Monday, August 15, 2016
In July, I drove some 2500 miles, from Pennsylvania to Arizona, to begin an exciting sabbatical opportunity. I enjoy this drive (especially since I tend to do it fairly rarely, perhaps once every seven years). I frequently visit friends along the way, and this summer I was struck by how many friends had saved up tough elder law stories for me.
A theme emerged from their stories. They would tell me, "I have an aging friend (or sometimes a family member or neighbor) who is in serious danger of physical or financial harm, but refuses to cooperate with reasonable plans to solve the problems. What are my options to help this person I care about?"
In one instance, it seemed clear the at-risk individual was affected by some level of cognitive impairment. But how to know for sure? Was the refusal to cooperate with a "better plan" the product of a sound, if somewhat eccentric mind? A neurocognitive assessment seemed warranted. We tried to arrange one. But the earliest appointment available was more than 60 days away and the potential for harm was immediate.
Thus, it was with great interest I read a preview of an article in the upcoming issue of the ABA publication, Bifocal. Professors Marshall Kapp, Shenifa Taite and Gregory Turner outline "Six Situations in Which Elder Law Attorneys and Physicians Caring for Older Patients Need Each Other." They are writing about a critical need for Medical-Legal Partnerships designed specifically to assist older persons and their family members. For example, on the topic of "self-neglect," the authors explain:
Mistreatment of older persons by others is a serious problem. Both the medical and legal conundrums became more complicated, and thus even more amenable to interprofessional collaboration, when self-neglect is entailed. A significant percentage of older adults, mainly living alone, do not regularly attend to their own needs or well-being regarding health care, hygiene, nutrition, and other matters. The majority of cases reported to APS agencies by health and social service professionals and family members are triggered by suspected self-neglect. The health care system expends considerable efforts trying to intervene in these situations to prevent increased rates of hospitalization, nursing home placement, and even death.
In situations involving suspected elder self-neglect, the physician’s role is vital in recognizing the potential problem, characterizing the nature and seriousness of the risk posed, and trying to identify clinically and socially viable intervention strategies. Among other concerns, decisional capacity issues almost always arise in these cases. The physician may look to an attorney for advice about legal reporting requirements or options, as well as the legal boundaries within which interventions may be designed and implemented in a manner that best respects the older person’s dignity and autonomy while protecting the vulnerable at-risk individual from undue foreseeable, preventable self-generated harm.
A growing number of law schools (including Penn State's Dickinson Law) have established Medical-Legal Partnership Clinics, where the collaborative relationship between attorneys and physicians is established in advance of need by clients. Often such clinics focus on younger clients, especially children. Elder-specific services are an important subset of the services that can be provided in a timely and professional setting. For more, read the full Bifocal article published in the-August 2016 issue -- and ask whether such services are available in your community.
August 15, 2016 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Housing, Legal Practice/Practice Management | Permalink | Comments (0)
Thursday, August 11, 2016
Serious bummer. According to an article in the Washington Post, the fight against ageism is a losing battle. Baby Boomers are Taking on Ageism---and Losing starts with the challenges that boomers face in the workplace: continuing in their jobs supervised by younger folks, or returning to the work force. This quote gave me pause: "At a time when conditions have vastly improved for women, gay people, disabled people and minorities in the workplace, prejudice against older workers remains among the most acceptable and pervasive “isms.” And it’s not clear that the next generations — ascendant Gen Xers and millennials — will be treated any better." Thus, we all should be concerned about ageism.
Ageism, not a new phenomenon, is explored from several angles in this article.
That bias [for young] is so common we frequently don’t recognize it. Todd Nelson, a psychology professor at California State University at Stanislaus, has singled out birthday cards for portraying advancing age as something to be ashamed of, with a tone that would never be used with race or religion. (“ ‘Ha-ha-ha, too bad you’re Jewish’ ... wouldn’t go over so well,” he noted.)
Internet memes like the “Scumbag Baby Boomer” and “Old Economy Steve,” which lambast boomers for transgressions from failing to adopt technology to causing the wars and recessions that millennials have weathered, channel resentment against an entire category of people in ways that might not be tolerated if they were members of another protected class.
As a big believer in life-long learning, I was concerned that there are those who have mindsets regarding the talents of those who are older. "In a 2015 survey by the Harris Poll, for example, 65 percent of boomers rated themselves as being the “best problem-solvers/troubleshooters,” and only 5 percent of millennials agreed. Fifty-four percent of millennials thought boomers were the “biggest roadblocks.” Sometimes these perceptions come straight from the top: Facebook founder Mark Zuckerberg once said 'young people are just smarter.'"
After looking at the laws that protect against age discrimination, the article examines some of the causes of ageism and efforts to thwart it. This article could be the foundation for a great discussion during the first week of your class. Check it out!
Wednesday, June 15, 2016
In a recent McKnight's News column, Registered Nurse Pam McKnally wrote an interesting and candid account of "What It's Like to Be a Nurse Whistleblower." Her experiences with retaliation -- indeed bullying-- after she complied with laws requiring to her report observations of improper use of narcotics in the workplace led her and others to advocate for changes in the law.
In April 2016, in response to the experiences of McKnally and others, Nebraska enacted changes to state law, prohibiting retaliation against whistleblowers and mandating confidentiality for the identities of anyone making reports of violations by "credentialed" health care providers. Nebraska Legislative Bill 750, amending Nebraska's law that governs a broad range of health care providers, specifies:
An individual or a business credentialed pursuant to the Uniform Credentialing Act shall not discriminate or retaliate against any person who has initiated or participated in the making of a report under the act to the department of [health and human services]. Such person may maintain an action for any type of relief, including injunctive and declaratory relief, permitted by law.
Further, the law now provides that "The identity of any person making such a report [of suspected violations] or providing information leading to the making of a report shall be confidential" and further, "The identify of any person making a report, providing information leading to the making of a report, or otherwise providing information to the department, a board, or the Attorney General included in such reports, complaints or investigational records shall be confidential whether or not the record of the investigation becomes a public record."
Whether the changes to Nebraska law, especially in the absence of a specific statutory sanction for retaliation or breach of confidentiality, will be effective to address the backlash experienced by McNally will bear monitoring. She cautions:
I resigned, as my work life was intolerable, and it was clear that I was about to get fired. The EOC investigated my claims. The costs in employee hours and attorney fees, plus fines for violations can be astronomical. Had the situation been handled differently by the Human Resource department, the outcome may have been much different.
It is time for employers to stop blaming and discrediting professionals who simply follow the law and advocate for themselves and their patients....
When nurses are happy they work hard. They are loyal and seek out constructive ways to help their organization deal with conflict. In long-term care, Medicare and Medicaid cuts mean money needs to be saved now more than ever. Keeping a business viable includes mitigating the need for attorneys and dealing with nurse turnover.
Thursday, June 9, 2016
Florida State Law Professor (and friend) Marshall Kapp has a new article out, and my recent post "He Died with Guns in His Closet" triggered him to share it with us. Marshall tackles the challenging topic of "The Physician's Responsibility Concerning Firearms and Older Patients," with thoughtfulness and candor.
Professor Kapp opens with observations and predictions about the potential for Americans to continue to own firearms as they age, even if they have declining cognition. He writes:
In the general population, the presence of firearms in the home is positively associated with the risk for completed suicide and being the victim of homicide. It is well-documented that “[g]un ownership and availability are common among the elderly”and that the rate of use of guns in suicides and homicides by older Americans is significant. Firearms, along with falls and motor vehicle accidents, cause the most traumatic brain injury deaths in the U.S. for people over age 75.
Mental illness has been found to be strongly associated with increased risk of suicide involving firearms. The disproportionate incidence and prevalence of cognitive and emotional disorders such as dementia, mild cognitive impairment, and depression--often presenting themselves simultaneously and exacerbating each other--among older persons has been identified clearly. However, many persons with such disorders do not receive a formal clinical evaluation for those issues. Age-associated decline in health status, in combination with other factors, is a risk factor for dementia.
Professor Kapp examines state laws and the collective role of the medical profession regarding firearms as a public health matter, including specific ideas about what might be an individual doctor's "duty to inquire about or report on access to weapons for a patient who demonstrates cognitive changes," and the potential for any such "duty" to impact patient choices about treatment. For example, he reports:
Under current law, physicians, with the possible exception of those practicing in Florida, have latitude to act according to their own discretion when it comes to questioning their patients about guns in the home in this context. According to a coalition of leading health professional organizations and the ABA, physicians are able to intervene with patients whose access to firearms puts them at risk of injuring themselves or others. Such intervention may entail speaking freely to patients in a nonjudgmental way, giving them safety-related factual information, answering patients' questions, advising them about behaviors that promote health and safety, and documenting these conversations in the patient's medical record (just as the physician would document conversations with their patients regarding other kinds of health-related behaviors).
On free speech implications, he writes:
The courts thus far are split in their responses to First Amendment challenges to compelled medical speech brought by physicians qua physicians in their role as patient fiduciaries or trust agents (as opposed to claims brought by physicians seeking protection in their capacity as ordinary citizens). Nevertheless, there is a strong argument for requiring that state laws compelling particular speech by physicians in their physician role be examined under at least a strict scrutiny standard.
And to further whet your appetite for reading the full article, in his conclusion, Professor Kapp advocates for certain changes in state law, including:
State statutes should authorize physicians to inquire of and about their older patients regarding patient access to firearms in the home and to counsel the patient, family members, and housemates about firearms safety, up to and including recommending that firearms be kept away from the patient. However, the states should not enact legislation that positively requires the physician to make such inquiries and engage in counseling, although states should consider a tort standard of care evolving through the common law in a direction that imposes an affirmative obligation on the physician to inquire and counsel.
The full article appears in the Spring 2016 issue of the Kansas Journal of Law & Public Policy.
June 9, 2016 in Cognitive Impairment, Consumer Information, Crimes, Current Affairs, Dementia/Alzheimer’s, Discrimination, Ethical Issues, State Cases, State Statutes/Regulations | Permalink | Comments (0)
Friday, May 13, 2016
Evict, Reject, Discharge: Are Nursing Homes Following the Rules or Is the Problem Bigger than "Rules"?
My colleague Becky Morgan posted earlier this week on the AP news story on nursing homes' attempts to evict difficult patients. This week the ABA Journal also linked to the AP story, plus tied the statistical reports of a nation-wide increase in complaints about evictions, rejections and discharges to one man's struggle to return to his California care center following what should have been short term hospitalization for pneumonia.
The story of Bruce Anderson is a reminder that a need for high-quality, facility-based "long term " care is not limited to "elderly" individuals. But it is also a reminder that individuals with serious behavioral issues, not just physical care needs, complicate the picture. Anderson experienced a severe brain injury at age 55 following a heart attack, but his younger age, lack of "private pay resources," and a history of apparently problematic behavior, are all reasons why a "traditional" nursing home may seek to avoid him as a resident.
The ongoing California litigation over Mr. Anderson and similarly situated residents heightens the need to think critically about whether we're being naive as a nation about "home is best" shifting of funding resources. Certainly there are many -- and probably too many -- individuals in facilities when they could be maintained at home if there was more funding to supplement family-based care.
At the same time, I tend to see this as downplaying the very real needs for high-level, behavioral care for individuals who aren't easily cared for by families or "traditional" nursing homes, much less by hospitals organized around critical care. It is about more than mere eviction, discharge and rejection statistics. The 1999 Olmstead decision was a watershed moment in recognizing the need for de-institutionalization of those with disabilities. But it may have pasted over the real need for quality of assistance and care in any and all settings, and what that means in terms of costs to a nation.
My thanks to Professor Laurel Terry at Dickinson Law who took time away from the fun of grading her exams to send us the ABA story.
Tuesday, May 3, 2016
The New York Times ran a story on May 2, 2016 that South Dakota is under investigation by the federal government for improperly placing many residents with disabilities in nursing homes instead of providing care in the community. South Dakota Wrongly Puts Thousands in Nursing Homes, Government Says reports that "the Justice Department said ... that thousands of patients were being held unnecessarily in sterile, highly restrictive group homes. That is discrimination, it said, making South Dakota the latest target of a federal effort to protect the civil rights of people with disabilities and mental illnesses, outlined in a Supreme Court decision 17 years ago."
As the story notes, many individuals need the level of care provided by a nursing home, but others do not. "But for untold numbers of others — with mental illnesses, developmental disabilities or chronic diseases — the confines of a nursing home can be unnecessarily isolating. Yet when patients seek help paying for long-term care, states often steer them toward nursing homes, even though it may not be needed." The article discusses the Olmstead decision and the government's strategies in these cases to challenge the placement.
South Dakota responded that they have made progress but the federal government sees it as not enough, especially since this is not a recent situation. "In-home health aides can be less expensive than nursing homes because they do not provide unnecessary services. States, though, face a chicken-or-egg conundrum. Does money go to nursing homes because beds are often more readily available than in-home services? Or are there fewer in-home services because less Medicaid money is spent on them? And nursing homes have little financial incentive to encourage patients to seek in-home care...."
This article can be a great starting point for an interesting discussion with students.
Wednesday, April 27, 2016
Southern California attorney and mediator Jill Switzer, who writes columns for Above the Law as "Old Lady Lawyer," uses lyrics from Kenny Rodger's The Gambler as part of her theme in a recent essay. She asks whether lawyers prepare themselves, not just financially, but emotionally, to retire at the right time. Suggesting the answer is "probably not," Switzer draws on data from a recent California State Bar survey:
On its website, the State Bar of California recently asked its lawyers “how long do you plan to keep practicing law?” The poll was completely unscientific, as it didn’t tally the results by age, years in practice, or any other criteria whatsoever. However, the result was not surprising, at least to this dinosaur: more than fifty percent of the responding lawyers said they would continue to practice as long as they are able. (Ten percent or so said they were looking to switch careers as soon as possible, approximately twenty percent said that they hoped to take early retirement, and approximately fifteen percent said they’d practice until they turned sixty-five. Note to millennials: the retirement age at which you can start receiving full Social Security benefits is creeping upward.)
And speaking of "farewell," did you notice that Above the Law recently terminated the "comments" option for readers of the frequently sharp-tongued blog? Details here, and I suspect a few readers might view this change as somewhat ironic.
Tuesday, April 26, 2016
I was bemused to realize that I was on my way to vote today in the primaries in Pennsylvania without knowing in advance the outcome of a dispute over language to be used on an a referendum issue on the ballot. The issue was mandatory retirement ages for judges in Pennsylvania. In Pennsylvania, state judges are elected.
An early formulation of the referendum question was as follows:
Shall the Pennsylvania Constitution be amended to require that justices of the Supreme Court, judges, and magisterial district judges be retired on the last day of the calendar year in which they attain the age of 75 years?
An alternative proposal for the wording was:
Shall the Pennsylvania Constitution be amended to require that justices of the Supreme Court, judges and justices of the peace (known as magisterial district judges) be retired on the last day of the calendar year in which they attain the age of 75 years, instead of the current requirement that they be retired on the last day of the calendar year in which they attain the age of 70?
Interesting, yes? The wording does appear to potentially influence the outcome on the referendum, particularly in a state where there has been a fair amount of turmoil about behavior of members of the judiciary, unrelated to age issues, but also unlikely to make the average member of the public eager to vote to extend time in office. From an education-of-the-voter standpoint, I was relieved when I saw the latter version on the ballot.
For more, read Penn Live's recent coverage on the "age" issue here. Plus, look for the outcome on the issue in news coverage after Tuesday's primary election.
4/26/16 Noon UPDATE: It turns out that even though "my" precinct's electronic ballot contained a referendum regarding the mandatory retirement age for judges, any vote on that issue doesn't actually count. The Pennsylvania legislature voted to take the judicial age question off the primary ballot. So, despite my own preference for an "educate-the-voter" version for such a referendum, on November 8 the "first" version of the language quoted above will appear. Hmmmmm. Here's more on this topic.
Tuesday, March 15, 2016
Our thanks to George Washington Law Professor Naomi Cahn for passing on this item from the Washington Post:
“I speak to a lot of big audiences of people over 50 looking for jobs,” says Kerry Hannon, career expert and author of “Getting the Job You Want After 50 for Dummies.” “I feel and I see the palpable fear. The job market has not improved for this set of people.”
“It’s not a pretty scene,” she says. “What happens is people say they will keep working, but for various reasons, including health, they don’t keep working.”
Employment consultant Sara Rix says surveys show that up to 80 percent of people think they will work in retirement. A much lower percentage of people actually do (19 percent, according to the AARP).
People don’t continue working for many reasons: layoffs, health and unexpectedly becoming a caregiver are just a few.
Those still able to work can face tremendous difficulties finding a new job. The elephant in the room is age discrimination....
For the full article by Columnist Rodney Brooks, see "Not Ready to Retire, But Not Finding Work."
Monday, January 25, 2016
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)
Friday, January 22, 2016
In South Korea, "filial duty" is apparently a hot topic, as reflected by a recent Korean Supreme Court ruling and a public survey. And it is more than a theoretical concept or moral obligation, with "contract" law principles now coming into play. As reported in English by the Korea Herald, published on December 30, 2015:
More than 75 percent of South Koreans surveyed by a local pollster think “filial duty contracts” -- a legal document that makes it mandatory for all grown children to financially and emotionally care for their aged parents -- are necessary should they receive any gifts such as real estate or stocks from them.
The survey results were released two days after the Supreme Court ruled in favor of an elderly father who filed a suit against his son, who, in spite of signing a filial duty contract, did not care for his ill mother as promised after receiving a personal estate. The court acknowledged the legality of the document and ruled the son must return the property to his father, as the property was gifted in exchange for his support.
Although "filial duty" has long been considered an important, traditional value in Korea, "the nation's changing family structure" and high costs for housing and education apparently have made it more difficult for elderly Koreans to rely on their children for voluntary care. The survey, of 567 Koreans, showed strong support for greater enforcement of "filial duty contracts."
Under the current law, a donor may rescind a gift contract if the recipient committed an act of crime against the donor, or if “the beneficiary is obliged to support the donor but does not do so.” However, the law also states that rescinding a gift contract does not have any effect once the gift has already been given to the beneficiary.
For more details, including a report on a pending bill that would give "Korean parents the right to sue their children in case of mistreatment and to ask them to return any gifts," read "77% of South Koreans See Need for 'Filial Duty Contracts.'"
Friday, January 15, 2016
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.
Thursday, January 14, 2016
We do not think much about silence, perhaps especially in law school and as lawyers. In the law, we tend to ignore silence, typically referring expressly to silence in one of two contexts: (1) the right to remain silent (in the criminal law context) and (2) silence as constituting consent (in the contract law context). Silence is an overlooked area with tremendous potential for facilitating the practice of law and helping clients.
From this broad introduction to the potential significance of silence, in the second half of her article Professor Bassett focuses more specifically on older clients, and the subtle ways in which "age bias" can influence an attorney-client relationship. For example, she writes:
When lawyers quickly fill in silences by asking additional questions, one risk is that the lawyer’s questions may reflect inaccurate assumptions or even stereotypes. Suppose, for example, that a client seeks legal advice about drafting a will, and the client briefly stops talking. Uncomfortable with the silence, the lawyer rushes in to fill that silence by asking, “Do you want your children to receive everything?” That question reflects an assumption—a common assumption, but an assumption nonetheless—that parents always want to bequeath everything to their children. Perhaps the client indeed does want to leave everything to his or her children, but the lawyer’s preemptive question may cause the client to feel uncomfortable expressing a contrary desire.
Good fuel for discussion in a variety of courses.
My thanks to Dickinson Law Professor Laurel Terry for sending the link to this article.
Wednesday, December 30, 2015
I was reading recently about microaggressions and was interested in this article in Huffington Post/ Post 50 on microaggressions as it pertains to elders. 10 Microaggressions Older People Will Recognize Immediately explains that microaggressions are "the small everyday slights (intended or otherwise) that harbor an underlying attitude of racism, sexism or homophobia -- have been making the rounds of college campuses and workplaces." The article explains that microaggressions also occur against elders and need to be included in the national discussion. The article provides 10 examples of microaggressions, including tone of voice, unflattering language and commercials, jokes about elders' lack of technology skills, and professionals talking to the child instead of the elder.
Having students list examples of such microaggressions could be an interesting exercise for a discussion about ageism.
Wednesday, December 16, 2015
As reported in the San Diego Tribune, Housing for Gay Seniors Coming to San Diego
A local nonprofit is preparing to build San Diego’:s first low-income apartment complex geared for senior citizens who are lesbian, gay, bisexual or transgender. When the 76-unit complex opens in North Park, San Diego will join Chicago, Philadelphia, Los Angeles and San Francisco as cities that provide this kind of housing.
Such housing is considered crucial because members of the LGBT community often feel unwelcome in ordinary senior complexes, where the older residents tend to be less open to alternative lifestyles.
“The people who will live here paved the way for younger LGBT generations, and many of them are forced back into the closet in traditional senior communities because of a lack of acceptance,” said Delores Jacobs, chief executive of the San Diego LGBT Community Center.
The $27 million complex will be open to all seniors, but the nonprofit building it — Community HousingWorks — plans to create a welcoming environment for LGBT seniors that will encourage them to move in, including on-site supportive services coordinated by the local LGBT Community Center.
Tuesday, December 8, 2015
As I prepare to teach both Contracts and Elder Law in the spring semester of 2016, I'm reminded by a recent ruling of why I added Contracts to my teaching package a few years ago. Protection of older persons often depends on how contracts are written, whether we are talking about insurance, health care, nursing home admissions, or age discrimination.
On the latter point, the Supreme Court of North Dakota recently affirmed summary judgment in favor of the employer on a claim by an employee that her dismissal violated the age discrimination rules under the state's Human Rights Act, pointing to the fact that the employee's termination was consistent with her employment contract as an at-will employee. The court ruled:
[The employer] Altru provided evidence in support of its summary judgment motion that [the employee] Yahna was a vascular ultrasound technologist and was required to take on-call responsibilities because she was not a supervisor or manager. Although Yahna claims she retained her supervisor and quality assurance responsibilities after Altru restructured the ultrasound department and when she was terminated, her argument ignores the effect of Altru's restructured ultrasound departments. We decline to construe the Human Rights Act to preclude an entity from restructuring its business and altering employee job responsibilities. Yahna's conclusory assertions about her understanding or belief regarding her job responsibilities after the restructuring do not raise a disputed factual issue that she refused to perform the on-call requirements for a vascular technologist at the time she was terminated. Yahna's speculation about her job position is not sufficient to defeat Altru's motion for summary judgment and she has not provided competent evidence to raise a factual issue that she was not a vascular technologist when she was terminated and that she was treated differently than other vascular technologists in Altru's restructured ultrasound department. Viewing the evidence in the light most favorable to Yahna, the evidence does not raise an inference that she was discharged because of her age; rather, she was terminated because she refused to be available for on-call responsibilities required for vascular technologists after Altru restructured the ultrasound department.
For the full opinion, see Yahna v. Altru Health System, 2015 ND 275, published December 1, 2015.
Tuesday, November 17, 2015
The Washington Post's magazine section runs a Work Advice column by Karla Miller. A recent question was intriguing:
As a longtime colleague of Susan’s, I’ve been asked by her boss to feel out whether she really means to leave the office only if “taken out in an ambulance or a coffin” (the boss’s words). I agree that it is probably time for her to retire (she is financially well off), but I also know she gets great satisfaction from her work. Should I broach the subject with Susan as a caring co-worker?
The response urges caution in participating in the employer's plan, observing bluntly "that smells like a steaming heap of age discrimination."
For the full discussion, See @Work Advice: Putting the Old, Gray Co-Worker Out to Pasture.
Wednesday, October 14, 2015
The Department of Justice announced a $255,000 settlement vs. a CCRC. United States Obtains $255,000 Settlement of Disability Discrimination Lawsuit Against Continuing Care Retirement Community in Lincolnshire, Illinois explains a proposed settlement (the settlement has to be approved by the court). The press release explains that this settlement resolves "allegations that the owners and managers of a continuing care retirement community known as Sedgebrook violated the Fair Housing Act by instituting policies and maintaining practices that discriminated against residents with disabilities at the facility, which is located in Lincolnshire, Illinois..."
The complaint alleges that since 2011, Sedgebrook has instituted a series of policies that prohibited, and then limited, residents’ ability to dine in the communal dining rooms of the independent living wing of the facility if they required assistance eating due to a disability. Additionally, the complaint alleges that Sedgebrook maintained a policy prohibiting residents of the independent living wing from hiring live-in caregivers and refused to grant reasonable accommodations to that policy that would have allowed Sedgebrook residents with disabilities to use and enjoy their apartments.
As part of the settlement, the CCRC "will appoint a Fair Housing Act compliance officer and will implement a new dining and events policy, a new policy applicable to residents’ private employment of caregivers, and a new reasonable accommodation policy. Additionally ... the company that manages Sedgebrook and is a named defendant in the lawsuit, will take steps to implement similar policies at the over 100 independent living and continuing care retirement communities it owns or manages across the country."
The complaint and consent order are available for download here.
Monday, September 28, 2015
Thomas Jefferson School of Law is hosting its second annual student writing competition focusing on disability law. The Crane Writing Competition, named in honor of a Thomas Jefferson alum, Jameson Crane III, seeks to encourage student scholarship at the intersection of law and medicine, or law and social services. A central purpose is to further development of legal rights and protections, and improve the lives of those with disabilities.
Who can enter? The competition is open to currently enrolled law students, medical students and doctoral candidates in related fields, who attend an accredited graduate program of study in the U.S.
Deadline for entries? January 15, 2016 (by midnight, Pacific Standard Time) via electronic submission. For details see the competition website at Thomas Jefferson School of Law: http://www.tjsl.edu/cranewritingcompetition
What will be your topic? The competition accepts papers on a wide range of topics related to disability law, including legal issues arising from employment, government services and programs, public accommodations, education, higher education, housing and health care. This should integrate well with students currently taking or who have recently completed a seminar course, thus allowing that all important "double value" for good papers.
Prizes include cash ($1,500 to first place; $1,000 for each of two second place winners), plus potential publication.
My thanks to Professor Susan Bisom-Rapp for sharing news of this year's competition. She is coordinating the competition and you can send questions directly to Susan.
Wednesday, September 2, 2015
UCLA's Center for Health Policy Research has issued its August 2015 report on "The Hidden Poor," using county-by-county data to demonstrate that "federal" definitions of poverty are not a sufficient measure of true poverty for seniors. What are the "hidden poor?" The UCLA report explains: "The Hidden Poor are defined as those who have incomes above 100 percent of the Federal Poverty Level (FPL), but who do not have enough income to make ends meet as calculated by the Elder Index."
A recent article in the Sacramento Bee highlights key components of the analysis:
More than 300,000 elderly Californians are officially poor, as measured by the federal government, but their numbers triple to more than 1 million when the “hidden poor” are counted, according to a new study from UCLA’s Center for Health Policy Research.
National poverty guidelines say that for a single elderly adult living alone, the poverty line is $10,890 a year, but UCLA’s “elder index” puts it at $23,364 in California.
Those “hidden poor” Californians over 65 tend to be Latino or black. Their greatest concentrations are found in rural counties with overall low income levels, topped by Imperial County, where more than 40 percent of the elderly are the hidden poor....
The study said population groups with especially large proportions of the hidden poor include grandparents raising grandchildren, elderly with adult children living at home, and single elders.
Accurate measurements of poverty are core to planning of resources for any age group, including seniors. How does your state account for needy seniors?