Sunday, December 29, 2013
Washington Post reporters Peter Whoriskey and Dan Keating use more than ten years of data from California to provide a detailed portrait of hospice, with national implications, concluding that providers are pursuing "healthier" patients to increase their margin. While acknowledging the importance of Medicare-supported hospice for individuals legitimately diagnosed with less than six months to live, the Washington Post article uses survival rates to suggest manipulation of the diagnosis for financial gain:
"[T]he survival rates at AseraCare are emblematic of a problem facing Medicare, which has created a financial incentive for hospice companies to find patients well before death. Medicare pays a hospice about $150 a day per patient for routine care, regardless of whether the company sends a nurse or any other worker out on that day. That means healthier patients, who generally need less help and live longer, yield more profits.
The trend toward longer stays on hospice care may be costing Medicare billions of dollars a year. In 2011, nearly 60 percent of Medicare’s hospice expenditure of $13.8 billion went toward patients who stay on hospice care longer than six months, MedPAC, the Medicare watchdog group created by Congress, has reported."
For the full Washington Post story, itemizing factors contributing to misuse of hospice, see "Hospice Firms Drain Millions from Medicare."
Tuesday, December 17, 2013
Via the Telegraph:
Tens of thousands of pharmacists, bus drivers and bank staff are being trained to recognise the signs of dementia as part of a “front-line force” against the disease. Managers of some of the biggest firms have pledged to educate staff to recognise the effects of dementia. Boots, Lloyds bank and First Group have all committed to do as much as possible to help dementia sufferers after David Cameron promised to lead a national “fightback” against the illness. Jeremy Hunt, the Heath Secretary, said “every section of society” must “step up” to help tackle the illness, which affects 800,000 people in the country. “Britain’s biggest companies will build up a front-line force of thousands of people able to spot the signs of dementia and understand the needs of sufferers, helping people with the disease to live a normal life for longer,” Mr Hunt told The Daily Telegraph. The Prime Minister said this week that a cure for dementia could be found within 12 years as he announced funding for research into the disease would be doubled.
Monday, December 2, 2013
At the heart of comparative research is the opportunity to rethink your own system. I was reminded of this point last week when meeting Claire Keatinge, the Commissioner for Older People in Northern Ireland (COPNI). Commissioner Keatinge is -- in a word -- dynamic, and it is impossible not to be impressed with her dedication to meeting the needs of older persons in her country. She is a leader, both actually and symbolically, for a hard-working team tackling a number of issues in ageing policy.
It is clear to me that "independence" is at the core of the role for the COPNI. What do I mean by independence? The COPNI is funded with public dollars, but the job includes making an independent evaluation of the needs and interests of the demographic, and then reporting and advocating for appropriate response by the government or other sectors. By comparison, I wonder whether state officers or offices charged with policy and laws in the U.S.are more likely to be serving a governmental agenda, and trying to sell that agenda to voters. This strikes me as a potentially important, if subtle, difference in systems.
A small example of the importance of independence: One of the COPNI's several goals is to identify and improve "uptake" of benefits available to older persons in the country. In Northern Ireland, and elsewhere in the U.K., there are official statistics on the dollars (whoops, I mean pounds) left on the table by individuals who fail to seek available public benefits or services. In N.I., there is a known gap. By comparison, I would be surprised to learn that we keep similar statistics on either the state or federal level in the U.S., much less have a policy of trying to reduce any gap.
Claire Keatinge also stressed that an individual assessment of need for health care, social care and security, should be exactly that, and not simply an assessment of what services are available. Helping individuals or their family members access services in the public, private and voluntary sectors is part of the COPNI plan of action, but, it strikes me that the emphasis on evidence-based policies may result in development of new services or better funding for existing programs.
Tuesday, November 26, 2013
While working in Europe, I first heard the label "befrienders," as applied to people who work their way into the lives of disabled or elderly persons. The relationship often starts with the befriender doing small, helpful tasks; over time, the helper gains trust that enables him or her to have a greater role in the elder's life, thus opening the door to exploitation of the person's diminishing powers of judgment, while gaining complete control over finances.
On November 5, the New Hampshire Supreme Court affirmed convictions on nine of eleven criminal counts for "befriender" Karen Gagne, accused of stealing over $500,000 from a ninety year old woman in a retirement center. The case is State of New Hampshire v. Karen Gagne, 2013 WL 512499 (2013).
I plan to write more in the future about the technical details of the crimes charged in this context, but one of the clear lessons from the history in this particular case is how much time it may take for the befriending pattern to develop and "ripen" into fraud that is recognized by third-parties. For example, Karen Gagne's involvement with the victim spanned years:
"The defendant met the victim in the 1980s when the defendant performed landscaping services at the victim's home. The two became friends and subsequently lived together as companions in the victim's home for at least one year until the victim asked the defendant to move out. In the summer of 2006, the defendant and the victim rekindled their friendship. The victim moved to Pleasant View Retirement Home (Pleasant View), and the defendant began driving the victim to doctors' appointments and nail appointments, and taking her to lunch. In addition, although the victim had previously had an accountant pay her larger bills, the defendant began handling the victim's bills, including payment of her rent at Pleasant View."
At some point, "helpful" friend Gagne began liquidating the elder woman's annuities or other property and borrowing additional money under the elder's name.
The fact that Gagne was giving herself gifts might not have been discovered, except that by the fall of 2008, Gagne was no longer making regular rent payments to the retirement home. She offered excuses, such as blaming a "grandson or nephew" for stealing money, and claimed that she, Gagne, was trying to "recover" the money in order to pay the victim's bills. By late 2009, the victim was so far behind in rental payments -- and the excuses had become so unbelievable -- that the facility's executive director contacted the Attorney General's office, thus leading to the criminal charges.
Having sat through trials of similar cases, and having read transcripts of other cases, I can just imagine how Gagne would try to justify her thefts, arguing that "her friend wanted her to have the money" to explain why the 90-year old woman had "signed" checks she wrote out for her. In fact, this "gift" argument actually worked as a defense to two of the criminal counts in the case, where the older woman had personal involvement in transactions. Nonetheless, on the majority of criminal counts, the Supreme Court concluded "the defendant was not privileged to infringe upon the victim's interest" in joint accounts, nor was Gagne justified in misapplication of funds she was handling as a "financial representative" of the elder.
Karen Gagne was originally sentenced to "an aggregate of 10 to 30 years in New Hampshire State Prison for Woman." It is not clear from the opinion whether remand on the overturn of two of the elevent counts would trigger a resentencing.
New Hampshire, by the way, is the state that recently passed a new law, permitting long-term care facilities to sue "fiduciaries" who misuse assets of a resident, if that misuse results in "disqualification" of the resident for Medicaid, as we discussed earlier this month.
From WBUR public radio in Boston Massachusetts, a story and podcast on "at-home funerals."
For a number of years I have invited an attorney with expertise in alternative funerals to speak to my classes. In fact, that is how I first learned that Costco carries urns and caskets (with a choice of standard or expedited shipping -- which strikes me as a trick question). As outlined by WBUR in the article, there is a surprising amount of freedom, if that is the right word, in the law of many states for families to choose informal funerals and burials.
Hat tip to Ann Murphy at Gonzaga Law for sharing this link. Our readers definitely are the key in helping to make this a "full service" blog!
Friday, November 22, 2013
A fascinating article in The Gerontologist analyzes Naturally Occurring Retirement Communities (NORCs) and a similar community-based model for aging in place, known as the Village. Frankly, it was only recently that I realized these labels may be used for developments with different identities.
Researchers in social work, welfare and public health programs at Rutgers, Berkeley, Michigan, and Maryland surveyed program leaders representing 69 Villages and 62 NORCS in early 2012, gathering data on services, activities, beneficiaries and funding sources.
Their analysis, presented in "A Tale of Two Community Initiatives for Promoting Aging in Place: Similarities and Differences in the National Implementation of NORC Programs and Villages," suggests that while both programs "aim to promote aging in place by offering a diverse range of supports and services to older adults within a locally defined geographic area," the means by which they achieve their aims differ. For example, "NORC programs reported offering more traditional health and social services, had more paid staff, and relied more on government funding than Villages."
The article also identified topics for further study, including the potential for longitudinal studies. Regional differences may also exist. "For example, NORC programs in New York likely differ in some ways from NORC programs nationally, given different organizations overseeing their development, . . . as well as distinct public policies defining the programs and eligibility criteria."
As a bit of history, Beacon Hill Village in Boston was begun in 2001 by a group of seniors who wanted to remain at home as long as possible in their neighborhood. An early model for NORCs is widely attributed to a co-op in New York City, begun in 1986 with support from private philanthropy and local government funding.
Thursday, November 21, 2013
Somehow I had missed this particular incarnation of predatory lending. The National Consumer Law Center (NCLC) recently circulated a consumer impact statement on pension-based loan scams. Often advertised as "cash advances," in reality the individual is agreeing to assign future pension payments to the lender, with repayment terms that include an outrageously high interest rate. In 2011, NCLC and attorneys with the National Association of Consumer Advocacy were successful in a class action suit in state court in California, in which they challenged loans requiring "assignments" of military pay or pensions as violating federal law. The court ordered restitution to the class members.
The New York Times ran a 2013 feature on "Loans Borrowed Against Pensions Squeeze Retirees," by Jessica Silver-Greenberg, part of a series on "A Vulnerable Age," that examined financial traps that can face older adults, especially during a tight economy. A sidebar to the article detailed an example of a loan to a disabled military veteran for $10,000, with a $353 monthly payment for 60 months, leading to total costs over the life of the loan of $21,180, representing an interest rate of 36.4%.
Wednesday, November 13, 2013
(Reuters) - Wearing her favourite black dress, 53-year-old Liu Fenqin sat nervously in a corner at an official match-making event in Shanghai, hoping to find a husband after her first marriage ended in divorce more than 10 years earlier. With China's divorce rate rising, Liu was one of thousands of middle-aged and senior lonely hearts who took part in the annual event sponsored by the Shanghai government after the upper age limit was raised from 45 to 60 this year. The event, which drew 30,000 people last year, attracted an estimated 40,000 this year after organisers lifted the age limit to satisfy demand from the growing number of divorcees, said Xu Tianli, vice chairman of the Shanghai Matchmaking Agency Management Association.
With some people there in their 60s and even 70s, the age limit was not absolute. Divorce rates in China have climbed for seven years in a row. In 2012, the year-on-year rise in divorces outpaced that of marriages for the first time, according to official data. The Chinese city with the highest divorce rate is Beijing, at 39 percent, according to local media. The issue has not escaped the notice of China's government, which is concerned that broken homes will erode social stability. "It's likely that children from divorced families will become social outcasts and vagrants. So it does have a negative impact on society." To mend ailing marriages and encourage senior singles to date, China has introduced a range of measures.
Wednesday, October 23, 2013
Powers of Attorney (POAs) are a key tool in estate planning and Medicaid planning. A thoughtfully drafted POA can avoid the need for a guardianship, for example, and thus avoid delays, embarrassment and greater expense for a principal who later becomes incapacitated.
Unfortunately, POAs can also be a tool for misuse by agents who can't resist the temptation to help themselves, rather than their principals. For a number of years, states have been struggling to balance utility against risk.
In Pennsylvania, for example, prior to 1999, statutory law governing POAs permitted principals to grant agents the authority to make gifts. Civil case law interpreted such gift-giving authority, unless expressly limited, as permitting agents to make "self-gifts." Even if the agent's self-gifting put the principal in serious financial jeopardy, some prosecutors declined to prosecute. Following a series of troubling reports and cases, in 1999 the Pennsylvania legislature amended state law to declare that all agents appointed under POAs were subject to specific fiduciary duties. The change also imposed a statutory presumption of limited gift authority (tied to annual federal gift tax exclusions) unless the principal expressly granted the agent "unlimited" gift authority.
Concern about misuse of powers of attorney has grown on a nationwide basis,especially after high profile cases such as that of New York heiress Brooke Astor, where her son used a POA to sell off artwork and other valuable property, while reportedly keeping his mother isolated from friends.
Even before the Brooke Astor case came to light, academics, legislators, judges and practitioners worked together in the Uniform Law Commission to propose amendments to statutory authority governing POAs, resulting in the Uniform Power of Attorney Act of 2006 (UPOAA), which superseded prior uniform law proposals. The UPOAA attempts to rebalance risk and power, or as the Commission summarizes:
"The UPOAA seeks to preserve the durable power of attorney as a low-cost, flexible, and private form of surrogate decision making while deterring use of the power of attorney as a tool for financial abuse of incapacitated individuals. It contains provisions that encourage acceptance of powers of attorney by third persons, safeguard incapacitated principals, and provide clearer guidelines for agents."
Adoption of the UPOAA has been fairly slow. As of today, only 13 states plus the U.S. Virgin Islands, have enacted the UPOAA.
In 2013, legislatures in Mississippi (H.B. 468) and Pennsylvania (S.B. 620) are considering adoption. In Pennsylvania, the need for clarification has been heightened by reaction to the Pennsylvania Supreme Court's opinion in Vine v. Commonwealth, 9 A.3d 1150 (Pa. 2010), where a POA was signed by a hospitalized principal, and used by the husband/agent to make self-benefiting changes to his wife's retirement accounts, while his wife was incapacitated.
Court practice and enforcement policies on POAs, guardianships and elder abuse are also under consideration by the Pennsylvania Elder Law Task Force (2013), chaired by Justice Debra Todd of the Pennsylvania Supreme Court.
In Pennsylvania, views on what changes to POA laws are necessary differ in small or large ways among bankers, estate attorneys, elder law attorneys and district attorneys, just to name a few of the interested parties.
The scholarship of law professors has been important to the debate over proper use of POAs, including two articles by Valparaiso Law Professor Linda Whitton, "Durable Powers of Attorney as Alternatives to Guardianship: Lessons We Have Learned" and "The New Power of Attorney Act: Balancing Protection of the Principal, the Agent and Third-Persons."
By the way, when I first drafted this post, I titled it "The Problem(s) with Powers of Attorney." Overnight, I rethought that title, because many POAs are never abused and agents frequently go above and beyond in performing uncompensated services, including financial management, for aging principals. I therefore retitled the post. What law reform movements are attempting to do is reduce the potential for abuse. Human nature being what it is, there is probably no law that can prevent abuse by a wrongly motivated agent. Who to trust with powers granted under a POA will always be an important matter for families to consider and discuss with their legal and financial advisors.
October 23, 2013 in Advance Directives/End-of-Life, Current Affairs, Estates and Trusts, Ethical Issues, Medicaid, Property Management, State Cases, State Statutes/Regulations | Permalink | Comments (0) | TrackBack (0)
Friday, October 4, 2013
Across the US, there are some 1,800 Continuing Care Retirement Communities (CCRCs). These are typically upscale settings that offer a range of housing options, services, activities and health care. Residents of CCRCs often have common interests, not just within their individual community's setting, but in the "larger" community of residents throughout the nation, and thus the idea of a National Continuing Care Resident's Association (NaCCRA) was born.
NaCCRA has two annual gatherings, as well as regular meetings at the chapter level in individual states. NaCCRA's Fall 2013 Meeting will be in Dallas, in conjunction with the LeadingAge Annual Meeting. Here are some of the planned NaCCRA sessions and related LeadingAge sessions:
Saturday, October 26: NaCCRA Board Meeting (starting at 5:30 p.m.)
Sunday, October 27:
9:00 - 9:15: General Business Meeting
9:15 - 11:45: "Imagining CCRCs of the Future," a moderated discussion, involving residents and other guests. (Moderators: Ron Herring, resident of The Glebe, Daleville, VA & Katherine Pearson, Professor of Law, Penn State Dickinson School of Law)
1:00 - 3:00: Opening General Session for LeadingAge
3:50-5:00: LeadingAge Concurrent Educational Sessions (24 sessions!), including:
- Progress toward Resident Engagement: One Year Later: Moderator Ron Herring (NaCCRA), Speakers: Ellen Handler, President of New Jersey's resident association (ORANJ); Marilyn Kennedy (COO for Episcopal Senior Communities); May Anna Colwell (CCRC resident and board member)
- Financial Ratios for CCRCs
- Urban Design Concepts to Reinvent Aging Communities Anywhere
- Governance Roundtables: Practical Solutions for a Better Board
The LeadingAge programming, with concurrent educational sessions throughout, continues on Monday through Wednesday, October 27-30. CCRC residents can register for the combined NaCCRA/LeadingAge meetings on line. Registration for the combined Meetings is without cost for CCRC residents!
For additional thoughts on CCRCs, from informed, resident perpsectives, visit NaCCRAU, a Learning Center for current and future residents.
LeadingAge is holding its annual meeting in Dallas this year, October 27-30, with a very busy and interesting schedule of events, including educational workshops. The workshops and associated meetings offer a deep well of cutting edge information about aging services, relevant to both the industry and the public.
So what is LeadingAge? To use their words, it is an association of "6,000 nor-for-profit organizations" that provide services to seniors, persons with special needs, and their families. The history of the organization as advocates for aging service providers traces to 1961. For a number of years it was known as the American Association of Homes and Services for the Aging (AAHSA), recognized as a leading trade group for non-profit providers, especially on the housing side, including Continuing Care Retirement Communities, Assisted Living facilities, and Nursing Homes. AAHSA initiated a self study in 2008, and in 2011 announced its change of name to LeadingAge. As with any strong trade group, LeadingAge keeps a close eye on legislation, public finance, and policy developments, both at the national and state levels.
My experience is that with the name change came a broadening of the association's identity, including greater involvement by older persons as individuals, volunteers, consumers, and users of aging services.
Larry Minnix is the long-time head of LeadingAge, with deep experience in the industry of aging services.
Thursday, October 3, 2013
A new Harris Interactive/HealthDay Poll finds that "more than two-thirds of Americans are anxious and uncertain about how they'll meet nursing home or home care costs should they need them." Fair enough. Plenty of good reasons for such anxiety.
However, in summarizing the poll results, the Harris folks also conclude:
"Most people were also wrong about how most of these costs are covered under the current system. About half (49 percent) mistakenly thought the bulk of the bill was paid by individuals, while one-third guessed Medicare. Only 19 percent understood that the major funder of long-term care is actually Medicaid, the government agency that covers health services for the poor."
But were those people actually "wrong?" Perhaps it depends on what you mean by "long-term care." If you are viewing that care as provided by paid individuals, whether in the home or in a facility, then the Harris poll's conclusions accurately point to Medicaid's continuing role as a dominant payment source.
But in the US the largest source of elder care is still the family, as documented by AARP Public Policy Institute's 2011 Update. Even though family members are not usually "paid" for the care with dollars per hour, there is a cost associated with that care. For example, famly care-givers are often unable to engage in other paid employment, or take time off from careers to assist with elders. And thus, perhaps interviewees for the Harris poll were correct, because they were thinking about the realities of families assuming the costs of long-term care.
In other countries, a distinction is often made between "health care" and "social care." What we call "long-term care" in the United States tends to lump these concepts together, while the most frequently needed services, such as assistance with bathing, dressing, meals, monitoring for safety or supervision with other activities of daily living, would often be characterized as social care in other countries. Caution is necessary in using labels to characterize the cost of care for older adults (or for any individuals needing assistance).
Monday, September 30, 2013
"Perdue tried to get help from Meals on Wheels Atlanta. In mid-April of 2012, she was twenty-seventh on a waiting list of 120. In November, she was still on the list, which had grown to 198. Her daughter finally found another program.
Such is the world of food rationing for the elderly—the hidden hunger few ever see. Tenille Johnson, one of two case managers at Meals on Wheels Atlanta, said there were others on the list who were even more in need than Perdue. In 2012, the program served 106,000 meals—up from 84,000 three years before—and it will serve about 114,000 this year. “We’ve been able to up our game and reduce the waiting list to between 145 and 160 seniors, but the need has outpaced us,” says executive director Jeffrey Smythe. “The numbers are going up more quickly than we projected. We have waiting lists all over the metro Atlanta area, even in suburban counties.”
The Nation writer first reported on underfunding for programs assisting home-bound elderly in 1998. "Little has changed in the last fifteen years," she reports. Except, as her article demonstrates in detail, the need is greater, on a nation-wide basis.
"The National Association of Area Agencies on Aging says nearly 60 percent of all Older Americans Act programs had waiting lists in 2010, but the ones for home-delivered meals are particularly urgent, since food is so basic to good health."
Remember the Older Americans Act (OAA), first enacted in 1965? Meals on Wheels was once a core component of OAA's programming, and administered to the states through Area Agencies on Aging. Charities, churches and other nonprofits have not been able to cover the gap in funding. As discussed earlier on this Blog, Congress still has not reauthorized the OAA,and as Lieberman's article demonstrates, there are very real consequences to Congressional gridlock and Congress's failure to address even uncontroversial programs while rehashing party-politics on the Affordable Care Act.
Hat tip to Kevin Schock, Penn State Law, for spotting this timely article.
Tuesday, September 24, 2013
For a number of years, I have taken on the interesting task of researching resident rights and financing or governance issues for "Continuing Care Retirement Communities" or CCRCs, an important part of the network of senior living options in the U.S. One of the many strengths of CCRCs is the way residents and administrators pull together to respond to a crisis or handle a challenge.
Frasier Meadow Retirement Community, a CCRC in Boulder, was hit hard by the recent devastating flooding in Colorado. The Assisted Living area was severely damaged, requiring relocation of AL residents. The good news is that the relocations were accomplished safely, and the hard work of clean-up and reorganization has begun. Regular updates on the Frasier website and social media connections have helped to keep families and friends up-to-date.
Hat Tip to Walt Boyer, board member at the National Continuing Care Resident's Association or NaCCRA, for information on Frasier's early recovery efforts.
Sunday, September 22, 2013
September 24 is the kick-off date for a world-wide Design Competition offered by Stanford's Center on Longevity. The Stanford Report explains the competition is intended to encourage innovation that helps the rising tide of seniors:
"The design contest solicits entries from student teams worldwide and is aimed at finding solutions that help keep people with cognitive impairments independent as long as possible."
The final presentations are scheduled for April 2014 with judging by a panel of academics, industry professionals, nonprofit groups and investors. The competition offers prizes, including the top prize of $10,000.
Hat tip to Professor Laurel Terry, for news on this interesting challenge.
Wednesday, September 11, 2013
On October 18, University of Kent Professor Julia Twigg, the author of "Fashion and Age: Dress, The Body and Later Life" (published by Bloomsbury Press), will be one of the featured speakers at a conference hosted by the U.K.'s Royal College of Art. The conference has an intriguing title: "(a)Dressing the Ageing Demographic."
Professor Twigg's latest book is an outgrowth of her sociology and social policy research into day-to-day lives. Thus, clothing and fashion choices for women may have implications for feelings of self-worth and identity as women age. Professor Twigg explains further:
"This book also touches on a second academic concern of mine which has been to bring wider perspectives to bear on the territory of ageing. For too long, later years have been analysed through the lens of social welfare, with an emphasis on frailty and dependence and, often, with an objectifying and distancing gaze. Although I have done work within this social welfare tradition -- and still value it -- I am pleased to have the opportunity this new work has given me to address a wider conception of age and its social significance, bringing to bear on it new literatures and analytical concerns."
Details of the conference are available here.
Monday, September 9, 2013
Recently a colleague described an estate planning dispute. After the death of the first spouse, it came out that the surviving spouse had never read the couple's estate plan, but had signed the documents in the attorney's office when they were presented. The individual failed to realize the documents were not entirely consistent with what the survivor believed to be the couple's plan. The problem may be hard to solve now that the first spouse has passed. Why would someone sign estate planning documents without reading them?
In this instance, the individual in question, a successful entrepreneur, was dyslexic; reportedly it would have taken the individual hours to read the will or trust carefully, and although the individual planned to read the documents upon returning home, that did not happen.
I suspect this happens far more often than lawyers would like to believe.
As explained by the International Dyslexia Association (IDA), dyslexia is a "language-based learning disability." According to the IDA, an estimated 15 to 20% of the population has a language-based learning disability, with some estimates suggesting one in nine individuals can be classified as having a severe disability. Dyslexia can involve a cluster of symptoms, but is most commonly associated with difficulty in reading.
According to some researchers, dyslexia may also by associated with problems in oral communication. For example, IDA advises:
"People with dyslexia can also have problems with spoken language, even after they have been exposed to good language models in their homes and good language instruction in school. They may find it difficult to express themselves clearly, or to fully comprehend what others mean when they speak. Such language problems are often difficult to recognize, but they can lead to major problems in school, in the workplace, and in relating to other people. The effects of dyslexia reach well beyond the classroom."
It is possible that by the time people get to the estate planning phase of life, they have developed or learned individual strategies for coping with dyslexia. Or, they may have become experts in hiding the fact of their dyslexia.
As lawyers, perhaps it is incumbent upon us to inquire tactfully about each client's comfort level in reading, especially in reading often-complex estate planning documents. Lawyers can offer alternatives to a formal "signing" session that puts pressure on even the strongest readers to sign without informed understanding of the documents.
Strategies may include remembering to provide all clients with quiet time to read the documents, before any signing session is planned. The lawyer can also "chart" the estate plan, to provide a pictorial image of the plan for clients. Lawyers and their staff can be patient in reviewing each aspect of the plan carefully, also involving the clients with conversation and dialogue (rather than monologues). I'm sure experienced practitioners and academics have developed a whole host of key strategies that can assist not only those with dyslexia, but those with other common barriers to understanding. Is dyslexia an understudied phenomenon in attorney-client relations? "Comments" open below.
And before anyone brushes off the topic as not relevant to "their" clients, let's remember that dyslexia can be present with highly successful people, and thus there is the potential for impact on families with significant estates.
Sunday, September 8, 2013
Friday, September 6, 2013
Thursday, September 5, 2013
University of California San Francisco (UCSF) researchers published a paper, made available this week in Nature, titled Video Game Training Enhances Cognitive Control in Older Adults. We can expect our students, children and grandchildren (not to mention game manufacturers) to remind us they were "right." From the abstract for the UCSF researchers' article:
Here we show that multitasking performance, as assessed with a custom-designed three-dimensional video game (NeuroRacer), exhibits a linear age-related decline from 20 to 79 years of age. By playing an adaptive version of NeuroRacer in multitasking training mode, older adults (60 to 85 years old) reduced multitasking costs compared to both an active control group and a no-contact control group, attaining levels beyond those achieved by untrained 20-year-old participants, with gains persisting for 6 months.
I suspect we will see a lot more on this area of research in the near future. Funding should be robust. Of course, I also suspect that not every game is equally helpful to cognitive enhancement and thus caution and consumer protections may be appropriate.