Tuesday, February 9, 2016

A New Time Line for Saving For Retirement?

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

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

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

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

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

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

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

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

 

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

 

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

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

Monday, February 8, 2016

Not Another Social Security Scam

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

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

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

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

 

 

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

Sunday, February 7, 2016

Senate Special Committee on Aging Upcoming Meeting

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

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

Thursday, February 4, 2016

New Brochure-Caregiver Advocates

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

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

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

 

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

Tuesday, February 2, 2016

Illinois Law Prof. Kaplan Offers "Boomer Guide" to Defined Contribution Plan Distributions

Prolific scholar Richard Kaplan, from Illinois Law, has a new article with a clever title. Here's a taste from the abstract for What Now? A Boomer’s Baedeker for the Distribution Phase of Defined Contribution Retirement Plans:” 

Baby Boomers head into retirement with various retirement-oriented savings accounts, including 401(k) plans and IRAs, but no clear pathway to utilizing the funds in these accounts. This Article analyzes the major factors and statutory regimes that apply to the distribution or “decumulation” phase of defined contribution retirement arrangements. It begins by examining the illusion of wealth that these largely tax-deferred plans foster and then considers how the funds in those plans can be used to: (1) create regular income; (2) pay for retirement health care costs, including long-term care; (3) make charitable donations; and (4) provide resources to those who survive the owners of these plans.

This very practical article appears in NYU's  Review of Employee Benefits and Executive Compensation, Chapter 4, for 2015. 

 

February 2, 2016 in Current Affairs, Estates and Trusts, Ethical Issues, Property Management, Retirement | Permalink | Comments (0)

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

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

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

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

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

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

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

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

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

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

Sunday, January 31, 2016

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

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

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

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

Thursday, January 28, 2016

Home Care & The Fair Labor Standards Act

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

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

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

 

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

If The Issue Is Accountability, Which Is Better? Power of Attorney or Guardianship?

Here are two recent appellate cases that offer views on issues of "accountability" by surrogate-decision makers.  

In the case of In re Guardianship of Mueller (Nebraska Court of Appeals, December 8, 2015), an issue was whether the 94-year-old matriarch of the family, who "suffered from moderate to severe Alzheimer's disease and dementia and resided in a skilled nursing facility," needed a "guardian."  On the one hand, her widowed daughter-in-law held "powers of attorney" for both health care and asset management, and, as a "minority shareholder" and resident at Mue-Cow Farms, she argued she was capable of making all necessary decisions for her mother-in-law.  She took the position that appointment of another family member as a guardian was unnecessary and further, that allowing that person to sell Mue-Cow Farms would fail to preserve her mother-in-law's estate plan in which she had expressly devised the farm property, after her death, to the daughter-in-law.  

The court, however, credited the testimony of a guardian-ad-litem (GAL), who expressed concern over the history of finances during the time that the daughter-in-law and the mother-in-law lived together on the farm, and further, expressing concerns over the daughter-in-law's plans to return her mother-in-law to the farm, even after a fall that had caused a broken hip and inability to climb stairs.  Ultimately, the Court of Appeals affirmed the lower court's appointment of the biological daughter as the guardian and conservator, with full powers, as better able to serve the best interest of their elder.  

Despite rejection of the POA as evidence of the mother's preference for a guardian,  the court concluded that it was "error for the county court to authorize [the daughter/guardian] to sell the Mue-Cow property.... There was ample property in [the mother's] estate that could have been sold to adequately fund [her] care for a number of years without invading specifically devised property." 

In an Indiana Court of Appeals case decided January 12, 2016, the issue was whether one son had standing to request and receive an accounting by his brother, who, as agent under a POA, was handling his mother's finances under a Power of Attorney.  In 2012, Indiana had broadened the statutory authority for those who could request such an accounting, but the lower court had denied application of that accounting to POAs created prior to the effective date of the statute.  The appellate court reversed:

The 2012 amendment did confer a substantive right to the children of a principal, the right to request and receive an accounting from the attorney in fact. Such right does apply prospectively in that the child of a principal only has the statutory right to request an accounting on or after July 1, 2012, but not prior to that date. The effective date of the powers of attorney are not relevant to who may make a request and receive an accounting, as only the class of persons who may request and receive an accounting, and therefore have a right to an accounting, has changed as a result of the statutory amendments to Indiana Code section 30-5-6-4. Therefore, that is the right that is subject to prospective application, not the date the powers of attorney were created

These cases demonstrate that courts have key roles in mandating accountability for surrogate decision-makers, whether under guardianships or powers of attorney.

January 28, 2016 in Advance Directives/End-of-Life, Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Property Management, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Wednesday, January 27, 2016

Learning for Learning's Sake?

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

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

Keep on learning everyone!

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

Tuesday, January 26, 2016

More on the Right to Die

Mother Jones, in the January/February 2016 issue, ran a story, My Right to Die: Assisted Suicide, My Family, and Me by Kevin Drum. This story starts with a personalized account of an individual who was terminally ill but didn't have the option of physician-aided dying.  The story provides an in-depth look at the laws of physician-aided dying and the arguments, both for and against.  The article then becomes even more personal when the author reveals his diagnosis of cancer for which there is no cure.  He reviews his options for the future and remarks that the California law on physician-aided dying now provides an option he didn't have until the law was signed.

The author speculates: is "assisted suicide is the next big civil rights battle? The fact that four states have approved assisted suicide in just the past seven years suggests momentum may finally be reaching critical mass. What's more, if Gallup's polling is to be believed, the word "suicide" has finally lost its shock value. Still, legislation continues to fail more often than it passes, even in blue states like Massachusetts and Connecticut. Right now, it's just too early to tell." The article can serve as a good foundation for a classroom discussion.

January 26, 2016 in Advance Directives/End-of-Life, Current Affairs, Health Care/Long Term Care, State Statutes/Regulations | Permalink | Comments (1)

Presidential Politics: Is There an "Aging Rust Belt" Effect Ahead?

As we (finally) get to the early primary and caucus stages of this Presidential election year, I'm struck by how much the pundits are talking about changing demographics, including the potential impact of growing diversity of race and national origin among potential voters.  At the same time, it will be interesting to see whether "aging" of the population, including the growing share of older voters, will play an equally significant role.  At least one early evaluation of swing state voting compares growing diversity of the Sun Belt states with aging in Rust Belt states:

Di­versity is also spread­ing, but much more slowly, in the six Rust Belt swing states (Iowa, Michigan, New Hamp­shire, Ohio, Pennsylvania, and Wis­con­sin). Com­pared with 2008, the mod­el pro­jects that by 2016 the white eli­gible voter share will drop in a range from Pennsylvania at the high end (3.1 per­cent­age points), to New Hamp­shire at the low end (1.2 points). Be­hind strong Obama turnout ef­forts, from 2008 to 2012, minor­it­ies in Ohio and Pennsylvania grew even faster as a share of ac­tu­al voters than as eli­gible voters. That helped Obama win Ohio in 2012, des­pite at­tract­ing ex­actly the same share of the white vote (41 per­cent) that Gore did and less than Kerry did (44 per­cent) when each lost the state in 2000 and 2004 re­spect­ively. (Obama also held Pennsylvania, des­pite win­ning con­sid­er­ably less of the white vote than either Gore or Kerry, who both car­ried the state.) But, over­all, ra­cial change is not nearly as big a factor in these brawny battle­grounds as in the Sun Belt swing states.

 

In those crit­ic­al Rust Belt states, the key demo­graph­ic change is the one cap­tured in the second chart: the pop­u­la­tion’s aging. In all six Rust Belt swing states, the mod­el pro­jects that adults 50 and older will con­sti­tute at least 45 per­cent of eli­gible voters by 2016; for each state ex­cept Pennsylvania, that would be an in­crease of at least 2.3 per­cent­age points since 2008. New Hamp­shire leads the list with an in­crease of 3.6 per­cent­age points in the over-50 share of eli­gible voters; the mod­el pro­jects Pennsylvania, which star­ted with the old­est eli­gible pop­u­la­tion, to in­crease the least at 1.8 per­cent­age points. (The Sun Belt swing states are also aging, but gen­er­ally not quite as fast as the Rust Belt battle­grounds.)

For more charts and analysis of historical facts and trends, read The Most Valuable Voters of 2016 by Robert Brownstein for the National Journal (February 2015).

My own sense is there is at least one major commonality among many older voters and younger non-white voters:  fear that they haven't earned enough -- or won't be able to earn enough --  to survive or thrive in a constricted economy.  Is it easier for the candidates to talk about terrorism or national security than it is to talk about social security through the lifespan?  

January 26, 2016 in Current Affairs, Statistics | Permalink | Comments (0)

Monday, January 25, 2016

Stopping Alzheimer's?

Earlier this month I read an article about the role of brain inflammation in Alzheimer's.  Scientists May Have Just Discovered the Key to Halting Alzheimer's  was published on January 11, 2016 in Huffington Post Science.  "Researchers at the University of Southampton in England conducted a series of experiments showing a chemical that reduces neuroinflammation may have the potential to protect against the memory and behavioral changes associated with the disease that affects roughly 5.3 million Americans."  The article explains the research and notes that "[a]n overactive immune system can result in chronic inflammation, which previous research has linked to Alzheimer's. These new findings makes it increasingly apparent that inflammation is not a result of Alzheimer's as much as a key driver of the disease." Further research will be taking place.  Exciting!

January 25, 2016 in Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Science | Permalink | Comments (0)

Science, Elder Law and Genetic Counseling...

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

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

 

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

 

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

 

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

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

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

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

Sunday, January 24, 2016

Natural Disasters Know No Season

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

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

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

Red Cross Disaster Preparedness for Seniors by Seniors.

Ready.gov  Seniors

CDC  Personal Preparedness for Older Adults and their Caregivers

FEMA  Elderly Special Needs Plans To Be Ready for Disaster

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

 

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

Thursday, January 21, 2016

A Closer Look at Goal Setting in Public Health: The Cuban Experience

I spent the first week of 2016 in Cuba with Dickinson Law students -- and it was an energizing experience (even as I fear I will never catch up on my other responsibilities this semester!).  The students' studies in Cuba were wide-ranging, with opportunities to engage with experienced legal professionals while discussing historic principles and modern plans for Cuba, including a close look at laws adopted just in the last two years that will affect economic development, international investment in Cuba, employment, property ownership and taxes.  For a full report on the course coverage and special events (including great photos by the students), see "Experience Beyond the Classroom Proves Invaluable."

Dr. Yoandra Adela Explaining Three Levels of Cuban Health Care SystemFor me, it especially interesting to hear directly about Cuba's health care system, which is highly regarded throughout the world, especially for its success in primary care for pregnant women.  From Dr. Yoandra Adelá (depicted left) we learned core principles that guide Cuba's plans for health care, including a goal of universal coverage, free and equally accessible to all Cubans.

Our professors freely admitted challenges that Cuba faces in trying to meet health care goals in a struggling economy, with international partners important in order for Cuba to maintain access to medicines, technology and even credit needed to improve buildings and make necessary repairs at treatment sites.

Since 1985, Cuba has recognized a medical specialization in "comprehensive care" -- which emphasizes preventative medicine and community-based contacts.  We saw this in action, where doctors from a local polyclinic spend half of their appointment days meeting patients in the office and half of those days seeing patients in their homes.   2L Student Corey Kysor Visits a Polyclinic in HavanaWe learned that for the elderly, many of the problems addressed by Cuban health care professionals mirror what is seen in the U.S., with hypertension and diabetes being significant health care risks; on the other hand, Cuba reports low incidence of infectious disease in their population.

I still need to learn more -- especially as I did not have time to fully explore "elder care," which reportedly includes some 380 hogares de ancianos and casas de abuelos, in addition to primary care offices that specialize in geriatric medicine. To the right is Corey Kysor, one of our law students visiting a Havana area polyclinic, the middle level of three components of health care available to all Cubans.  (And yes, our law school does plan to return to Cuba in the next academic year to offer additional opportunities for comparative legal studies.)

If you would like to read more, from the perspective of a law student who had already experienced foreign legal systems such as China before traveling for her first time to Cuba this January, read Joy Lee's "Inside Cuban Law and Culture: A Law Student's Perspective."  

January 21, 2016 in Current Affairs, Health Care/Long Term Care, Housing, International, Science | Permalink | Comments (0)

Wednesday, January 20, 2016

JAMA Current Issue Death, Dying and End of Life

The January 19, 2016 issue of the Journal of the American Medical Association (JAMA) is a theme issue on Death, Dying and End of Life.  There are 15 articles and opinion pieces on a range of topics, including several on physician-aided dying, as well as an audio of the editors' summary.  Check it out!

January 20, 2016 in Advance Directives/End-of-Life, Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care | Permalink | Comments (0)

Friday, January 15, 2016

Ageism in Social Media?

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

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

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

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

It’s as current as Twitter.

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

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

Meanwhile, society does its best to accent the negative.

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

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

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

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

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

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

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

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

Thursday, January 14, 2016

Living Closer to Mom?

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

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

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