Tuesday, March 10, 2015
University of Florida Professor Stephen M. Golant has a new book, Aging in the Right Place. The gerontologist advocates examining a host of modern options, and urges resistance to an overly simplistic mantra of "aging in place" as the only goal. For example, he examines assisted living, co-housing, supported "independent living" environments, the "village" movement and CCRCs.
Interviewed for a Washington Post article, Golant explained:
“It’s not an all-or-nothing situation, obviously,” Golant said in an interview about aging-in-place. “But I just wanted to point out the imperfections, and the weaknesses in some of the arguments. . .I want to point out that sometimes there’s too much hype.”
It’s the sort of hype that has surrounded what he calls the New Gerontology, a long running trend that sometimes seems to imply that if people follow certain regimens of diet, physical exercise, social activity and cognitive training, they might avoid aging altogether.
As I have also suggested here, it is important for individuals and families to be realistic about what it will take to stay at home safely, making it important to be open to a larger definition of "home" in order to emphasize better quality of life.
Friday, February 27, 2015
Check out Volume 48, Issue 1 of the Indiana Law Review which contains articles from the 2013 Program on Law & State Government Fellowship Symposium: State Governments Face the Realities of Aging Populations. Three articles are included from the symposium, all of which are available on-line. The articles include Introduction: Governing Choices in the Face of a Generational Storm, Aging Populations and Physician Aid in Dying: The Evolution of State Government Policy, and What the Future of Aging Means to All of Us: An Era of Possibilities.
Monday, February 16, 2015
The themes for the two day conference are:
November 12 (Day 1): Connecting Across Discipline and Geography:
Join practitioners from law, social work, health care, finance, non-profit and other sectors from across the country and around the world to talk about the challenges and issues involved in working with older adults. Particular topic areas we are seeking include:
- elder abuse,
- assisted living and retirement housing,
- financial abuse,
- age friendly communities, and
- outreach strategies.
November 13 (Day 2): Key Practice Challenges and Hot Topics in Legal
Explore issues engaged in powers of attorney and substitute decision-making, health care decision-making and end of life care, mental capacity and dementia, elder abuse and neglect, and other challenging subjects that arise in representing older adults and their families.
Contact National Director Krista Bell with any questions, and additional details, including submission information are available here.
February 16, 2015 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Health Care/Long Term Care, Housing, International, Retirement, Social Security | Permalink | Comments (0) | TrackBack (0)
Wednesday, February 11, 2015
The Center for Retirement Research at Boston College has a nifty pamphlet on Using Your House for Income in Retirement. The booklet covers home ownership in retirement and options, including downsizing and reverse mortgages. The booklet includes graphics and checklists, helpful examples and list of other helpful "decision aids" available on their website.
Saturday, February 7, 2015
Driving home last evening, I had one of those "driveway" moments, where you don't want to shut off the car -- and thus the radio -- because a program on NPR is so compelling.
This time it was the Invisibilia story of Iggy Ignatius, born in India, but living in Florida. He decided to create a retirement community that looked like home, with low buildings, a courtyard, Bollywood movies, lots of Indian food, and lots of ... Indians. At first, his creative timing seemed all wrong, as he was opening the doors in 2008, on the threshold of what turned out to be a deep recession, hitting many Florida housing ventures hard. But, in fact, he sold out the first condo wing almost immediately, and success has apparently continued. Iggy has a theory for the popularity of his Indian retirement community:
"And at that time, he thinks, it's beyond your control. No matter who you are, you'll experience a deep primal desire to withdraw, like a salmon swimming upstream to the place of its birth to spawn and die. 'I think that is an animal instinct which we as human beings seem to have.'"
Hmmm. I'm not sure spawning salmon are experiencing the same motivations as elderly individuals, regardless of ethnicity. But, the story continued with a potential science-based explanation:
"Iggy is absolutely right, according to Jeff Greenberg, a professor of psychology at the University of Arizona. If you raise the specter of death in a person's mind, he says, Christians like Christians better; Italians like Italians better. Even Germans, who are usually pretty lukewarm about other Germans, if you get them to contemplate their own mortality, suddenly they really like Germans...."
Thus, if true, there is a potential dark side to a "return to kind," both in terms of the subconscious fears that may drive it, and the impact on community and society.
Does this make sense to you? To read or listen to the whole story, go to "Being With People Like You Offers Comfort Against Death's Chill."
Wednesday, February 4, 2015
Part 2 of the provocative New America Media series on "Death of a Black Nursing Home," describes a pervasive, discriminatory impact by states in deciding how to use Medicaid funding for health and long-term care. In "Why Medicaid's Racism Drove Historically Black Nursing Home Bankrupt," Wallace Roberts writes:
"About 90 percent of Lemington’s residents were Medicaid recipients. The industry’s average, however, is 60 percent, so Lemington’s mission of providing care for low-income people from the area put it at a competitive disadvantage.
Lemington’s over-reliance on Medicaid was the principal reason its debt grew from a few hundred thousand dollars in 1984, to more than $10 million, including a $5.5 million mortgage on a new facility in 1984.
Pennsylvania’s Medicaid payments for nursing home reimbursement were too low to enable the home to hire enough trained staff. Lemington’s former human resources director, Kevin Jordan, noted that the home was “always scrambling to cover payroll” and spent lots of money on 'legal fees fighting the union.'”
The article details serious mistakes made by individuals in the operation of Leimington Home for the Aged, but also points to essential problems in Medicaid funding that doomed the facility to failure. The author calls for reforms, including a consistent, national approach to long-term care funding, to eliminate -- or at least reduce -- the potential for misallocation of money by states:
"Although the leadership of Lemington Home must bear the responsibility for those legal judgments and the fate of an important institution, the racist history imbedded in Medicaid’s rules for the past 80 years should share the brunt of the blame for bankruptcies at hundreds of long-term care homes largely serving black, latino and low-income elders.
One needed change would be to award nursing homes in African American, Hispanic and low-income neighborhoods serving large numbers of Medicaid recipients larger “disproportionate share payments.” Under the law, such homes receive additional reimbursements for serving a larger-than-usual proportion of very poverty-level residents. But the higher rate also doesn’t kick in unless a facilty has at least a 90 percent occupancy rate, which many homes like Lemington can’t easily reach. Rules relaxing that standard would bring badly needed revenue to vulnerable homes.
Congress could also require that all nursing homes accept a minimum number of Medicaid patients so as to spread the financial burden.
But to truly do the job, Medicaid should be federalized—taken out of the hands of state and local officials, many of whom use get-tough rhetoric in elections to stigmatize and punish often-deserving people...."
The full articles are interesting -- we will link to any future parts of this bold series.
February 4, 2015 in Current Affairs, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Medicaid, Medicare | Permalink | Comments (0) | TrackBack (0)
Tuesday, February 3, 2015
This Blog has followed the complicated recent history of bankrupt Lemington Home for the Aged, in Pittsburgh, with posts here and here. New America Media, a national association of over 3000 ethnic media organizations, has begun an important, multi-part series examining the "impoverished history of race" in long-term care for persons of color. The Lemington Home becomes a case study. The series is titled The Death of a Black Nursing Home.
"[W]hat happened to Lemington is not uncommon. Researchers at Brown University found that more than 600 other nursing homes in African American, Hispanic and low-income neighborhoods also went bankrupt during this period.
Their study examined the closings of more than 1,700 independent nursing homes between 1999-2009 and found that those located in largely ethnic and low-income communities were more likely to have been closed, mostly because of financial difficulties.
Specifically, nursing homes in the zip codes with the highest percentage of blacks and Latinos were more than one-third more likely to be closed, and the risk of closure in zip codes with the highest level of poverty was more than double that of those in zip codes with the lowest poverty rate."
Observing that "Medicaid homes can't compete" successfully, the article examines reimbursement rates under Medicare and Medicaid and the disproportionate effect of underfunding on minority communities.
"The principal authors of the study, Vincent Mor and Zhanlian Feng, both of Brown at the time (Feng is now at the Research Triangle Institute), noted 'closures were more likely to occur among facilities in states providing lower Medicaid nursing home reimbursement rates.' That left these homes without the resources they needed to compete successfully in an industry experiencing an oversupply of beds and intensified competition....
While Medicaid reimbursement rates vary by state, they are always below Medicare’s reimbursement levels or the fees charged to people who pay for their own care. The demise of Lemington and other nursing homes in minority and low-income neighborhoods is a direct result of this flawed payment scheme. However, large for-profit nursing home chains, some of which are owned by private equity companies and real estate investment trusts, can maximize profits by using expensive and aggressive marketing practices to cherry pick the wealthier residents in a given area while reducing the number of their own Medicaid clients.
Medicaid’s payment structure also has impacted the quality of care in nursing homes with predominantly minority residents."
We will link to the next parts of the series as they become available.
From WGEM.com in Hannibal, Missouri, coverage on "2,000 Veterans Waiting in Line to Get Into Missouri Nursing Homes,"
"Some wait more than a year to get full care covered through veteran's benefits, and it's even harder for veterans without a state home close to where they live because they have even fewer options.
'I had to have a place to go, so they got me in,' Army veteran Robert Johnson said. Johnson is at Beth Haven Nursing Home in Hannibal for the time being. He had to choose a private care facility because there are relatively no veteran's homes in the area. 'Oh yeah, it's pretty expensive to stay here,' Johnson said. 'I think they ought to have something to help veterans out. A lot of people have a pretty hard time anymore.'
Veterans who pay for private care do get supplemental money through benefits, and those using Medicaid also get personal allowance, but sometimes it's not enough. Beth Haven CEO Paul Ewert says there are some cases where families have to either pay out of pocket or travel hours away for full care."
Wednesday, January 28, 2015
LeadingAge, an senior housing and senior care organization that often takes a prominent advocacy role on behalf of nonprofit Continuing Care Retirement Communities, has a "NameStorm Survey" underway. The survey explores whether another name (and presumably an acronym other than CCRC) would better "resonate with consumers?" Everyone is invited to weigh-in, including current residents at CCRCs.
Here's the link to the reasons for the brainstorming of names, and here is a link to the on-line survey, that takes just a few minutes. The survey window closes on February 15, 2015.
Wednesday, January 21, 2015
Catching up with three new elder law-related articles from SSRN that look very interesting:
"The Universality of Medicaid at Fifty" by University of Kentucky Law Professor Nicole Huberfeld, forthcoming in the Yale Journal of Health Policy Law & Ethics:
"This essay, written for the Yale Law School symposium on The Law of Medicare and Medicaid at 50, explores how the law of Medicaid after the ACA creates a meaningful principle of universalism by shifting from fragmentation and exclusivity to universality and inclusivity. The universality principle provides a new trajectory for all of American health care, one that is not based on individual qualities that are unrelated to medical care but rather grounded in non-judgmental principles of unification and equalization (if not outright solidarity). This essay examines the ACA's legislative reformation, which led to universality, and its quantifiable effects. The essay then assesses and evaluates Medicaid’s new universality across four dimensions - governance, administration, equity, and eligibility. Each reveals a facet of universality that underscores this new principle’s importance for health care into the future."
"This paper analyzes nursing home failures in light of the federal regulatory regime that oversees them. Section II provides a framework for the discussion of nursing homes by describing the choices seniors have for their living arrangements. In order to establish context for the current social and legal space inhabited by nursing homes, Section III traces the historical development of the modern nursing homes, with a particular focus on the landmark laws of the 1960s that paved the way for late-twentieth century proliferation of nursing homes. With this background in mind, Section IV explores the federal regulatory regime that governs nursing homes, and Section V details the bodies and mechanisms that enforce federal rules and regulations. Section VI provides evidence and statistics regarding the prevalence of abuse and neglect in nursing homes and argues that these data evidence a troubled regulatory system. Section VII examines the Patient Protection and Affordable Care Act, which has been heralded as the most significant legislation affecting the healthcare industry in decades, and concludes that the law does not contain provisions that will serve to reduce elder abuse and neglect in any significant way. Section VIII offers recommendations to improve nursing home care in light of the foundation provided by PPACA. Section IX discusses potential blowback that these and other solutions may present and urges reformers to proceed carefully and thoughtfully before enacting any proposed reform."
"This Article explores the impact of federal law on a state fiduciary’s management of digital assets. It focuses on the lessons from the Stored Communications Act ('SCA'), initially enacted in 1986 as one part of the Electronic Communications Privacy Act. Although Congress designed the SCA to respond to concerns that Internet privacy posed new dilemmas with respect to application of the Fourth Amendment’s privacy protections, the drafters did not explicitly consider how the SCA might affect property management and distribution. The resulting uncertainty affects anyone with an email account."
Wednesday, January 14, 2015
A 90-year-old resident apparently wanted "out" of her personal care home in Pennsylvania -- but being kicked out probably wasn't the outcome her family wanted to see for their restless matriarch. The personal care home issued a discharge notice on safety grounds, due to her "continued exit-seeking from the building."
On January 9, 2015, the Commonwealth Court of Pennsylvania, an intermediate court, ruled that a core right recognized in state and federal law for residents of "long-term care nursing facilities" -- the right to seek third-party review when the resident or family disagree with a facility's involuntary discharge or transfer decision -- does not apply to "personal care homes" under the state licensing and regulatory system. See Bouman v. Department of Public Welfare, Case No. 1262 C.D. 2014, decided November 14, 2014.
Perhaps a new facility was the best decision, but at age 90, the woman's options for settling into a new place may be very limited. The short opinion does not reveal whether other approaches, including behavioral "distraction" techniques that often are effective for those with dementia, were explored. And without an appeal right, families may have no effective way of advocating for those approaches.
Friday, January 9, 2015
Michigan Governor Rick Snyder signed Michigan Senate Bill 886 and related bills (SB 887, 888 and 889) into law on December 30, 2014. The new law is described as "an ongoing effort to continue to support consumer choice and protection while encouraging continued investments into vital care facilities" in the state of Michigan, focusing on continuing care retirement (CCRCs) and life care communities.
The law, titled the Continuing Care Community Disclosure Act, would appear to replace prior law, and thus it will be important to sit down with the new provisions and examine them carefully, especially given the announced reasons for passage. I'm guessing there might be some trade-offs here, with both consumers and providers having interests at stake. According to press releases, some of the "major" provisions of the new law include:
- A limit on amortization of the entrance fee to 1.5 percent for each month of occupancy
- A requirement for any continuing care community to register with the Department of Licensing and Regulatory Affairs (LARA)
- Setting a $250 registration fee and a $100 renewal fee
- Organizations must report if any executive officers or director has been convicted of certain felonies
- A feasibility study with a business plan must be included in each application
- Exemptions from promulgated rules governing different types of facilities could be granted if the rules interfere delivery of care or with moving residents between different facilities
- Regulations on the fees facilities may charge and how refunds are provided to potential and former residents
- A continuing care community could petition for a guardian if a resident became incapacitated and unable to handle his or her personal or financial affairs
The legislation reportedly had the support of LeadingAge in Michigan. I'm curious about the background on this new legislation -- perhaps some of our readers know the history and reasons for new laws here?
Tuesday, January 6, 2015
The New Mexico Court of Appeals recently rejected the claim by El Castillo, a Continuing Care Retirement Community (CCRC), for charitable property tax exemptions. I was particularly interested in this ruling, as I have visited the campus several times over the years, and have come to know many residents, who are some of the most active, socially aware seniors I've encountered. Just trying to keep up with 78-year old friends who are walking, walking, walking (at 7,000 feet) to their meetings can be a challenge. The campus is very pleasant, quite modestly appointed, and fairly compact -- but perhaps most important of all, it has a terrific location. I suspect that is a large part of the reason it is on the tax assessor's radar. The campus is just a few blocks from the heart of beautiful Santa Fe and steps away from Canyon Road's art galleries.
El Castillo has operated as a CCRC since 1971, with a Type A or "Life Care" structure, where residents age 65 and older pay non-refundable entrance fees, plus monthly service fees, with the expectation that all needs, whether in so-called "independent" apartments, assisted living units or nursing care, are provided on the same campus. El Castillo is not associated with a particular faith nor with any fraternal organization, but it has operated since its inception under Section 501(c)(3) of the Internal Revenue Code, and thus is exempt from income taxes based on historical rulings that permit charitable tax exemptions for "homes for the aged." However, as we have discussed in the past in this Blog, a state's standards for charitable property tax exemptions can be quite different than the IRS approach to charitable income tax exemptions.
State and local governing bodies are constantly in search of tax revenues, and CCRC campuses, especially in urban locations, can be a tempting target. Under New Mexico's state constitution, at Article VIII, Section 3, "all property used for educational or charitable purposes shall be exempt from taxation." Prior cases interpreting this provision did not require a facility to be operated "exclusively" for charitable purposes, but the landowner has the burden to show it operates "primarily and substantially for a charitable purpose."
Key to the court's denial of the tax exemption was its observation that El Castillo appeared to operate as a self-sustaining unit funded entirely by fees paid by residents, with little or no "charitable" base. The Court rejected El Castillo's argument that its charitable mission was to provide life-time care for residents who could (and sometimes do) become personally unable to pay, and that such a mission was only possible through "subsidizing" such residents by, in essence, pooling the fees paid by all residents. As demonstrated by contrasting rulings on property tax exemptions in other states, the financial analysis necessary to support a charitable use property tax exemption may require detailed analysis and advanced planning. There is a fine line for any nonprofit to balance costs, sources of revenues and the goal of sustainability. In some instances, I have seen denial of property tax exemptions be the final straw for some nonprofit operators, especially those struggling with rising costs or occupancy rates after the 2008 financial downturn.
In New Mexico, there is both a constitutional basis for seeking a property tax exemption and a statutory basis. The ruling on El Castillo -- which by the way, when translated from Spanish, means "The Castle" (a bit of irony perhaps, given the court's seeming hostility towards the exemption claim, pointing to the lack of "indigent" residents) -- was based only on the state constitution. It appears the tax assessor actually failed to perfect his attempt to appeal a separate portion of the lower court ruling that had granted El Castillo the right to charitable tax exemptions on statutory grounds. Thus, it would appear that El Castillo would not immediately feel the effects of the Court's ruling, at least not for the specific tax years at issue in the multi-year litigation. In a footnote, the Court of Appeals judges acknowedged that their decision on El Castillo creates a "dfferent result" than the same court's 2013 ruling on charitable property tax exemptions for a different life-care community, La Vida Llena, in Albuquerque, N.M. The Court distinguished the La Vida Llena ruling as based only on statutory grounds.
For the complete ruling, including a complex jurisdictional issue, see El Castillo Retirement Residences v. Martinez, Case No. 31, 704, decided December 17, 2014.
Back in November, NPR ran a moving story about two employees of an ALF who stayed to care for residents left behind when the ALF closed, leaving the residents to fend for themselves. The NPR story, 'If We Left, They Wouldn't Have Nobody' tells how the cook and the janitor stayed to care for the residents, even though the rest of the employees left when they were no longer paid. The article notes that the story was the catalyst for legislation, "the Residential Care for the Elderly Reform Act of 2014." The audio of the story is available here.
Friday, January 2, 2015
What a great idea--livable communities. AARP offers a great website on livable communities. The website covers a number of topics including a network of age-friendly communities as well as a toolkit and information to make a home appropriate for aging in place. Check it out!
Monday, December 29, 2014
Christopher Robb is in his final year at Westminster College in Pennsylvania and for his senior Media project he tackled "filial laws." His impressive work included researching the history of such laws and studying recent court cases in Pennsylvania. He interviewed and filmed a host of individuals from across the state who have experience with recent trends in use of filial support laws by nursing homes to seek payment from adult children for bills not satisfied by the resident's resources, insurance or Medicaid. Chris Robb's resulting 15 minute video is titled, "Am I My Mother's Keeper?" Thank you for sharing it with the Elder Law Prof Blog!
Friday, December 26, 2014
I have written before about allegations of "bust out schemes" in long-term care companies. The theory is that operators of businesses facing huge obligations, especially obligations arising from court judgments based on negligent care in nursing homes, try to transfer and hide assets to avoid paying the legal damages. Allegations of this form of fraud are at the heart of a complicated case, In re Fundamental Long-Term Care Inc., pending in the bankruptcy courts of Florida, focused on operations in that state, but also in Illinois and Maryland. The allegations are wild, with alleged manipulation of an elderly graphic artist, now himself a resident of a nursing home, to "buy" the shell company that was saddled with $119 million in default judgments arising out of two wrongful death cases dating back to 2003, plus perhaps as many as 150 additional, pending claims.
The presiding U.S. Bankruptcy Court judge, Michael Williamson in Tampa, Florida, has announced a "tentative ruling" that owners of the multistate chain of nursing homes have committed fraud by transferring liabilities to an asset-less shell company, in order to isolate responsibility for more than $2 billion in jury verdicts. At the same time, the judge apparently indicated he sees no evidence to hold a private equity firm -- and probably the defendant with the deepest pockets -- liable for the fraud commited by the nursing home companies it provided with financing. Apparently the judge's "tentative ruling" is intended to encourage the parties remaining on both sides of the case to be realistic during mediation sessions ordered by the court to take place in January.
In addition to the extraordinary dollars involved in the alleged fraud, media sources have covered the case closely because Illinois Governor Elect Bruce Rauner was once a manager of an investment firm involved in financing for the nursing home chain. Governor-to-Be Rauner has not been a defendant in the liability cases, and has strongly denied any knowledge or responsibility for the alleged fraud.
The case is In re Fundamental Long-Term Care Inc., 11-bk-22258, 13-ap-00893, U.S. Bankruptcy Court, Middle District of Florida.
Monday, December 22, 2014
The amazing things you find when you start cleaning your office! Here's a find. Notre Dame Law Professors Margaret Brinig and Nichole Stelle Garnett wrote a great piece for The Urban Lawyer on what are sometimes called "granny pads," or more formally, "accessory dwelling units." The authors track reform measures enacted in at least 12 states that either enable or mandate authority for such units, thus preventing local building or zoning limitations from restricting landowners to "one unit" per lot. Additional reforms have occured at some municipal levels. They point to experiences in California as a cautionary tale, however, suggesting that "local parochialism remains alive and well in American zoning codes, often buried in regulatory details that escape the attention of advocates and academics alike."
Here's a link to the full article, "A Room of One's Own? Accessory Dwelling Unit Reforms and Local Parochialism." I'm embarrassed to admit this particular journal issue was on the 2013 level of my cleaning efforts. Who knows what other gems may be hiding!
Sunday, November 30, 2014
Justice Department Reaches $437,500 Agreement with City of Ocean Springs, MS to Resolve Disability Discrimination Lawsuit
The Justice Department announced a comprehensive settlement today, resolving a federal civil rights lawsuit against the City of Ocean Springs, Mississippi, for alleged violations of the Americans with Disabilities Act (ADA). Under the proposed consent decree, the City will pay $437,500 in damages to a psychiatric treatment facility that was discriminated against by the City. The decree also requires systemic reforms to the City's land use and zoning practices to eliminate barriers for providers of mental health services to people with disabilities and combat the stigma of mental illness. The complaint, also filed in federal court today, alleges that the City discriminated against Psycamore, LLC, an outpatient psychiatric treatment facility, when it denied a certificate of occupancy and a use permit because Psycamore treats patients with mental illness.
Thursday, November 27, 2014
Recently I have encountered several thoughtful articles about the language we use, and the approaches taken, when talking with older persons. This seems to be an especially appropriate topic for the holiday season, when families often come together, sometimes from great distances. Whether we are talking with clients or family members, some of the same dynamics may be in play, especially when the question is about planning for the future.
From the ABA Commission on Law and Aging's Bifocal publication, comes David Solie's "The Wrong Signals: Shutting Down the Planning Conversation Before It Starts." He encourages us to "consider the psychological landscape of older clients -- it is a world embedded with two dominant agendas posing significant resistance to change. Together, these psychological currents create a deep inertia to disrupting the status quo." He labels these barriers to change as:
- Ambivalence and the "Righting Reflex," and
- The Need for Control
He suggests approaches, including the use of open-ended questions, reflective listening, and making a conscious decision about what words to use. For example, he suggests that when we start to discussion options, we explain more clearly that advance planning helps to "preserve choice" and avoids "loss of control."
Another potential problem may arise from "Elderspeak," a label social scientists use to refer to a tendency to use "patronizing" tones or words when speaking to anyone who is older. One recent article in McKnight's News made me chuckle, as it points to the well-meaning but potentially misguided use of words such as ""honey" by professionals when working with elders.
My father, a federal judge for more than 30 years, at age 89 may have forgotten many things -- but he does not take kindly to being called "honey" by strangers. He now has an entire assisted living campus, even a few of the other residents, calling him "Judge" or "Your Honor." I bet you might know a judge or two like that? When it comes to control, I'm not sure who is teaching whom about holding court.
Here's to more humor in all of our holidays -- and more opportunities for effective communication -- both within the family and beyond. Happy Thanksgiving!