Monday, May 30, 2016

Call for Abstracts-Association for Gerontology in Higher Education

The Association for Gerontology in Higher Education's (AGHE) annual conference is scheduled for March 9-12, 2016 in Miami, Florida. The call for abstracts for one of the six themes for the conference closes at noon on June 1, 2016. For more information, click here.

 

May 30, 2016 in Consumer Information, Current Affairs, Programs/CLEs | Permalink | Comments (0)

Thursday, May 26, 2016

End of Life Prognosis: Is the Glass Half-Full or Half-Empty?

We all know folks who are the glass half-full type (optimist), as well as the glass half-empty type (pessimist).  When one talks to those folks, how those folks interpret what they hear depends on what "glass type" they are.   The Journal of the American Medical Association (JAMA) ran a story about a study, Prevalence of and Factors Related to Discordance About Prognosis Between Physicians and Surrogate Decision Makers of Critically Ill Patients.  According to the abstract, "[m]isperceptions about prognosis by individuals making decisions for incapacitated critically ill patients (surrogates) are common and often attributed to poor comprehension of medical information."

The authors noted how important it is for the health care surrogate to have information in order to make a health care decision for the patient. But, according to the study,

Numerous studies over the last 3 decades indicate that surrogates of patients with advanced illness often have optimistic expectations about prognosis. This is problematic because optimistic expectations are associated with more use of invasive treatments in dying patients and delayed integration of palliative care. Clinicians cite unrealistic expectations by surrogates as one of the most important barriers to high-quality end-of-life care in seriously ill patients.(citations omitted).  

The authors look at some of the reasons for this disparity in viewpoint (including the lack of medical knowledge by surrogates). Here is one example of their findings regarding the disparity of views:

Physician-surrogate discordance about prognosis occurred in 122 of 229 instances (53%; 95% CI, 46.8%-59.7%). Among the 229 surrogates participating in the study, 98 (43%) were more optimistic than physicians and 24 (10%) were more pessimistic. Sixty-five instances (28%) were related to a combination of misunderstandings by surrogates and differences in belief between the physician and surrogate about the patient’s prognosis; 38 (17%) were related to misunderstanding only; 7 (3%) were related to different beliefs; and data were missing for 12.

The authors explore the reasons for the surrogates' glass half-full view and learned that the surrogates felt that a positive attitude:  "would improve the patient’s outcomes or protect themselves from emotional distress"; was justified because they knew the patient better than the doctor, including knowing if the patient were a strong person; and/or was based on their religious beliefs.

The study also explored the glass half-empty views of surrogates.  The study authors concluded that "[a]mong critically ill patients receiving care in ICUs, discordant expectations about prognosis were common betwTeen patients’ physicians and surrogate decision makers and were related to both misunderstandings by surrogates about physicians’ assessments of patients’ prognoses and differences in beliefs about patients’ prognoses."

The article is available here for free

May 26, 2016 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Health Care/Long Term Care | Permalink | Comments (0)

Older and Poorer? Local Governments Need to Plan

Governing ran an article last month, An Older, Poorer America Is Coming, The article opens

The percentage of older Americans living below the federal poverty line has decreased by two-thirds since 1966. That year, according to data from the Pew Research Center, 28.5 percent of Americans age 65 and over were poor. By 2012, that number had declined to just 9.1 percent.

But we may be at the end of that happy trendline. I think that over the next five to 10 years we will see a dramatic reversal in the economic fortunes of millions of our oldest residents. That has profound implications for governments at all levels.

Discussing how we fund retirement (the 3-legged stool), the author notes the changes in pension plans, the low amounts saved and the higher amount of debt. This is not particularly new to those of us who teach elder law. But consider the following from the author:

You can put off retirement, and many are. The labor force participation rate for those 65 and older increased from 12.4 percent in 1994 to 18.6 percent in 2014. But you can’t put off aging. The collapse of incomes for this group when they no can longer work is going be a double hit for government, decreasing the taxes they pay just as they need more public services.

The author calls on local governments to be planning for this scenario: "the consequences of dramatic increases in the older poor, including looking at affordable housing, transit and health care." Noting the potential power of the ballot box, the author concludes "Given the size of the baby boom population, a return to the poverty rates that existed among aging Americans before the War on Poverty would result in more than 8 million newly impoverished seniors. They’re not going to sit quietly on a street corner with a tin cup."

May 26, 2016 in Consumer Information, Current Affairs, Retirement | Permalink | Comments (0)

Plaintiffs' Class Certified in Dispute over LTC Insurance Coverage for Care by "Managed Residential Communities" or "Assisted Living Services Agencies"

As we've reported fairly often on this Blog (see e.g., here, re California litigation), the long-term care insurance (LTCI) industry has been battling disputes on many fronts.  One of the fronts is whether insurers can deny benefits to pay for care provided in settings other than "skilled nursing facilities."  On March 1, 2016, a federal court in Connecticut granted class certification to estates and policy holders who are challenging denial of coverage for stays in "managed residential communities" (MRCs) in Connecticut or to cover services provided through "assisted living services agencies" (ALSAs).  In Estate of Gardner v. Continental Casualty Company, 2016 WL 806823, the court agreed the plaintiffs had satisfied the class certification requirements for "numerosity," commonality, and typicality of issues, as well as establishing grounds to argue "imminence of injury" to support a claim for injunctive relief:

While Plaintiffs do seek monetary relief, it appears to the Court that what they primarily seek is forward-looking relief. Plaintiffs purchased long-term care policies, presumably with the expectation that they would utilize their coverage over a long term. Any adequate remedy would have to ensure that they could obtain coverage for claims prospectively. For that, an injunction is required. Moreover, Plaintiffs leave no ambiguity about the content of the injunction they seek: an end to Defendant's alleged policy of denying claims for assisted-living facilities across the board. This is exactly the type of relief Rule 23(b)(2) was designed to facilitate. Because Plaintiffs' proposed Rule 23(b)(2) class satisfied all of the requirements of Rule 23, certification is proper.

For more on the background of the Connecticut case, see "Connecticut class action accuses insurer of denying assisted-living claims." 

May 26, 2016 in Consumer Information, Estates and Trusts, Ethical Issues, Health Care/Long Term Care, Housing, State Statutes/Regulations | Permalink | Comments (0)

Tuesday, May 24, 2016

Texas Appellate Case Demonstrates Significance of Contract Terms for Continuing Care Eviction

On April 28, 2016, the Texas Court of Appeals affirmed an award of some $145k in damages to an elderly couple for breach of a "Life Care" contract by their residential community.   In Barton Creek Senior Living Center, d/b/a Querencia at Barton Creek v. Howland, the residential community staff attempted to refuse to communicate with the children of a couple, in their 80s, on the reported grounds that "communication with their children was unworkable because of the discord with the children."  The facility, Querencia, reportedly soon "terminated the Life Care Agreement with the Howlands and ordered them to vacate the premises within thirty days." The Howlands did vacate the premises, moving to an assisted living community with a different pricing and service structure; however, they contended they were denied the "benefit of their bargain" with Querencia.  

On appeal, Querencia does not challenge the finding that it failed to comply with the Life Care Agreement, but contends that the evidence is legally and factually insufficient to support the damages awarded to Howland. Specifically, Querencia argues that the damages cannot be tied to the pre-termination notice being 30 days instead of [the contract's specified notice of]  60 days. It also contends that Howland does not deserve damages for assistive services used after termination that they were already using before termination. Finally, Querencia contends that it properly withheld ten percent of the Howlands' deposit pursuant to their contract.

The appellate court rejected these arguments with a textbook discussion of remedies for breach of contract necessary to protect the non-breaching party's expectation interest:

Although the Howlands employed private care providers while at Querencia, there is evidence that the Howlands' move to The Summit increased their monthly expenses because the monthly rent was higher at The Summit, it provided fewer services than Querencia, and services at The Summit were more expensive.... Howland claimed over a million dollars in damages, Querencia countered that Howland profited from the breach, and the jury awarded Howland $82,500 plus the unrefunded deposit. The evidence in the record supports the jury's exercise of its role as factfinder regarding the damages award. The evidence also supports the jury's award of $62,990 representing the portion of the Howlands' deposit that Querencia did not refund. Querencia asserts that it was entitled to retain ten percent of the Howlands' deposit under the terms of the Life Care Agreement. But the jury found that Querencia breached that agreement, and restitution is a permissible measure of damages for breach of contract.... The jury was empowered to and did decide that Querencia must compensate for its breach by returning the final ten percent of the Howlands' deposit.

The finding of breach appeared to have been predicated on the contract's specified grounds  permitting termination, which included fairly standard provisions such as inability to meet medical needs, nonpayment by the residents, or a resident's breach of "policies and procedures" that create a situation that is "detrimental to the health, safety or quiet enjoyment of the community by other residents or the staff." The court appeared to be persuaded by the argument that Querencia failed to comply with a further contractual provision, mandating parties be given an "opportunity-to-cure" in the event of disputes.  

Despite the affirmance on damages, the appellate court also set aside the trial court's award of $166k in attorney's fees for the plaintiffs, rejecting a "lodestar" argument for the award, and remanded the case for further proceedings on reasonable and necessary fees.

In reading the opinion (and the headnotes from Westlaw on the opinion, which refer to Querencia as a "nursing home"), I'm struck once again by the confusion that "continuing care" contracts, including so-called "life care" contracts, can cause for parties, although usually any landmines tend to affect resident rights, rather than providers.  Thus, I would anticipate that in the future, providers worried about protecting their right to terminate relations with "troublesome" individuals, will attempt to beef up their "policies and procedures," to give clearer rights to refuse to communicate with troublesome family members of residents.  

May 24, 2016 in Consumer Information, Ethical Issues, Health Care/Long Term Care, Housing, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Friday, May 20, 2016

Caregiving's Impact

I had mentioned previously that I was looking at the Genworth annual cost of care survey.  As a corollary, Genworth has information about who provides care, referred to as The Expanding Circle of Care.  The website mentions the caregivers, with "[t]he Beyond Dollars Research reveal[ing] 5 key insights on the true impact of long term care." The Expanding Circle of Care Beyond Dollars 2015 explains the 5 "key insights" in the executive summary. The circle of care is explained as:

The financial, physical and emotional demands of providing care for a loved one can sometimes be more than a single caregiver can handle. The good news is that more family members are helping provide care. The opportunity to plan for the likelihood of needing long term care before a crisis situation occurs remains large. Our research has shown that a "Circle of Care" often forms around the care recipient, involving people who provide different levels and types of support.

The second insight is that although caregivers are positive about their role of caregivers, they note that "[c]aregiving can negatively impact health & well-being", including familial relationships and interactions with friends. The third insight is instructive regarding the future: "Caregivers’ savings and retirement funds are at risk"

Caregivers who help provide financial assistance for the care of their loved ones estimate that they pay, on average, a total of about $10,000 in out-of-pocket expenses.

That’s up from an average of $7,285 in 2010. Those financial expenses can include everything from household expenses, personal items, or transportation services, to payment of informal caregivers or long term care facilities.

Most caregivers did not anticipate or plan for this expenditure. In many cases, they are cutting back on personal spending and savings. More significantly, some may be jeopardizing their own financial futures.

 

It follows logically then that the fourth insight  builds from the third one: "Caregivers’ careers and livelihoods are impacted by providing care."  The caregivers who work reported a definite impact on their jobs, which in turn impacts the caregiver's bottom line. "Absences, reduced hours and chronic tardiness can translate into a significant reduction in a caregiver’s paycheck."

The executive summary is available here.

 

 

 

 

May 20, 2016 in Consumer Information, Current Affairs, Health Care/Long Term Care, Statistics | Permalink | Comments (0)

Thursday, May 19, 2016

Simulated Aging

While I was on the Genworth site looking at the looking at their annual Cost of Care survey findings, I noticed their simulated aging project, R70i Aging Experience. The Genworth R70i Aging Experience, according to the website "uses state-of-the-art technology to help people step into their future selves and directly experience the physical effects associated with aging. The experience reinforces the importance of thinking about future long term care needs and talking to loved ones about how they would like to age." The website offers interactive controls so the user can examine certain points of the "aging suit" as well as a video that shows how the suit functions along with a narration.  This would be really cool if we could have one for our students to use, so they can experience it firsthand. (If anyone from Genworth is reading this and wants to donate one to us, I promise we'll share with other educational institutions :-))

May 19, 2016 in Consumer Information, Current Affairs, Health Care/Long Term Care, Science | Permalink | Comments (0)

Wednesday, May 18, 2016

Aging. Can We Cure It?

We have blogged before about the idea of aging that is something to be "cured".  The recent article in the New York Times explained some cutting edge research about fighting aging. Dogs Test Drug Aimed at Humans’ Biggest Killer: Age explains about a clinical trial with dogs that has implications for humans "the trial also represents a new frontier in testing a proposition for improving human health: Rather than only seeking treatments for the individual maladies that come with age, we might do better to target the biology that underlies aging itself."  The drug being tested on dogs was previously tested on mice and "improved heart health and appeared to delay the onset of some diseases in older mice" but there is no guarantee that the same result will be achieved with dogs.

According to the article, age itself serves as a huge risk factor for a number of fatal diseases, so "[a] drug that slows aging, the logic goes, might instead serve to delay the onset of several major diseases at once." "Geroscience" that is "the study of aging’s basic biology" according to those quoted in the article, hasn't received a lot of attention. There's some genius in the approach of testing this drug with dogs, given American's love affair with their dog family members.

“Many of us in the biology of aging field feel like it is underfunded relative to the potential impact on human health this could have,” said Dr. Kaeberlein, who helped pay for the study with funds he received from the university for turning down a competing job offer. “If the average pet owner sees there’s a way to significantly delay aging in their pet, maybe it will begin to impact policy decisions.”

The article explains that research has been  more "disease-specific" rather than globally looking at slowing down aging. Although the article does mention some projects that are specifically looking at slowing down or reversing aging.  The article also explains the challenges for research in this field. What would be the results to humans if this research proves successful? A longer, healthier life. And if it isn't successful? Dr. Kaeberlein, explained: “I would argue we should be willing to tolerate some level of risk if the payoff is 20 to 30 percent increase in healthy longevity,” he said. “If we don’t do anything, we know what the outcome is going to be. You’re going to get sick, and you’re going to die.”

 

May 18, 2016 in Consumer Information, Current Affairs, Health Care/Long Term Care, Science | Permalink | Comments (0)

Sunday, May 15, 2016

Caregiving For Elders-Not Just A Family Issue, But A Work Issue

We have posted before about family caregivers and their importance.  AARP's May 10, 2016 blog  post,  Eldercare Primarily Concerns Older Workers and Their Employers, Right? Think Again,  explained that "[f]or employers big and small, the need to support workers who also provide unpaid care for a family member is a growing reality." A huge number of family members who work (60%) also serve as family caregivers.  Here's an important point about those 60%, slightly over 50% of them are at least 50 years old. But caregiving is not just an elder law issue, because there is a significant number of younger caregivers too. Almost three-quarters of millenials reported that they were caregiving and working. The blog post ends with the suggestion that
"[a]dvancing a culture of understanding about eldercare needs is especially important to help make the workplace more supportive of workers who are also family caregivers — many of whom are in their prime working years."

 

May 15, 2016 in Consumer Information, Current Affairs, Health Care/Long Term Care, Other | Permalink | Comments (0)

HCR ManorCare to "Spin Off" Into "SpinCo"

As reported in several financial news services, including McKnight's Long-Term Care News here, HCR ManorCare, owner/operator of a large number of skilled nursing and assisted living properties, is to be spun off by its corporate parent, HCP Inc., into the hands of "an independent real estate investment trust" called, appropriately enough, "SpinCo."  

Certainly this seems to be a move to improve the financial position of HCP by separating the nursing home operations from independent living operations;  it remains to be seen whether it also allows "troubled" HCR ManorCare to resolve concerns about quality of care and billing practices. The business history of ManorCare, with all of its various partners and name changes, probably serves as a marker for changes throughout the skilled care industry.   For ManorCare's own perspective on its history, see "Our History Is Still Being Written."   

May 15, 2016 in Consumer Information, Dementia/Alzheimer’s, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Housing | Permalink | Comments (0)

Thursday, May 12, 2016

Capacity to Drive

The latest issue of Biofocal from the American Bar Association Commission on Law & Aging is out, and the cover story is an article by Erica Wood on Evaluating the Capacity to DriveMs. Wood explores the question of what is the needed capacity to drive, and notes the skills one needs to be a safe driver.

[E]valuating capacity to drive is of course different from evaluating capacity to make decisions or execute legal transactions. First, driving involves a mix of mental, physical, and sensory abilities. Second, driving has serious risk not only for oneself but also for others as well. And third, the determination of capacity to drive initially rests not with a judge but with the commissioner of the state department of motor vehicles—although judges may well be involved in decisions about drivers licenses, as described in the “View from the Bench” by Judge Lyle. While state laws vary, the Uniform Vehicle Code provides that a license may be denied if the state commissioner finds that a person “by reason of physical or mental disability would not be able to operate a motor vehicle with safety upon the highways” (National Committee on Uniform Traffic Laws and Ordinances).

Using the ABA/APA handbook for psychologists "general capacity evaluation framework," Ms. Wood breaks down the assessment elements for capacity to drive: the legal element, the functional component, diagnosis, values, mental health assessment, risk assessment, and clinical judgment that is needed in order "to integrate all of the evidence from the previous steps on supports, conditions, risks, abilities and limitations." The article underscores the need to examine the driver's values, consider emotional factors such as hallucinations and whether the person has capacity with support. Capacity with support is explained as "supports and accommodations that might enhance ability."

In the driving context, this might mean a change of eyeglasses, a higher seat or pillow, a revolving seat, or pedal modifications. With such supports, a functional assessment will test for visual acuity; flexibility to look behind and check blind spots on the road; and strength for control of the steering wheel, brakes, accelerator, and clutch. An assessment also will test the driver’s knowledge about driving rules and what to do in emergency or unexpected situations.

A pdf of the article is available here.

May 12, 2016 in Consumer Information, Current Affairs, Other, State Statutes/Regulations, Travel | Permalink | Comments (0)

Wednesday, May 11, 2016

A Power of Attorney Without Power

On May 6, 2016, the New York Times ran an article by Paula Span for the New Old Age series, Finding Out Your Power of Attorney Is Powerless. Experienced elder law attorneys are unlikely to be surprised by the point made in the article:  financial institutions want customers to use their own powers of attorney, not one drafted by the customer's lawyer.  The article notes this is "very unwelcome news, because by now the older account holders may not be competent to sign legal forms."  One frustrated customer offered this insight "[w]e have a  power of attorney, but we can’t use it ... People sign these anticipating incapacity. Once incapacity arrives, it’s too late to sign another one.”

As the article notes, this isn't a huge revelation to elder law attorneys but "[i]t’s not clear how often similar scenarios, with their Catch-22 absurdity, take place."  The article offers the other side of the issue, from the financial institution's perspective, since these institutions are in charge of the customer's money, and everyone knows about the increase in financial exploitation, issues with diminished capacity of customers and family members who are the perpetrators. But notes one expert, "banks have other motivations, too. 'Typically, when they’re insisting on their own forms, they’re concerned about liability,'” 

The article offers suggestions-have a lawyer intercede with the financial institution or be proactive and "ask... a brokerage or bank if it requires its own durable power of attorney document and, if it does, having your relatives sign it when they are still capable of doing so. You’ll have to do this for every institution where they have an account."  There is a big caveat with this second suggestion, according to the article, quoting Craig Reaves, a past president of NAELA: "read those bank forms carefully or have a lawyer review them, Mr. Reaves advised. They can contain disadvantageous indemnity or arbitration clauses, or provisions that contradict the individual’s general power of attorney. In such cases, 'I’ll tell clients not to sign, and we’ll fight the fight,' he said."  Some family members caught in the catch-22 came up with their own solutions, such as opening accounts at other financial institutions or waiting until the parent is having a "lucid moment" to sign the bank's form.

It's hard to explain to students why a financial institution refuses to accept a legally valid DPOA drawn by an attorney.  This article sheds some light on the problem, but clearly, it's still a problem.

 

May 11, 2016 in Consumer Information, Current Affairs, Property Management | Permalink | Comments (0)

Tuesday, May 10, 2016

Nursing Home Resident Evictions Increase for "Problem" Residents

Let's just start by saying the article I'm about to cite is a must-read for us. 

The AP did a story on May 8, 2016, Nursing homes turn to eviction to drop difficult patients. The article opens "Nursing homes are increasingly evicting their most challenging residents, advocates for the aged and disabled say, testing protections for some of society's most vulnerable...Those targeted for eviction are frequently poor and suffering from dementia, according to residents' allies. They often put up little fight, their families unsure what to do. Removing them makes room for less labor-intensive and more profitable patients, critics of the tactic say, noting it can be shattering." 

The AP did a study of data from the Long-Term Care Ombudsman Program and learned that complaints regarding involuntary discharges have increased by about 57% since 2000. "[Discharge] was the top-reported grievance in 2014, with 11,331 such issues logged by ombudsmen, who work to resolve problems faced by residents of nursing homes, assisted living facilities and other adult-care settings."  Why this increase in discharges? The article offers that the involuntary discharge often happens "because the resident came to be regarded as undesirable — requiring a greater level of care, exhibiting dementia-induced signs of aggression, or having a family that complained repeatedly about treatment, advocates say. Federal law spells out rules on acceptable transfers, but the advocates say offending facilities routinely stretch permitted justifications for discharge. Even when families fight a move and win an appeal, some homes have disregarded rulings."

The American Health Care Association offers an opposing view of the discharges, explaining that in some cases it is "lawful and necessary to remove residents who can't be kept safe or who endanger the safety of others, and says processes are in place to ensure evictions aren't done improperly."

The article also includes examples where a resident is admitted to a hospital and when ready to return to the nursing home, is refused readmission. Several cases are highlighted in the article, with experts from both sides of the issue offering opinions. The article also references staffing levels and the trauma encountered by residents who find themselves in a discharge situation.

Have your students read the applicable federal statute and then this article. I guarantee an interesting discussion.

May 10, 2016 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Medicaid | Permalink | Comments (0)

Monday, May 9, 2016

New Article-Preventing DPOA Abuses

The May 2016 issue of the South Carolina Bar Journal, SC Lawyer contains the article, Quick and Dirty Tips to Prevent Power of Attorney AbuseThe author offers several tips, starting with meeting with the client alone, determine if the client has capacity to sign the DPOA, ascertain the client's goals and expectations, "name an honest, trustworthy and trusted agent" (the author suggests the attorney "[google the agent and check your local court judgment index"); consider co-agents; use a springing POA; include an accounting provision to require the agent "to account in some fashion to a family member(s) or other trusted individual. It can be as formal or as informal as the principal desires. In that way there is another person informed about the principal’s financial situation" and even using a "cooling off" period for the client to think further before signing the DPOA.

The article also covers actions when the agent misuses the DPOA. The article concludes

There is no easy answer to the problem of elder financial abuse. There is no silver bullet. Elder financial abuse is a problem that is only going to get worse. We as attorneys can’t prevent all financial abuse, but we need to be aware of, and adopt, measures that reduce the risk of durable power of attorney abuse. The threat can never be eliminated, but with communication and education, it can be minimized.

 

Thanks to the article's author, Michael J. Polk, for sending me the link to the article.

 

May 9, 2016 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care, Property Management, State Statutes/Regulations | Permalink | Comments (0)

Sunday, May 8, 2016

Alzheimer's: Unraveling One's Life

The New York Times recently ran an in-depth article about Alzheimer's impact on one woman.  Fraying at the Edges covers the journey of Geri Taylor, who at the beginning stages of Alzheimer's is described as in the "waiting period" of Alzheimer's. This 12 page article is an incredible personal look at one person's life with Alzheimer's. The article is accompanied by photos and short videos.  Read this article!

May 8, 2016 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s | Permalink | Comments (0)

Thursday, May 5, 2016

A Handbook for Aging

Ever think humans need to come with a user's manual to explain the aging process? According to the Washington Post article on April 22, 2016, help is on the way.  ‘Old Age: A Beginner’s Guide’: What you really need to know about life’s later years reviews “Old Age: A Beginner’s Guide.”  The article describes the author

Kinsley is both realistic and remarkably cheerful in writing about aging, death and his own health in this brief collection of essays, some of which have appeared in Time, the New Yorker and elsewhere. The book is framed as a guide to old age for Kinsley’s contemporaries. “Sometimes I feel like a scout for my generation,” he writes, “sent out ahead to experience in my fifties what even the healthiest boomers are going to experience in their sixties, seventies or eightes.”

He describes the Boomers as wanting longevity but really wanting cognition.  The Post describes the book as a fun and informative read. 

Whether offering a final set of goals for achievement-oriented boomers, describing his DBS (deep brain stimulation) surgery, debating stem-cell research or defending his decision after the Parkinson’s diagnosis (“I chose denial”), Kinsley, a contributing columnist to The Washington Post, is refreshingly straightforward and often wickedly funny.

The New York Times review of the book is available here.

May 5, 2016 in Books, Consumer Information, Current Affairs, Health Care/Long Term Care | Permalink | Comments (0)

Wednesday, May 4, 2016

Keep Working-It May Help You Live Longer

The Wall Street Journal ran an article on May 2, 2016 that working past 65 may be good for the worker's longevity. Retiring After 65 May Help People Live Longer covers a recent study published in the Journal of Epidemiology and Community Health. "The risk of dying from any cause over the study period was 11% lower among people who delayed retirement for one year—until age 66—and fell further among people who retired between the ages of 66 and 72, the study found."  One limit on the study-individuals studied were limited to those born between 1931-1941.  The study noted  "[postponing retirement may delay the natural age-related decline in physical, cognitive and mental functioning, reducing the risk of chronic illness...."

Here is an excerpt from the abstract:

Background Retirement is an important transitional process in later life. Despite a large body of research examining the impacts of health on retirement, questions still remain regarding the association of retirement age with survival. We aimed to examine the association between retirement age and mortality among healthy and unhealthy retirees and to investigate whether sociodemographic factors modified this association. .....

Conclusions Early retirement may be a risk factor for mortality and prolonged working life may provide survival benefits among US adults.

The full article is available for purchase here.

Thanks to Professor Dick Kaplan for sending us the link to the article.

May 4, 2016 in Consumer Information, Current Affairs, Other, Retirement | Permalink | Comments (0)

Tuesday, May 3, 2016

Chronically Ill or Disabled In South Dakota-Is A Nursing Home In Your Future?

The New York Times ran a story on May 2, 2016 that South Dakota is under investigation by the federal government for improperly placing many residents with disabilities in nursing homes instead of providing care in the community. South Dakota Wrongly Puts Thousands in Nursing Homes, Government Says reports that "the Justice Department said ... that thousands of patients were being held unnecessarily in sterile, highly restrictive group homes. That is discrimination, it said, making South Dakota the latest target of a federal effort to protect the civil rights of people with disabilities and mental illnesses, outlined in a Supreme Court decision 17 years ago." 

As the story notes, many individuals need the level of care provided by a nursing home, but others do not.  "But for untold numbers of others — with mental illnesses, developmental disabilities or chronic diseases — the confines of a nursing home can be unnecessarily isolating. Yet when patients seek help paying for long-term care, states often steer them toward nursing homes, even though it may not be needed."  The article discusses the Olmstead decision and the government's strategies in these cases to challenge the placement.

South Dakota responded that they have made progress but the federal government sees it as not enough, especially since this is not a recent situation. "In-home health aides can be less expensive than nursing homes because they do not provide unnecessary services. States, though, face a chicken-or-egg conundrum. Does money go to nursing homes because beds are often more readily available than in-home services? Or are there fewer in-home services because less Medicaid money is spent on them? And nursing homes have little financial incentive to encourage patients to seek in-home care...."

This article can be a great starting point for an interesting discussion with students.

May 3, 2016 in Consumer Information, Current Affairs, Discrimination, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Medicare | Permalink | Comments (0)

Sunday, May 1, 2016

Go For A Walk Outside-Nature Increases Length of Life!

We've all been reading the articles about global warming and the impact on the planet, and on us.  Although Earth Day is a couple of weeks past us, there's even more reason to think about the future of the planet. The Washington Post ran the article Why living around nature could make you live longer.   The article highlights a recent study that indicates that not only is living near nature good for your health, it may help you live longer!  The study was published on April 14, 2016 in the journal, Environmental Health Perspectives (EHP), Exposure to Greenness and Mortality in a Nationwide Prospective Cohort Study of Women. Here are some excerpts from abstract from the EHP article:  "Objectives: We aimed to examine the prospective association between residential greenness and mortality... Conclusions: Higher levels of green vegetation were associated with decreased mortality. Policies to increase vegetation may provide opportunities for physical activity, reduce harmful exposures, increase social engagement, and improve mental health. While planting vegetation may mitigate effects of climate change, evidence of an association between vegetation and lower mortality rates suggests it also might be used to improve health."

Now, back to the Washington Post story, which tells us "[t]his is all in line with the ways previous research has suggested greenness can affect health. Places with more vegetation are generally thought to be less polluted, and the presence of vegetation, itself, can help keep air cleaner. And green spaces like parks can help encourage people to get outside, exercise and engage with other people — all factors that can improve overall health. The effects on mental health may be somewhat less straightforward, but nonetheless important, as this study suggested."  As far as mental health, the article notes that social engagement and human's long term connection with nature is rejuvenating.

The article quotes one of the authors that more study is needed on the "finer details" of our interacting with nature. But for now, go outside and take a walk (and maybe buy some houseplants, too).

 

 

 

 

May 1, 2016 in Consumer Information, Current Affairs, Health Care/Long Term Care, Other, Science | Permalink | Comments (0)

Thursday, April 28, 2016

A Greener Death

We have heard about green cemeteries.  Environmentally sensitive deaths have expanded beyond green cemeteries.  According to the New York Times article from April 22, 2016 (Earth Day to those of you reading this closely), others are thinking about lowering the environmental impact a traditional burial may cause. Mushroom Suits, Biodegradable Urns and Death’s Green Frontier starts the story explaining one person's idea, a mushroom suit, or more specifically "the Infinity Burial Suit. It’s a $1,500 outfit that incorporates mushrooms meant to break down a human corpse, cleanse it of toxins and distribute nutrients back into the soil. No one has been buried in it yet, but ... a man who suffers from a chronic illness has agreed to be the first."

In addition to green burials, "[a]t Western Carolina University, researchers with the Urban Death Project are learning how best to turn corpses into compost. In Los Angeles, Undertaking LA operates a “do-your-own-death” workshop to give people the tools to plan home funerals."

What do these new businesses have in common (other than death)? "Design and innovative technology seem to be an important component of these new death products. Roger Moliné, the 24-year-old co-founder of Bios Urn, began a Kickstarter campaign after customers asked for better ways to monitor the health of the trees growing from biodegradable urns. The company raised over $83,000 to design an incubator that, through a sensor embedded in the soil, will send updates to a custom phone app. Around 60,000 urns have been ordered and 200 incubators pre-ordered."

So how do you know if burial products are truly green? Well, there is (you thought I was going to say app for that, didn't you)... there is a council that oversees this.  The Green Burial Council grants certification to products that are actually earth-friendly. The list of certified products is available here.

 

April 28, 2016 in Consumer Information, Current Affairs, Other | Permalink | Comments (0)