Tuesday, May 3, 2016

Chronically Critically Ill and Stable

The New York Times ran an article by a doctor, When the Patient Won’t Ever Get Better, which illustrates a difficult scenario for patients and families.  A patient, doing well, is hospitalized for some condition, surgery may occur and although successful, subsequently the patient develops one health problem after another, and will never recover to her condition prior to the hospitalization.  Detailing the ups and downs of one patient, the doctor describes the patient "[a]nd then, things stopped getting better. Time slowed. There she was – neither dead nor truly alive – stuck, it seemed, in limbo."  The patient declined again, more infections, use of a ventilator, etc. and then "[w]ith ... [the] constellation of ventilation dependence, infections and delirium, she had what doctors call 'chronic critical illness.'”

According to the author, this isn't that unusual a story.

[T]here are about 100,000 chronically critically ill patients in the United States at any one time, and with an aging population and improving medical technologies, this number is only expected to grow. The outcomes of these patients are staggeringly poor. Half of the chronically critically ill will die within a year, and only around 10 percent will ever return to independent life at home.

We can all imagine the scenario where our parent has a health crisis and all we want to know is whether she survived and is she "stable."  After time passes, we learn that she is stable, but is chronically critically ill and won't improve.  Here's how the author describes the situation

In the early moments of critical illness, the choices seem relatively simple, the stakes high – you live or you die. But the chronically critically ill inhabit a kind of in-between purgatory state, all uncertainty and lingering. How do we explain this to families just as they breathe a sigh of relief that their loved one hasn’t died? Should we use the words “chronic critical illness”? Would it change any decisions if we were to do so? .... 

Perhaps this reality would be a good situation to use to discuss with our students whether they can draft language in an advance directive to deal with these situations.

May 3, 2016 in Advance Directives/End-of-Life, Cognitive Impairment, Current Affairs, Health Care/Long Term Care | Permalink | Comments (0)

Sunday, May 1, 2016

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

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

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

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

 

 

 

 

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

Friday, April 29, 2016

Is Nursing Home Operator Entitled to Bar Plaintiff Firm's Use of Finger-Pointing Ads?

It seems nursing home operators are calling upon some of the same "trade practice" laws they are sometimes accused of violating, in an effort to thwart what the operators see as misleading advertising by personal injury attorneys.  

One of the latest suits has reached the Georgia Supreme court, where the Mississippi-based law firm of McHugh Fuller Group is seeking to overturn a lower court's injunction preventing it from running a statewide ad campaign, including full-page color ads, seeking potential clients who "suspect that a loved one was NEGLECTED or ABUSED" by a nursing home run by PruittHealth, Inc.  From an April 27, 2016  Georgia Courts' summary of parties' arguments before the high court

PruittHealth sued the law firm under the Georgia Deceptive Trade Practices Act, which authorizes a court to issue an injunction (a court order requiring a certain action be halted) against anyone who uses someone’s trade name without permission if there is even a “likelihood” that the use will injure the business reputation of the owner or dilute its trade name or mark. The trial court entered a temporary restraining order against the law group, scheduled a hearing and notified the parties that it intended to consider PruittHealth’s request for a permanent injunction. The trial court issued another order on June 1, 2015, permanently stopping the law group from running ads that used PruittHealth’s trade names, service marks, or other trade styles. The law group filed a motion for reconsideration, which the trial court denied. The law firm is now appealing to the Georgia Supreme Court....

 

The law group argues, among other things, that the court erred in determining the ads violated Georgia Code section 10-1-451(b), which is called Georgia’s “antidilution statute.” That statute says dilution occurs “where the use of the trademark by the subsequent user will lessen the uniqueness of the prior user’s mark with the possible future result that a strong mark may become a weak mark.” The law firm argues that it is not eroding the strength of PruittHealth’s mark, but is only identifying specific nursing homes against which it is accepting cases, and that PruittHealth failed to demonstrate that actual injury occurred as a result of the ads.

This isn't the first time that the McHugh Fuller Law Group has been on the receiving end of a lawsuit by a nursing home company.  In February 2015, Heartland of Portsmouth in Ohio and McHugh Fuller Law Group were in federal court arguing about diversity jurisdiction over Heartland's claim the law firm was using "false and misleading advertising in order to encourage tort litigation" against the nursing home's operations in Ohio.  Similar litigation, seeking injunctive relief, was underway by Genesis Healthcare Corporation against the McHugh Fuller firm in West Virginia in 2007, although it is unclear from my research whether either of those cases reached a final resolutions.  

My thanks to Professor Laurel Terry, Dickinson Law, for pointing me to this ABA Journal post that encouraged my search for more about these cases.

April 29, 2016 in Current Affairs, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Cases, Health Care/Long Term Care, Legal Practice/Practice Management | Permalink | Comments (0)

Thursday, April 28, 2016

A Greener Death

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

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

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

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

 

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

Wednesday, April 27, 2016

Physician-Aided Death Legislation and the Impact on the Medical Profession

JAMA's Journal of Internal Medicine ran an article in the April issue, The Challenge of New Legislation on Physician-Assisted Death .  From the legal profession, we know how these laws work. But from the medical profession, according to the article, doctors need to think about how to incorporate this into their practices.   Here is a sample of the article:

By the end of 2016, more than 80 million people in the United States and Canada will live in a jurisdiction allowing physician-assisted death. As such, this practice can no longer be considered a quirky experiment in a few states. The North American experience with physician-assisted death began in 1994, when voters in Oregon approved a ballot measure, the Death With Dignity Act, allowing a physician to prescribe a lethal dose of a medication that a patient voluntarily self-administers. Oregon stood alone for 14 years until Washington (2008), Vermont (2013), and now California (2015) approved similar laws. As of January 2016, the effective date of the California law, known as the End of Life Option Act, is uncertain. These laws are in general very similar, with safeguards that include requirements for a waiting period and that eligible patients be mentally competent, not mentally ill, and have a life expectancy of less than 6 months. In 2009, the Montana Supreme Court removed prohibitions against physician-assisted death for competent patients. There are no reporting requirements in Montana, so little is known about the actual practice of physician-assisted death in that state. In 2015, the Canadian Supreme Court unanimously reversed a federal law that prohibited physician-assisted death and gave the government until June 2016 to establish mechanisms for access to such assistance. (citations omitted)

A subscription is required to read the entire article.

April 27, 2016 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Health Care/Long Term Care, State Statutes/Regulations | Permalink | Comments (0)

Tuesday, April 26, 2016

Dangers of Polypharmacy

In Elder Law world we know the dangers that may occur with taking multiple medications. The New York Times ran an article last week that focused on the topic; The Dangers of ‘Polypharmacy,’ the Ever-Mounting Pile of Pills.  "Geriatricians and researchers have warned for years about the potential hazards of polypharmacy, usually defined as taking five or more drugs concurrently. Yet it continues to rise in all age groups, reaching disturbingly high levels among older adults."

When your doctor asks you what medications you take, do you include vitamins and supplements in your answer? Many don't, according to the article, referencing a study in the Journal of American Medical Association's Journal of Internal Medicine, "A recent study in JAMA Internal Medicine, however, found that more than 42 percent of adults didn’t tell their primary care doctors about their most commonly used complementary and alternative medicines, including a quarter of those who relied most on herbs and supplements."

How many people take multiple medications?  "More than a third were taking at least five prescription medications, and almost two-thirds were using dietary supplements, including herbs and vitamins. Nearly 40 percent took over-the-counter drugs."

Don't we all take supplements and vitamins? Although there is no age-specific time when folks start doing so, there is a difference in the impact based on age.

Though drug interactions can occur in any age group, older people are more vulnerable, said Dr. Michael A. Steinman, a geriatrician at the University of California, San Francisco, who wrote an accompanying commentary. ..Most have multiple chronic diseases, so they take more drugs, putting them at higher risk for threatening interactions...The consequences can also be more threatening.

The article suggests the need to revamp our health care system so it's not fragmented and until then, ask doctors and pharmacists about medications, and include vitamins and supplements in your list of medications.

The article about the study is available here.

April 26, 2016 in Consumer Information, Current Affairs, Health Care/Long Term Care | Permalink | Comments (0)

Monday, April 25, 2016

Kudos to the Chief Justice

Last week 12 lawyers who are deaf or hard of hearing were sworn into the Supreme Court Bar.  That in and of itself is very special. It was made more so by the actions of Chief Justice Roberts.  Chief Justice Roberts learned some sign language for the occasion; "[a]fter they were presented to the court for admission, Roberts signed in American Sign Language: 'Your motion is granted.'”  Well done Chief Justice.

April 25, 2016 in Consumer Information, Current Affairs, Federal Cases, Legal Practice/Practice Management, Other | Permalink | Comments (0)

Sunday, April 24, 2016

Know Any 100 Year Olds? If Not Now, You Will Soon!!

Pew Research Center issued a recent Fact Tank on Centenarians worldwide.  World's Centenarian Population Projected to Grow Eightfold by 2050 explains the number of centenarians is growing rapidly. Check this out: "[t]he world was home to nearly half a million centenarians (people ages 100 and older) in 2015, more than four times as many as in 1990, according to United Nations estimates. And this growth is expected to accelerate: Projections suggest there will be 3.7 million centenarians across the globe in 2050."  We know that the oldest-old have been the fastest growing for some time, so it makes sense that the number of centenarians is growing as well.  The report discusses the difficulty in verification of ages for this group for various reasons.

Who has the most centenarians?  "[T]he available data suggest that the U.S. leads the world in terms of the sheer number of centenarians, followed by Japan, China, India and Italy." The U.S. population isn't aging as fast as other countries, according to the report, and is "aging at a slower rate than Japan and Italy, partly due to its higher fertility and immigration rates – there are now 2.2 centenarians per 10,000 people."  By 2050, China will have the greatest number of centenarians, and "[t]he centenarian share of the populations of the U.S. ...  will grow less rapidly. There will be 9.7 centenarians per 10,000 people in the U.S. ..."

April 24, 2016 in Consumer Information, Current Affairs, Statistics | Permalink | Comments (0)

Thursday, April 21, 2016

Elders and Social Media

All of us who use social media, raise your hands. Ok, so that is a lot of us.  And social media isn't just the province of the young, even though some of us may be digital immigrants. The New York Times ran a recent article about elders on Facebook. Why Do Older People Love Facebook? Let’s Ask My Dad explains about a recent survey done by Penn State. 

The press release about the study, Sorry kids, seniors want to connect and communicate on Facebook, too explains "[o]lder adults, who are Facebook's fastest growing demographic, are joining the social network to stay connected and make new connections, just like college kids who joined the site decades ago, according to Penn State researchers." The study looks at the reasons why elders would be drawn to use Facebook, including curiosity, keeping in touch with friends, and connecting with family, as well as communicating with those with shared interests, what the authors refer to as social bonding, social bridging and social surveillance.

The authors suggest that the social media designers need to look at making the media more elder-friendly, and "emphasize simple and convenient interface tools to attract older adult users and motivate them to stay on the site longer."  The volume of elder users is growing,  so "[d]evelopers may be interested in creating tools for seniors because that age group is the fastest growing demographic among social media users. In 2013, 27 percent of adults aged 65 and older belonged to a social network, such as Facebook or LinkedIn, according to the researchers. Now, the number is 35 percent and is continuing to show an upward trend."

Returning to the New York Times article, the author asked her dad about his Facebook use; "he wanted to be better at keeping in touch with family and with the friends he remembers from my childhood. He told me over Facebook chat (naturally) that his curiosity about what others were up to was his main motivator in finally learning to navigate Facebook."  The author quotes one of the co-authors of the study: "[a]s Facebook continues to be a bigger part of American life, the ever-growing population of older Americans is figuring out how to adapt. As people grow older, peer communication through chatting, status updates and commenting will become more important ... and Facebook will need to adapt tools that are suited for an aging audience."

April 21, 2016 in Consumer Information, Current Affairs, Statistics, Web/Tech, Weblogs | Permalink | Comments (0)

Wednesday, April 20, 2016

Physician-aided Dying in Canada

Prime Minister Justin Trudeau was the focus of an article in the New York Times last week on physician-aided dying in Canada. Justin Trudeau Seeks to Legalize Assisted Suicide in Canada reports that a proposed law was introduced that would allow physician-aided dying  "for Canadian residents and citizens who have "a “serious and incurable illness,” which has brought them 'enduring physical or psychological suffering.'"

Under Canada’s proposed law, people who have a serious medical condition and want to die will be able to commit suicide with medication provided by their doctors or have a doctor or nurse practitioner administer the dose for them. Family members and friends will be allowed to assist patients with their death, and social workers and pharmacists will be permitted to participate in the process.

The legislation follows a ruling by the Canadian Supreme Court which eliminated a criminal ban on physician-aided dying. A copy of that decision is available here.

One striking difference in the proposed legislation in Canada compared to those states in the U.S. where physician-aided dying is legal is that "a doctor or nurse practitioner [may] administer the dose for them. Family members and friends will be allowed to assist patients with their death, and social workers and pharmacists will be permitted to participate in the process."

Not all in Canada are in favor of the legislation. CBC Canada ran a story,  Religious groups react to physician-assisted dying bill LIVE where a number of groups stated concerns about the legislation.  The video is available here.

If any of our readers are from Canada, we would be very interested in hearing more about the discussion in Canada on this proposal.

April 20, 2016 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Health Care/Long Term Care, International | Permalink | Comments (0)

Tuesday, April 19, 2016

More on Medicare LTC

After my post on an article about adding  a long term care benefit to Medicare, Professor Dick Kaplan (prolific author, elder law guru and friend) sent me an email reminding me about an article he wrote in 2004 that discussed the topic. "Cracking the Conundrum: Toward a Rational Financing of Long-Term Care,” is available from his SSRN page. Here is the abstract  

This article provides a comprehensive solution to the financing of long-term care for older Americans that balances government and family responsibility, while recognizing the different settings in which long-term care is provided. The article begins by examining the spectrum of long-term care in the United States from home health care to assisted living to nursing homes, as well as hybrids such as continuing care retirement communities. Successive sections of the article then analyze the federal government's health care program for older persons (Medicare), the joint state and federal program for poor people of any age (Medicaid), and private long-term care insurance in terms of how these mechanisms treat long-term care in each setting.

Finding serious deficiencies and inconsistencies in all three mechanisms, the article then offers a co-ordinated alternative: expand Medicare to cover long-term care in nursing homes but maintain responsibility for other long-term care settings with the affected individuals and their families. This approach recognizes that nursing home care substitutes for hospital care that Medicare would otherwise cover, while other long-term care settings substitute for family-provided care. Long-term care insurance would then be used as a means of financing long-term care in settings other than nursing homes, thereby making it more appealing. In addition, such insurance would be less expensive than presently, because it would no longer be priced to cover costly nursing home care. The article also recommends that such insurance be improved by standardizing policy options and features into a fixed set of packages that would be uniform among carriers. Other recommendations include ensuring price stability of issued policies and providing independent reviews of gatekeeper claim denials. The article concludes with some observations regarding financing of these proposals.
Professor Kaplan directs the reader to pages 82-88 for more on this topic.
Thanks Dick!

 

April 19, 2016 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare | Permalink | Comments (0)

Monday, April 18, 2016

Safe Banking for Seniors Campaign

The American Bankers Association Foundation has released  resources for banks as part of its "Safe Banking for Seniors" campaign. The introduction explains:

​​Financial abuse against older Americans can take many forms, from illegal debits, to third-party scams and even unauthorized withdrawals by an approved caregiver. And with the share of the U.S. population 60 years and over projected to reach 30 percent by 2025, the opportunities to take advantage of these at-risk bank customers become more prevalent—by the minute. 

Join us in o
ur pledge to empower customers and communities with the facts, tools and best practices they need to bank more securely. Together, we can help eliminate the almost $2.9 billion lost annually to fraud against older Americans. ​​​​​​​​​​​​​​

Registration is required to receive access to the resources page and banks receive resources on the following: prevention of ID theft, choosing a financial caregiver, spotting and evading scams and being a responsible financial caregiver. Consumer resources include information on joint bank accounts and protecting someone from financial exploitation. There are a number of other resources for bankers. as well as a list of participating banks.

April 18, 2016 in Consumer Information, Current Affairs | Permalink | Comments (0)

Sunday, April 17, 2016

Time for Medicare Part LTC?

Periodically we will see observations about whether Medicare should offer a long term care benefit as part of Medicare coverage (would this be Part E or maybe Part LTC?).  It isn't a secret that many often think Medicare has a long term nursing home benefit, confusing what Medicare covers with what Medicaid does. Health Affairs Blog ran a story recently about  Medicare and long term care. Medicare Help At Home offers some sobering data

Nine million community-dwelling Medicare beneficiaries—about one-fifth of all beneficiaries—have serious physical or cognitive limitations and require long-term services and supports (LTSS) that are not covered by Medicare. Nearly all have chronic conditions that require ongoing medical attention, including three-fourths who have three or more chronic conditions and are high-need, high-risk users of Medicare covered services.

Gaps in Medicare coverage and the lack of integration of medical care and LTSS have serious consequences. Beneficiaries are exposed to potentially high out-of-pocket expenses. Medicaid covers LTSS for very low-income Medicare beneficiaries, but only one-fourth of Medicare beneficiaries with serious physical or cognitive limitations are covered by Medicaid.

The authors offer a 3-part proposal that would expand Medicare coverage to include home and community-based coverages:

  1. A Medicare home and community-based benefit for those with two or more functional limitations, Alzheimer’s, or severe cognitive impairment, according to an individualized care plan based on beneficiary goals. This would cover up to 20 hours a week of personal service worker care or equivalent dollar amount for a range of home and community-based LTSS.
  2. Creation of new Integrated Care Organizations (ICOs) accountable for the delivery and coordination of both medical care and LTSS that meet quality standards, honor beneficiary preferences, and support care partners.
  3. Innovative models of health care delivery including a team approach to care in the home building on promising models of service delivery that improve patient outcomes, reduce emergency department use, prevent avoidable hospitalization, and delay or reduce long-term institutional care.

The article goes on to explain eligibility, beneficiary cost-sharing, financing, care delivery and coverage. The article concludes, offering that with the Baby Boomers " the Medicare program ... was not designed to support their [boomers] preferences for independent living and functioning.

Moving forward, adoption of a home and community based benefit in Medicare would constitute an important first step to helping beneficiaries afford the services and support they need to continue living independently. Adoption of innovative models of care emphasizing care at home or in independent living settings would reduce the difficulty and risk of obtaining services in traditional health care settings such as physician offices and hospitals. It would also reduce beneficiary reliance on Medicaid’s safety-net coverage of institutional care. It is a policy proposal worthy of serious consideration as the nation grapples with Medicare redesign to meet the needs of an aging population.

 

 

 

April 17, 2016 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare | Permalink | Comments (2)

Friday, April 15, 2016

What's the Connection Between "Living Wills" for Banks vs Humans?

Lately, I've been hearing and seeing the phrase "living wills" in mainstream news sources such as the New York Times, but at first the context was confusing to me because the media were speaking and writing about Big Banks, not humans. So, how did it come about that following the 2008 financial crisis, regulators started requiring large financial institutions to have "living wills?"

The Wall Street Journal explains in What You Need to Know About Living Wills [in the context of Big Banks]:

A living will is a document from a financial firm that describes how it would go through bankruptcy without causing a broader economic panic or needing a bailout from taxpayers. The largest U.S. banks have filed several versions of them since the 2010 Dodd-Frank law, which ​required living wills from financial firms ​that were judged to pose a potential risk to the broader economy. The documents are also known as resolution plans. “Resolution” is regulatory parlance for dealing with a failing financial firm.  Living wills are separate from other regulatory requirements, such as annual “stress tests” that measure whether could banks survive a severe recession.

I've not yet determined who first came up with "living wills" to describe what Dodd-Frank, at 12 U.S.C. Section 5361(d), refers to as "resolution plans." Without accurate, full disclosure, addressing all aspects of the financial institution's operations, such plans -- by any name -- seem unlikely to achieve the goal of greater market stability.  As another WSJ writer points out, the utility of Big Banks' living wills comes if not just regulators, but the Bank executives, are paying attention:

The point of the living wills, like the stress tests, is to sit banks down and make them comb through their businesses in excruciating detail, with a focus on grim aspects like liquidity crunches and operational risks in bankruptcy. A useful result of the living wills is that, if they're done correctly, they give regulators a good overall picture of how a bank works, how money flows between its parts, what its pressure points are, and how it responds to crisis. But a much more important result is that, if they're done correctly, they give bankers themselves that same overall picture: They force a bank's executives and directors to understand the workings of the bank in a detailed and comprehensive way. And if they're done incorrectly, that's useful too: They let the regulators and bankers know what they don't know.   

The full article on this point is titled, with nice irony, Living Wills Make Banks Think About Death.  There, a least, is one similarity in living wills for humans and banks.  

April 15, 2016 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Estates and Trusts, Ethical Issues, Federal Cases | Permalink | Comments (2)

Multigenerational Housing-The Hot New Thing!

The New York Times ran a story recently about a new trend in housing for elders---multigenerational homes.  Multigenerational Homes That Fit Just Right are homes that, as the name implies, are designed for multiple generations of a family that live in the same house.  "[A] growing number of families ... are seeking specially designed homes that can accommodate aging parents, grown children and even boomerang children under the same roof. The number of Americans living in multigenerational households — defined, generally, as homes with more than one adult generation — rose to 56.8 million in 2012, or about 18.1 percent of the total population, from 46.6 million, or 15.5 percent of the population in 2007, according to the latest data from Pew Research. By comparison, an estimated 28 million, or 12 percent, lived in such households in 1980."

But how does one accommodate family dynamics when living together under one roof? In fact, the story notes, many of the multigenerational households do live in an "ordinary" home. But, it appears that the building industry has developed an option that is catching on, "responding quickly to this shifting demand by creating homes specifically intended for such families."  For example, one builder's homes "don’t offer just a spare bedroom suite or a “granny hut” that sits separately on the property or a room above a garage. The NextGen designs provide a separate entranceway, bedroom, living space, bathroom, kitchenette, laundry facilities and, in some cases, even separate temperature controls and separate garages with a lockable entrance to the main house. Family members can live under the same roof and not see one another for days if they so choose."

The article explains the drivers for the trend, baby boomers (of course), the 2008 recession, tough job market and higher rents facing millenials, the boomerang children and again, those baby boomers, "[m]any [of whom] are planning ahead in hopes that they can devote more attention to their children and grandchildren — and spend little, if any, time in a nursing home."

Expect to see more of these multigenerational homes over the next years. From a legal perspective, it seems that ground rules, a family contract and a care  would be important to the success of the venture (whose turn is it to cut the grass this week? No loud music after 11 p.m. as a couple of an examples).  What an interesting concept of the market changing to accommodate demand.

April 15, 2016 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Property Management, Retirement | Permalink | Comments (1)

Thursday, April 14, 2016

Seattle University School of Law Receives ABA Approval for LLM in Elder Law

As reported in The National Jurist, Seattle University School of Law has been approved by the ABA for an LLM program in elder law.  The Elder Law LLM will be "added soon," along with new LLM programs in tribal law and technology.  Details include:

The elder law LL.M. will train attorneys to provide representation, advocacy, and leadership in the areas of law that impact seniors and people with disabilities. Courses will cover a wide range of legal issues, including health care coverage, age discrimination, and protection from abuse and neglect.

According to an ABA website here, other law schools with LLMs in Elder Law include (of course!) Stetson University, University of Kansas, Touro University and Western New England University. Review of the linked websites suggests to me that at Touro, the LLM program may have evolved into or merged with a resource center and research platform with the title Aging & Longevity Law Institute.  I was unable to find any current information on an LLM at University of Kansas.  

April 14, 2016 in Current Affairs, Programs/CLEs | Permalink | Comments (0)

Wednesday, April 13, 2016

Hoarding-More Prevalent Than You May Think.

I ran across a couple of articles recently about hoarding.  We all have "stuff" and the older we get, the more "stuff" we may have as we accumulate a lifetime of memories. Does that mean we are hoarders? According to the article in the Washington Post, Hoarding is a serious disorder — and it’s only getting worse in the U.S.,

While the stockpiling of stuff is often pinned on America’s culture of mass consumption, hoarding is nothing new. But it’s only in recent years that the subject has received the attention of researchers, social workers, psychologists, fire marshals and public-health officials.

They call it an emerging issue that is certain to grow with an aging population. That’s because, while the first signs often arise in adolescence, they typically worsen with age, usually after a divorce, the death of a spouse or another crisis.

So you have a lot of stuff. And maybe you are disorganized (I once had someone tell me people do two kinds of organizing, some are "pilers" and others are "filers").  Does that mean you are a hoarder? Not necessarily, according to the article, because "[h]oarding is different from merely living amid clutter, experts note. It’s possible to have a messy house and be a pack rat without qualifying for a diagnosis of hoarding behavior. The difference is one of degree. Hoarding disorder is present when the behavior causes distress to the individual or interferes with emotional, physical, social, financial or legal well-being." 

The article offers some interesting insights into hoarding and the research (such as it runs in families) but it isn't until recently that it's been thought of as a brain disorder.  Not only may hoarding have lacked attention in the past, it's one of those situations where the person may not know to seek treatment and the response requires a multi-disciplinary approach. The article has a lot of good information and is insightful in covering the issues.

Then look at this article in Huffington Post's Post 50, 5 Signs That Someone You Love May Be A Hoarder where one expert is quoted as predicting about 4 million people in the U.S. are hoarders. "Hoarding ...  is associated with a number of things including difficulty processing information, the inability to make decisions when confronted with a large amount of information and a failure to categorize things — meaning you can’t see the commonality of objects and they instead all look unique to you." This article offers 5 signs that someone is a hoarder, including constant attendance at garage sales and swap meets, never inviting visitors to the person's home, never giving anything away, keeping every scrap of paper and getting upset at the suggestion of discarding possessions.  Sound like anyone you may know?

 

April 13, 2016 in Cognitive Impairment, Consumer Information, Current Affairs, Health Care/Long Term Care, Other | Permalink | Comments (0)

Tuesday, April 12, 2016

What is Old? Watch the video!

Huffington Post's Huff/Post 50 ran a story with an accompanying video, Millennials Show The World What They Believe ‘Old’ Looks Like.  Not unexpectedly, their initial impressions involved some stereotypical perceptions of those who are older. Then watch the video to see what they have learned and how their views changed.  Show the video to your class!

Also, take a look at the new book, Disrupt Aging, from the CEO of AARP, Jo Ann Jenkins.

April 12, 2016 in Books, Consumer Information, Current Affairs, Film, Other, Web/Tech | Permalink | Comments (0)

Learning is a Lifetime Habit

As law profs, that title doesn't surprise us. Learning is something we continually do (and so too, hopefully, our students). The Pew Research Center released a new report, Lifelong Learning and Technology. The report looks at learning from a variety of points, including learners who learn for employment and learners who learn for personal reasons.

As far as age for the personal learners, the report provides a breakdown for the percentage "of adults in each group who participated in at least one of a variety of activities in the past 12 months related to personal growth and enrichment...." for those age 65 and older, the percentage engaged in personal learning was 72%. For professional learners ("[a]mong employed adults, % of those who took a course or got extra training in the past 12 months for job-related reasons...") the percentage for those 65 and older was 47%.

The study doesn't just look at age of the learner, but looks at a number of variables, including education, income, ethnicity, race, access to and ownership of tech devices and internet, etc. A pdf of the report is available here.

April 12, 2016 in Consumer Information, Current Affairs, Other, Statistics, Web/Tech | Permalink | Comments (0)

Monday, April 11, 2016

Is Aging Something to Be Cured?

We have all seen advertisements for "anti-aging" products and claims of products and research to defeat aging, reverse the effects of aging or at least slow down time.  Last month Fortune ran the article, The Obsession With 'Curing' Aging Is Now Big Business. Opening with statistics about Baby Boomers, the article next notes that "[i]t comes as little surprise, then, that finding ways to extend a healthy life has become big business, attracting many tens of millions in investment dollars from the likes of Google ...  and numerous biotechnology companies."  The article looks at six "tech titans" who are financing research for "longevity solutions," including the co-founder of the Methuselah Foundation who explains "[t]he Methuselah Prize has been credited for encouraging scientists to work on anti-aging research and treat aging as a "medical condition...." The research is fascinating. Check out the article and consider including this topic in a class discussion.

April 11, 2016 in Consumer Information, Current Affairs, Health Care/Long Term Care, Science | Permalink | Comments (0)