Argen Medical recently joined Stony Brook Community Medical, Stony Brook Medicine’s expanding network of community practices and physicians. The medical group practices obstetrics and gynecology in Port Jefferson Station.
“We are extremely pleased that Dr. Gustavo San Roman is joining the Stony Brook family,” said Dr. Todd Griffin, chair, Department of Obstetrics, Gynecology and Reproductive Medicine, Stony Brook Medicine. “He has been an outstanding Ob-Gyn in the community and a wonderful proponent of women’s health.”
Stony Brook Medicine welcomes private practices that are committed not only to the community but to providing the highest level of quality care. Argen Medical has been providing expert, comprehensive care to women of all ages in the community for more than 30 years.
“I am very excited to be back at Stony Brook University Hospital. I have built a practice based on the concept of providing excellent and personalized Ob-Gyn care,” said San Roman. “With this in mind, I have helped to build many strong families in our community. In fact, I am now taking care of the next generation of women whose births I attended many years ago.”
“As a member of Stony Brook Medicine, I have the honor to continue to provide complete personalized Ob-Gyn services in my Port Jefferson Station office and three local hospitals,” he added.
The Argen Medical team, comprised of San Roman and two nurse practitioners, Laura Doti and Jaclyn Cuccinello, welcomes new patients. And as a bilingual practice, they are able to offer comprehensive services to Spanish-speaking patients as well.
For more information, call 631-331-8777.
Pictured in photo, from left, Jaclyn Cuccinello, Gustavo San Roman and Laura Doti.
Suffolk County Community College announced Aug. 6 that alumna Jill L. Santiago of Middle Island has been named executive director of the Center for Social Justice and Human Understanding: Featuring the Holocaust Collection.
A graduate of Suffolk County Community College, with a bachelor’s in sociology from Stony Brook University and a master’s in history from Queens College, Santiago launched her career at the Center for Social Justice and Human Understanding as a student volunteer more than a decade ago. During that time she has been involved in the development of educational programming and expansion of community outreach to significantly grow programs on and off Suffolk’s three campuses. Santiago also teaches courses at Suffolk about the Holocaust and Western civilization.
The center, whose mission is to educate the community about historical events and to promote cultural understanding and respect for human dignity, now reaches more than 8,000 participants each academic year.
The center is located at Suffolk County Community College’s Ammerman Campus in Selden, in the Huntington Library, 533 College Road, Selden. Hours are Monday through Friday from 9 a.m. to 4 p.m. when classes are in session. For more information, call 631-451-4117.
Northport Chorale will hold open auditions at the Northport High School Choir room, 154 Laurel Hill Road, Northport on Wednesdays, Sept. 4, 11 and 18 at 7 p.m. for its upcoming winter concert with the Northport Community Band. All voices needed. For more info, call Debi at 631-223-3789 or visit www.northportchorale.org.
When planning for the differently abled, the use of supplemental needs trusts as part of your estate planning will ensure that you have provided protections for those with special needs and disabilities.
When considering your estate planning, it is important to consider any beneficiaries who may have special needs or disabilities. Receiving an outright inheritance could negatively affect these individuals, as oftentimes they are entitled to, and receive, need-based government benefits such as SSI, Medicaid and Group Housing, to name a few, which either supplement or fully cover the living and medical expenses of the individual.
Safeguarding these benefits by using supplemental needs trusts rather than an outright distribution can ensure that you can leave funds to a loved one who has special needs without the risk of interfering with their government benefits.
Supplemental needs trusts can be established as “first-party” or “third-party trusts.” This article highlights third-party supplemental needs trusts which are, simply stated, trusts funded with the assets of a third-party, anyone other than the differently abled individual.
To understand the difference, first-party trusts are funded with the assets or income of the differently abled person and are often used to safeguard benefits after the individual receives an inheritance or some other windfall. First-party supplemental needs trusts are also often used to protect money that was in the name of the individual at the onset of a disability.
First-party supplemental needs trusts are available to persons under the age of 65, and thanks to recent legislation, can be created by the individual him or herself, a parent, guardian or through the court. Although a terrific planning tool, when possible it is preferable to address these planning needs ahead of time to ensure no interruption of benefits and a maximum preservation of assets.
The first-party trust requires a payback provision which dictates that any monies that remain in the trust at the time of the individual’s death must be paid to the state in an amount equal to the medical assistance paid on behalf of the individual.
Third-party supplemental needs trusts can either stand alone or be incorporated into your estate planning. These trusts can be created by anyone for the benefit of the disabled individual. They can be funded upon creation or can be prepared with the idea of funding at the time of the death of the creator.
The assets in the trust can be used to provide the individual with comforts they would otherwise not be able to afford. Because these trusts are set up with the fund of a third party, unlike the first-party supplemental needs trusts, they do not have a payback provision.
Upon the death of the original beneficiary of the trust, whatever assets remain in the trust can be distributed in accordance with the grantor’s wishes. By leaving assets in a supplemental needs trust, you would be able to provide for your loved one and ensure the continuation of imperative benefit on which he or she relies.
It is important to note that funds between a first-party trust and a third-party trust should never be co-mingled. Specifically, if monies which originated with the disabled individual go into a third-party trust, the protections afforded to third-party trusts (i.e., no payback provision) may extinguish and a payback could be required.
Overall, supplemental needs trusts are invaluable for planning for those differently abled. The trusts can enhance the quality of life for the person and supplement the benefits he or she is already receiving.
Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.
Balance and strengthening exercises help to prevent falls. Stock photo
Our best line of defense is prevention
By David Dunaief, M.D.
Dr. David Dunaief
When we are young, falls usually do not result in significant consequences. However, when we reach middle age and chronic diseases become more prevalent, falls become more substantial. And, unfortunately, falls are a serious concern for older patients, where consequences can be devastating. They can include brain injuries, hip fractures, a decrease in functional ability and a decline in physical and social activities (1). Ultimately, falls can lead to loss of independence (2).
Of those over the age of 65, between 30 and 40 percent will fall annually (3). Most of the injuries that involve emergency room visits are due to falls in this older demographic (4).
What can increase the risk of falls?
Many factors contribute to fall risk. A personal history of falling in the recent past is the most prevalent. But there are many other significant factors, such as age, being female and using drugs, like antihypertensive medications used to treat high blood pressure and psychotropic medications used to treat anxiety, depression and insomnia.
Chronic diseases, including arthritis, as an umbrella term; a history of stroke; cognitive impairment; and Parkinson’s disease can also contribute. Circumstances that predispose us to falls also involve weakness in upper and lower body strength, decreased vision, hearing disorders and psychological issues, such as anxiety and depression (5).
How do we prevent falls?
Stock photo
Fortunately, there are ways to modify many risk factors and ultimately reduce the risk of falls. Of the utmost importance is exercise. But what do we mean by “exercise”? Exercises involving balance, strength, movement, flexibility and endurance, whether home based or in groups, all play significant roles in fall prevention (6). We will go into more detail below.
Many of us in the Northeast suffer from low vitamin D, which may strengthen muscle and bone. This is an easy fix with supplementation. Footwear also needs to be addressed. Nonslip shoes, if recent winters are any indication, are of the utmost concern. Inexpensive changes in the home, like securing area rugs, can also make a big difference.
Medications that exacerbate fall risk
There are a number of medications that may heighten fall risk. As I mentioned, psychotropic drugs top the list. Ironically, they also top the list of the best-selling drugs. But what other drugs might have an impact?
High blood pressure medications have been investigated. A propensity-matched sample study (a notch below a randomized control trial in terms of quality) showed an increase in fall risk in those who were taking high blood pressure medication (7). Surprisingly, those who were on moderate doses of blood pressure medication had the greatest risk of serious injuries from falls, a 40 percent increase. One would have expected those on the highest levels to have the greatest increase in risk, but this was not the case.
While blood pressure medications may contribute to fall risk, they have significant benefits in reducing the risks of cardiovascular disease and events. Thus, we need to weigh the risk-benefit ratio, specifically in older patients, before considering stopping a medication. When it comes to treating high blood pressure, lifestyle modifications may also play a significant role in treating this disease (8).
Why is exercise critical?
All exercise has value. A meta-analysis of a group of 17 trials showed that exercise significantly reduced the risk of a fall (9). If the categories are broken down, exercise had a 37 percent reduction in falls that resulted in injury and a 30 percent reduction in those falls requiring medical attention. Even more impressive was a 61 percent reduction in fracture risk.
Remember, the lower the fracture risk, the more likely you are to remain physically independent. Thus, the author summarized that exercise not only helps to prevent falls but also fall injuries. The weakness of this study was that there was no consistency in design of the trials included in the meta-analysis. Nonetheless, the results were impressive.
Unfortunately, those who have fallen before, even without injury, often develop a fear that causes them to limit their activities. This leads to a dangerous cycle of reduced balance and increased gait disorders, ultimately resulting in an increased risk of falling (10).
What specific types of exercise are useful?
Many times, exercise is presented as a word that defines itself. In other words: Just do any exercise and you will get results. But some exercises may be more valuable or have more research behind them. Tai chi, yoga and aquatic exercise have been shown to have benefits in preventing falls and injuries from falls.
A randomized controlled trial, the gold standard of studies, showed that those who did an aquatic exercise program had a significant improvement in the risk of falls (11). The aim of the aquatic exercise was to improve balance, strength and mobility. Results showed a reduction in the number of falls from a mean of 2.00 to a fraction of this level — a mean of 0.29. There was no change in the control group.
There was also a 44 percent decline in the number of patients who fell. This study’s duration was six months and involved 108 postmenopausal women with an average age of 58. This is a group that is more susceptible to bone and muscle weakness. Both groups were given equal amounts of vitamin D and calcium supplements. The good news is that many patients really like aquatic exercise.
Thus, our best line of defense against fall risk is prevention. Does this mean stopping medications? Not necessarily. But for those 65 and older, or for those who have “arthritis” and are at least 45 years old, it may mean reviewing your medication list with your doctor. Before considering changing your BP medications, review the risk-to-benefit ratio with your physician. The most productive way to prevent falls is through lifestyle modifications.
Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.
Dorothy Crawford with her granddaughter and great-granddaughter
About 110 family and friends gathered at St. Johnland Nursing Center in Kings Park on Aug. 1 to celebrate its Medical Model Adult Day Health Service Annual Breakfast.
Participants who attend the Monday through Saturday program were joined by family and friends for a wonderful morning of food, fun and music. Guests had an opportunity to see the program firsthand and get a glimpse of how their loved one spends a typical day interacting with others and engaging in games and other mindful activities.
Lillian Safina with her son
Providing care for an aging parent, spouse or loved one can be an overwhelming responsibility for family members and friends. Adult Day Care at St. Johnland Nursing Center offers a wide range of services for adults who need a protective environment but choose to remain in the community and continue to be a vital part of family life.
St. Johnland Nursing Center is a nonprofit, nonsectarian facility, offering residents excellence in skilled nursing care and all aspects of rehabilitation, Alzheimer’s/dementia care, head injury rehabilitation, adult day care, home health care and subacute care.
To learn more about St. Johnland programs and services visit www.stjohnland.org.
This week’s shelter pet is Sully, a 5-year-old tabby cat. Sully is the sweetest boy and loves to be with people. He had a home for most of his life, however, recently his owners opened their front door, let Sully out and never let him back into the house.
He was homeless and living on the streets for about 3 to 4 months before a Kent volunteer who lives on that same street started feeding and caring for him. The volunteer was not able to take the cat in himself, so he brought him to the shelter for adoption. Won’t you come and spend some time with Sully? We dare you not to fall in love!
Sully comes neutered, microchipped and is up to date on all his vaccines.
Kent Animal Shelter is located at 2259 River Road in Calverton. The adoption center is open seven days a week from 10 a.m. to 4 p.m. For more information on Sully and other adoptable pets at Kent, call 631-727-5731 or visit www.kentanimalshelter.com.
Calling all photographers and nature lovers! The Friends of Caleb Smith Preserve is sponsoring a photography contest now through Jan. 31, 2020.
The community is asked to send in digital photographs that highlight the natural beauty of Caleb Smith State Park Preserve, 581 West Jericho Turnpike, Smithtown.
The contest will be divided into two divisions; Adult: age 18 or older (or out of high school); and Youth: ages 8 to 18 (or still in high school). There will be two first-place prizes of $100 in each division, two second-place prizes of $50 and two third-place prizes of $25. Judging will take place in February 2020.
Contestants must be able to prepare digital files according to specific guidelines, complete a paper entry form, submit the photograph files via email and pay an entry fee of $10 per photograph. Contestants must also have access to a valid email address for communication with contest officials.
A reception honoring the winners and finalists will be held at the park museum in March 2020. Winning photographs and honorable mentions will be printed and displayed.
Copies of the official contest rules, as well as entry forms, are available at the park office. For further information, please contact the park at 631-265-1054 or email the Friends of Caleb Smith at [email protected].
Visit www.friendsofcalebsmith.org for information about all activities and events.
Meet historical figures including Anna Smith Strong, left, and Benjamin Tallmadge at Culper Spy Day
Meet Big Bill the Tory during Culper Spy Day
On Saturday, Sept. 14, 2019 from 9 a.m. to 4 p.m., Tri-Spy Tours, the Three Village Historical Society, the Long Island Museum and the Ward Melville Heritage Organization will present a day of spy-related tours and activities for the 5th annual Culper Spy Day.
The event is named for the Culper Spy Ring founded by Benjamin Tallmadge of Setauket, which provided Gen. George Washington with the information he needed to turn the tide of the American Revolution.
A collaboration of more than 40 historical and cultural organizations, from Montauk to Manhattan, will gather in the Three Village area for a day of community events. Participants will have the opportunity to build their own Revolutionary War story and to visit the places where history was made during this self-guided tour. Activities throughout the community will include tours, a Revolutionary War encampment, Colonial cooking demonstrations, musical performances, crafts and more.
Featured events
The Three Village Historical Society will host Anna Smith Strong and her famous clothesline, invisible ink demonstrations, a Spies! exhibit, children’s book signing, Colonial music by the Three Village Chamber Players from noon to 4 p.m., an outdoor gift shop and Tavern on the Field featuring food trucks Eat Me, Drink Me, Fat Boys BBQ Bus and Food Nation Generation.
The Long Island Museum in Stony Brook will hold blacksmithing demonstrations in the Samuel West Blacksmith Shop from 10 a.m. to 4 p.m. LIMarts artists Joseph Rotella and Lori Scarlatos will paint plein air in the carriage shed at the Caroline Church in Setauket from 11 a.m. to 3 p.m.
Meet historical figure Robert Townsend, center, during the event
The Ward Melville Heritage Organization will have costumed docents guide visitors through their c. 1709 Thompson House and their c. 1665 Joseph Brewster House. Living historian Diane Schwindt of Stirring Up History will be serving up some tasty and authentic 18th-century treats from America’s past on the front lawn of the Brewster House. A miller will be on hand to demonstrate the workings of the c. 1751 Stony Brook Grist Mill throughout the day.
George Washington’s original letters to members of his spy ring will be on display at the Stony Brook University Library’s Dept. of Special Collections between 10 a.m. and noon.
The Three Village Inn and the Country House Restaurant in Stony Brook will feature a spy lunch for an additional fee. Reservations are required (not included in Spy Day ticket price).
Other Culper Spy Day sites and activities include historical cemetery tours, tea with Big Bill the Tory, viewing of the Vance Locke murals at the Setauket Elementary School and new this year, the 42nd Royal Highland Regiment of Foot encampment with musket firing and battle drills on the Village Green for the ultimate Culper Spy Day experience. Build your own Revolutionary War story and see history come to life at this fun-filled event.
If you go:
Tickets, which are $25 adults, $5 children ages 6 to 12, children under the age of 6 and veterans are free, may be purchased online at www.tvhs.org or in person at the Three Village Historical Society at 93 North Country Road in Setauket. Participants will receive a bracelet and a copy of the Culper Spy Day map with all event listings. Tickets are good for admission to participating organizations on Sept. 14. Some organizations include additional dates.
For more information, please visit www.culperspyday.com.
Jerry Allen of Middle Island took this picture at Port Jefferson Harbor in June on his iPhone. He writes, ‘As has so often been the case this summer, the skies suddenly darkened with thunder and lightning in the distance. The storm passed over, however leaving in it’s wake blazing skies, twinkling lights on a fishing boat heading back and an unexpected brilliant sunset for all to enjoy.’
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