to adults who suffer from mental illness who are unlikely to survive safely in the community without supervision.  These individuals must have a history of lack of compliance with treatment for mental illness that resulted in: a) two inpatient hospitalizations in a mental health facility in the last three years, or b) one or more acts of serious violent behavior towards themselves or others in the last four years, or c) one or more threats or attempts at serious physical harm against themselves or others in the last four years.

The ultimate goal of MHL 9.60 is to bring mental health services to bear in critical cases to prevent another tragedy, like the death of Kendra Webdale.  MHL 9.60 proceedings are most commonly brought by county mental health authorities, but the statute does permit the proceeding to be brought by close family members and adults who live with the mentally ill individual.

The MHL 9.60 statute is titled “Assisted outpatient treatment,” which is often shortened to “AOT.”  As its name implies, the goal of the law is to put together a plan of outpatient treatment for the individual that can be made part of a judicial order.  For the proceeding to go forward, the petition must be accompanied by a statement by a physician that because of their examination of the individual or based on other factors, they believe the individual would benefit from AOT.

The judge hearing the case must find by “clear and convincing evidence” that AOT services are appropriate and that there is no “appropriate and feasible less restrictive alternative.”  If the judge so finds, he or she can order that the individual take appropriate medications and abide by a treatment plan designed to assist with their condition.  The treatment plan may include things like case management services, individual or group therapy, and alcohol or substance abuse treatment.  The court can order the AOT services plan to be in place for up to one year.

If the individual receiving AOT services fails to comply with the plan set forth for their treatment, MHL 9.60 provides a mechanism for him or her to be taken into custody and evaluated by appropriate medical professionals.  The law allows for the individual to be held for up to seventy-two hours, and potentially longer, based on the circumstances.

If someone who struggles with mental illness is not a good candidate for guardianship under Mental Hygiene Law Article 81, there may be tools that can be brought to bear under Mental Hygiene Law Article 9.60.  MHL 9.60 does not appoint a guardian for the individual, but rather mandates a program of assisted outpatient services to the mentally ill individual – which may help save their life, or potentially the life of another.

Matthew J. Dorsey, Esq. is a Partner with O’Connell and Aronowitz, 1 Court St, Saratoga Springs.  Over his 24 years of practice, he has focused in the areas of elder law, guardianship, estate planning, and estate administration.  Mr. Dorsey can be reached at 518-584-5205, mdorsey@oalaw.com, and www.oalaw.com. 

How Spinal Alignment Can Help You Improve Your Sports Performance

Do you have trouble meeting your athletic goals despite hours of practice time? Skill isn’t the only factor that affects your ability to run faster, throw a ball accurately or prevent the other team from scoring. A misaligned spine may compromise your range of motion, recovery time and flexibility, causing performance difficulties. Fortunately, spinal manipulations performed by your chiropractor can correct misalignments and help you excel at your favorite sport or activity.

6 Spinal Alignment Advantages

• Fewer Injuries. Misalignments not only affect your spine but can also cause tightness in your muscles, ligaments, and tendons, increasing your risk of injury. Regular visits to your chiropractor will decrease misalignments, known as subluxations, and help you avoid aches, pains, and serious injuries.
• Better Balance. Correcting subluxations may also have a positive effect on your balance, improving your ability to make a save, avoid a fall if you stumble or perfect your balance beam routine. During spinal manipulation treatment, your chiropractor uses gentle, hands-on pressure to improve the alignment of the vertebrae in your back and neck.
• Improved Strength. Strength, an important factor in many sports, can decrease if you have a subluxation. The problem may affect your ability to grip or catch the ball, tackle opponents, run long distances or make key plays. Chiropractic provides a natural strength-boosting option. Brazilian researchers discovered that manipulating the vertebrae in the neck offered significant increases in strength. Judo athletes who received cervical (neck) spinal manipulation therapy improved their grip strength by 16 percent on the right side and 11 percent on the right side. Their results were published in the January 2012 issue of Manipulative and Physiological Therapeutics.
• Quicker Healing Time. Correcting subluxations can also help you reduce healing time after an injury. Manipulations, electrical stimulation, ultrasound therapy, and other treatments decrease inflammation, ease spasms, enhance healing and improve the flow of blood and nutrients to the injured area.
• Faster Recovery Time. Sports take a toll on your body, no matter how diligently you stretch and warm-up before starting an activity. Without an adequate rest period following exertion, you may increase your risk of injury. When your spine is aligned properly, you may notice that it doesn’t take quite as long to return to top form.
• More Flexibility. Spinal manipulation, massage, and other treatments loosen tight joints and muscles, in addition to improving spinal alignment. These treatments increase your range of motion, prevent the formation of scar tissue, and decrease stiffness caused by tight muscles and joints.

Thanks to your visits to the chiropractor, you may find that it’s easier to follow through when you swing a golf club or racquet or notice that you can stretch a little farther when making a diving catch.

• Enhanced Performance. You’ve probably noticed that your performance suffers if your back and neck hurt, your muscles are tight, or you have a throbbing headache.
• Fortunately, aches and pains due to subluxations won’t prevent you from excelling when you make chiropractic therapy part of your training regimen. Treatments may also improve nerve function, improve your reaction time, and even help you breathe more deeply.

Would you like to enhance your sports ability with chiropractic treatment? We’ll devise a comprehensive treatment plan that will help you improve your performance and strength and avoid injuries. Contact us to schedule your appointment.

I know it violates a big rule of periodical publishing to print something out-of-season, but this is also a column about being a mom, and I tell you as a mom — if I don’t do something when I think of it, it won’t get done. So I’m sorry to tell you that, even though Halloween is over and we’ve moved on to thinking about The Most Wonderful Time of the Year (in which I include Thanksgiving), I have some Halloween ideas I need to share. I’ll leave it to you to decide if you want to save this list for future use; I know I myself will be referring to it often for many years to come.

This has to do with big kids — particularly, in my house, middle school and high school kids. This has to do with costumes — particularly, in my house, kids professing to not be at all interested in dressing up for Halloween and they wouldn’t have any idea what to wear as a costume anyway. This has to do with last-minute freak outs — particularly, in my house, the fact that the eleventh hour seems to be exactly when my children decide to do something they’d previously decided not to do, or change their minds about something previously decided upon, but they have no ideas about how to make it all happen. Yes, at the very last minute a couple of my boys decided they did want to dress up for Halloween after all.

We took to the internet to see if we could find costume ideas. Our standards were very low — we just wanted ideas that could be pulled together in a few minutes with things we had around the house, even if they were dumb, even if they challenged the very definition of “costume.” These were my favorites:

Ghost
One of the most classic Halloween costumes, and one of the easiest!

Cereal Killer
The picture I saw online of a “Cereal Killer” costume was of a bunch of mini cereal boxes affixed to a shirt with plastic knives stuck in each one and red paint around each knife puncture and on the shirt, but even just one regular sized cereal box could do.

50s guy or lumberjack
I’m grouping these two together because they both involve jeans — only the shirts change. 50s guy can wear just a white t-shirt with the sleeve rolled; a black leather jacket is a bonus. A lumberjack only needs a flannel shirt; suspenders would be a fun addition, but not necessary.

Nerd
Shirt tucked in, pants hiked up, and hair parted in the middle and slicked down seem to be the hallmarks of a “nerd,” at least in a “Halloween costume” kind of way. A pair of glasses would complete the look nicely, if you had them.

Swimmer
While a bathing suit and swim shirt wouldn’t be great for trick-or-treating in the cold, this could be a perfect costume for a Halloween party or to wear to school. A towel around the neck, flip flops, and goggles would all be good accessories if available.

Bag of leaves
All you need is a big garbage bag and leaves! Cut holes in the bottom of the garbage bag and step into it, pulling it up to the top of your legs (over your pants), and put some leaves in it — voila! You’re a bag of leaves!

Three hole punch guy
After googling “fast easy costumes for teens,” I also googled “Jim Halpert Halloween costumes” — Jim Halpert is a character on the show “The Office” whose Halloween costumes almost always involved the smallest amount of effort necessary. One of them was “Three-hole-punch Jim,” in which he cut out three large black circles (construction paper is perfect for this) and stuck them in a vertical row to one side of his shirt. Not only does this allow you to pass as technically having a costume, but the connection to the “The Office” adds an extra layer of comedy for anyone familiar with the show.

Jake from State Farm or Dave
I have to give credit for this one to some of the teens that have trick-or-treated at my house in past years. The first time I saw a teen wearing a red polo shirt and khakis with a nametag that said, “Jake from State Farm,” I laughed out loud! Similarly, one of Jim Halpert’s “costumes” on “The Office” was a nametag that said, “Dave.” When people asked him what he was, he’d point to the nametag and say, “Dave.” So dumb, yet so funny!

Error404:  Costume not found 
I thought this last idea was pretty clever: It’s just a matter of putting the words, “Error 404: Costume not found” on your shirt! It could be as easy as writing it on a piece of paper and sticking it to the front of your shirt.

You can see what I meant when I wrote in the beginning that it didn’t matter if the ideas I found were dumb or even challenged the very definition of “costume”! I really think this list is going to come in handy in my house in the coming years — I hope you find it as helpful as I do. Happy Thanksgiving to you all!

Kate and her husband have seven sons ages 17, 15, 13, 11, 9, 7, and 3. Follow her at www.facebook.com/kmtowne23, or email her at kmtowne23@gmail.com.

Seven-in-ten retirees will need some form of long-term care, which means that, for couples, there is a 91% chance of one spouse needing care. November is Long-Term Care Awareness Month. This is an issue that will affect nearly everyone, so it’s important to have a plan to provide for your care, while protecting your family and assets from the risks associated with long-term care.

People generally plan for their long-term care for two reasons. First, they want to make sure that they receive the best care available, by qualified caregivers. Second, if married, they want to make sure that their assets are protected so that their spouse will be able to continue his/her standard of living. The average widow outlives her husband by twelve years –what will those years look like if the couple’s nest egg was spent on her husband’s long-term care?

In this part of New York, long-term care can cost upwards of $10,000/month.  With an average nursing home stay of more than 2.5 years, you can see how quickly assets can be depleted. So, what is a person to do?

Often care begins with one spouse providing it, but the needs can quickly outpace the spouse’s ability or skill level.  Could your spouse pull you out of a bathtub today? Could they do it twenty years from now? Are they the most qualified person to provide care?   What if your spouse pre-deceases you? Who will take care of your spouse after you die?

Gifting and trusts used to be a popular way to protect assets, however uncertainty in the legal landscape makes this a risky strategy. There is currently a five-year look back period for gifts, and it’s very possible that period could be extended. Will you know when you’re five years from needing care? What if the look back goes to ten years? Today, we see this type of planning used when a more effective strategy isn’t available. 

The most effective strategy for planning for the day your health changes is private long-term care insurance. Insurance can provide the flexibility of receiving care from a qualified professional caregiver in your home, an assisted living facility, or a nursing home, or in all three setting as your needs change. This means that you can still be surrounded by your loved-ones, but without burdening them with your care.  We feel the prime age range for securing coverage is in your mid- to late-50s, while you’re still healthy enough to qualify, although your needs may differ.

Here’s what to look for in a long-term care policy:

1. A good insurance policy should include an inflation protection component, so that the policy’s benefit will increase as the cost of care increases. These inflation protection benefits are generally available with between 3% and 5% annual increases. 

2. A policy should allow you to receive care where and how you like: in your home, an assisted living facility, or a nursing home, as your needs demand.

3. Many policies will offer a cash benefit; a portion of your benefit paid directly to you rather than to your care provider. This benefit can be used for in-home modifications and other expenses related to your needs.

4. Your policy should provide a daily benefit large enough to cover the cost of care in the region you plan to receive it. Remember that any shortfall will have to be paid out-of-pocket. In the event the cost of care is lower than expected, the policy will generally provide benefits for a longer period of time.

5. Make sure your carrier has a high credit rating. Since any guarantees are based on the claims-paying ability of the carrier, you’ll want to be confident your carrier will still be around when it comes time to pay for your care. 

When you’re young and providing for a family, the risk to your family is that you’ll die prematurely. Once you’re retired, the risk is often no longer death, but the day your health changes.  Do you have a plan to provide for your care? Long-term care insurance is not the only way to plan for your care and associated expenses, but it is the most foolproof.  If you don’t qualify for insurance, then trust work or gifting may be necessary. 

At the very least, you should be discussing your needs with your family and your Certified Financial Planner® professional to ensure that you know your options, and are able to make an informed decision on a strategy.  Your advisor is the best person to educate you about the options, based on their understanding of your unique circumstances.

Securities offered through Cadaret, Grant & Co., Inc. Member FINRA/SIPC. Advisory services offered through Sterling Manor Financial, LLC, or Cadaret Grant & Co, SEC registered investment advisors. Sterling Manor Financial and Cadaret, Grant are separate entities.