Monday, November 17, 2014

PA Supreme Court's Elder Law Task Force Issues "Bold" Recommendations

On November 17,  2014, following more than a year of study  and consultation, the Pennsylvania Supreme Court's Elder Law Task Force issued a comprehensive (284 pages!) report and recommendations addressing a host of core concerns, including how better to assure that older Pennsylvanians' rights and needs are recognized under the law.  With Justice Debra Todd as the chair, the Task Force organized into three committees, focusing on Guardianships and Legal Counsel, Guardianship Monitoring, and Elder Abuse and Neglect.  The Task Force included more than 40 individuals from across the state, reflecting backgrounds in private legal practice, legal service organizations, government service agencies, social care organizations, criminal law, banking, and the courts. Pennsylvania Supreme Court Elder Law Task Force 2014 

From the 130 recommendations, Justice Todd highlighted several "bold" provisions at a press conference including:

  • Recommending the state's so-called "Slayer"  law be amended to prevent an individual who has been convicted of abusing or neglecting an elder from inheriting from the elder;
  • Recommending changes to court rules to mandate training for all guardians, including, but not limited to, family members serving as guardians;
  • Recommending adoption of mandatory reporting by financial institutions who witness suspected elder abuse, including financial abuse.

The full report is available on the Pennsylvania Supreme Court website here.  As a consequence of the Task Force study, the Supreme Court has approved the creation of an ongoing "Office of Elder Justice in the Courts" to support implementation of recommendations, and has created an "Advisory Council on Elder Justice to the Courts" to be chaired by Pennsylvania Superior Court Judge Paula Francisco Ott. 

November 17, 2014 in Consumer Information, Crimes, Current Affairs, Housing, State Statutes/Regulations, Statistics | Permalink | Comments (0) | TrackBack (0)

Thursday, November 6, 2014

NYT: Calling for "Silver" (Higher) Standards in Architecture and Design

Dr. Louise Aronson, a clinical professor in Geriatrics at University of California San Francisco, wrote a great piece in the New York Times recently, calling for a "silver" standard for architecture and design, to better meet the needs of older adults in public and private accommodations, while also making life easier and safer for everyone.  She explains:

"I unloaded the walker and led my 82-year-old father through the sliding glass doors. Inside, there was a single bench made of recycled materials. I noticed it didn’t have the arm supports that a frail elderly person requires to safely sit down and get back up. It was a long trek to the right clinic and I was double-parked outside. Helping my father onto the bench, I said, “Wait here,” and hoped he would remember to do so long enough for me to park and return.

 

He nodded. We were used to this. It happened almost everywhere we went: at restaurants, the bank, the airport, department stores. Many of these places — our historic city hall, with its wide steps and renovated dome, the futuristic movie theater and the new clinic — were gorgeous.

 

The problem was that not one of them was set up to facilitate access by someone like my father."

The irony was that the medical center building Dr. Aronson was writing about was brand new and renowned for its "green" design.  Nonetheless, it was failing to meet the practical needs of its many silver-haired clients. 

For more on how a revolution -- and incentives -- are needed to better meet the needs of an aging world, see "New Buildings for Older People."   

November 6, 2014 in Consumer Information, Discrimination, Housing, Property Management | Permalink | Comments (0) | TrackBack (0)

Monday, November 3, 2014

Lillian Hyatt and the Importance of Advocacy -- Even In Your 80s

 

While I was in California last summer, a friend introduced me to Lillian Hyatt.  I had already known of her by reputation and it was a real pleasure to speak to her in person and to continue our communications by telephone and mail. She's a dynamo, a person who does not take aging "lying down."  Born in 1925 (believe me, she doesn't mind me disclosing that fact!), Lillian Hyatt is just about as active in "retirement" as she was during her many years as a writer, consultant, advocate, social worker, and university professor. 

So I was especially interested to notice that when I clicked on a hyperlink embedded in a recent New York Times article about the impact of "falling" in an "aging nation," it took me to  a press release about Lillian Hyatt.  Back in 2008, Ms. Hyatt filed suit against a California Continuing Care Retirement Community (CCRC), to prevent it from banning walkers from the dining room of this high-end retirement community.   She needed the walker to maneuver in what was, in essence, her home. 

The lawsuit, asserting violation of the federal Fair Housing Act and other state and federal laws that address discrimination based on disability, was settled in 2010.  Others have pursued similar claims in assisted living settings, public spaces and more.  For more on the continuing impact of Ms. Hyatt's advocacy -- even though, curiously, she is never mentioned by name in the NYT article -- read "Bracing for the Falls of an Aging Nation."  Advocates such as Ms. Hyatt challenge all of us to work harder to find a better balance between protection and respect for independence.

November 3, 2014 in Consumer Information, Current Affairs, Housing, Retirement | Permalink | Comments (0) | TrackBack (0)

Wednesday, October 29, 2014

Non-Profit versus For-Profit Long-Term Care Providers: Does It Make a Difference?

LeadingAge is an organization representing "nonprofit" long-term care providers, including operators of CCRCs, home health agencies, day-care centers, nursing homes, Section 8 public housing, and similar companies.  During the recent national meeting of LeadingAge in Nashville, one topic was an "alarming trend" in the growth of the for-profit long-term care sector.  As reported in McKnight's,  during the conference LeadingAge Chairman David Gehm warned the audience that the for-profit sector is "growing nearly eight times as fast as the nonprofoit sector ... citing figures from investment bank Ziegler."  Gehm is reported as pointing to reduced access to affordable capital as as one factor contributing to the pressures on the nonprofit industry.  He argued a "vibrant nonprofit long-term care sector benefits the whole country."  

On the consumer-cost side of the equation, it does seem that what was once a price differential between the two sectors for cost of care is narrowing.  Nonetheless, historically there has been a certain additional trustw0rthiness factor associated with monprofit providers that often gave them an edge in the marketplace. But is that still true? 

As my students in my Nonprofit Organizations class come to realize, there is often a difference between "charitable" care and "nonprofit" care.  But is the difference between nonprofit care and for-profit care becoming harder to evaluate? 

October 29, 2014 in Consumer Information, Health Care/Long Term Care, Housing | Permalink | Comments (1) | TrackBack (0)

Monday, October 27, 2014

Debating Fiduciary Duties and Resident Rights in Continuing Care Communities

Last week I was part of a panel hosted by the National Continuing Care Residents' Association (NaCCRA) in Nashville, a component of the larger (much larger!) annual meeting of LeadingAge.  The theme for the panel was "Resident Engagement in Continuing Care Life" and for my part of the panel, I used an interesting Third Circuit bankruptcy court decision, In re Lemington Home for the Aged, to discuss whether residents of financially troubled CCRCs should be treated as entitled to enforce specific fiduciary duties owed by the CCRC owners to creditors generally, even unsecured creditors, fiduciary duties that may give rise to a direct cause of action connected to "deepening insolvency."  NaCCRA LeadingAge Meeting October 2014

Jennifer Young (pictured on the left), a CCRC resident, talked about what it is like to "be" an unsecured creditor in a CCRC's Chapter 11 bankruptcy court proceeding.  Her explanation of how creditors' committees operate in bankruptcy court (including how they hire legal counsel and how that counsel is paid out of the Debtor's estate) was both practical and illuminating.  The closing speaker on the panel was Jack Cumming (below left). Jack's has deep experience as an actuary and a CCRC resident.  He noted the disconnect between the intentions of providers and the realities faced by residents and called for stronger accountability in investment of resident fees.Jack Cumming October 2014  I always come away from my time with Jack with lots to think about. Our moderator was NaCCRA president Daniel Seeger (right), from Pennswood Village in Pennsylvania.  Dan Seeger October 2014

In my final comments, I reminded our audience that even though our panel was focusing on "problems" with certain CCRC operations, including some multi-site facilities, many (indeed most) CCRCs are on sound financial footing, especially as occupancy numbers rebound in several regions of the country.  Both panelists and audience members emphasized, however, that for CCRCs to be able to attract new residents, the responsibility of the CCRC industry must improve.  For more on these financial points, go to NaCCRA's great educational website, that includes both text and videos, here.

Interestingly, during the LeadingAge programming that began on Saturday, October 18 and continued through October 22, I was hearing a lot about a potentially major shift in the long-term housing and service market.  Some of the largest attendance was for deep-dive sessions on new service models for "Continuing Care at Home," sometimes shortened to CCAH or CCaH.  CCAH is often seen as a way for more traditional CCRCs to broaden their client base, particularly in the face of occupancy challenges that began with the financial crisis of 2008-2010.  

As a corollary of this observation about market change, one of the topics under debate within the leadership of LeadingAge is whether Continuing Care Retirement Communities need a new name, and I can see movement to adopt a name that aligns better with the larger menu of non-facility based services that many providers are seeking to offer. 

Of course, as a law professor, I wonder what these market changes mean for oversight or regulation of new models.  Not all states are keeping up with the changes in the Continuing Care industry, and name changes may complicate or obscure the most important regulatory questions.       

October 27, 2014 in Current Affairs, Ethical Issues, Federal Cases, Health Care/Long Term Care, Housing, Retirement, State Cases, State Statutes/Regulations | Permalink | Comments (0) | TrackBack (0)

Tuesday, October 21, 2014

Alberta care homes fight to prevent release of financial reports

Via the Calgary Herald:


A continuing care operator is fighting a recent ruling by Alberta’s information czar that would reveal how hundreds of millions in taxpayer dollars are spent each year at the province’s nursing homes and supportive living facilities.  A continuing care operator is fighting a recent ruling by Alberta’s information czar that would reveal how hundreds of millions in taxpayer dollars are spent each year at the province’s nursing homes and supportive living facilities.  Shepherd’s Care Foundation is asking the courts to overturn a decision by the Office of the Information and Privacy Commissioner ordering the release of the complete annual financial returns it and other operators file with Alberta’s health authority.  In a notice seeking judicial review, the Edmonton-based organization says making the returns public under the province’s freedom of information legislation would cause significant harm to its business and labour relations interests.  Filed as a condition of the facility’s contract with Alberta Health Services, the returns show the amounts a facility derives each year from the public purse and from resident fees.  The document also details how much of that money is spent on care, food and administration and whether any surplus or profit is left over at the end of 12 months.  The OIPC ruling stems from requests filed with AHS by the Alberta Union of Provincial Employees several years ago for the returns of 15 continuing care operators with which it was involved in collective bargaining on behalf of workers.

Read more here.

October 21, 2014 in Consumer Information, Housing, International | Permalink | TrackBack (0)

Monday, October 20, 2014

Improvements Coming to Nursing Home Compare

Earlier this month, CMS announced that it was going to update and improve the Nursing Home Compare site, which should result in more accurate information available for consumers. According to the October 6, 2014 press release, "the expansion and strengthening of the agency’s widely-used Five Star Quality Rating System for Nursing Homes will improve consumer information about individual nursing homes’ quality."

Starting in January, "CMS and states will implement focused survey inspections nationwide for a sample of nursing homes to enable better verification of both the staffing and quality measure information that is part of the Five-Star Quality Rating System." CMS is also adding to the quality measures used. Also CMS will be doing some "focused survey inspections" for verification purposes  of the information that is being submitted.

According to the Center for Medicare Advocacy October 16, 2014 weekly alert, a new law, "[t]he Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act of 2014) ... supports one of the key changes –providing funding to implement a provision of the Affordable Care Act (ACA) that requires nursing home staffing data reported on Nursing Home Compare to be electronically-submitted and "based on payroll and other verifiable and auditable data."

Check it out!

October 20, 2014 in Consumer Information, Health Care/Long Term Care, Housing, Medicare | Permalink | Comments (0) | TrackBack (0)

Monday, October 13, 2014

NSCLC Hosts Webinar on "Assisted Living State by State"

Our friends at National Senior Citizens Law Center, in cooperation with the Assisted Living Consumer Alliance, are hosting a free webinar on Wednesday, October 22 on "Assisted Living State by State."

The program will offer several perspectives on regulatory systems that may affect the range of care options that are not defined as "skilled care."  The program will use California has part of the focus, while explaining what regulations are already in use and whether improvements are needed across the nation.

Here's additional information the link for registration for this free, hour-long program.   

October 13, 2014 in Housing, Webinars | Permalink | Comments (0) | TrackBack (0)

Monday, October 6, 2014

Sharing As Our Future?

Remember as little kids our parents taught us that sharing was a good thing?  Sharing has its benefits, as we all know, and I'm sure we have all talked about shared housing in our classes. One of the hottest trends right now is car sharing.

There is an organization that is devoted to shareablity. The website,  Shareable "is an award-winning nonprofit news, action and connection hub for the sharing transformation. What’s the sharing transformation? It’s a movement of movements emerging from the grassroots up to solve today’s biggest challenges, which old, top-down institutions are failing to address."

It appears that Seoul, South Korea has taken sharing to an entirely new dimension as they are the "sharing city." Sharing City Seoul: A Model for the World reports on Seoul's Sharing City initiative, started in 2012.   The story Is Seoul the Next Great Sharing City? explains that city leaders determined  to position "it... to be a model city for sharing. A new, city-funded project called Sharing City, Seoul aims to bring the sharing economy to all Seoul citizens by expanding sharing infrastructure, promoting existing sharing enterprises, incubating sharing economy startups, utilizing idle public resources, and providing more access to data and digital works." The laudable goals of becoming the model sharing city include "to create jobs and increase incomes, address environmental issues, reduce unnecessary consumption and waste, and recover trust-based relationships between people."

How does this connect to elder law? The Next Great Sharing story explains that part of the sharing initiative includes shared housing, "connecting senior citizens who have extra rooms with students who need a room."  There is also information about shared meals and other initiatives. Think how the sharing model could help eliminate isolation amongst elders! 

Is it working? The Model story from June of 2014 provides an update: Housing and Inter-generational Connection: To address the housing crisis and reduce the social isolation of seniors, a program was created to match young people with idle rooms in seniors’ houses. There have been 28 matches to date."

There is also a working group on a sharing economy movement in San Francisco. There are policies  for a shareable community available for city leaders (request here).

Thanks to my dear friend and colleague, Professor Mark Bauer, for sharing the article with me. 

 

October 6, 2014 in Consumer Information, Housing, International | Permalink | Comments (0) | TrackBack (0)

Tuesday, September 30, 2014

Aussie way of life ideal for dementia-friendly communities

Via the Canberra Times:

Australia, with its weather, way of life and friendly people, has a unique advantage to produce "dementia-friendly" communities and help those affected lead fulfilling lives, according to a visiting British expert. Steve Milton, a director of Innovations in Dementia in Britain, was in Canberra this week to give a talk about dementia-friendly communities on behalf of Alzheimer's Australia.  There were sound economic reasons for supporting people with dementia at a community level, he said. "If you were able to prevent people with dementia going into care homes earlier than they needed to by 12 months, we're looking at a saving of $2 billion, which is not an insignificant amount to do something that people want anyway."  Alzheimer's Australia national president Graeme Samuel said it was important to help people with dementia sustain their independence, dignity and sense of community.  Milton said access to public transport, ensuring environments were easily accessible to people with dementia and things such as Australia's many sports clubs were important factors in helping those affected overcome barriers such as social isolation and stigma.  

Read more here.

September 30, 2014 in Cognitive Impairment, Housing, International | Permalink | TrackBack (0)

A Different Housing Bubble? Elders Selling Homes.

Kudos again to my friend and colleague, Professor Mark Bauer (current chair of the AALS Aging & Law section, btw) for sending me this article, The Great Senior Sell-Off Could Cause the Next Housing Crisis.  The article appeared in The Atlantic's CityLab, and although the article was published in 2013, I think it is still important to read (if you didn't when it was first published) because it predicts the busting of another housing "bubble" starting in 2020, just 6 years from now.

The article opens with looking at the various names of animals being swallowed by the python (that is, the Boomers and the American population). (As an aside, the article lists a number of animals--I'd only heard of the pig, but now I know we Boomers might also be compared to a bunny (cute) or "a really big rat" (ugh)). But I digress.

The focus of the article is on what will happen when the Boomers reach a certain age where they decide to sell their homes...and hope there are buyers galore for them. A researcher quoted in the article indicates that in certain larger metro areas, there should be buyers, but in less populous areas, not so much.  He describes what he calls "the “great senior sell-off” .... sometime later this decade ... [that] he predicts that it could cause our next real housing crisis."

Changing demographics will also affect the housing market and demand will not be in sync with supply as housing preferences change with age and demographics.  There is something of a bleak housing future ahead for many elders, according to the expert, who predicts "there will be two classes of seniors in America: those “aging in place” voluntarily, and those “aging in place” involuntarily because they can’t sell their homes."  His concerns about aging in place are best summarized by how a person's abilities change once s/he gets to an advanced age and becomes unable to do basic upkeep or maintenance yet the housing market will tumble, leaving some only the choice of abandoning their homes.

September 30, 2014 in Current Affairs, Housing, Retirement, Statistics | Permalink | Comments (0) | TrackBack (0)

Friday, September 26, 2014

Add This to Your Vocabulary: The Grey Belt

I always love learning new lingo.  I've heard parts of the US described as the "sun belt", the "rust belt" and the "corn belt" to name a few. Now I've learned that I live in the "sun belt" and next door to the "Grey Belt."  Thanks to my friend and colleague Professor Mark Bauer for sending me the Associated Press article, Fla.'s 'Gray Belt' a glimpse at nation's future. 

According to the article, Citrus County, Florida is the heart of the "Grey Belt"  in which "more than a third of residents are senior citizens, one of the highest rates in the nation... The county isn't simply a stereotype of Florida, where in just 15 years, one in four residents will be 65 or older. It's a peek into the not-too-distant future of the nation, where the number will be one in five."

So what's the implication of living in the "Grey Belt?"  The article notes that the businesses reflect the population and the economy shows the effect of such a population. For example, the story notes that the "economy based on low-skill jobs such as health-care aides, retail clerks and food service workers."  The result of a community where people move in to retire, rather than age-in place?  "[Those who move into an area generally aren't eager to fund schools ... whereas those who remain in the communities where they worked and raised their families tend to support education and other public spending that doesn't benefit them directly. Citrus County voters lived up to that thesis as recently as two years ago when they decisively rejected a referendum to raise property taxes to fund schools."

The article discusses the dilemma these cities face-they need younger folks to work in the service jobs that cater to the elder residents, but these folks don't always want to move to a community that is primarily elder residents.   One pastor even described his church as a "hospice church" because "congregants either die or move back north to spend their last years near relatives. Changes that might attract younger families for the almost 500-member congregation often meet resistance..."

Although Citrus County might be the center of the Florida Grey Belt, the phrase actually refers to a swath of 8 counties  with "among the oldest populations in the nation, not to mention in Florida, which has long had the highest rate of seniors in the nation, and will for decades yet... [with] Sumter [county] ...  home to the largest concentration of seniors of any county in the nation..."

Ok but really--is Florida the only location of the "Grey Belt"? We all know the US population is aging, so what about it--do we have more grey belts?  Depends on how you look at it. According to the AP article, "North Dakota, Texas, and Michigan have pockets of seniors on par with the Gray Belt counties in Florida. But unlike the Florida counties, which have grown from the migration of new seniors, they have gotten grayer as a result of younger residents leaving."

Keep in mind that the Florida grey belt only encompasses 8 counties. The state is a bit of a hodgepodge, demographically speaking, since the grey belt "contrasts starkly with the state's younger and more diverse major metro areas ...  and the interests of Gray Belt residents will diverge politically, socially and economically from Florida's more youthful cities."  Competing interests based on age will show up at the ballot box as well--talk about a tightrope for state leaders!

According to an economist with the U. of Florida ("in the nieghborhood" of the grey belt), "[s]ince voting power will tilt in favor of the older residents because of their higher voter-participation rates, the key to keeping both sides happy is to devolve all kinds of governmental decisions on taxes, planning and education from the state level to the local level so that residents in areas with both high and low concentrations of seniors will feel like their voices are being heard."

Here we go....and please, no jokes about Florida and voting. Deal?

September 26, 2014 in Current Affairs, Housing, Retirement | Permalink | Comments (0) | TrackBack (0)

Thursday, September 18, 2014

Home, Housing & Boomers

My colleague and dear friend Mark Bauer (current chair of the Aging & Law AALS section) sent me a link to an article published in CityLab.  The article is titled Where Are the Baby Boomers Going to Live Out Their Golden Years? The article mentions a recent report from Harvard's Joint Center for Housing StudiesHousing America's Older Adults. The Harvard website for this project includes a number of resources, including the report, an interactive map, an infographic, videos of the keynote address and panel discussion. If you don't have time to read the entire report, be sure to read the executive summary, available here.

The CityLab article mentions some other helpful sources, including an AARP survey on preferences regarding aging at home. The article references aging and disability, looking at the suitability of Boomers; homes for them in the future

The housing stock built for Baby Boomers largely wasn't designed with accessibility in mind. There are five universal-design housing features that tend to address a variety of disabilities that residents face as they age: no-step entries; single-floor living; switches and outlets set at lower heights; extra-wide hallways and doors; and lever-style doors and faucets. Nearly 90 percent of existing homes have one of these features, according to the report—but just 57 percent have two.

The article notes that more recently built homes are more likely to include at least some of these universal design features, but concludes

Yet these detached, single-floor, single-family homes—and the automobile-centric society that comes with them—are only going to fall further out of step with the needs of residents over time. And sooner rather than later. Homes can be retrofitted with lever-style handles and no-step entries (albeit at great expense). It's much harder to turn exurban and rural communities where older Americans live into places that nurture seniors rather than isolate them.

September 18, 2014 in Current Affairs, Housing, Retirement | Permalink | Comments (0) | TrackBack (0)

Wednesday, September 17, 2014

Question: What's the Green House Project? (Hint: It's Not About Growing Tomatoes)

Recently I sat in on a very interesting webinar on The Green House Project.  I had heard the phrase "green house" connected to new options for Continuing Care Retirement Communities (CCRCs), but I was not sure what it entailed, and it turns out it is not limited to CCRCs.  (When I first heard the term, I confused it with "green designs" intended to lower energy costs, or perhaps some movement to include gardening as therapy.) 

Here are a few highlights from what I now understand:

  • The Green House Project, about 11 years old, began with development support from a number of funding sources, including the Robert Wood Johnson Foundation, as a new approach to long-term care, requiring a major change in thinking about senior housing design and staffing.
  • The hallmark is person-centered care in a cluster setting of no more than 12 individuals, preferably 10.
  • Residents have individual bedrooms and bathrooms, thus creating "home" environments.
  • Meals are prepared and served in the central space - again, an effort to provide "home" settings.
  • No call buttons, no nursing stations, and as few wheelchairs as possible.
  • Expanded roles (and enhanced esteem) for staff members; the in-house caregivers or "shahbazim" have a wider range of responsibilities that include cooking and activity planning, and these roles involve specialized training.

Individual facilities can become "trademarked" Green Houses -- although the term has also become something of a trend in the senior housing industry, without being tied strictly to trademarking.  The Green House Project, a nonprofit organization, charges fees for formal consultations in the planning process. In some instances, fees may be covered by grants from other foundations. 

Here's the link to the Green House Project website, including information on additional upcoming (and free!)  webinars on financing, plus opportunities to participate in on-site workshops. I can see these as useful resources for students asked to consider new models for care.

September 17, 2014 in Health Care/Long Term Care, Housing, Webinars | Permalink | Comments (0) | TrackBack (0)

Tuesday, September 9, 2014

Intergenerational Housing--A Cool Idea From Oregon

One of the things (among the many things) I like to post about is the concept of age-friendly communities that allow a person to age in place.  Governing ran an article last month, showcasing a cool project in Oregon that provides intergenerational housing. Young and Old Find Common Ground in Oregon Housing Community explains about Bridge Meadows where elders and foster children reside in the same housing complex, where the units are provided for free to the foster parents.  "Bridge Meadows, a 36-unit apartment complex in [Portland] ... mixes incomes, generations and skill sets in a way that enlivens and enriches the lives of young and old alike." Twenty-seven of the units are for lower-income elders with the rest for those who will be foster parents (or even legal guardians) for at least 3 children within 5 years. Not only do the elders get a break on the housing costs they get to be involved!

[E]lders volunteer their time to work with the kids in the complex. For at least 100 hours per quarter, they tutor, cook, babysit, participate in outdoor activities and so forth. The complex also offers a computer room, library, public courtyard and community garden to help foster connections.

As far as the kids, the program has had a pretty significant impact. Of the "29 children ... 24 were formerly in foster care. Of those 24, just over half are either adopted or in legal guardianship and the rest are on their way to adoption or legal guardianship. In other words, they're all now part of functional families, in permanency or on their way."

The head of Bridge Meadows is pretty enthused about this model's ability to be duplicated, noting that it serves as a solution for 2 serious problems our society is facing, (1) "how to civically attend to our rapidly aging population and" (2) "how to place all the troubled kids peppering children and family services systems in the country."

The author has some concerns about effective replication but still considers this program jan important addition to the spectrum of strategies.  It is a nifty idea! More information about the project, as well as photos, are available on their website.

September 9, 2014 in Current Affairs, Housing, Other | Permalink | Comments (0) | TrackBack (0)

Monday, September 1, 2014

When You Need a Passport to Visit Mom

The NY Times ran an article a few days ago about retirees who are spending the rest of their lives (or a substantial part thereof) traveling...abroad.  The August 29, 2014 article, Increasingly, Retirees Dump Their Possessions and Hit the Road focuses on the rising number of individuals who choose to travel when they retire. The article cites to statistics from the Commerce Department that "[b]etween 1993 and 2012, the percentage of all retirees traveling abroad rose to 13 percent from 9.7 percent...." As well, over a quarter of a million Social Security recipients receive their benefits at an oversees address,  close to "48 percent more than 10 years earlier...."  The article discusses the value of post-retirement travel, from checking items off one's bucket-list, to quoting experts on how today's retirees are changing the notion of a "typical" retirement.  One expert describes the travel value this way: "an extended postretirement trip can assuage a sense of loss from ending a career."  Of course, many chose domestic travel over international, but the opportunities are there-whether to see the world, or to give back to a global community. 

The article highlights a trend of sorts. Of course, not everyone may choose this path for retirement. But it does make for an interesting question when deciding where to spend the holidays when mom is now living in another country ....

Thanks to Stetson Law student Erica Munz for bringing the article to my attention.

September 1, 2014 in Current Affairs, Housing, International, Retirement, Travel | Permalink | Comments (1) | TrackBack (0)

Sunday, August 24, 2014

Pennsylvania Commission Urges Reforms for Long-term Care Services & Supports

The Pennsyvania Joint State Government Commission issued a final report of its Advisory Committee on Long Term Care Services and Support for Older Pennsylvanians on August 21, 2014, following a year-long assessment of existing concerns of independent and care-dependent elders in Pennsylvania.

In a one-page summary of the 200 page report, the Commision makes the following Recommendations:

"Opportunities exist to improve system structure and organization, reduce barriers, and break down silos that characterize service delivery and payment. Better care transitions and improved coordination of service providers are also crucial, along with increased support for family caregivers. Focused information and awareness for consumers and families helps ensure they know where to turn when a crisis hits, which is often their first exposure to long term care. Expanding access to services and supports, through a tiered system that shares costs, will help improve quality and increase accountability. Enhancements to local resources, including Area Agency on Aging networks, will focus services and advance more equal community, facility, and home care options. These reforms will help ensure access to long term care for all Pennsylvania seniors, and prevent those who need assistance but don’t qualify for supports, from falling between the cracks."

Now comes the hard work . . . getting to an implementation stage.

August 24, 2014 in Health Care/Long Term Care, Housing, State Cases, State Statutes/Regulations | Permalink | Comments (0) | TrackBack (0)

Tuesday, August 19, 2014

A Sign of the Times? From Luxury Seaside Hotel to....

This summer I had the pleasure of visiting friends on the West Coast, including a stop in Carlsbad, California to learn more about actuarial and accounting standards for continuing care communities (CCRCs). As I walked into "Carlsbad by the Sea" on the corner of Grand Avenue and the old Pacific Coast Highway, I thought things looked a bit familiar.  The mission style, the healing waters from a "well" across the street, a Victorian style building a few steps away that I seemed to recall as the "chicken place" (and honestly, that's a compliment!) -- they all seemed familiar.  I telephoned my mother in Phoenix and asked, "by any chance, when I was a kid, did we ever stay at a hotel at this location?" 

My mother laughed and said that the family didn't -- but she and my father visited the historic Carlsbad Hotel on this spot in 1952 on their honeymoon! Cbts-historic-frontjpgShe told me they had the "best" roast beef in the dining room.  I had seen pictures  of my parents in photo albums, arm in arm in the hotel gardens and sitting on the steep steps to the beach.  (Later, as a family, we also toured Carlsbad on a family summer vacation -- hence my memories of the "chicken place," a restaurant popular with families because of a huge plaster chicken on the corner and live hens and roosters roaming the grounds.  At that age I didn't make the connection to what we were probably eating....).

I learned that the Carlsbad Hotel was first opened in the late 1880s.  In 1929, it was rebuilt in a classic California mission style (shown above)and the resort was known for its proximity to the beach -- and its hot and cold mineral baths.  In the 1930s, the resort was popular with the Barrymores and Greta Garbo. Carlsbad by the Sea Retirement Community 2014 In the 1990s it closed -- and was eventually rebuilt and reopened as Carlsbad by the Sea Retirement Community My mother enjoyed my latest photos, showing how the garden and building traditions continue in the new setting. Steps to the Sea in Carlsbad 2014 

So, from luxury hotel to a remarkably nice retirement community by the sea, with independent living, assisted living and skilled nursing available on the site.  And, I'm happy to report there is still very fine dining available.  The "hospitality" industry has given way to the "long-term care" industry.  All of this is another sign of our aging times, right?

P.S.  For more on the "chicken place," once called the Twin Inns, here's a link, including a surprising Pennsylvania-to-California connection.

August 19, 2014 in Current Affairs, Housing | Permalink | Comments (0) | TrackBack (0)

Monday, August 18, 2014

Housing the Elderly vs. Housing FOR the Elderly

A number of years ago I audited a very interesting course in a gerontology program with the title "Housing the Elderly."  It occurred to me at the time, however, that the title was a bit unfortunate, as it implied "warehousing" old folks rather than truly accomodating potential needs.   Fortunately, over time I have sensed a  growing appreciation of the significance of the distinction. 

I was reminded of this while reading "For an Aging Parent, an 'In-Law Suite' Can Provide a Home within a Home" in the Washington Post.  The article describes the experience of one family's decision to add a bedroom suite on the first level of their home to meet the needs of a aging parent.  According to housing experts quoted in the article "demand for in-law suites is growing." 

The article contrasts "true in-law suites" -- defined as a "living space integrated into a house to accomodate an older or disabled reative" -- with "accessory dwelling units" or ADUs.  ADUs "function as separate dwelling units and often are intenteded for rental." As I recall, a few years ago, prefabricated versions of ADUs were popular in the media and dubbed "granny pods."  Does anyone know whether granny pods ever caught on?  The article suggests that building codes and zoning codes may present barriers to certain types of supplemental construction.  I suspect that it would also be easy to trigger homeowner association restrictions.

The article suggests practical considerations:

  • The suite should be comfortable and private to foster a feeling of independence....
  • At the same time, it should be close and connected to the family living area.
  • Place the suite on the main floor so that it has access to shared living spaces without the barrier of stairs.
  • Incorporate wide hallways and doorways (at least 36 inches) in the suite and adjoining living spaces to accommodate wheelchairs, walkers and people walking side by side.
  • Integrate features that are attractive but safe and accessible, such as smooth flooring, lever handles for doors and faucets, non-skid bathroom flooring, a large curbless shower, a shower bench, a hand-held shower head, a chair-height toilet and sturdy, good-looking grab bars.

Many of these are core principles for "Universal Design," a housing construction movement that can be traced back to the early 1960s.  

Building or selecting a new house?  Consideration of universal design features may make it possible to stay at home much longer as you age.  AARP offers additional suggestions in a recent interview with Universal Design Specialist Richard Duncan.   And more info is available at UniversalDesign.com including citations to local, state or federal laws that may mandate certain elements of universal design for new construction.

August 18, 2014 in Consumer Information, Current Affairs, Housing | Permalink | Comments (2) | TrackBack (0)

Thursday, July 31, 2014

Chicago Declaration on the Rights of Older Persons to Be Presented August 1

Chicago Declaration on Rights of Older Persons Side EventAt the 2014 International Elder Law and Policy Conference hosted by John Marshall Law School in Chicago on July 10 and 11, many weeks of hard work culminated in adoption of a "Chicago Declaration on the Rights of Older Person."  The 11th draft -- of what is to be a working document for the future -- will be presented at the Fifth Working Session of the United Nations Open-Ended Working Group on Ageing to be held in New York City this week. 

In addition, the Chicago Declaration was submitted by United States Representative Janice Schakowsky (Illinois) to the Congressional Record on July 25. 

Congratulations to all who worked on this, with the leadership of many, including Associate Dean Ralph Rubner and Amy Taylor, Head Research Coordinator at John Marshall Law School.  More work for everyone is ahead on this exciting task of seeking wider recognition of the human rights of older persons. 

Speakers at the "Side Event" for the Chicago Declaration, to be held on August 1 at the U.N., include William Pope, Commissioner of the American Bar Association Commission on Law and Aging, and Ebbe Johansen, Vice President, AGE Platform Europe from Brussels.    

July 31, 2014 in Current Affairs, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, Housing, Retirement | Permalink | Comments (1) | TrackBack (0)