Thursday, August 7, 2014

Haunting self portraits from the descent into Alzheimer's....

Wednesday, August 6, 2014

Tennessee: Limits on Estate Planning Attorney's Authority to Disclose Will

 

In recent Formal Ethics Opinion 2014-F-158, the Board of Professional Responsibility for the Supreme Court of Tennessee addressed the following interesting question:

"Can a lawyer who represented a testator refuse to honor a court order or subpoena to disclose, prior to the client's death, a Will or other testamenatry document executed when the testator was competent on the basis that the document is protected against disclosure by the attorney-client privilege or confidentiality."

The Board's opinion indicates that not only "may" the lawyer refuse to disclose the will, but where circumstances indicate the client is no longer able to give informed consent because of intervening dementia, the lawyer may have a duty to raise all "nonfrivolous grounds" to protect the will from disclosure, including privileges under Tennessee statutes, citing Rule of Professional Conduct 1.6(c)(2). 

In opening its analysis, the Board noted that it has become "increasingly common for courts to appoint attorneys in a representative capacity to represent individuals suffering from dementia and/or Alzheimer's who are the subject of a dispute or litigation regarding management of the individual's funds and/or person." During the course of the dispute, parties may attempt to seek review of the will prior to the death of the testator, citing reasons such as the need to "engage in estate planning." 

The Board acknowledged the potential for facts that would permit the lawyer to disclose the contents of the disabled client's will, such as when a "lawyer believes the disclosure of the contents ... would be in furtherance of client's interest."

In commentary on the Tennessee Board Ethics Opinion, the ABA/BNA Manual on Professsional Conduct, in Vol. 30, No. 15, observed that "a 2010 law review article cites demographic patterns that have increased the likelihood of such scenarios," pointing to "A Common Thread to Weave a Patchwork: Advocating for Testatmentary Exception Rules,"  3 Phoenix L. Rev. 729, 734-35 (2010) by then law student Andrew B. Mazoff, now an attorney in Phoenix.

Thanks to my colleague and ethics guru, Laurel Terry, for sharing this ethics opinion.

August 6, 2014 in Cognitive Impairment, Estates and Trusts, Ethical Issues, State Cases | Permalink | Comments (0) | TrackBack (0)

Tuesday, August 5, 2014

New Book: The Law and Ethics of Dementia

The Law and Ethics of Dementia, co-edited by Israel Doron, Charles Foster and Jonathan Herring, recently released in hardback by Hart Publishing and available for e-readers in September, is definitely on my "must read" list.   Followers of this Blog will certainly recognize Issi Doron, from the University of Haifa, who has long exercised an international, comparative perspective on issues in ageing.  Professor Foster is a practicing barrister and a fellow at Green Templeton College, University of Oxford, which is also the working home of prolificFoster, Herring and Doron on The Law and Ethics of Dementia writer and Law Professor Herring.

The book is organized into five parts, Medical Fundamentals, Ethical Perspectives, Legal Perspectives, Social Aspects, and Patient and Carer Perspectives. As part of the first section, physicians and researchers Amos Korczyn and Veronika Vakhapova co-author "Can Dementia be Prevented?" a question we all hope will be answered in the affirmative. Not surprisingly, given the title of the book, the section on ethical perspectives promises to be especially fascinating, offering multiple views on ethical components of decision making and care. To suggest the scope, Andrew McGee's chapter is on "Best Interest Determinations and Substituted Judgement," while Leah Rand and Mark Sheehan tackle the challenge of "Resource Allocation Issues in Dementia."

In the Social Aspects section, I notice that Syracuse Law Professor Nina Kohn has a chapter on "Voting and Political Participation," while Chinese (and University of Pennsylvania) health care scholar Ruijia Chen and colleagues address "Physical, Financial and Other Abuse."

With more than forty individual chapters and dozens of international writers, this book promises to be a key guide  for the future. 

August 5, 2014 in Advance Directives/End-of-Life, Books, Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Ethical Issues | Permalink | Comments (0) | TrackBack (0)

Thursday, July 24, 2014

The Five Halves of Elder Law

The CarTalk Guys on National Public Radio have a crazy tradition of breaking their one hour radio program into "three halves" (okay, they have a lot of crazy traditions -- I'm focusing on just one).  In that tradition, I'd been thinking about how the practice of "elder law" might also have three halves, but then I realized  that perhaps it really has five halves.  See what you think.

  • In the United States, private practitioners who call themselves "Elder Law Attorneys" usually focus on helping individuals or families plan for legal issues that tend to occur between retirement and death.  Many of the longer-serving attorneys with expertise in this area started to specialize after confronting the needs of their own parents or aging family members. They learned -- sometimes the hard way -- about the need for special knowledge of Medicare, Medicaid, health insurance and the significance of frailty or incapacity for aging adults.  They trained the next generations of Elder Law Attorneys, thereby reducing the need to learn exclusively from mistakes.

 

  • Closely aligned with the private bar are Elder Law Attorneys who work for legal service organizations or other nonprofit law firms.  They have critical skills and knowledge of  health-related benefits under federal and state programs.  They also have sophisticaed  information about the availability of income-related benefits under Social Security.  They often serve the most needy of elders.  Their commitment to obtain solutions not just for one client, but often for a whole class of older clients, gives them a vital role to play. 

 

  • At the state and federal levels, core decisions are made about how to interpret laws affecting older adults.  Key decisions are made by attorneys who are hired by a government agency. Their decisions impact real people -- and they keep a close eye on the financial consequences of permitting access to benefits, even if is often elected officials making the decisions about funding priorities. I would also put prosecutors in this same public servant "Elder Law" category, especially prosecutors who have taken on the challenge of responding to elder abuse. 

 

  • A whole host of companies, both for-profit and nonprofit, are in the business of providing care to older adults, including hospitals, rehabilitation centers, nursing homes, assisted living facilities, group homes, home-care agencies and so on -- and they too have attorneys with deep expertise in the provider-side of "Elder Law," including knowledge of  contracts, insurance and public benefit programs that pay for such services.

 

  • Last, but definitely not least, attorneys are involved at policy levels, looking not only to the present statutes and regulations affecting older adults, but to the future of what should be the legal framework for protection of rights, or imposition of obligations, on older adults and their families.  My understanding and appreciation of this sector has increased greatly over the last few years, particularly as I have come to know human rights experts who specialize in the rights of older persons.

Of course, lawyers are not the only persons who work in "Elder Law" fields and it truly takes a village -- including paralegals, social workers, case workers, health care professionals, and law clerks -- to find ways to use the law effectively and wisely. Ironically, at times it can seem as if the different halves of "elder law" specialists are working in opposition to each other, rather than together. 

My reason for trying to identify these "Five Halves" of Elder Law is that, as with most of us who teach courses on elder law or aging,  I have come to realize I have former students working in all of these divisions, who began their appreciation for the legal needs of older adults while still in law school.  Organizing these "halves" may also help in organizing course materials.

I strongly suspect I'm could be missing one or more sectors of those with special expertise in Elder Law.  What am I forgetting?   

July 24, 2014 in Cognitive Impairment, Consumer Information, Crimes, Health Care/Long Term Care, Housing, Medicaid, Medicare, Other, Social Security | Permalink | Comments (1) | TrackBack (0)

Wednesday, July 16, 2014

Significant Statistics on Drop (yes, drop!) in Alzheimer's Incidence in US

From McKnight's comes this interesting report on new statistical information on Alzheimer's:

"The odds of developing Alzheimer's disease fell sharply among seniors in the United States over the last 30 years, according to research presented Tuesday at the Alzheimer's Association International Conference in Copenhagen. The finding casts a new light on prior estimates that the number of people needing long-term care will triple by 2050, largely due to Alzheimer's."

For a more complete report on the Conference, see McKnight's piece "Chance of a senior developing Alzheimer's has dropped 44% over the last three decades, large U.S. study shows."

July 16, 2014 in Cognitive Impairment, Dementia/Alzheimer’s, Health Care/Long Term Care | Permalink | Comments (0) | TrackBack (0)

Wednesday, July 9, 2014

Updates on Programming at July 2014 Int'l Elder Law and Policy Conference

We've previously posted advance information about the International Elder Law and Policy Conference that will be  hosted this week -- July 10-11 -- in Chicago.  The organizers are John Marshall Law School; Roosevelt University, College of of Arts and Sciences; and East China University of Political Science and Law.

The conference will have an interesting format, combining presentations from a range of professionals with experience working with or for older persons, and working sessions to draft a model "International Bill of Rights for Elderly Persons, in parallel with U.N. sessions on ageing. 

As an example of the breadth of participation and coverage at this conference, my session  on Thursday focuses on "Health Care, Caregving for Older Persons and Legal Decision Making," and will be co-moderated with Professor Walter Kendall at John Marshall.  The panel includes the following topics and speakers:

  • "Dementia and Planning Death: The Challenge for Advance Directives," by Meredith Blake at University of Western Austalia Law School
  • "Social Change and Its Apparent Effect on Senior Care Services: A Comparative Study of Post-Soviet Union Russia and the U.S.," by Amy Delaney, partner at Delaney, Delany & Voorn in Illinois, and Alina Risser, a lawyer from Russia, currently studying law at John Marshall;
  • "Rights are Not Good for Older Persons in Long-Term Care Settings? Experience from the European Union," by Nena Georgantzi, Legal Officer for AGE Platform Europe;
  • "Bridging the Caregiver Gap: Does Technology Provde an Ethically and Legally Viable Answer?," by Donna Harkness, University of Memphis School of Law;
  •  "The Insufficiency of Spiritual Support of Urban Elders in China and Suggestions on Legislation," by Jun Li, East China University of Political Science and Law.

 We'll report more after the events on Thursday and Friday!  

July 9, 2014 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care | Permalink | Comments (0) | TrackBack (0)

Wednesday, July 2, 2014

2014 Webinar Series on Alzheimer’s Disease and Related Dementias

The Administration for Community Living, Centers for Disease Control and Prevention, and the National Institute on Aging are collaborating to host a webinar series to increase knowledge about Alzheimer’s disease and related dementias, and resources that professionals in the public health, aging services, and research networks can use to inform, educate, and empower community members, people with dementia, and their family caregivers.

You can register for all the webinars or just the one that most interests you.  You must register separately for each webinar.  If you plan to view the webinar in a central location with others, we encourage only one person to register for the group.

Each webinar is from 1:30 p.m.–3:00 p.m. ET/12:30 p.m.–2:00 p.m. CT/ 11:30 a.m.–1:00 p.m. MT/10:30 a.m.–12:00 p.m. PT.  The schedule is as follows:

Tuesday, July 22, 2014:  Updates on Alzheimer’s Disease and Related Dementias Resources

Thursday, August 28, 2014:  Community Collaborations for Assisting People with Alzheimer’s and Dementias: The Steps to Success

Thursday, September 25, 2014:  Alzheimer’s Research Updates

Click here for additional information on the series and each webinar session.

July 2, 2014 in Cognitive Impairment, Dementia/Alzheimer’s, Webinars | Permalink | TrackBack (0)

Wednesday, June 18, 2014

What's New In the War on Alzheimer's?

Psychiatric Times has an update on "What's New in the World on Alzheimers," written by Alisa J. Woods, PhD.    Here's the intriguing opening, minus the footnotes:

"It’s hard to believe that 40 years ago it was proposed that Alzheimer disease (AD) is caused by brain aluminum. Some people even threw out their cookware, in fear of acquiring the memory-impairing disease. The aluminum hypothesis has long since been discounted, and research has marched forward: β-amyloid (Aβ) protein was identified in 1984 in brain plaques of patients with AD, and hyperphosphorylated τ protein was identified in 1986. These are true AD markers; possible culprits behind neuronal death and memory impairment....

 

In the trenches of Alzheimer research, the battle continues . . . but where do we stand? Is the war on AD dementia nearing conclusion, or are we simply in the initial throes of the fight? In interviews with Psychiatric Times, 3 AD experts, Murali Doraiswamy, MD, of Duke Medicine; James Lah, MD, PhD, of Emory University; and Dagmar Ringe, PhD, of Brandeis University weighed in on this important topic."

To read the full article, you can register with the publication on-line, free of charge. 

June 18, 2014 in Cognitive Impairment, Dementia/Alzheimer’s | Permalink | Comments (0) | TrackBack (0)

Friday, June 13, 2014

When Senior Living Facilities Face NIMBY Complaints...

Dedham, Massachusetts, established as a town in 1636 just to the west and south of Boston, has a long history, including an interesting early debate on governance, as suggested by one protest.  According to historian and University of Chicago Law School Professor Geoffrey R. Stone, a group of local Dedham citizens erected a "liberty pole" in protest of the evils of the Federalist government, with a placard reading:

"No Stamp Act, No Sedition Act, No Alien Bills, No Land Tax, downfall to the Tyrants of America; peace and retirement to the President; Long-Live the Vice President."

Wishing "happy retirement" to the then-president, John Adams, was not a message of good will or appreciation.

In light of this history, a modern debate in Dedham caught my eye, involving opposition to construction of a senior living community in a residential neighborhood of that town.  As reported in a local Dedham news source:

"'Can you imagine waking up in the morning … there’s a house next door with 72 people in it with a very large staff and a whole lot of friends visiting?' Paul Reynolds said at a May 13 Dedham Zoning Board of Appeals meeting. 'If it could happen in this neighborhood where we can change the rules and change the definition of what single family is, where else could that happen?'

 

Artis Senior Living officials applied a month ago for a special permit that would allow the company to build an Alzheimer's and dementia care facility at 255 and 303 West Street—two residential properties on 7.71 acres that include conservation land. The ZBA decided to continue the hearing after several precinct one residents objected.

 

The Virginia-based company had initially proposed to build a 37,000 square foot, single story facility and about 21 feet tall. However, representatives presented a slightly different footprint last week after the board and residents raised concerns regarding the size of the property at an April 22 meeting."

In deference to the opposition, the developers changed the design, from a one story complex to a two story building centered on the 7 acre plot, thus allowing a greater buffer zone of more than 300 feet (that's a football field, right?) between the buildings and any of the closest neighbors. 

The protests apparently continue, however, thus demonstrating that in additon to opposing prisons and half-way houses for drug treatment, Not-In-My-Back-Yard" or NIMBY  movements can target seniors.  John Adams would appreciate the history, perhaps.

June 13, 2014 in Cognitive Impairment, Health Care/Long Term Care, Housing | Permalink | Comments (0) | TrackBack (0)

Sunday, June 8, 2014

Model & Restaurateur B. Smith Discloses Alzheimer's Diagnosis

B_Smith_Dan_Gasby2 with mikeDuring an upcoming television broadcast of CBS Sunday Morning on June 15, popular model, restaurant owner and chef B. Smith will talk about her diagnosis  -- and early attempts to hide -- her Alzheimer's disease.   Even now she is just age 64.  Based on a clip from the program, it appears that the discussion of the medical facts behind this illness will be frank and educational.  

June 8, 2014 in Cognitive Impairment, Dementia/Alzheimer’s | Permalink | Comments (0) | TrackBack (0)

Monday, June 2, 2014

Another Allegation of Assisted Suicide -- or Homicide -- in Pennsylvania

We've written here about the high profile Mancini case of alleged assisted suicide here in Pennsylvania, that was resolved in 2014 when the trial court dismissed the charges pending against the daughter, a nurse, who was alleged to have facilitated her ill, elderly father's death by a morphine overdose. 

Charges have now been filed in another Pennsylvania case that is, perhaps even more troubling, although probably less likely to attract support from "death with dignity" movements.  The case does, however, raise important questions about both mental health and income supports for persons at risk, including those facing poverty.   

Last week, Koustantinos "Gus" Yiambilisis, age 30, from Bucks County, PA, was charged both with assisted suicide and homicide for the death of his 59 year old mother by carbon monoxide, following his alleged use of a borrowed generator to accomplish a mutual suicide pact.  News reports, including articles by Jo Ciavaglia for the Bucks County Courier Times, suggest that the son had recently lost his job and needed surgery for a brain tumor, while both mother and son are reported to have left suicide notes behind.  The son survived, revived after emergency workers summoned to the house found the mother and son unconscious in the home.  The mother later died in the hospital.

June 2, 2014 in Cognitive Impairment, Crimes, State Cases, State Statutes/Regulations | Permalink | Comments (0) | TrackBack (0)

Sunday, June 1, 2014

Minnesota News: Court order approves Jensen Compehensive Plan of Action

On March 12, 2014, U.S. District Judge Donovan Frank of the District of Minnesota issued a court order adopting and approving the Comprehensive Plan of Action for the Jensen Settlement Agreement. The agreement was the result of a lawsuit filed against DHS in 2009 alleging that residents of the former Minnesota Extended Treatment Options (METO) program were unlawfully and unconstitutionally secluded and restrained. The Comprehensive Plan of Action outlines the path that the department will take to come into compliance with the terms of the agreement.

The Minensota DHS says that it is actively working to implement the plan and other mandates of the federal court, including departmentwide training on the agreement and plan.

The Jensen Settlement Agreement, approved Dec. 5, 2011, allowed the department and the plaintifs to resolve the claims in a mutually agreeable manner.

More information is on the Jensen Settlement page on DHS' website.

 

June 1, 2014 in Cognitive Impairment, Discrimination, Federal Cases, Federal Statutes/Regulations | Permalink | TrackBack (0)

Friday, May 30, 2014

It couldn't be more timely: ACL funding opportunity for supported decision-making

A huge theme at the 3rd World Congress on Guardianship was supported decision-making.  I was pleased and suprised to find this in my mailbox this morning:

ACL Funding Opportunity: Supported Decision Making

The purpose of this project is to create a training and technical assistance/resource center on supported decision making. The Center will collect and disseminate materials on supported decision-making, including the experiences of people with intellectual and developmental disabilities (I/DD) in making informed decisions with the use of supports. The project will also include a proposal to develop measures to compare outcomes for people with I/DD and older Americans who use supported decision-making methods and practices to exert control and choice in their own lives compared with outcomes for individuals under substituted decision-making arrangements.

Deadline:  Electronically submitted applications must be submitted no later than July 2, 2014 at 11:59 p.m.

Click here to download additional information including the application package.

May 30, 2014 in Cognitive Impairment, Elder Abuse/Guardianship/Conservatorship, Grant Deadlines/Awards | Permalink | TrackBack (0)

Thursday, May 29, 2014

Greenlee kicks off 3d World Congress on Adult Guardianship

GreenleeAsst. Sec. on Aging Kathy Greenlee helped to kick off the 3d World Congress on Adult Guardianship with truly one of the most powerful speeches on valuing our seniors that I have ever heard.  Greenlee spoke of the danger of trivializing the lives of the elderly, especially those with advanced dementia, reminding us that the loss of memory does not equal the loss of self.  I wish I had recorded her speech, but thankfully, it will be published later this year in Stetson's  Journal of International Law & Aging Policy.  Stay tuned for more reports on the Congress from your intrepid reporters, Kim Dayton and Becky Morgan!

 

May 29, 2014 in Cognitive Impairment, Dementia/Alzheimer’s, Discrimination, Programs/CLEs | Permalink | TrackBack (0)

Tuesday, May 20, 2014

South Carolina Supreme Court Rejects "Vulnerable Adult" Conclusion Based on Age

In Doe v. South Carolina Department of Social Services, the state's Supreme Court analyzes the standards for state intervention to provide involuntary protective services on the grounds the individual is a "vulnerable adult" under South Carolina's statutory authority. In a 3 to 2 decision filed on April 30, 2014, the majority of the court Court concludes:

"Although we believe the family court was well intentioned, we find that it erred in classifying Doe as a vulnerable adult under the Act. Specifically, there was no evidence that Doe's advanced age impaired her ability to adequately provide for her own care and protection. Without this threshold determination, the court erred in ordering Doe to remain in protective custody until the identified protective services were completed."

The dissent finds the majority's reasoning too narrow, pointing to the following facts:

"On July 31, 2012, law enforcement officers went to the home of Doe, then age 86. Doe, suffering from a heart condition, lived alone. Doe refused entry to the officers. The doors and windows to the home were barricaded. The officers noticed a hose running from a neighbor's home through a hole in the roof of Doe's home. This was Doe's only source of water, for water service had been stopped for nonpayment. The inside of the home was, according to the officers, 'in an unsanitary and deplorable condition.' There was mold present as well."

The outcome of the case is influenced by the testimony of a physician, who despite the conditions of the home and the physical infirmities of Doe, observed that she "appeared to have 'the minimum levels of competency to function independently' as there was no evidence of dementia, severe emotional issues, or obvious physical limitations." Doe was apparently either without adequate financial resoures or unable to manage her resources to live more safely in the home, but she firmly rejected the alternative of transfer to another setting.

Although overruling the trial court's conclusion that Doe was a vulnerable adult, the Superme Court also remanded for additional findings of the current status of Doe, who received emergency services in the interim.

Tough facts that demonstrate the challenge of balancing safety for persons at risk of "self neglect" with respect for the autonomy of the individual, a challenge that can arise at any age. Poverty adds to the challenge. 

 

May 20, 2014 in Cognitive Impairment, Ethical Issues, State Cases, State Statutes/Regulations | Permalink | Comments (0) | TrackBack (0)

Monday, May 19, 2014

Planning for the "Tough" Times

Casey Kasem, Mickey Rooney, Brooke Astor.  High profile, recent examples of tough times for aging individuals.  For lawyers, their histories demonstrate the challenges of planning. Lawyers juggle tough questions about how to handle waning capacity and respect an individual's preferences, while recognizing the probable need for safety and quality care. Add to this the reality that family members are often involved directly and indirectly.  We hope everyone agrees and is well intentioned, but, there are no guarantees. 

Texas Elder Law Attorney Renee Lovelace has a very good article from a few years ago, using another high profile example of the challenges of planning.  She writes about economist and statistician Mollie Orshansky who passed away in 2006 at the age of 91.  Orshanky's name has been in the news again recently because of renewed discussion of the "poverty thresholds" she articulated in the 1960s and which are still used (probably irrationally) as a measurement tool for public benefits. 

In her later years, Orshansky was at the center of a dispute about care that might be in her "best interest" but that also might be inconsistent with her expressed wishes.  In "Working with Elder Clients Who Refuse Help," (Texas Bar Journal, February 2008, available as downloadable PDF from archives), Renee writes:

"But when Ms. Orshansky needed assistance, she rejected help from family. She was hospitalized, and the court, critical of the family for not preventing her decline, appointed a nonfamily guardian. The resulting saga included an interstate guardianship battle, allegations of family kidnapping, a riveting series of Washington Post articles and Senate Committee hearings.  While Mollie's story may be movie-worthy, it is alarming to realize that she did everything that we suggest clients do to plan ahead — and her case still had a disastrous result."

Lovelace identifies several key points to keep in mind when helping clients to plan ahead, including the importance of "the talk" with family members.  She discusses the possibility of building in monitoring options, while also recognizing the potential for even the best intentioned caretaker or agent to make mistakes. She talks realistically about the need for balance between "people, paper and money." 

What are other techniques and approaches -- more than just documents and legal advice -- that seasoned lawyers use to avoid these kinds of disputes?  Feel free to add your "comments."

May 19, 2014 in Cognitive Impairment, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues | Permalink | Comments (0) | TrackBack (0)

Wednesday, May 14, 2014

Frolik & Kaplan: "Elder Law in a Nutshell" (6th Edition!)

It occurs to me that what I'm about to write here is a mini-review of a mini-book. Slightly  complicating this little task is the fact that I count both authors as friends and mentors.

The latest edition of Elder Law in a Nutshell by Professors Lawrence Frolik (University of Pittsburgh) and Richard Kaplan (University of Illinois) arrived on my desk earlier this month. (As Becky might remind us, both are definitely Elder Law's "rock stars.")  And as with fine wine, this book, now its 6th edition, becomes more valuable with age.  This is true even though achieving the right balance of simplicity and detail cannot be an easy task for authors in the intentionally brief "Nutshell" series.  Presented in the book are introductions to the following core topics:

  • Ethical Considerations in Dealing with Older Clients
  • Health Care Decision Making
  • Medicare and Medigap
  • Medicaid
  • Long-Term Care Insurance
  • Nursing Homes, Board and Care Homes, and Assisted Living Facilities
  • Housing Alternatives & Options (including Reverse Mortgages)
  • Guardianship
  • Alternatives to Guardianship (including Powers of Attorneys, Joint Accounts and Revocable Trusts)
  • Social Security Benefits
  • Supplemental Security Income
  • Veterans' Benefits
  • Pension Plans
  • Age Discrimination in Employment
  • Elder Abuse and Neglect

The authors describe their anticipated audience, including "lawyers and law students needing an overview of some particular subject, social workers, certain medical personnel, gerontologists, retirement planners and the like."  Curiously, they don't mention potential clients, including family members of older persons.  I suspect the book can and does assist prospective clients in thinking about when and why an "elder law specialist" would be an appropriate choice for consultation.  This book is a very good starting place.

What's missing from the overview?  Not a lot, although I find it interesting that despite solid coverage of the basics of Medicaid, and even though it is unrealistic to expect exhaustive coverage in a mini-book, the authors do not hint at the bread and butter of many elder law specialists, i.e., Medicaid Planning.  Thus, there's little mention of some of the more cutting edge (and therefore potentially controversial) planning techniques used to create Medicaid eligibility for an individual's long-term care while also preserving assets that otherwise would have to be spent down. 

Modern approaches, depending on the state, may range from the simple, such as permitted use of assets to purchase a better replacement auto, to more complex planning, as in states that permit purchase of spousal annuities or use of promissory notes, allow modest half-a-loaf gifting, or recognize spousal refusal.  Even though the federal Deficit Reduction Act of 2005 succeeded in restricting assets transfers to non-spouse family members, families, especially if there is a community spouse, may still have viable options.  Without appropriate planning the community spouse, particularly a younger spouse, may be in a tough spot if forced to spend down to the "maximum" permitted to be retained, currently less than $120,000 (in, for example, Pennsylvania).  See, for example, a thoughtful discussion of planning options, written by Elder Law practitioners Julian Gray and Frank Petrich.    

Perhaps the Nutshell omission is a reflection of the unease some who teach Elder Law may feel about the public impact of private Medicaid planning?  

May 14, 2014 in Advance Directives/End-of-Life, Books, Cognitive Impairment, Dementia/Alzheimer’s, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Medicaid, Medicare, Property Management, Social Security | Permalink | Comments (0) | TrackBack (0)

Monday, May 12, 2014

Free Webinar May 21: Risks of Hearing Loss in Our Aging Population.”

Risks of Hearing Loss in Our Aging Population
MGS and MAGEC Free Webinar
Wednesday, May 21, 2014
Noon to 1 PM CDT

Research out of Johns Hopkins Medical Center is showing a correlation between hearing loss, falls, and dementia in people over the age of 50.  People in this age group who have a hearing loss, are at higher risk for falls and for dementia.  And not only is the risk higher for the onset of dementia, but also for a faster decline in functioning.

This information has implications for quality of life, demand for assisted living and/or skilled nursing care, and for healthcare costs.  Given these implications, are there actions that can be taken to counteract these risks?

The Minnesota Gerontological Association and the Minnesot Association for Guardiansip and Conservatorship are offering a free Webinar on” Risks of Hearing Loss in Our Aging Population.”  This session will explore the research in this area and discuss some potential solutions.
 
Speaker: 

Marty Barnum CSC, MA, currently works as a consultant and an interpreter.  She recently spent a year with the Office of Ombudsman for Long-Term Care under a special contract to look at the needs of nursing home residents with hearing loss.

Ms. Barnum previously coordinated interpreter services for the state of Minnesota, taught at St. Catherine University, and provided advocacy services for Deaf, hard-of-hearing and deafblind people in medical and legal situations.
 
Note: MGS has upgraded to the "Go to Webinar" platform for this webinar. You can now listen and watch through your computer, IPad, tablet or smart phone.
 
Register for this free webinar
 
Download the flyer

MGS and MAGEC Free Webinar
Wednesday, May 21, 2014
Noon to 1 PM CDT

May 12, 2014 in Cognitive Impairment, Dementia/Alzheimer’s, Programs/CLEs, Webinars | Permalink | TrackBack (0)

Thursday, May 8, 2014

Alzheimer's Accountability Act

Via the Alzheimer's Association:

Congress unanimously passed the bipartisan National Alzheimer’s Project Act (P.L. 111-375) in 2010. The law instructs the Department of Health and Human Services (HHS) to develop a strategic plan to address the rapidly escalating Alzheimer’s disease crisis. The annually updated National Alzheimer’s Plan must be transmitted to Congress each year and is to include outcome-driven objectives, recommendations for priority actions and coordination of all federally funded programs in Alzheimer’s disease research, care and services. The plan also includes the goal of effectively treating and preventing Alzheimer’s by 2025.

 

The one missing piece in this plan is a projection of the level of funding necessary to reach the critical goal of effectively treating and preventing Alzheimer’s by 2025. The Alzheimer’s Accountability Act represents a bipartisan effort to ensure that Congress is equipped with the best possible information to set funding priorities and reach the goal of the National Plan to Address Alzheimer’s Disease - effectively preventing and treating Alzheimer’s by 2025.

To express your support for the Alzheimer's Accountability Act, go here.

May 8, 2014 in Cognitive Impairment, Dementia/Alzheimer’s, Federal Statutes/Regulations | Permalink | TrackBack (0)

Wednesday, May 7, 2014

British government calls for dementia friendly workplaces

Via the BBC:

Businesses must become more dementia-friendly and support employees who care for loved ones with dementia, the British government says. With dementia affecting nearly 700,000 people in England alone, thousands of working friends and relatives end up taking on the role of carer. In 2014, 50,000 carers will have quit their job and 66,000 more will have to make adjustments at work, says Public Health England. It is launching an awareness campaign. The Dementia Friends initiative aims to show it will take a whole-society response to enable people with the condition to live well. To become a friend, individuals watch a short online film, which explains what dementia is, how it affects individuals and what people can do to help those living with the disease.

The average person diagnosed with dementia has been in their current job for at least nine years. Inevitably, many individuals affected while still working will have to take early retirement at some point. However, with support from employers, they may be able to keep working for longer, says the Alzheimer's Society.

Read more here.

May 7, 2014 in Cognitive Impairment, Dementia/Alzheimer’s | Permalink | TrackBack (0)