Monday, April 27, 2015

NPR: Drop-in Chefs for Seniors

Occasionally I feel a little "push-pull" from the different directions that writing about "laws and policies of aging" takes me.  One minute I'm writing about hunger for seniors in our nation's capitol, a dynamic driven by poverty, and then there is today's story from NPR on Drop-In Chefs Help Seniors Stay in Their Own Homes.   

"Part of the business plan is keeping the service affordable. In addition to the cost of the food, the client pays $30 an hour for the chef's time. That's usually a couple of hours a week of cooking and cleaning up the kitchen. There's also a $15 charge for grocery shopping. So clients pay on average $45 to $75 a week.

 

And while there are lots of personal chefs out there and services that deliver meals for seniors there are few services specifically for older adults that prepare food in their homes."

All part of the big, complex picture of "aging." 

April 27, 2015 in Consumer Information, Current Affairs, Food and Drink, Housing | Permalink | Comments (0) | TrackBack (0)

Sunday, April 26, 2015

Cool Tool-Center for Financial Literacy in Retirement

The Center for Retirement Research-Center for Financial Literacy at Boston College has created a cool tool for folks to recognize bad behaviors that impact retirement.  According to the website

Curious Behaviors That Can Ruin Your Retirement is an interactive program on behavioral impediments to retirement planning. A host leads users through exercises designed to create an “Aha!” moment as they relate to the behaviors. The host then explains how the behavior can hinder retirement planning and how to cope with it. Users can then go to a “Learn More” page with additional information in various media formats.

The link to the tool is available here. It takes about 10 minutes to work through it. Check it out and have your students check it out as well!

 

April 26, 2015 in Consumer Information, Current Affairs, Retirement | Permalink | Comments (0) | TrackBack (0)

NYT: Financial Skills May Be "First to Go"

Sunday's New York Times has a feature article on aging and financial skills, and the message is not "just" for individuals with dementia:

"Studies show that the ability to perform simple math problems, as well as handling financial matters, are typically one of the first set of skills to decline in diseases of the mind, like Alzheimer’s, and Ms. Clark’s father-in-law, who suffered from mild dementia, was no exception. Research has also shown that even cognitively normal people may reach a point where financial decision-making becomes more challenging."

The article gives several example of individuals who were vulnerable to exploitation, because of their reduced interest in or understanding of financial decisions. David Laibson, an economics professor at Harvard, one of the researchers cited in the article said "he believed that crystallized intelligence tended to plateau when people reached their 70s." Further, "he wishes all 65-year-olds would start by simplifying their financial lives, reducing the money clutter to just a few mutual funds at a reputable institution."

The article, As Cognition Slips, Financial Skills Are Often the First to Go, offers several links to recent reports and studies, as well as examples of "early signs."  

Hat tip to Penn State's Dickinson Law 1L student Spencer Flohr for sharing the link to this article -- and noting the probable relevance to law students' studies of trusts and estates law. Good catch!

April 26, 2015 in Cognitive Impairment, Consumer Information, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Property Management | Permalink | Comments (1) | TrackBack (0)

Friday, April 24, 2015

Got an Idea? Maybe You Are an Inventor!

Are you an inventor?  Ever have a good idea for an invention?  There is a renaissance of sorts in American ingenuity with an increasing number of older Americans becoming inventors.  The NY Times ran a story about older inventors on April 17, 2015. More Older Adults Are Becoming Inventors notes this renaissance

Whether as volunteers or for profit, older inventors ... are riding a rising tide of American innovation. They are teaming up, joining inventors clubs and getting their products into the marketplace. And older inventors bring valuable skills to their work, many experts say, like worldly wisdom and problem-solving abilities that can give them an advantage over younger inventors.

According to the article, the Baby Boomers are at least part of the catalysts for this surge of older inventors, as the boomers look for products to assist them as they get older. According to one expert quoted in the article, older inventors may have an edge over younger ones, since "[a]n aging brain can see patterns better.”  Before you get out the proverbial drawing board, the article notes that inventions don't necessarily lead to wealth with less than 5% of inventions making money, not to mention the prototype and startup costs

April 24, 2015 in Consumer Information, Current Affairs, Other | Permalink | Comments (0) | TrackBack (0)

Thursday, April 23, 2015

How Does Your Neighborhood Rate for "Aging in Place?" AARP Offers Livability Index

As outlined by The Washington Post, AARP Public Policy Institute has a new "Livability Index" offered as a way to evaluate factors such as safety, security, ease of getting around, access to health care, and housing affordability.

More intangible factors are also assessed, such as WiFi, farmers' markets and "public policies that promote successful aging."

(After following the trauma of the trial in Iowa, I wonder whether "criminal laws on sexual relations between husband and wives if one has dementia" should be added as an express factor?)

For more, read here and here.  Hat Tip to ElderLawGuy Jeffrey Marshall for the pointer. 

April 23, 2015 in Consumer Information, Housing, Retirement, Statistics | Permalink | Comments (0) | TrackBack (0)

Justice in Aging: Webinar on New Person-Centered Care Rules

Justice in Aging (formerly National Senior Citizens Law Center) is offering a free webinar on Wednesday. April 29, from 2 to 3 p.m. (eastern time) on "How New CMS Person-Centered Care Planning Rules Apply to Medicaid Delivered Long-Term Services and Supports (LTSS)."

They report their webinar will focus on the rules as they apply to long-term services and supports delivered through Medicaid home and community-based waivers, and will:

  • Provide background context for the new person-centered planning and service plan      rule
  • Analyze the requirements of the new rule
  • Give examples of how selected states (Minnesota, New Jersey, Tennessee, and Wisconsin) are implementing provisions of the rule
  • Identify gaps where more detailed state rules or better managed care plan contractual terms are needed to ensure that compliance with the intent of the rule

Who should participate?  The program is suggested for health care professionals and their staffs, attorneys for consumers of LTSS services, and public employees --  and consumers, too. 

Here is the link for the registration

April 23, 2015 in Consumer Information, Health Care/Long Term Care, Medicaid, Medicare, State Statutes/Regulations, Webinars | Permalink | Comments (0) | TrackBack (0)

Wednesday, April 22, 2015

New Report Spotlights Ineffectiveness of Enforcement of Nursing Home Care Standards

LTCCC press release says new study assesses nursing home citation rates nationwide, finds little or no punishment when nursing homes fail to provide care that meets the standards they are paid to achieve, even when such failures result in significant suffering.

Widespread and persistent nursing home problems, including serious deficiencies in care, result in unnecessary harm to thousands of vulnerable residents every day. Deficient and worthless services also cost taxpayers hundreds of millions of dollars a year. The nursing home industry frequently complains that it is one of the most highly regulated in the country. But what does that mean when so many nursing homes are consistently paid to provide care that fails to meet those standards?

LTCCC’s new report, , presents a comparative overview of every state’s (50 states + DC) performance on several key criteria. LTCCC assessed overall state citation rates, number and amounts of fines that each state has imposed in the last three years for violations of minimum standards and the rates at which the states identified resident harm when they found deficiencies. In addition to reviewing state citations as a whole, the study focused on three criteria important to quality care – pressure ulcers, staffing and antipsychotic drugging.

“While no data are perfect, we felt that assessing overall citation and penalty rates, as well as citations for three critical quality criteria, would together provide valuable insights into State Survey Agency performance and the extent to which important problems are being addressed in each state” said Richard Mollot, LTCCC’s Executive Director and author of the report.

Select findings:

1.     Resident Harm. States only find harm to residents 3.41% of the time that they cite a deficiency. California and Alabama tied for lowest in the country, finding harm only 1.14% of the time.

2.     Inappropriate Antipsychotic Drugging. The nationwide average antipsychotic drugging rate is 18.95% while the average citation rate for inappropriate drugging is 0.31%.  This indicates that there is a significant amount of inappropriate antipsychotic drugging that is not being cited by the states.

3.     Pressure Ulcers. Pressure ulcers (bed sores) are a problem for over 86,000 nursing home residents. Though they are largely preventable, states cite nursing homes the equivalent of less than 3% of the time that a resident has a pressure ulcer. When states do cite a facility for inadequate pressure ulcer care or prevention, they only identify this as harmful to residents about 25% of the time.     

4.     Sufficient Care Staff. Insufficient care staff is one of the biggest complaints made by nursing home residents and their families. Studies have repeatedly identified it as a serious problem in a majority of US nursing homes.  Nevertheless, insufficient staffing is rarely cited by the states. The annual rate of staffing deficiencies per resident is infinitesimal: 0.042%. Less than 5% of those deficiencies are identified as resulting in harm. Twenty one states never connect insufficient care staff to resident harm in their states.

The report is available on LTCCC’s dedicated nursing home website at http://www.nursinghome411.org/articles/?category=lawgovernment. The website includes interactive charts showing key rates for each state as well as national averages.  They include state rankings on criteria identified as important to nursing home resident care and the protection of taxpayer funds that pay for the majority of nursing home care. These charts can be used to gain insights into the strengths and weaknesses of quality oversight in any state. 

April 22, 2015 in Consumer Information, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Health Care/Long Term Care, State Statutes/Regulations | Permalink | TrackBack (0)

Tuesday, April 21, 2015

Funding Opportunity: Senior Medicare Patrol and State Health Insurance Assistance Program

Seeking Applications for Hard-to-Reach Beneficiary Project

The Administration for Community Living oversees two programs geared toward educating and empowering Medicare beneficiaries; the Senior Medicare Patrol (SMP) and the State Health Insurance Assistance Program (SHIP). The SMP helps beneficiaries spot and report fraud related to their use of Medicare, and the SHIP provides information and counseling to help Medicare beneficiaries select health insurance programs that best meet their needs.

ACL seeks to assist these state-based programs in providing their services to hard to reach beneficiaries.  Cooperative agreements of up to $150,000 will be awarded to successful applicants proposing to develop new and creative strategies and tools for connecting with hard to reach beneficiaries.  Entities eligible to apply include domestic public or private non-profit organizations.  Hard to reach populations include, but are not limited to, the following groups:

  •  Medicare Beneficiaries under age 65
  •  Lesbian, Gay, Bisexual, and Transgender Medicare Beneficiaries
  •  American Indian/Alaska Native Medicare Beneficiaries
  •  Beneficiaries located in rural areas
  •  Limited-English Speaking Beneficiaries
  •  Medicare Beneficiaries of Racial/Ethnic Minority Communities

An informational conference call will be held on Thursday, May 7, 2015 at 2:00 p.m. ET. To participate in the call, dial 1-888-566-5976, when prompted, enter passcode: 5922266.

Letter of Intent Due: April 30, 2015

Application Deadline: June 14, 2015

Click here to see the full announcement.

April 21, 2015 in Consumer Information, Grant Deadlines/Awards, Medicare | Permalink | TrackBack (0)

Friday, April 17, 2015

Searching for Answers to Questions about Continuing Care: Point/Counter Point

Scott E. Townsley, a very bright attorney, an adjunct associate professor at UMBC's Erickson School of Aging Studies, and a principal with CliftonLawsonAllen LLP, invited me to join him recently for a presentation to the 2015 Mid-Atlantic Region Resident Council Conference in Silver Spring, Md. (The lovely D.C. area cherry trees were in full bloom that day.) Cherry Trees at Riderwood Community 2015

Our theme was "Hot Topics in Continuing Care."  Scott, a regular consultant to nonprofit CCRCs, used his deep experience in senior housing to outline his perspective on the biggest issues facing CCRCs. In preparation for my part, I reached out to my contacts in resident groups around the country and asked them to share with me their biggest concerns. 

We then trimmed down our two respective lists and used a Point/Counter Point approach to the debate.  Do any of our readers remember 60 Minutes' James Kirkpatrick and Shana Alexander?  (Okay, how about Dan Aykroyd and Jane Curtin's lampoon of the Point/ Counter Point format?  I think it is fair to say that we were less political than the first combo, and more polite -- if less humorous -- than the SNL crew.  But we had fun.)

With a tip of the hat to David Letterman in borrowing his "top ten" format, here is a very distilled version of my list of Resident Concerns:

10. What does it really mean to be a nonprofit CCRC in 2015?

9.  Do we need to worry about conversions of nonprofit CCRCs to for-profit?

8.  What is the right response to the trend that residents are older and more disabled, even when first entering the community?

Continue reading

April 17, 2015 in Consumer Information, Dementia/Alzheimer’s, Discrimination, Health Care/Long Term Care, Housing, Property Management, Retirement, State Statutes/Regulations, Web/Tech | Permalink | Comments (3) | TrackBack (0)

Thursday, April 16, 2015

Comment Window Opens for Proposed Rules re Conflicts of Interest in Retirement Advice

The U.S. Department of Labor has released a new proposed rule intended to protect consumers from conflicts of interest among an array of folks who want to give advice about how and where to invest 401(c) and IRA retirement funds.  The new rule would impose a "fiduciary duty" standard on those advisors, rather than the current, lower "suitability" standard for investment advice.

A DOL press release explains the goal: 

"This boils down to a very simple concept: if someone is  paid to give you retirement investment advice, that person should be working in  your best interest," said Secretary of Labor Thomas E. Perez. "As commonsense  as this may be, laws to protect consumers and ensure that financial advisers  are giving the best advice in a complex market have not kept pace. Our proposed  rule would change that. Under the proposed rule, retirement advisers can be  paid in various ways, as long as they are willing to put their customers' best  interest first."

 

Today's announcement includes a proposed rule that would  update and close loopholes in a nearly 40-year-old regulation. The proposal  would expand the number of persons who are subject to fiduciary best interest  standards when they provide retirement investment advice. It also includes a  package of proposed exemptions allowing advisers to continue to receive payments  that could create conflicts of interest if the conditions of the exemption are  met. In addition, the announcement includes a comprehensive economic analysis  of the proposals' expected gains to investors and costs.

The New York Times covers the new rules in "U.S. Plans Stiffer Rules Protecting Retiree Cash," and notes the history of opposition to this kind of reform from -- surprise, surprise -- the "financial services industry." There is a 75-day window for public comments on the latest proposal.

Perhaps my biggest surprise was the remarkably "consumer friendly" presentation of the proposed change by the Department of Labor on its webpage, beginning with this simple video describing conflicts of interest.   

April 16, 2015 in Consumer Information, Current Affairs, Estates and Trusts, Ethical Issues, Federal Statutes/Regulations, Property Management, Retirement | Permalink | Comments (0) | TrackBack (0)

NYT: Nursing Homes Chase Lucrative Patients (But That's Not the Whole Story)

From the New York Times on April 14, an article from the business section, As Nursing Homes Chase Lucrative Patients, Quality of Care is Said to Lag.

Promises of “decadent” hot baths on demand, putting greens and gurgling waterfalls to calm the mind: These luxurious touches rarely conjure images of a stay in a nursing home.

 

But in a cutthroat race for Medicare dollars, nursing homes are turning to amenities like those to lure patients who are leaving a hospital and need short-term rehabilitation after an injury or illness, rather than long-term care at the end of life.

 

Even as nursing homes are busily investing in luxury living quarters, however, the quality of care is strikingly uneven. And it is clear that many of the homes are not up to the challenge of providing the intensive medical care that rehabilitation requires. Many are often short on nurses and aides and do not have doctors on staff.

Some colorful quotes here ("patients are leaving the hospital half-cooked"), but a lot of this well-written article nonetheless seems like old news to me (okay, perhaps that's because of my chosen research focus), with reporting on trends influenced by operating margins on the "nonprofit" side of care, and "return on investment" for shareholders on the for-profit side.  Perhaps "intensity" of the pressures is the theme here? 

Tip of the hat to George Washington University Law student Sarah Elizabeth Gelfand ('16) and GW Professor Naomi Cahn for making sure we saw this article!  

April 16, 2015 in Consumer Information, Ethical Issues, Health Care/Long Term Care, Housing, Medicaid, Medicare, Retirement, Statistics | Permalink | Comments (0) | TrackBack (0)

Saturday, April 11, 2015

ALs, PCHs, CCRCs, SNFs, RCFEs and the Name Game in Senior Housing

One of the first assignments I give to law students in my Elder Law course is to visit a "nursing home" and to see if they can get a copy of the admission agreement or contract.  (Most of the facilities in my area cooperate with these student visitors.)  The lesson here, however, is revealed when the students bring the documents back to the classroom for discussion. We discover that the majority of the contracts are not for admission to "skilled nursing facilities."

More frequently the facilities in question are licensed as "continuing care retirement communities" or CCRCs, which are big in Pennsylvania, or personal care homes (PCs or PCHs), or assisted living (AL) communities, each of which have different state regulations applying to their operations. These are not "nursing homes," or at least, they are not "skilled nursing facilities." Further, in Pennsylvania, increasingly there may be no label at all -- at least not a label that the public is familiar with -- and that is often by design as the facility or community may be attempting to avoid a "higher" level of requirements. 

The usual explanation is that the choice in label is not driven by concerns over "quality" of care, but by costs of having to meet some non "care" related regulation, such as AL state requirements for room size or physical accommodations.  The facility makes the case that it can meet the real needs of its clientele without being tied to "higher care" and therefore more "costly" models for senior housing.  Fair enough.  Caveat emptor.  If you are the customer, make sure you do your homework, ask questions, comparative shop, and avoid assumptions based on pretty pictures in marketing brochures. And try to do all of this before an emergency that accelerates the need for a move.

But, there can be significant differences triggered by a label (or lack thereof) that are not readily apparent to the public. A recent Policy Issue Brief published by Justice In Aging (formerly the National Senior Law Center) uses examples from California to shine a spotlight on subtle issues in labeling, as well as on the importance of regulations that are responsive and up-to-date.  Merely changing an "identity" or label should not be the basis for failing to comply with minimum standards relevant to the clients' needs.

In How California's Assisted Living System Falls Short in Addressing Residents' Health Care Needs,  Justice in Aging (JIA, to make our circle of acronyms almost complete), provides a sample job notice for a California facility and asks "can you spot the legal violations in this Assisted Living job announcement?" The notice, appears to be hiring for a "certified med aide," despite the fact that  there is no such thing in California, and more importantly, if the facility calling itself "Assisted Living" is actually a RCFE (residential care facility for the elderly), the California regulations do not permit staff to administer medications.  Outside of Medicare/Medicaid standards for skilled nursing facilities -- the "nursing homes" of the past -- there are no national standards for labeling of "assisted living" or the many alternatives. 

JIA's issue brief dated April 7, 2015 is part of a series that explores how California's system functions and points to ways it could be modified to help assure residents their expectations and needs will be satisfied.

The lessons in the JIA brief -- with a few tweaks to respond to any given state's set of acronyms -- seem equally relevant in all states.

April 11, 2015 in Consumer Information, Ethical Issues, Health Care/Long Term Care, Housing, Medicaid, Medicare, Retirement | Permalink | Comments (0) | TrackBack (0)

Saturday, April 4, 2015

"Informal" Arrangements for Home Care? What's the Downside? Here's One...

When it becomes impossible for a loved one to stay at home without help, one decision that families made need to face is whether to use an agency, or hire one or more individuals outright. Agencies are usually more expensive (at least on paper). But direct hires of home aides can raise other questions, including how to handle state and federal income taxes and documentation, insurance, transportation (read: more insurance questions), coverage for holidays, sick leave, overtime, and more.  You start off thinking this is short term help; the reality is it can last much longer....

But there is still one more question that may not be on the family's radar screen, until it is too late.

If the informal home care arrangements eventually don't suffice, perhaps because of increasing frailty and care needs, what happens when the individual's money is gone and there is a need for Medicaid-paid care?  

As explained in a recent Michigan Court of Appeals case, "informal" arrangements for home care may trigger ineligibility for Medicaid-paid care based on state rules or policies implementing federal law.

Continue reading

April 4, 2015 in Consumer Information, Current Affairs, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, State Cases, State Statutes/Regulations | Permalink | Comments (0) | TrackBack (0)

Thursday, April 2, 2015

Must Lawyer Consult With "Agent" Before Complying With Elderly Client's Request to Terminate POA?

Here is a recent ruling (February 2015), based on a fact pattern that many elder law attorneys will appreciate as both familiar and challenging.

In Runge v. Disciplinary Board, the Supreme Court of North Dakota reversed a disciplinary board "admonishment" of an attorney for "violating" the Rules of Professional Conduct, Rule 1.14.  North Dakota's Rule 1.14, addressing representation of a "client with limited capacity," is similar to the ABA Model Rule 1.14 on clients with "diminished capacity."

At issue in the disciplinary proceeding was the lawyer's representation of a 79-year-old man who was residing in a "Care Center." The man wished to leave the nursing home, against "medical advice" and, apparently also in opposition to his daughter's apparent belief about what was best for him. The man had, before experiencing a heart attack, named his daughter as an agent under a durable POA. 

By the time the attorney met with the man, the man had been living in the care center for several months.  After meeting with the older man (and a female friend of the man), at the man's request the attorney prepared a revocation of the POA.  The lawyer explained to the care center that absent someone holding a guardianship or custodianship for the man, and as long as the lawyer was persuaded his client had sufficient capacity, the revocation of the POA was effective and neither the center nor the daughter had grounds to prevent him from leaving.

Unhappy with this outcome, the daughter filed a Disciplinary Board complaint against the attorney, asserting the lawyer had acted improperly by failing to consult with her as her father's named agent, and taking the position her father's "incapacity" for purposes of an earlier "emergency care" statement was conclusive of his incapacity.  The Court, however, observed:

"Here no guardianship or conservatorship existed that withdrew Franz's authority to act for himself. Rather, Franz shared his authority to act and he remained free to withdraw the authority conferred under that power of attorney, which, in any event, precluded anyone from making his medical decisions. This record reflects [Lawyer]Runge talked with Franz by telephone and in person to ascertain his wishes before Franz revoked the power of attorney. Runge's recitation of his conversations with Franz does not clearly and convincingly establish Franz was incapacitated in April 2013. This record does not reflect any subsequent attempt to obtain a court-ordered guardianship or conservatorship for Franz, which belies any suggestion that he was incapacitated in April 2013."

Therefore, the North Dakota Supreme Court dismissed the daughter's Disciplinary Board complaint.

Significantly, the Court observes that although the lawyer "could" have contacted the daughter before executing the revocation of the POA, the provisions of Rule 1.14 did not "require" him to do so. 

Lots of potential lessons here.  A key to the outcome seems to be the lawyer's persuasive testimony, showing the care he took in making the decision to represent the man and to prepare the revocation.  As the court observed, "[The lawyer's] assessment of [the man's] capacity was within the range of a lawyer's exercise of professional judgment."  This case is another demonstration that lawyers hold a lot of power -- and responsibility -- in matters involving client capacity.  

Many thanks to Professor Laurel Terry at Dickinson Law for sending this decision our way. 

April 2, 2015 in Cognitive Impairment, Consumer Information, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, Legal Practice/Practice Management, State Cases, State Statutes/Regulations | Permalink | Comments (2) | TrackBack (0)

Wednesday, April 1, 2015

AARP Reports on the Struggle to Overcome Unemployment for Older Job Seekers

The AARP Public Policy Institute has recently published an Insight Report (March 2015) on older workers and unemployment following the recent economic crisis.  The report draws upon surveys of persons aged 45 to 70 affected by unemployment during the last 5 years.  The primary focus of the analysis is on "reemployment," including what strategies were used in successful efforts to find jobs. 

Lots of interesting information here.  Even though the rate of unemployment is lower for older workers, those losing their jobs later in life stayed unemployed longer than younger job seekers, and their recovery jobs reportedly paid less.  Some of the findings, however, are of equal relevance to younger job seekers.  One set of responses was especially sobering, on a question about possible working life regrets:  

"When asked whether there was anything they wished they had done differently over their working lives or careers to better position themselves for dealing with unemployment, 52 percent said 'yes.' The most common answer —65 percent — was a wish that they had saved more money. Also of note, 48 percent wished they had gone back to school to complete or get another degree, and 38 percent wished they had chosen a different field. The unemployed and the long–term unemployed were more likely than the other groups to wish they had chosen a different field. Those who elected that regret also tended to be younger (56 percent were ages 45 to 54)."

Many thanks to Professor Naomi Cahn at George Washington Law for alerting me to this report, and sending a link to related Wonk Blog coverage of the study from the Washington Post  -- lots of well-explained graphs from an oral presentation that accompanied the launch of AARP's written report. 

April 1, 2015 in Consumer Information, Current Affairs, Discrimination, Ethical Issues, Retirement, Statistics | Permalink | Comments (0) | TrackBack (0)

Tuesday, March 31, 2015

Educating the Public about Powers of Attorney (With the Help of Friends Across the Pond)

As we have described often on this Blog, there is a fair degree of concern about whether members of the public understand the potential significance of a  Power of Attorney before they sign the document.  Apparently the U.S. is not alone in this concern. 

Recently, Northern Ireland's Law Society (for comparison purposes, an organization which somewhat of a hybrid of the American Bar Association and a state's licensing board or disciplinary authority), issued an interesting pamphlet about "enduring powers of attorney" or EPAs, to serve as a guide for members of the public, using a Q & A format. EPAs are similar to our durable POAs, and, of course, their utility depends on being executed in advance of any need.  Topics addressed include: 

  • Do I lose control when I sign an EPA?
  • Is this just a note of my wishes?
  • Do I need an EPA if I have a will?
  • If I don't have investments or property is there any point?
  • What if all my assets are jointly owned?
  • Can I have more than one attorney [agent]?
  • Who should I appoint as my attorney [agent]?
  • What power does an attorney [agent] have?
  • What responsibilities does my attorney [agent] have?
  • Is my attorney [agent] paid for work undertaken?
  • Can I change my mind and revoke an EPA?
  • If I recover my capacity, who is in charge of my affairs?
  • Is it expensive to make an EPA? 

You are curious about the answers, aren't you!  For the cleanly written answers to these questions, access the PDF from the Law Society here.   Thank you to my Dickinson Law colleague Laurel Terry for the pointer.

March 31, 2015 in Consumer Information, Ethical Issues, Property Management | Permalink | Comments (0) | TrackBack (0)

Monday, March 30, 2015

Catching Up with the U.S. Senate Special Committee on Aging

As Maryland reader Dennis Brezina (and legislative assistant to Wisconsin Senator Gaylord Nelson) helpfully reminded me, with the new Congress there has been a changing of the leadership of the Senate Special Committee on Aging.  The new Chair and Ranking Member of the Committee are, respectively,  Senators Susan Collins, (R-Maine) and Claire McCaskill (D-Missouri).

This committee maintains a  "fraud hotline," for reporting abuse, including financial exploitation, affecting vulnerable seniors.  The number is 1-855-303-9470.  For more on the Committee's interest in this topic, reports from recent hearings are available on the Committee website. 

Thanks, Dennis!

March 30, 2015 in Consumer Information, Elder Abuse/Guardianship/Conservatorship, Ethical Issues | Permalink | Comments (0) | TrackBack (0)

Friday, March 27, 2015

How Old Are You? No really, How Old Are You?

 

I thought it fitting to end the week with a recent story from the New York Times.  You know that old saying  that goes something like this "you are only as old as you feel"? Well according to Social Security, a whole bunch of us are a lot older than we are.... The A.P. ran an article on March 16, Flawed Social Security data say 6.5M in US reach age 112. The article notes that the reality is only about 42 people in the world are that old. So what about the other 6.4+ million others?  According to the article, lack of death certificates can be a partial explanation.

But Social Security does not have death records for millions of these people, with the oldest born in 1869, according to a report by the agency's inspector general.

Only 13 of the people are still getting Social Security benefits, the report said. But for others, their Social Security numbers are still active, so a number could be used to report wages, open bank accounts, obtain credit cards or claim fraudulent tax refunds.

The Senate Committee on Homeland Security & Government Affairs held a hearing on  SSA and death records on March 16, 2015. The solution is a bit more complicated than you might think, according to the article. Think about paper records and how time consuming it is to convert them to electronic records.  Social Security is concerned about whether 6.5 million people are alive or not, but  "the inspector general's report did not verify that any of the 6.5 million people are actually dead. Instead, the report assumed they are dead because of their advanced age." An SSA official was quoted as saying "our focus right now is to make sure our data is as accurate and complete as it can be for our current program purpose,... Right now, we're focused on making sure we're paying beneficiaries properly, and that's how we're investing our resources at this time."

March 27, 2015 in Consumer Information, Current Affairs, Social Security | Permalink | Comments (0) | TrackBack (0)

Tuesday, March 24, 2015

Are Doctors Failing to Tell Patients of Diagnosis of Alzheimer's? And Why Not?

The Alzheimer's Association's 2015 Facts & Figures Report that many doctors fail to tell patients (or their family members) about a diagnosis of Alzheimer's is getting a lot of attention, including this Morning Edition story

Why aren't doctors revealing their diagnoses?  During my work in Northern Ireland on access to justice for older adults, we realized that the doctor's diagnosis is a key opportunity for families to receive early advice about "non-medical" planning, such as arranging for powers of attorney or other arrangements for financial management, while the patient has adequate cognition to help with decision-making.  If communication of the diagnosis is delayed, the window for effective participation in planning may also be lost.

March 24, 2015 in Cognitive Impairment, Consumer Information, Dementia/Alzheimer’s, Ethical Issues, Health Care/Long Term Care | Permalink | Comments (0) | TrackBack (0)

Thursday, March 19, 2015

NAELA Submits Comments on Proposed VA Regs re Eligibility for Benefits

The National Academy of Elder Law Attorneys (NAELA) recently submitted detailed formal comments to proposed VA rules affecting asset tests for eligibility for Veterans benefits. They begin:

NAELA welcomes the effort to try to make the eligibility criteria for pension and other benefits administered by VA objective and transparent, but we believe that these proposed regulations, if implemented, would cause substantial harm to wartime Veterans, their spouses, and dependents and will not solve the serious issue of unscrupulous organizations taking advantage of potential beneficiaries by selling inappropriate annuities or trusts.

 

In addition, we express the serious concern that the proposed rules 3-year look-back period and transfer of assets penalty exceed statutory authority, opening up VA to future litigation and causing additional uncertainty for Veterans and their families.

For the full NAELA submission, see here

March 19, 2015 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Veterans | Permalink | Comments (0) | TrackBack (0)