Friday, February 12, 2016

Family Dynamics and Caregiving: A Bumpy Road or Smooth Sailing?

Every family has its own unique dynamics with siblings having specific relationships with siblings and with parents.  When a parent needs caregiving, those dynamics can play a role, according to an article posted on the AARP website on January 27, 2016.  The article, When a Troubled Past Affects Present Caregiving, quotes a family therapist who explains:

According to family therapy pioneer Ivan Boszormenyi-Nagy, we subconsciously keep tallies in our relationships — who has done what for whom over time. As a result, our past interactions with family members powerfully shape our responses to calls for care... [a] history of feeling neglected generally creates resentful caregivers.

The article offers several suggestions for helping focus past relationships into positive caregiving decisions including not being trapped by the past, remembering the good, and focusing on values rather than revenge when decision-making. "Living that value through caregiving doesn't completely erase the pain of a flawed past relationship. But it affirms that you are not so hamstrung by old hurts that you can't rise above them and be the kind of person you wish your parent, sibling or whomever you're caring for had been."

 

February 12, 2016 in Cognitive Impairment, Consumer Information, Current Affairs, Health Care/Long Term Care | Permalink | Comments (0)

Thursday, February 11, 2016

A Dangerous Promise to Loved Ones?

The Washington Post's Tara Bahrampour has a very thoughtful article this month focusing on a common fact pattern.  One family member asks -- or another family promises -- that "a nursing home" will never be utilized for care needs.  While fear may be driving the request, guilt and strong feelings of moral obligations may be driving the promise.  Both sides, however, may need more information to make the best decision:  

For many, the idea of being sent to a facility implies abandonment. Older Americans remember the poorhouse , where the old and infirm were hidden away to die. But many younger people also are repelled by the idea.

 

There’s now a wider spectrum of facilities catering to different levels of need, but even the best ones can feel institutional. Daily life is often rigidly regulated, robbing residents of autonomy, and the familiar faces and spaces of a person’s life are gone....

 

A couple of generations ago, families were more likely to care for their parents at home — but people didn’t live as long. Thanks to modern medicine, even those with devastating illnesses such as Alzheimer’s can live many years past their diagnoses. But caring for them at home becomes increasingly difficult as cognition and self-care skills worsen. Safety, of the patients and of other family members, can also become a factor.

Ultimately, as geriatrician Bill Thomas explains for the article, instead of "red herring" promises that may be impossible to keep, everyone could benefit if there were stronger advocates, including families, demanding more of the nation's long-term care industry:

"The nursing home industry has, ironically, benefited tremendously from the low expectations people have,” Thomas said. “They have successfully persuaded people that you’ve got no other choice — it’s got to be cold and sterile and rigid.”

As some family members explain, they have learned the more important promise is to keep caring, regardless of the better "place" for care.  For the full piece, read "Promise You'll Never Put Me In A Nursing Home."   

Special thanks to George Washington Law Professor Naomi Cahn for sharing this article. 

February 11, 2016 in Consumer Information, Dementia/Alzheimer’s, Health Care/Long Term Care, Housing | Permalink | Comments (0)

Wednesday, February 10, 2016

Criminal History Not Bar to Employment in SNF In Pa.

Elderlawprof blog founder, elderlaw prof extraordinaire and renaissance woman, Professor Kim Dayton sent the following article Nursing homes free to hire applicants with criminal histories; Pennsylvania won't appeal decision striking down law .  According to the article, the state has decided not to appeal a decision striking a Pennsylvania law  that "prohibiting nursing homes and long-term care facilities from hiring employees with criminal histories." The article explains that the law contained a lifetime employment ban in the state's APS statute.  Part of the challenge to the law is that the statute didn't differentiate  between the types of crimes, circumstances or even when the crime was committed, so something minor or a crime committed decades ago would count in imposing the lifetime ban.

The opinion is available here.

February 10, 2016 in Consumer Information, Crimes, Current Affairs, Health Care/Long Term Care, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Tuesday, February 9, 2016

A New Time Line for Saving For Retirement?

We have posted several times on how much one needs for retirement and whether folks are saving enough to have a financially secure retirement. An article in the Washington Post on January 12, 2016 features a new report from Fidelity Investments that shows savers need to get much more aggressive with saving for a financially secure retirement. How big your retirement fund should be at every age, according to one guide explains that Fidelity revised its guidelines at the end of last year using a more conservative return rate. Here is an example of their recommendation:

people save one times their salary by their 30th birthday. By the time they’re 35, savings should add up to double their annual pay. By 40, a retirement account should hold three times a person’s salary. The numbers keep growing, all the way to age 67, by which retirement savings should add up to 10 times a person’s pay.

The article notes that this guide may seem aggressive and intimidating to some, but emphasizes that it is just one guideline, and if nothing else, should be the catalyst to get people saving for retirement.  Get out that piggy bank.....

February 9, 2016 in Consumer Information, Current Affairs, Retirement, Social Security, Statistics | Permalink | Comments (0)

Examining Ethical Issues in Expansion of Legal Services to Low-Income Older Adults

As someone who developed and led an Elder Protection Clinic staffed by law students for more than a decade, I was interested to see that the latest issue of ABA's Bifocal publication includes an article titled "Ethical Challenges of Using Law Student Interns/Externs to Expand Services to Low-Income Older Adults." The article was earlier used as presentation materials for the 2015 National Law and Aging Conference in Washington, D.C., in October of 2015.  

The writers outline the potential for students and recent graduates to serve identified legal service needs and use the experience of Elder Law of Michigan,Inc. to demonstrate how one model, with a Legal Hotline, has evolved over time: 

In 2013, we switched to a model that placed the law students directly on the front lines answering calls to the legal hotline. In 2014, almost 25% of the calls handled by the hotline were done by either a law student or recent college graduate. This means that without this resource, almost 1,500 seniors would not have received service in 2014.

 

At first glance, you would wonder why we didn’t just use more law students to help more clients. After all, if 25% of the cases is great, wouldn’t 50% of the cases be better? Not really. Here are a few of the unintended consequences that resulted from our increased use of law students.

 

  • The amount of staff time needed to train and supervise law students increases considerably. For each student who works on the legal hotline, we need a third of a full-time employee's time for supervision. There was a diminishing need for more supervision once we had three students working at the same time. So, for us to minimize the additional staff time needed, we scheduled at least three law students at the same time.
  • Client donations dropped. After careful research, we found that clients who called and were assisted by a law student didn’t feel the need to donate to the organization because ELM was getting free help and the service provided was part of the law school experience. So clients were less likely to donate to us if they were assisted by a law student.
  • More staff wanted to be involved with the law students. We found that as our law student program grew, more of our staff wanted to be involved with the program. They liked the energy that was created by this group each day. (We had 11 law students each semester, so there was always a lot of activity.) Not everyone can work with the law students every day. They have to share!

February 9, 2016 in Consumer Information, Current Affairs, Ethical Issues, Legal Practice/Practice Management | Permalink | Comments (0)

Monday, February 8, 2016

Not Another Social Security Scam

Yes, another Social Security Scam is making the rounds. The AARP Fraud Watch Network alerted folks about a new scam that the FTC has discovered. According to the Fraud Watch explanation,  people are being sent

an email with the subject line “Get Protected.” ...  The email describes that the Social Security Administration (SSA) is supposedly offering great new features to help taxpayers protect their personal information and identities. It sounds so good that you may be tempted to click on the link provided — [don't do so]  ...It’s a SCAM!

The scammers pose as SSA employees and to be even more authenticate-sounding, may even mention the “SAFE Act of 2015.”  Of course, the email includes a link, and we all know what happens when one clicks on a link in a scam email....bad things.

The FTC alert, with helpful information on how to spot scams, is available here.  To sign up for blog alerts from the FTC, click here.

 

 

February 8, 2016 in Consumer Information, Crimes, Current Affairs, Retirement, Social Security | Permalink | Comments (0)

Will Avvo Fixed-Fee Legal Services Help or Hurt the Practice of "Elder Law"?

As described recently by the ABA Journal, Avvo, founded in Seattle by a self-described "tech-savvy lawyer,"  Mark Britton,  in order "to make legal easier and help people find a lawyer," is expanding its offerings of "fixed-fee, limited-scope" legal services.  The ABA Journal reports:

Avvo first got into the business of offering legal advice last year when it launched Avvo Advisor, a service that provides on-demand legal advice by phone for a fixed fee of $39 for 15 minutes. With this new service, Avvo will determine the types of services to be provided and the prices. Attorneys who sign up will be able to select which services they want to offer. When a client buys a service, Avvo sends the client’s information to the attorney. The attorney then contacts the client directly and completes the service.

 

Clients will be able to choose the attorney they want from a list of those within their geographic area who have registered to participate. Clients pay the full price for the service up front.

 

After the service is completed, Avvo sends the attorney the full legal fee, paid once a month for fees earned the prior month. As a separate transaction, the attorney pays Avvo a per-service marketing fee. This is done as a separate transaction to avoid fee-splitting, according to Avvo. Attorneys pay nothing to participate except for the per-case marketing fee.

Some practitioners undoubtedly are nervous about the effects of this format, expressing concern about quality and "price-point" effects.  Others see this as an option for the known, huge number of low and modest income persons, who never communicate with attorneys, for a host of reasons including concerns about price.  

Will older clients and their families, facing a range of transactions that could benefit from legal assistance, from POAs to contracts for care, use Avvo?  

 

February 8, 2016 in Consumer Information, Ethical Issues, Legal Practice/Practice Management | Permalink | Comments (0)

Sunday, February 7, 2016

Senate Special Committee on Aging Upcoming Meeting

The Senate Special Committee on Aging has a meeting scheduled for 2:30 p.m., est on February 10, 2016. The topic of this meeting is "to examine a new scam by global drug traffickers perpetrated against our nation's seniors." Stay tuned for more information

February 7, 2016 in Consumer Information, Crimes, Current Affairs, Health Care/Long Term Care, International | Permalink | Comments (0)

Friday, February 5, 2016

Is It Possible to "Care for Mom When You Live Far Away"? -- ElderLawGuy Shows How

My friend and mentor Jeffrey Marshall, a/k/a ElderLawGuy on Twitter, once again uses practical experiences to illustrate how "planning in advance" for the possibility of emergencies makes sense, particularly as our loved ones age.  He tracks the aftermath of an always dreaded "fall," an event in the life of an older person that too often can precipitate a downward spiral in the absence of a holistic care plan plan:  

[M]y wife and I were thousands of miles away. How could we get her the immediate help that she needed?

 

Fortunately, the help was available. My wife and I had previously hired a professional care manager, Bonnie, in the town where gramma lives. As soon as we got the call from the emergency room we contacted Bonnie and filled her in. She swung into action at once. She visited gramma and evaluated her condition. She implemented a system of caregivers to stay with gramma. She set up a Monday morning appointment with gramma’s physician, attended it with her, and reported back to the family.

 

Bonnie served as the family’s eyes and ears and local expert and was able to ensure that gramma got the care and support she needed when she needed it.  

For more details, read Jeff's blog post, "Caring for Mom when you are far away."  I know that in my own family, who also lives far apart, over the course of my regular visits home I probably visited 10 different care providers with my mother or sister.  This was during the year before we actually made the decision for my father.  I kept saying "we can make these decisions without an emergency." It became my mantra. Not every emergency needs to be an emergency....  

February 5, 2016 in Advance Directives/End-of-Life, Consumer Information, Estates and Trusts, Ethical Issues, Health Care/Long Term Care | Permalink | Comments (0)

Thursday, February 4, 2016

New Brochure-Caregiver Advocates

The National Center on Elder Abuse (NCEA) sent an email to the elderabuse listserv on February 4, 2016 that announced the release of a new brochure for family caregivers on how to advocate for those in their care with dementia.  The email announcement explained that the

material was created by the USC Department of Family Medicine, with funds provided by the Archstone Foundation, and was developed using input from actual family caregivers of people with dementia through informant interviews and focus groups. The brochure provides information about elder abuse, tips for caregivers on how to protect and advocate for their loved ones, real life scenarios, and resources. The goal of this brochure is to help family caregivers of people with dementia to learn how to take care of themselves in order to prevent mistreatment....

The brochure explains elder mistreatment, offers tips on advocating for and protecting relatives with dementia and provides helpful contacts along with examples. The web version is available here and the print version, here.

 

February 4, 2016 in Cognitive Impairment, Consumer Information, Crimes, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship | Permalink | Comments (0)

Webinar: Addressing Financial Abuse of Low-Income Elders

Attorneys from Justice in Aging and Pro Seniors, Inc., with support from a grant from the Administration for Community Living, are offering a free webinar that targets the way in which older adults can lose benefits such as Social Security, SSI or Medicaid because of the actions by others who prey upon them.  

The Webinar on "Recognizing and Remedying Elder Financial Abuse in Medicaid Denials" is on Tuesday, February 16, from 2 to 3:30 p.m. EST, and is part of a series on protection of older adults from abuse for the National Legal Resource Center, working in conjunction with the National Consumer Law Center.

Here's a link to the registration page -- and again it is free!  

February 4, 2016 in Consumer Information, Crimes, Elder Abuse/Guardianship/Conservatorship, Webinars | Permalink | Comments (0)

Tuesday, February 2, 2016

Challenge to Attorney General's "Outsourcing" of Consumer Protection Suits Against Nursing Homes Fails in PA

In GGNSC v. Kane, decided January 11, 2016, the Pennsylvania Commonwealth Court rejected a challenge by owners and operators of long-term care facilities to the use of a private law firm to investigate and pursue claims based on alleged improper billing, contracting and marketing practices.  The ruling was 6 to 1, with the lone dissenting judge not filing an opinion.

In the challenge, begun as a declaratory judgment action, the Facilities contended the investigations were "not based on any material consumer complaints," but were instead based on efforts by the law firm (Cohen Milstein) to generate lawsuits in Pennsylvania and other states. In Pennsylvania, beginning in 2012, the Pennsylvania Office of Attorney General signed a contingent fee agreements with the Cohen Milstein law firm, which has a history of pursuing class action suits in business and consumer protection areas. The Court permitted the Pennsylvania Health Care Association, a trade group for some 450 long-term care providers in the state, to join the Facilities' challenge as a petitioner.  

In July 2015, the Facilities' challenge was "overtaken" by a Consumer Protection Law enforcement lawsuit filed by the Pennsylvania AG against two GGNSC facilities and 12 Golden Living nursing homes. Cohen Milstein was listed as counsel representing the State.  Some of the Facilities' original arguments for blocking the Cohen Milstein investigatory actions became moot after the consumer protection suit was filed or could be addressed in the enforcement suit, according to the Commonwealth Court decision.  (Other states have also contracted with Cohen Milstein to bring nursing home cases, including New Mexico.) 

However, the Facilities continued to argue that only the Pennsylvania Department of Health (DOH) had "authority" to investigate or pursue litigation regarding quality of care.  The Commonwealth Court disagreed:

Any investigation or enforcement action initiated by OAG is directly related to "unfair or deceptive acts or practices" purportedly committed by the Facilities with respect to the staffing levels at their facilities.  As a result, while minimum staffing levels may be regulated by DOH for health and safety purposes, any representations, advertisements or agreements that the Facilities made with their residents with respect to staffing levels, whether in accord with those required by statute or regulation or not, may properly be enforced by OAG through its authority conferred by the Administrative Code and the Consumer Protection Law. Such action is proper under the foregoing statutes and does not constitute any impermissible administrative rulemaking regardless of whatever evidence OAG uses to establish a violation, including any type of staffing model.  What OAG is seeking to enforce is the level of staffing that the Facilities either represented, advertised, or promised to provide to their residents and not what level OAG deems to be appropriate for the care of such residents.

Further, the Commonwealth Court ruled the Facilities "lacked standing" to challenge the OAG's use of a private law firm to investigate or prosecute the claims under the Administrative Code or the Consumer Protection Law, citing the Pennsylvania Supreme Court's similar ruling in Commonwealth v. Janssen Pharmaceutica, Inc. in 2010, a suit  about alleged off-label drug prescriptions, pursued with the assistance of contracted outside counsel. 

The outsourcing of state claims for consumer protection suits raises interesting issues.  Such financial arrangements with outside law firms may be especially attractive to states in terms of risk/reward potentials, as the private firms typically agree to fund all or a portion of litigation costs for the class-action-like suits, with lower contingent fee percentages (10 to 20%) than you would see when such a firm handles suits on behalf of  private plaintiffs.  The option could be attractive to financially-strapped states or "embattled" state prosecutors such as the Pennsylvania AG.

Companies, particularly health care companies, have organized efforts to resist what they see as "abusive" lawsuits generated by private law firms.  As one industry-focused report argues here, private firms lack a proper "public" perspective, failing to take into account the impact on business development, while also arm-twisting companies to extract settlements, arguing this comes at a high-dollar cost to the state's residents. 

February 2, 2016 in Consumer Information, Current Affairs, Ethical Issues, Health Care/Long Term Care, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Monday, February 1, 2016

How Well Do Families Understand Updated Wage & Hour Rules for "Home Care"?

Over the last 20 years, I've definitely noticed a change when, during a meeting with a new person, I'm asked "what do you teach?"  For many years, I would get a blank stare or, perhaps, "what exactly is elder law?"  Now, more frequently the response is "do you have time for a quick question?"  (Unfortunately, quick questions rarely have quick answers, even when I begin "Let me suggest you see an experienced attorney in your area....") 

I'm hearing more questions about home care workers.  One frequent question is about overtime pay, and the type of employment definitely matters.  The U.S. Department of Labor (DOL) website has helpful materials, and the site reports on the effect of recent litigation affecting home care workers.  

Recently someone asked me if it was "safe" to assume they don't have to keep track of "overtime" hours, because the individual they have hired has irregular, mutually adjustable hours and is permitted to sleep when they stay overnight.  Family members will tell me "we just want someone there in case something happens."  That scenario is definitely affected by whether or not the employee's duties are correctly described as "companionship" services.  There is a limited exemption from minimum wage and overtime pay requirement for "companionship" employees.  

In late 2014, the DOL issued a detailed "Home Care Final Rule" that became effective only after litigation in the federal Court of Appeals rejected a challenge by third-party employers (home care agencies) to implementation.  See Home Care Association of America v. Weil.  Thus, as of January 1, 2016, the Department of Labor takes the position the Home Care Final Rule is now fully enforceable.  

As the DOL explains, its Final Rule defines "companionship services" as the provision of "fellowship and protection."   "Companionship services" may also include the provision of care if the care is attendant to and in conjunction with fellowship and protection services, so long as the "care" does not exceed 20 percent of the total hours worked per person and per workweek. Driving "usually" constitutes assistance with instrumental activities of daily living (IADLs) and if the employee is working for less than 24 hours per shift, any permitted sleep time must still be compensated. (State rules may also have tighter rules affecting payments.)  

DOL provides this example:

Sue, a direct care worker employed solely by Ms. Jones, regularly works 35 hours per week in Ms. Jones' home. Sue primarily provides fellowship and protection to Ms. Jones. If she also spends no more than 7 hours per week (20% of her work time for Ms. Jones) providing assistance to Ms. Jones with ADLs and IADLs, she is providing care within the scope of the definition of companionship services, and Ms. Jones is not required to pay her minimum wage and overtime compensation.

For more, see FAQs about Home Care on the DOL website -- or, better yet, talk to an experienced attorney in your city! 

February 1, 2016 in Consumer Information, Ethical Issues, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care | Permalink | Comments (0)

Sunday, January 31, 2016

Don't Fall for this (or any other) Scam

The Social Security Administration posted on its blog about a Social Security scam involving phishing.  According to the post, the scam focuses on "protecting" yourself from identity theft and financial fraud.  "The subject line says “Get Protected,” and the email talks about new features from the Social Security Administration (SSA) that can help taxpayers monitor their credit reports, and know about unauthorized use of their Social Security number. It even cites the IRS and the official-sounding “S.A.F.E Act 2015.” It sounds real, but it’s all made up." The post offers a couple of tips to suss out a scam. If the email ended up in your junk folder, it could be a scam. Also, mouse over the URL and see if it is really from SSA, or from a .com site instead.

Always remember-if in doubt, don't click on the link and don't provide personal information.

January 31, 2016 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Retirement, Social Security | Permalink | Comments (0)

Thursday, January 28, 2016

Home Care & The Fair Labor Standards Act

Earlier this month, CMS published a CMCS information bulletin with the subject, Options for Medicaid Payments in the Implementation of the Fair Labor Standards Act Regulation Changes .  This is a re-release of the informational bulletin originally published in early July of 2014. Why? Because this informational bulletin is intended 

to assist states in understanding how they may ament their current 1915(c) waivers and state plan (1905(a), 1915(i), 1915(j), and 1915(k)) personal care services to implement Fair Labor Standards Act (FLSA) changes in a timely way, and in understanding Medicaid reimbursement options that will enable them to account for the cost of overtime and travel time during the workday that are likely compensable as the result of the DOL home care final rule.

CMS stands ready to help by providing "technical assistance to states seeking to adjust Medicaid reimbursement and other program policies to appropriately support FLSA compliance in home and community based LTSS. Additionally, DOL is continuing to provide extensive, individualized technical assistance." The focus of the bulletin is on home-care services that are use "self-directed service options" but  the bulletin also notes "that FLSA implications also exist for services furnished through agency-delivered models."

 

January 28, 2016 in Consumer Information, Current Affairs, Health Care/Long Term Care, Medicaid, State Statutes/Regulations | Permalink | Comments (0)

Wednesday, January 27, 2016

Learning for Learning's Sake?

Isn't that a great thought. Students learning for thee sake of learning!  The New York Times ran at article on January 1, 2016 on that exact topic. Older Students Learn for the Sake of Learning explains those "the 150,000 men and women nationally who participate each year at more than 119 Osher Lifelong Learning Institutes. The institutes, affiliated mostly with colleges and universities, are among the best-known advanced adult educational programs in the country. Along with an array of other such programs fitting under the “lifelong learning” umbrella, they tend to attract educated, passionate people who are seeking intellectual and social stimulation among peers who often become new friends."

The article distinguishes this type of learning from the more traditional adult ed classes, since "lifelong learning programs position themselves as communities where the participants not only take on challenging subjects but also seek to engage more deeply with their fellow students."  The article runs through the research on the advantages to ongoing education to a sharp brain.

Keep on learning everyone!

January 27, 2016 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Retirement | Permalink | Comments (0)

Monday, January 25, 2016

Science, Elder Law and Genetic Counseling...

I think I might like winter better, if it always happened "conveniently" and with plenty of notice, as did Saturday's snow in Pennsylvania.  For once, I was prepared to be at home, with a stack of good reading materials for catching up when the joys of house-cleaning and snow shoveling faded. 

I am intrigued by the Fall 2015 issue of the NAELA Journal that focuses on how advances in genetic testing and medicine may be reflected in the roles of lawyers who specialize in elder and special needs counseling.  A leading article in the issue introduces the three primary uses of modern genetic testing -- for diagnosis of disease, for determination of carrier status, and for predictive testing -- while reminding us there are limits to each function.  In looking at age-related issues, the authors note:

 

Genetic testing is beginning to reveal information regarding susceptibilities to the dis­eases associated with old age: Alzheimer’s disease, Parkinson’s disease, diabetes, and cancer. Genetic test results showing a higher risk of such diseases can result in a cascade of conse­quences. Francis Collins, mentioned at the beginning of this article, responded to his test results thoughtfully by making lifestyle changes to reduce the probability that the increased genetic risk would be expressed in actual disease. It is important to note that, for some con­ditions, lifestyle factors’ influence on disease risk is understood; however, for many of the conditions that affect seniors, this influence is not yet known.

 

Other reactions to a high-risk test result may be more aggressive than diet and exer­cise changes. A well-publicized example is Angelina Jolie’s bilateral mastectomy. She was cancer-free but learned that she carries a BRCA1 mutation, which increases her lifetime risk for breast and ovarian cancer. She chose to undergo prophylactic mastectomy to reduce her breast cancer risk, whereas other women choose to increase breast cancer surveillance, such as undergoing more mammograms and breast MRIs. Both options are available to women who carry a BRCA1/2 mutation.

 

Will those found to be at elevated risk for more complex conditions such as Alzheimer’s disease or Parkinson’s disease make premature life choices, such as early retirement or mar­riage, based on perceived risk? Earlier in this article it is explained that an individual’s geno­type rarely determines his or her medical destiny. For example, many people with a higher genetic risk for Alzheimer’s disease will not actually develop it, while many with no apparent higher genetic risk will. Is the risk that members of the general public will misunderstand and overreact to the results of a genetic test sufficient reason to prevent them from obtaining the information gleaned from such a test? Should we be ensuring that those undergoing genetic testing are aware of its benefits and limitations through individualized genetic counseling? This, of course, presents its own challenges of access and availability.

In reading this, it seems likely that lawyers may encounter complicated issues of confidentiality, especially when counseling "partnered" clients, while also increasing the significance of long-range financial planning and assets management.  

For more, read Genetic Testing and Counseling Primer for Elder Law and Special Needs Planning Attorneys, by CELA Gregory Wilcox  and Rachel Koff, Licensed Certified Genetic Counselor. 

January 25, 2016 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Discrimination, Estates and Trusts, Ethical Issues, Retirement, Science | Permalink | Comments (0)

Sunday, January 24, 2016

Natural Disasters Know No Season

It seems that no matter the season, there is some type of natural disaster that occurs (example-tornados the week before last in Florida, a major snow storm in the Northeast a few days ago).  We all need to be prepared for natural disasters, and it is important to realize that elders may be disproportionally affected in some cases.  The New York Times on January 8, 2016 ran an article on the importance of being prepared. "Natural disasters, which appear to be on the rise in part because of climate change, are especially hard for older adults. They are particularly vulnerable because many have chronic illnesses that are worsened during the heat of a fire or the high water of a flood. And many are understandably reluctant to leave homes that hold so much history."  The article references studies that reveal a disproportionate number of some natural disasters have been elders. 

One key to survival, as the article notes, is advance planning.  A number of resources, state specific or national, are available online to help prepare.  Every year in Florida, the media alerts us to the approach of hurricane season and we purchase our hurricane supplies and prepare.  Friends in California have told me about their earthquake kits.  The article notes that local governments may have registries for those with special needs or may need assistance in an evacuation.   Preparing in advance for shelter for pets in emergency evacuations is important, since not all emergency shelters take 4-footed family members. The article notes there is even an app for help when disaster strikes!

The article has some good ideas that are valuable to all of us. Here are just a few of my favorite websites for information.

Red Cross Disaster Preparedness for Seniors by Seniors.

Ready.gov  Seniors

CDC  Personal Preparedness for Older Adults and their Caregivers

FEMA  Elderly Special Needs Plans To Be Ready for Disaster

AoA  Keeping Older Americans and People with Disabilities Safe and Healthy During Emergencies

 

January 24, 2016 in Consumer Information, Current Affairs, Health Care/Long Term Care, Other | Permalink | Comments (0)

Friday, January 15, 2016

Ageism in Social Media?

I recently ran into an article published in December of 2015 that I thought was interesting.  Fighting Ageism in the Twitter Era (Getting Old Isn't All That Bad) was published in the Arizona Republic/New America Media.  The December article followed up a late November opinion piece titled, Valdez: Getting old isn't all that bad by Linda Valdez that opened with this:

The baby boomers, AKA the nation’s silver tsunami, had better pay as much attention to changing attitudes about aging as they did to shaking up all those previous social norms.

In our culture, old things get replaced with something nice and new. Like the latest smart phone.

Apply the concept to people, and it’s called ageism.

It’s as current as Twitter.

A team of researchers at Oregon State University took a look at tweets about people with Alzheimer’s disease and found ridicule, stigma and stereotypes.

In the December article, the author, reporting on the Gerontological Society of America's annual scientific meeting in November, was in attendance as a Journalist in Aging Fellowship.  After generally reviewing topics covered in the conference, the author notes that the Boomers wish to age in place, yet many may not be physically able to do so and blame themselves for their own inability to do so.  Enter negative thoughts about aging:

Meanwhile, society does its best to accent the negative.

Asked to characterize the aging, some people recorded during on-the-street interviews dredged up cliches about spry retirees on vacation, but most talked about decline, disease, dependency.

“Society isn’t betting on them,” said one man.

These interviews were done as a result of a project with 8 of the national aging organizations, who were looking for metaphors for aging because how we look at something is crucial to how we apply information about it.  The article concludes

[T]he way information is framed has an impact on how people use the information, which should come as no surprise to those who reframed cultural norms about race, gender, sex, the environment and entertainment.

The baby boomers have a lot at stake, and that includes [the author] me. I’m no fan of euphemisms, but I’m all for promoting a fine-wine view of life. It should get better with age. We should feel better about aging.

If some creative wordsmithing and mass marketing helps our society recognize that aging doesn’t diminish value or humanity, it would be a real contribution to our collective understanding of who we boomers are.

Turning to the researchers at Oregon State U who did the analysis of tweets, their article, Portrayal of Alzheimer's Disease on Twitter is available in volume 55 of the Gerontologist, the publication of the Gerontological Society of America.

January 15, 2016 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Discrimination, Statistics | Permalink | Comments (0)

Thursday, January 14, 2016

Living Closer to Mom?

How close do you live to your mom? If you are within 20 minutes, then you are a typical American.  The New York Times ran a story on December 23, 2015 that discusses how many miles away adult  kids live from their moms. The Typical American Lives Only 18 Miles From Mom explains that     "[t]he typical adult lives only 18 miles from his or her mother, according to an Upshot analysis of data from a comprehensive survey of older Americans. Over the last few decades, Americans have become less mobile, and most adults – especially those with less education or lower incomes — do not venture far from their hometowns."  The article discusses the importance of physical proximity of families when an elder needs caregiving. "Over all, the median distance Americans live from their mother is 18 miles, and only 20 percent live more than a couple hours’ drive from their parents. (Researchers often study the distance from mothers because they are more likely to be caregivers and to live longer than men.)"

The article discusses the factors that impact the distance the kids live from mom, including education, geographic location, marital status and culture. The article notes that caregiving goes both ways, with elders providing child care for their grandchildren.  The article also covers the challenges of caregiving, and the future needs for caregiving.

January 14, 2016 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Other | Permalink | Comments (0)