Tuesday, March 27, 2018

Guess Which Segment of the Senior Living Market is Experiencing the Largest Growth...

I was a bit surprised to read an article this month reporting that Continuing Care Retirement Communities (CCRCs), also known as Life Plan Communities, are experiencing not just growth in occupancy over the last 12 months, but comprise "the only segment of senior living and long-term care to see increased occupancy in 2018."  Lois Bowers, senior editor at McKnight's Senior Living provides the summary of the study:  

The stabilized occupancy rate for CCRCs has increased 30 basis points to 91.5% over the past 12 months and has stayed in the low 90s for the past 10 years, according to the company's senior housing research national report for the first half of 2018.

 

“Rent growth remains strong, with the average advancing 3.2 percent to $3,322 per month in 2018,” the authors wrote about CCRCs, also known as life plan communities.

 

Independent living is the big draw in these communities, where many operators are reducing the number of skilled nursing beds, according to the report.

For more, read CCRCs Alone in Occupancy Increase This Year, Report Says. 

 

March 27, 2018 in Consumer Information, Health Care/Long Term Care, Housing, Property Management, Statistics | Permalink | Comments (0)

Friday, March 23, 2018

National Council on Disability Calls for Nationwide Reforms for Guardianships

On March 22, 2018, the National Council on Disability (NCD) released a new 200-page report and recommendations,  calling for substantial reform of the rules and processes used to place individuals with disabilities or the elderly under guardianships. 

As set forth in the press release, NCD's findings include:

  • Guardianship is often imposed when not warranted by facts or circumstances, because guardianship proceedings often operate under erroneous assumptions that people with disabilities lack capability to make autonomous decisions.
  • Capacity determinations often lack sufficient scientific or evidentiary basis.
  • Although guardianship is considered a protective measure, courts often lack adequate resources, technical infrastructure, and training to monitor guardianships effectively and hold guardians accountable, which at times allows for guardians to use their positions to financially exploit people subject to guardianships or subject them to abuse or neglect.
  • People with disabilities are often denied due process rights in guardianship proceedings. 
  • Although most state laws require consideration of less-restrictive alternatives, courts do little to enforce those requirements.
  • Similarly, though every state has a process for the restoration of one’s rights lost through guardianship, the process is rarely used.
  • There is a lack of data on existing guardianships and newly filed guardianships, which frustrates efforts of policymakers to make determinations about necessary areas for reform.

NCD also makes seven sets of specific recommendations, often calling upon the U.S. Department of Justice to take a leadership position in protecting the civil rights of individuals, including providing states with guidance and support for review of existing guardianships with a goal of assessing the potential for restoration of rights.  

Here is a link providing access to the full report, Beyond Guardianship: Toward Alternative That Promote Greater Self-Determination, and to a literature review, and to a qualitative research report summary in support of the NCD recommendations.

My special thanks to Pennsylvania Superior Court Judge Paula Ott for sending me timely information on these publications.

March 23, 2018 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Property Management, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (0)

Thursday, March 22, 2018

Free Webinar Protecting Elders From Scams

The National Center of Law & Elder Rights has announced their next webinar,  Legal Basics: Protecting Older Adults Against Fraudulent Schemes and Scams. The webinar is scheduled for April 10, 2018 at 2 edt.  Here's a description of the webinar:

With savings and assets accumulated over a lifetime, older adults are attractive targets for individuals promoting fraudulent schemes and scams. Scammers use deception, misrepresentation and threats to convince older adults to send money or provide personal financial information. Most frauds and scams go unreported. 

This webcast will provide an overview of the frauds and scams aimed at older adults, discuss legal protections, and provide resources to aid older adults defrauded by the individuals and business that promote these scams. The webcast will also focus on efforts by the Federal Trade Commission to prevent older adults from falling victim to these scams. 

To register for this free webinar, click here.

March 22, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Programs/CLEs, State Statutes/Regulations, Webinars | Permalink | Comments (0)

Wednesday, March 21, 2018

World Elder Abuse Awareness Day is June 15, 2018

With World Elder Abuse Awareness Day just a few months away, it's time to think about any events your organization might offer.  According to the USC Center on Elder Mistreatment NCEA email, a microsite has been created  that offers suggestions, helpful hints, events and more. Want to take some kind of action? Check the information here for 13 ideas in a number of categories. Planning an event? List it there. It's never too early to start planning!  And let others know using #WEAAD.

March 21, 2018 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care, International, Other, Programs/CLEs | Permalink | Comments (0)

Tuesday, March 20, 2018

Senate Committee on Aging: Top 10 Elder Scams

A little mid-week reading for you. The Senate Committee on Aging has released their 2018 Fraud Book, listing the top 10 elder scams of 2018.  Fighting Fraud: Senate Aging Committee Identifies Top 10 Scams Targeting Our Nation’s Seniors  lists the top 10 scams of the year, based on reports to the hotline, which are (drum roll please) 

IRS Impersonation Scams

Robocalls and Unsolicited Phone Calls

Sweepstakes Scams / Jamaican Lottery Scams

"Can You Hear Me?” Scams

Grandparent Scams

Computer Tech Support Scam

Romance Scams

Elder Financial Abuse

Identity Theft

Government Grant Scams

Here is the executive summary for the report:

From January 1, 2017, through December 31, 2017, the Senate Aging Committee’s Fraud Hotline received a total of 1,463 complaints from residents all across the country. Calls pertaining to the top 10 scams featured in this report accounted for more than 75 percent of the complaints.

                The top complaint, the focus of more than twice as many calls as any other scam, involves seniors who receive calls from fraudsters posing as agents of the Internal Revenue Service (IRS). These criminals falsely accuse seniors of owing back taxes and penalties in order to scam them. Due to the extremely high call volume and continued reports from constituents from across the country, the Aging Committee held a hearing on April 15, 2015, to investigate and raise awareness about the IRS imposter scam. Prior to a large law enforcement crackdown in October 2016, nearly three out of four calls to our Hotline involved the IRS impersonation scam. In the three months after the arrests, reports of the scam into the Committee’s hotline dropped by an incredible 94 percent. Though the numbers have since rebounded somewhat, they are still far below the levels we have seen in the past.

                The second most common scam reported to the Hotline involved robocalls or unwanted telephone calls. On June 10, 2015, the Aging Committee held a hearing on the increase in these calls that are made despite the national Do-Not-Call Registry. The Committee examined how the rise of new technology has made it easier for scammers to contact and deceive consumers and has rendered the Do-Not-Call registry ineffective in many ways. On October 4, 2017, the Aging Committee held an additional hearing on robocalls, this time examining recent developments by both the private and public sectors to combat robocalls and protect seniors from fraud.

Sweepstakes scams, such as the Jamaican lottery scam, continue to be a problem for seniors, placing third on the list. A March 13, 2013, Aging Committee hearing and investigation helped bring attention to these scams and put pressure on the Jamaican government to pass laws cracking down on criminals who convinced unwitting American victims that they had been winners of the Jamaican lottery. The United States government has had some recent success in bringing individuals connected to the Jamaican lottery scam to trial, but these types of scams continue to plague seniors.

A new scam to make the top 10 list for 2017 involves consumers receiving calls in which the caller would simply ask “Are you there?” or “Can you hear me?” in order to prompt the recipient to say “yes.” According to the Federal Trade Commission (FTC), these illegal robocalls are pre-recorded, and are

designed to identify numbers that consumers are likely to answer, allowing scammers to better identify and connect with potential victims. The increased use of this tactic by scammers in robocalls last year demonstrates how sophisticated scammers are.

Grandparent scams, the focus of a July 16, 2014, Aging Committee hearing, were next on the list. In these scams, fraudsters call a senior pretending to be a family member, often a grandchild, and claim to be in urgent need or money to cover an emergency, medical care, or a legal problem.

Computer scams were sixth on the list and the subject of an October 21, 2015, Committee hearing. Although there are many variations of computer scams, fraudsters typically claim to represent a well-known technology company and attempt to convince victims to provide them with access to their computers. Scammers often demand that victims pay for bogus tech support services through a wire transfer, or, worse yet, obtain victims’ passwords and gain access to financial accounts.

Romance scams were seventh on the list. These calls are from scammers who typically create a fake online dating profile to attract victims. Once a scammer has gained a victim’s trust over weeks, months, or even years – the scammer requests money to pay for an unexpected bill, an emergency, or another alleged expense or to come visit the victim – a trip that will never occur.

Elder financial abuse was eighth on the list and the topic of a February 4, 2015, Committee hearing. The calls focused on the illegal or improper use of an older adult’s funds, property, or assets. Chairman Susan M. Collins, former Ranking Member Claire McCaskill, and current Ranking Member Robert P. Casey Jr. have introduced the Senior $afe Act, which would allow trained financial services employees to report suspected cases of financial exploitation to the proper authorities without concern that they would be sued for doing so. The Committee also examined the financial abuse of guardians and other court appointed fiduciaries at a hearing in November 2016.

Identify theft was the ninth most reported consumer complaint to the Fraud Hotline in 2017. This wide-ranging category includes calls about actual theft of a wallet or mail, online impersonation, or other illegal efforts to obtain a person’s identifiable information. On October 7, 2015, the Aging Committee held a hearing titled “Ringing Off the Hook: Examining the Proliferation of Unwanted Calls”, to assess the federal government’s progress in complying with a new law requiring the removal of seniors’ Social Security numbers from their Medicare cards, which will help prevent identity theft. Medicare will start mailing the new cards in April 2018.

            Government grant scams rounded out the top 10 scams to the Fraud Hotline last year. In these scams, thieves call victims and pretend to be from a fictitious “Government Grants Department.” The con artists then tell the victims that they must pay a fee before receiving the grant.

The report is available here.

From January 1, 2017, through December 31, 2017, the Senate Aging Committee’s Fraud Hotline received a total of 1,463 complaints from residents all across the country. Calls pertaining to the top 10 scams featured in this report accounted for more than 75 percent of the complaints.

                The top complaint, the focus of more than twice as many calls as any other scam, involves seniors who receive calls from fraudsters posing as agents of the Internal Revenue Service (IRS). These criminals falsely accuse seniors of owing back taxes and penalties in order to scam them. Due to the extremely high call volume and continued reports from constituents from across the country, the Aging Committee held a hearing on April 15, 2015, to investigate and raise awareness about the IRS imposter scam. Prior to a large law enforcement crackdown in October 2016, nearly three out of four calls to our Hotline involved the IRS impersonation scam. In the three months after the arrests, reports of the scam into the Committee’s hotline dropped by an incredible 94 percent. Though the numbers have since rebounded somewhat, they are still far below the levels we have seen in the past.

                The second most common scam reported to the Hotline involved robocalls or unwanted telephone calls. On June 10, 2015, the Aging Committee held a hearing on the increase in these calls that are made despite the national Do-Not-Call Registry. The Committee examined how the rise of new technology has made it easier for scammers to contact and deceive consumers and has rendered the Do-Not-Call registry ineffective in many ways. On October 4, 2017, the Aging Committee held an additional hearing on robocalls, this time examining recent developments by both the private and public sectors to combat robocalls and protect seniors from fraud.

Sweepstakes scams, such as the Jamaican lottery scam, continue to be a problem for seniors, placing third on the list. A March 13, 2013, Aging Committee hearing and investigation helped bring attention to these scams and put pressure on the Jamaican government to pass laws cracking down on criminals who convinced unwitting American victims that they had been winners of the Jamaican lottery. The United States government has had some recent success in bringing individuals connected to the Jamaican lottery scam to trial, but these types of scams continue to plague seniors.

A new scam to make the top 10 list for 2017 involves consumers receiving calls in which the caller would simply ask “Are you there?” or “Can you hear me?” in order to prompt the recipient to say “yes.” According to the Federal Trade Commission (FTC), these illegal robocalls are pre-recorded, and are

designed to identify numbers that consumers are likely to answer, allowing scammers to better identify and connect with potential victims. The increased use of this tactic by scammers in robocalls last year demonstrates how sophisticated scammers are.

Grandparent scams, the focus of a July 16, 2014, Aging Committee hearing, were next on the list. In these scams, fraudsters call a senior pretending to be a family member, often a grandchild, and claim to be in urgent need or money to cover an emergency, medical care, or a legal problem.

Computer scams were sixth on the list and the subject of an October 21, 2015, Committee hearing. Although there are many variations of computer scams, fraudsters typically claim to represent a well-known technology company and attempt to convince victims to provide them with access to their computers. Scammers often demand that victims pay for bogus tech support services through a wire transfer, or, worse yet, obtain victims’ passwords and gain access to financial accounts.

Romance scams were seventh on the list. These calls are from scammers who typically create a fake online dating profile to attract victims. Once a scammer has gained a victim’s trust over weeks, months, or even years – the scammer requests money to pay for an unexpected bill, an emergency, or another alleged expense or to come visit the victim – a trip that will never occur.

Elder financial abuse was eighth on the list and the topic of a February 4, 2015, Committee hearing. The calls focused on the illegal or improper use of an older adult’s funds, property, or assets. Chairman Susan M. Collins, former Ranking Member Claire McCaskill, and current Ranking Member Robert P. Casey Jr. have introduced the Senior $afe Act, which would allow trained financial services employees to report suspected cases of financial exploitation to the proper authorities without concern that they would be sued for doing so. The Committee also examined the financial abuse of guardians and other court appointed fiduciaries at a hearing in November 2016.

Identify theft was the ninth most reported consumer complaint to the Fraud Hotline in 2017. This wide-ranging category includes calls about actual theft of a wallet or mail, online impersonation, or other illegal efforts to obtain a person’s identifiable information. On October 7, 2015, the Aging Committee held a hearing titled “Ringing Off the Hook: Examining the Proliferation of Unwanted Calls”, to assess the federal government’s progress in complying with a new law requiring the removal of seniors’ Social Security numbers from their Medicare cards, which will help prevent identity theft. Medicare will start mailing the new cards in April 2018.

            Government grant scams rounded out the top 10 scams to the Fraud Hotline last year. In these scams, thieves call victims and pretend to be from a fictitious “Government Grants Department.” The con artists then tell the victims that they must pay a fee before receiving the grant.

rant.

TThe 60 page report is available here.

March 20, 2018 in Books, Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, State Cases, State Statutes/Regulations | Permalink

Monday, March 19, 2018

Med Students Learn to Talk About Dying

Kaiser Health News featured a story about teaching med students how to talk about death to patients and families. Oregon Medical Students Face Tough Test: Talking About Dying features a test administered to med students in Oregon. " OHSU officials say they’re the first medical students in the U.S. required to pass a tough new test in compassionate communication."

Compassionate communication test requires that the med students "[b]y graduation this spring ... be able to show that, in addition to clinical skills, they know how to admit a medical mistake, deliver a death notice and communicate effectively about other emotionally and ethically fraught issues."  The curriculum was revamped to incorporate "communication, ethics and professionalism" throughout.   Communication is required learning in all medical schools but the OSHU approach may be groundbreaking with the evaluation component.  

March 19, 2018 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Ethical Issues, Health Care/Long Term Care | Permalink | Comments (0)

Sunday, March 18, 2018

No Right To Try Law Yet

Two weeks ago we reported that the House of Representatives were scheduled to vote on the Right to Try Bill that had previously passed the Senate.  If you were betting that the House would also pass the bill, you would be .... wrongHouse Rejects Bill to Give Patients a ‘Right to Try’ Experimental Drugs explains the vote wasn't particularly close.  "The bill was considered under special fast-track procedures that required a two-thirds majority for passage, and it fell short. When the roll was called, 259 House members supported the bill, and 140 opposed it." Those that voted against the bill, the majority Democrats, were worried about patient harms, whether creating false hope or harming patients since the drugs wouldn't have gone through the rigorous FDA process. The article quotes one of the House leadership that the bill will be brought back for another vote, but even so there is no guarantee of passage. There are a number of opponents to the bill, including medical personnel and patient advocaates.  "[M]ore than 75 patient advocacy groups, including the lobbying arm of the American Cancer Society, opposed the bill. .. The American Medical Association said it “does not believe that the bill will substantially improve patient access to investigational therapies.” And the American Society of Clinical Oncology, representing cancer doctors, said the bill “could do more harm than good for patients with life-threatening illnesses” because it would remove the Food and Drug Administration from the evaluation of the risks and potential benefits of some treatments."

A House Committee will address the bill on March 19, according to a March 16, 2018 post from Bloomberg BNA Health Care Daily report so stay tuned.

March 18, 2018 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care | Permalink | Comments (0)

Thursday, March 15, 2018

Who Doesn't Want to Live in Margaritaville?

Margaritaville, at least the Jimmy Buffett version, is no longer a state of mind. The Washington Post ran a story about Jimmy Buffett's foray into senior housing. Adopting a laid-back attitude at Latitude Margaritaville  explains that the "Key West-inspired houses are being built along streets linked to lyrics of Buffett’s 1977 hit 'Margaritaville.'" Continuing the them, the pet spa is "Barkaritaville" and the fitness center is "Fins up!" Guess what's on the menu at the local restaurant? If you guessed "Cheeseburger in Paradise" you'd be right! And as the article makes clear,  Buffett is a significant business entrepreneur.

How's this for fun in a 55+ community. "[O]ne element of Latitude Margaritaville that makes it unusual for an active-adult community: Live music shows will be scheduled five to seven nights a week."  But why a 55+ community for Jimmy Buffett? "he decision to expand the Margaritaville brand into active-adult communities seems like a natural fit, particularly because Buffett’s fans tend to be aging baby boomers who have followed his career for decades."  And fans have come-with over 100,000 requesting information about the planned community.  The homes are selling like hot cakes (or maybe sponge cake would be better to say) with over 225 selling within two months. However, there's a ways to go to full occupancy once the 2 developments of 7,000 are finished over the next decade. The community is around 10 miles away from Daytona  Beach and close to hospitals and other services.  Many other amenities are planned, and of course, there is always the chance that Jimmy Buffett might perform!

Who would want to pass up the chance to live on Spongecake Court?  Come on-admit it, that song is going through your head now....

March 15, 2018 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Other, Retirement | Permalink | Comments (0)

Wednesday, March 14, 2018

Dementia-Friendly City in Heart of Silicon Valley

Somehow I never thought I'd right that phrase. Yet, Palo Alto is taking steps to become a dementia-friendly city! Palo Alto looks to become a 'dementia-friendly city' explains that

Palo Alto is among a growing number of communities around the world that have begun to look at how government, businesses and residents can work together to provide better resources — like training for first responders, community support networks and policies that better aid employees who are also caregivers — for the expanding population of aging adults who are being diagnosed with dementia.

Palo Alton has a little more than 30,000 residents now who have dementia (including Alzheimer's) and it is estimated that that number will exceed 50,000 by 2030. "As part of its broader push for an "age-friendly Silicon Valley," Santa Clara County last year joined Dementia Friends, a global movement begun by the Alzheimer's Society in the United Kingdom to change the way people think about dementia."

A public hearing on this is scheduled for late March.  Thanks to my colleague and dear friend Mark Bauer for alerting me to this article.

 

March 14, 2018 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Other | Permalink | Comments (0)

Tuesday, March 13, 2018

Expanding the Right to Physician-Aided Dying?

The Washington Post recently ran an article about efforts underway by some folks to expand Oregon's physician-aided dying law to include those individuals who do not have terminal illnesses. In Oregon, pushing to give patients with degenerative diseases the right to die explains efforts to expand the scope of Oregon's law to cover those with degenerative diseases, such as "[p]eople with Alzheimer’s, Parkinson’s, Huntington’s, multiple sclerosis and a host of other degenerative diseases [who] are generally excluded from the Oregon law." Why? you might ask. "[B]ecause some degenerative diseases aren’t fatal. People die with Parkinson’s, for example, not because of it. Other diseases, such as advanced Alzheimer’s, rob people of the cognition they need to legally request the suicide medications."

The article notes that this effort isn't limited to just Oregon. In fact, there are "[r]elatively modest drives ... afoot in Washington state and California, where organizations have launched education campaigns on how people can fill out instructions for future caregivers to withhold food and drink, thereby carrying out an option that is legal to anybody: death by starvation and dehydration. (It is often referred to as the “voluntarily stopping eating and drinking” method.)"

Interestingly, the article reports that not all in the right to die movement are in favor of broadening the law.  In fact "groups such as Compassion & Choices, the nation’s largest right-to-die organization, and the Death With Dignity National Center, a main author of the original law, have little appetite for widening access to lethal drugs in the states where medically assisted suicide already is legal."

These initiatives aren't just limited to the U.S. The story reports in Canada The Quebec "provincial government is studying the possibility of legalizing euthanasia for Alzheimer’s patients. Unlike medically assisted suicide, a medical doctor would administer the fatal dose via injection. A survey in September found that 91 percent of the Canadian province’s medical caregivers support the idea."

The Oregon legislature has taken the first step,  the passage last month of legislation to investigate "how to improve the process of creating and carrying out advance directives. Gov. Kate Brown (D) is expected to sign it."

The article also reminds us of the Harris case where Mrs. Harris, with an advance directive, was spoon fed by the facility where she resided.  There have been a number of folks requesting language added to their advance directives to avoid the spoon-feeding issue according to the attorney for Mr. Harris.

March 13, 2018 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, State Statutes/Regulations | Permalink | Comments (1)

House to Vote on Right To Try Bill

We have previously blogged about right to try laws and the bill making its way through Congress. The House of Representatives is scheduled to vote on the bill today according to the March 12, 2018 Bloomberg's Health Care Daily Report (subscription required). The Report explains

The bill set to be voted on in the House narrowed the Senate-passed version’s definition of who could seek unapproved drugs to “strike the right balance for patients and their safety,” Reps. Greg Walden (R-Ore.), chairman of the House Energy and Commerce Committee, and Michael Burgess (R-Texas), head of the panel’s health subcommittee, said in a joint statement.

If passed, the Senate will have to vote again on the measure or, less likely, form a conference committee to work out the differences, according to a statement from House Majority Leader Rep. Kevin McCarthy (R-Calif.).

I'll report back once we know more.

March 13, 2018 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care | Permalink | Comments (0)

Technologies to Connect & Age in Place

There are amazing technologies out there, and I'm sure more are being invented as I write this.  Kaiser Health News ran a story about technology designed to allow elders to age in place and to satay connected. New Technologies Help Seniors Age In Place — And Not Feel Alone opens by relating a story of  one elder who agreed to the use of a long-distance monitoring system so her son across the country could keep track of her well-being. "For many, the technology offers not just the tools they need to continue to live at home, but newfound confidence and connectedness with faraway family and friends."  One expert quoted in the article has named this trend as "'monitored independence,' and it is changing how older generations age in America. 'People want to be autonomous, irrespective of age,'" said this expert.  The article notes that voice-assisted technologies are goign to play a large role in helping elders age in place as these devices can do a lot more than just play music. Pair those with apps designed to help elders and will become proactive in interactions rather than reactive. The article offers a forthcoming app as an example where it will ask the elder if the elder has remembered to take her medication. There are currently apps that remind the user to take medication and allows the user to designate a second party to get an alert if the user misses a dose of medication.

More fall detection devices are coming our way as well, some very soon and others before too long.

It's interesting to see tech moving into this market and hopefully more will be done to help us live independently longer.  Is anyone thinking about the privacy aspects of using all this tech?

March 13, 2018 in Consumer Information, Current Affairs, Health Care/Long Term Care, Other, Web/Tech | Permalink | Comments (1)

Friday, March 9, 2018

Law and the 100 Year Life-Lecture at Illinois Law

The U. of Illinois College of Law will be holding the Ann F. Baum Memorial Elder Law Lecture on March 12 from noon-1. Professor Anne Alstott of Yale will speak on Law and the 100-Year Life.  Here's a bit of info about the lecture. "Children born in the United States today are projected to live to 100 years, on average. How should we think about adjusting elder law in light of the social and economic changes that will result?"

March 9, 2018 in Consumer Information, Current Affairs, Ethical Issues, Health Care/Long Term Care, Other, Programs/CLEs | Permalink | Comments (0)

Thursday, March 8, 2018

Young Blood for Anti-Aging?

The subject of this story caught me off guard, having not contemplated it.  Stat ran the story, How a society gala was used to sell young-blood transfusions to baby boomers desperate to cheat death.

The story focuses on a luncheon event in south Florida where audience members were pitched on "[p]aying to participate in a soon-to-launch clinical trial testing transfusions of young blood [which] “offers the greatest potential for everyone in this room to add a lot of healthy years to their life... 'Not only do you get to potentially live longer … but you’re going to be healthier. And some of the chronic problems you have now may disappear.'”  Stat had a number of medical experts review the materials for the clinical trial "and all sharply criticized the study’s marketing, design, and scientific rationale."  Although the final price has yet to be determined, one suggested cost for the treatment was over a quarter of a million dollars.

The article discusses what is involved in clinical trials, other trials with similar goals and general reactions to the proposal.  It is a fascinating article.  It can be used as a jumping off point for a discussion about ageism.

 

 

March 8, 2018 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care | Permalink | Comments (0)

Wednesday, March 7, 2018

Family Fights Over Care for Mom:Subject of Academy Award

We all know that family dynamics are not always the most pleasant and can lead to strife, stress and litigation. Kaiser Health News ran a recent story that details a conflict within a family. A Tale of Love, Family Conflict And Battles Over Care For An Aging Mother focuses on the story “'Edith + Eddie,' a short documentary vying for an Academy Award Sunday,[which] is a gripping look at a couple in their 90s caught up in an intense family conflict over caring for an aging parent." The short film starts a few months after the couples' marriage and ends (spoiler alert) "months later with the couple being separated by Edith’s court-appointed legal guardian, with police on the scene, and Edith taken off abruptly to Florida. Shockingly, Eddie died only a few weeks later." Interwoven with the love story are allegations within Edith's family of fighting siblings, guardianship and financial concerns.

The movie is focused on the love story. The columnist took a broader approach, diving into the family dynamics, finding "[t]hree daughters in distress over the care of an aged mother and roiled by disputes played out in courtrooms among far-flung siblings." Eventually two of the three daughters were named co-guardians , but even so, the road was bumpy; "the sisters for years had bickered over what was best for their mother."  The marriage occurred after the guardianship was established, so the question of the validity of the marriage was also at play here.  The co-guardians didn't work well together. One wouldn't consult the other and moved her mother frequently without telling the other family members of the mother's location. Finally a non-relative guardian was appointed, but even she wasn't able too keep track of the mother's location.  The guardian wanted Edith to go to Florida for a bit so the guardian could find an appropriate ALF for her.  After more hurdles, Edith finally went to Florida where her health slowly began to improve.

The story ends with this "Edith passed away last March of natural causes at the age of 98, after living with her daughter in Florida through the end of her life. She never went to an institution. Her home wasn’t sold until after her death; there was no attempt to plunder her estate by lawyers or family members. That’s the other story of Edith+Eddie."

Watch the film. Read the article.  Lots of class discussion could come out of this.

March 7, 2018 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Film, Health Care/Long Term Care | Permalink | Comments (0)

Tuesday, March 6, 2018

Florida Moves Forward on Backup Generator Requirements for Nursing Homes

With little time left in the 2018 legislative session, will the legislature pass a rule requiring nursing homes to have emergency generator back up?  According to Health News Florida, Rules For Backup Power For Nursing Homes Go To Florida House. The bill "would require facilities to have a generator capable of keeping facilities at 81 degrees or lower for at least four days. It also requires them to keep 72 hours of fuel on site." According to the article, ALFs are not included in the requirement. Assuming approval then Florida's "577 nursing homes in Florida must be in compliance by July 1, but as of Jan. 8, 108 were already in compliance. AHCA can grant an extension until Jan. 1, 2019, for nursing homes that would face delays in installing equipment."  Stay tuned-we will know in a matter of days.

March 6, 2018 in Consumer Information, Current Affairs, Health Care/Long Term Care, State Statutes/Regulations | Permalink | Comments (0)

Monday, March 5, 2018

News Feature Focuses on Court-Appointed Guardian in Pennsylvania, Raising Important Systemic Questions

From Nicole Brambila, an investigative journalist for the Reading [Pennsylvania] Eagle, comes an article examining the history of a specific individual appointed by courts to serve as a guardian in multiple cases, in different counties in Pennsylvania.  The article raises important questions about court oversight, including but not limited to whether there should be mandatory criminal background checks for those serving as court-appointed fiduciaries:  

If [an elderly couple in Montgomery County, Pennsylvania] were astonished to learn the court-appointed guardian [for the 79-year-old husband] had not been paying the mortgage and other bills, their surprise would pale in comparison to the revelations yet to come.  Unbeknownst to them, Byars [the guardian in question] had been convicted multiple times of financial theft.

 

Her most recent arrest came in 2005.  She pleaded guilty to felony fraud and was sentenced to 37 months in a federal prison after cashing $20,000 in blank checks [she] found while rummaging through trash cans at a Virginia post office. 

The article points to another case in Philadelphia Orphans Court, where an attorney representing family members of a different person alleged to be in need of a guardian, looked into the background of Byars, and discovered records detailing her history.  The attorney was successful in having her removed as the court-appointed guardian in that case.  The Reading Eagle reporter writes:

For six months she continued serving as guardian to 52 incapacitated Philadelphians. No other Philadelphia judge removed her until after the Reading Eagle made dozens of inquiries in January with the court, Adult Protective Services, the Pennsylvania Department of Aging and state lawmakers about her appointments. . . . 

 

Philadelphia Orphans Court works with more than a dozen professional guardians. Ten of these, including Byars, carry some of the highest caseloads: 22, 48, 54 and more. But none more than Byars, who was appointed in Philadelphia alone 75 times from 2014 through 2016, according to court dockets.

For more, read Unguarded: Montgomery County Couple's Trust Betrayed, published March 4, 2018 in the Reading Eagle [paywall protected, although there is a $1 fee for single day access].  

 

March 5, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (1)

Surgery Late in Life?

Kaiser Health News ran the story, Never Too Late To Operate? Surgery Near End Of Life Is Common, Costly that opens with this startling statistic: "Nearly 1 in 3 Medicare patients undergo an operation in their final year of life." Several paragraphs into the story the quote is repeated, but with this additional information: "[n]early 1 in 3 Medicare patients undergo an operation in the year before they die, even though the evidence shows that many are more likely to be harmed than to benefit from it."

So why does this happen? According to the article, there are financial incentives plus we are dealing with a "medical culture" where "patients and doctors are reluctant to talk about how surgical interventions should be prescribed more judiciously.... "  The article discusses several surveys regarding surgeries in the older population with the benefits and burdens from such surgeries.  As well, there are significant implications for elders undergoing surgery, including longer recovery time and less tolerance with anesthesia.

Thinking through medical treatment options takes time. One tool being developed by "[m]any hospitals and health systems is ... “decision aids,” easy-to-understand written materials and videos to help patients make more informed medical decisions, giving them time to develop more realistic expectations." Another approach discussed in the article is a move away from the use of statistics and instead have the focus on narratives where the "doctors should lay out the best, worst and most likely outcomes."  If the best cases scenario resulting from the medical intervention isn't something that the patient finds acceptable, then that's a big indicator that the patient should not undergo the medical intervention.

Interesting ideas!

March 5, 2018 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare | Permalink | Comments (0)

Wednesday, February 28, 2018

Conversations on Living with Dementia

Kaiser Health Network offered this moderated discussion with 5 panelists, Conversation On Living Well With Dementia.

On Feb. 13, Kaiser Health News hosted an informative and important discussion about improving care and services for people with dementia and supporting their caregivers. It was opportunity to learn from experts in the field about the challenges and difficulties facing the patient, the caregiver, the community and policymakers. Topics included understanding the stages of dementia from a medical, social, psychological and environmental perspective (it’s not just memory loss); how to find help; how to manage difficult behaviors; and understanding medications for people with dementia.

The 90 minute discussion can be viewed by clicking here.

February 28, 2018 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Programs/CLEs, Webinars | Permalink | Comments (0)

Tuesday, February 27, 2018

Medicare Good News...and not... out of the Bipartisan Budget Act of 2018

As part of the Bipartisan Budget Act of 2018,  signed into law earlier in February, Medicare's therapy caps were repealed!  As explained by Justice in Aging in a recent fact sheet, ""[t]he law permanently repeals the payment cap on outpatient physical, occupational, and speech therapies effective January 1, 2018, and makes changes to the medical necessity review process for these services." As well, the law closes the donut hole one year earlier, "at which time beneficiaries will be required to contribute 25% to the cost of prescription drugs. This provision does not affect coverage for beneficiaries who receive the Part D low-income subsidy known as “Extra Help,” since they already don’t experience the donut hole."

Then there is the change to Home Health Care, starting in 2020, where "[t]he home health payment episode will be reduced from 60 days to 30 days and therapy thresholds will be eliminated. Beginning in 2019, Medicare will be allowed to base eligibility determinations for home health services on a review of the patient’s medical record including a home health agency’s record beginning in 2019."  As well, the Part B and D premiums for higher income beneficiaries will go up starting in 2019.

To read the entire fact sheet, click here.

 

February 27, 2018 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare | Permalink