Friday, July 11, 2014
The Employee Benefit Research Institute (EBRI) issued a June 19, 2014 fast facts on What Long-Term Care Costs in Retirement Could Do to Retirement Readiness. Here is a description
A new report by the nonpartisan Employee Benefit Research Institute (EBRI) reveals that assuming 100 percent of the average expenses (based on post-retirement income) for components likely to be encountered on a regular basis (e.g., food, housing, transportation)—but ignoring the costs of nursing home and home health care expenses—about 17 percent of those in the second-income quartile would run short of money by the 20th year in retirement, as would 5 percent of those in the third-income quartile and 1 percent of those in the highest-income quartile, assuming a retirement age of 65.
The full report, "Short" Falls: Who's Most Likely to Come Up Short In Retirement & When? offers the following executive summary
• This Notes article provides new results showing how many years into retirement Baby Boomer and Gen Xer households are simulated to run short of money, by preretirement income quartile.
• Under a variety of simulated post-retirement expense scenarios, the lowest preretirement income quartile is the cohort where the vast majority of the retirement readiness shortfall occurs, and the soonest. When nursing home and home health-care expenses are factored in, the number of households in the lowest-income quartile that is projected to run short of money within 20 years of retirement is considerably larger than those in the other three income quartiles combined.
• Extending the results to a maximum of 35 years in retirement (age 100, assuming retirement at age 65), 83 percent of the lowest-income quartile households would run short of money and almost half (47 percent) of those in the second-income quartile would face a similar situation. Only 28 percent of those in the third-income quartile and 13 percent of those in the highest income quartile are simulated to run short of money eventually.
The full report is available here.
Thursday, July 10, 2014
The National Senior Citizens Law Center (NSCLC) is offering 2 webinars on DOMA-one focusing on Social Security & SSI and the other on Medicare & Medicaid. These two are part of their free webinar series. The first one, One Year After DOMA: An Update on Social Security and the Special Impact on SSI for Same Sex Couples is scheduled for July 22 from 2:00-3:00 p.m., edt. Click here to register. The second, One Year After DOMA: An Update on Medicare and Medicaid and the Impact for Same Sex Couples is scheduled for July 23 from 2:oo-3:00 p.m., edt. Click here to register.
One of the effects of "devolution" in the United Kingdom has been opportunities for Northern Ireland, Wales and Scotland to consider afresh their domestic laws and policy guidelines, separate from the mandates of Parliament in London. As those following recent UK news will know, Scotland this has gone beyond mere "home rule." A referendum vote on full independence is scheduled in Scotland for September 18, 2014.
Northern Ireland has not moved as quickly on adoption of domestic laws and policies. In part because of interruptions in efforts to fully establish home rule following disruptions of violence and the "Troubles," the process of enacting NI domestic laws has been slower paced than in Wales or Scotland, even after the Good Friday Agreement of 1998.
Nonetheless, high on the domestic agenda in NI have been laws and policies related to older people. One of the first modern era laws passed by Stormont was domestic legislation that established an independent Commissioner of Older People for NI. The discussions on that law overlapped with my Fulbright year and sabbatical in NI in 2009-10, and resulted in passage in January 2011.
The first Commissioner, Claire Keatinge, was appointed to a four year term in November of 2011. In my observation, Claire is a force of nature and if anyone can create a clear path to establish ageing as a priority matter for action in NI, it will be this dynamo.
On June 25, Commissioner Keatinge presented her call for fresh adult safeguarding legislation in NI. With emerging data suggesting significant increases in the number of cases of alleged abuse of older people, Commissioner Keatinge commissioned an evaluation of existing laws and comparative approaches in other nations. She asked whether and how NI can better protect adults from abuse, including physical, emotional, sexual and financial abuse. After receipt of the academics' report, her in-house legal team responded, helping her present a clear written call for action, a template for legislation.
As explained in her launch on June 25, the Commissioner advocates for:
- Clear definition of "adult at risk," the target term for safeguarding measures and not limited to older adults, as well as enhanced definitions of abuse or harm, and especially of financial abuse;
- Establishment of an adult safeguarding board, with statutory powers;
- Specific duties for relevant bodies and organizations within NI to report, investigate, provide services and cooperate with other agencies to order to better protect "adults at risk;"
- Specific powers of access to an individual believed to be at risk of harm or abuse, to defuse the potential for the abuser to influence the investigation process; and
- Protection from civil liability for those making reports of suspected abuse.
Further, Commissioner Keatinge recommends additional consideration be given to whether an Adult Safeguarding Bill -- as a single piece of legislation -- should grant specific powers to authorities to remove an individual at risk or ban a suspected abuse from contact. Her call for action recommends consideration of a specific grant of power to access financial records, often deemed crucial to investigation of financial risk and proof of abuse. Also on the Commissioner's radar screen is the potential adoption of specific criminal charges for "elder abuse" or "corporate neglect."
It has been exciting for me to see the evolution of the Commissioner's role and her use of the Queens University Belfast and University of Ulster academic reviews (on which I consulted). Professor John Williams (depicted on the far left, next to Claire Keatinge in yellow), head of the department of law and criminology at Aberystwyth University in Wales provided forceful support for the proposed legislation in Northern Ireland during his commentary at the launch, saying the status quo cannot be justified.
I'd like to say I see an easy path for a comprehensive Adult Safeguarding Law to emerge in the near future for Northern Ireland, thus serving as a role model for other jurisdictions facing similar issue.
I have to admit, however, that I was discouraged by what sounded -- at least to me -- like vacillation coming from key government leaders. The Minister of Health, Social Services and Public Safety in the Northern Ireland Executive, Edwin Poots (above, in the blue tie). spoke at the Commissioner's launch, expressing his own concern for older people as victims of abuse, especially financial abuse; however, I was disappointed when Minister Poots predicted that it would not be possible for Stormont to reach the issue of safeguarding legislation in the next 21 months. (Of course, coming from the political gridlock of Congress in the U.S., and as a witness to the snail's pace for protective legislation in my home state of Pennsylvania, I guess I should not be too surprised.)
Still, the good news is that the first major steps have been taken by Commissioner Keatinge and her capable staff including Catherine Hewitt and Emer Boyle, with strong support at the launch from social and health care professionals who have seen first hand the potential for subtle and not-so-subtle abuse of elder, disabled or frail adults in Northern Ireland.
And by the way, Professor Williams from Wales will be one of the presenters at the 2014 International Elder Law and Policy Conference at John Marshall Law in Chicago, speaking on older persons' access to justice as a key component of international human rights on Friday, July 11. It is a small world at times and one with a growing commitment to tackle key topics in ageing.
Wednesday, July 9, 2014
The National Senior Citizens Law Center (NSCLC) is offering a free webinar July 31, 2014 at 2:00 p.m., edt on The Changing Landscape of Assisted Living – Recent Federal and State Developments. The information about the webinar offers this information
How good is assisted living? To a great extent, it depends on what state you’re in, as assisted living standards are dependent upon state law. This presentation will include the results of a 12-state study on assisted living laws.
Also, hear from advocates engaged in state efforts to improve assisted living
through the legislative process – California, where the RCFE Reform Act of 2014
is moving through the state legislature; and Connecticut, which has revamped
its assisted living regulations to improve resident health and safety.
The presentation also will announce a new California-focused reform
To register for the webinar, go to the NSCLC events page here.
One of the great components of the network of "Law Prof Blogs" is Chinese Law Prof Blog, edited by Professor Donald Clarke at George Washington Law. Professor Clarke posted a recent entry entitled "Controversy Over Elder Law in China," pointing to draft legislation related to "support" for the aged. While the links in this particular posting are -- of course -- to Chinese language sources, I suspect this might be another aspect of the debate about filial support laws that I've been following through Australian media sources. Here is an English language report on a dramatic Chinese case involving what I would describe as a filial support law matter. Hat tip to my Penn State colleague Professor Beth Farmer for bringing the interesting and wide-ranging Chinese Law Prof Blog to my attention.
Perhaps we'll hear more about this at the 2014 International Elder Law and Policy Conference in Chicago at John Marshall Law this week. Stay tuned.
We've previously posted advance information about the International Elder Law and Policy Conference that will be hosted this week -- July 10-11 -- in Chicago. The organizers are John Marshall Law School; Roosevelt University, College of of Arts and Sciences; and East China University of Political Science and Law.
The conference will have an interesting format, combining presentations from a range of professionals with experience working with or for older persons, and working sessions to draft a model "International Bill of Rights for Elderly Persons, in parallel with U.N. sessions on ageing.
As an example of the breadth of participation and coverage at this conference, my session on Thursday focuses on "Health Care, Caregving for Older Persons and Legal Decision Making," and will be co-moderated with Professor Walter Kendall at John Marshall. The panel includes the following topics and speakers:
- "Dementia and Planning Death: The Challenge for Advance Directives," by Meredith Blake at University of Western Austalia Law School
- "Social Change and Its Apparent Effect on Senior Care Services: A Comparative Study of Post-Soviet Union Russia and the U.S.," by Amy Delaney, partner at Delaney, Delany & Voorn in Illinois, and Alina Risser, a lawyer from Russia, currently studying law at John Marshall;
- "Rights are Not Good for Older Persons in Long-Term Care Settings? Experience from the European Union," by Nena Georgantzi, Legal Officer for AGE Platform Europe;
- "Bridging the Caregiver Gap: Does Technology Provde an Ethically and Legally Viable Answer?," by Donna Harkness, University of Memphis School of Law;
- "The Insufficiency of Spiritual Support of Urban Elders in China and Suggestions on Legislation," by Jun Li, East China University of Political Science and Law.
We'll report more after the events on Thursday and Friday!
July 9, 2014 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care | Permalink | Comments (0) | TrackBack (0)
Tuesday, July 8, 2014
Huffington Post ran an article on June 19, 2014 about hospice. Hospice, Inc.: How Dying Became A Multibillion-Dollar Industry focuses on the growth of the use of hospice and how companies sign up new patients. The article tells the story of one patient and the care she received. The article covers the lawsuits brought by the Department of Justice against hospice providers. The article also has an interactive chart that allows the reader to look at hospice in the reader's geographic area. The article has a lot of data and charts to illustrate the numbers. The article discusses the inspections process "[t]he types of violations vary, with many involving improper training or record keeping, such as not preparing written care plans for patients. Others involve threats to patient life or safety."'
As far as the issue with longevity, the article notes that "[t]he Medicare Payment Advisory Commission has urged the federal government to restructure the hospice benefit to remove such incentives by reducing payments for longer stays, warning that such changes are “imperative.” The Centers for Medicare and Medicaid Services ... has not adopted the proposed changes."
As far as oversight and quality of care,
[t]he government is only now starting to collect basic data to gauge the quality of care, more than 30 years after the benefit was introduced. New measures, ushered in under the Affordable Care Act, require hospice operators to submit data that measure seven different conditions for hospice patients, such as pain or shortness of breath... Still, these new requirements, which go into effect in July, are unlikely to capture many of the oversights and abuses alleged by hospice patients and employees. Several of the measurements are “yes or no” questions that simply determine whether hospice providers are screening patients for various ailments.
If one looks at the Uniform Law Commission website, it appears that slow but steady progress is being made by states in adopting recommended legislation governing Powers of Attorney (POAs). The ULC recommendation reflected more than four years of research and drafting, culminating in a detailed proposal for POAs issued in 2006. According to the website, 16 states have enacted the uniform law, with an additional four states, Connecticut, Mississippi, Washington, and my own home state, Pennsylvania, considering adoption in 2014. The ULC's recommendations were a deliberate attempt to "preserve the durable power of attorney as a low-cost, flexible, and private form of surrogate decision making while deterring use of the power of attorney as a tool of financial abuse of incapacitated individuals."
On July 3 last week, Pennsylvania's Governor Corbett signed legislation, now designated as Act 95 of 2014, making significant changes to the existing law governing POAs in Pennsylvania. However, the passage of this law also demonstrates how so-called "uniform" laws may be less than uniform from state-to-state in terms of their actual requirements, and I tend to wonder whether other states have also enacted some variation on the ULC's recommendation.
Pennsylvania Act 95 of 2014 (available as HB 1429 here) took more than 3 years of drafting, redrafting, hearings, negotiations, and compromises to accomplish. The spur for adoption was a court decision invalidating transactions executed in reliance on a "void" power of attorney, one purportedly "signed" with an X by a woman while hospitalized. The majority decision put the financial impact on the party accepting the POA, without regard to whether it was using good faith in relying on a document that may appear valid on its face. After that decision, many Pennsylvania retirement plan administrators, banks or other financial institutions were reluctant to honor POAs, fearing they could become the guarantor of misused authority. See Vine v. Commonwealth of Pennsylvania State Employees Retirement Board, 9 A.3d 1150 (Pa. 2010).
PA Act 95 of 2014 addresses the "Vine" question by clarifying a grant of immunity for any person who in "good faith accepts a power of attorney without actual knowledge" of voidness or other invalidity. But Act 95 also mandates certain execution protocols, including:
- for most but not all POAs, requiring the principal's signature, mark or third-party signature to occur in front of two adult witnesses;
- requiring the principal to acknowledge his or her signature before a notary public or other individual authorized by law to take acknowledgments;
- continuing the requirement that principals must sign "notice" forms, but now with enhanced warnings about the significance of POAs, including the recommendation that "before signing this document, you should seek the advice of an attorney at law to make sure you understand it;"
- continuing the requirement that agents must sign an acknowledgement of certain responsibilities, now including an obligation to "act in accordance with the principal's reasonable expectations."
Each of these execution requirements, although certainly permitted by ULC's proposal (and perhaps also entirely consistent with the ULC's concern about the potential for financial abuse), is greater than what is required by the Uniform Law on Powers of Attorney.
At the same time, the Uniform Power of Attorney Act includes potential remedies for abuses of POAs not addressed by old or new law in Pennsylvania, including Section 116 that would grant spouses, parents, descendants and presumptive heirs the right to seek judicial review of an agent's conduct. One open question in Pennsylvania is whether wider standing to challenge suspected abuse is necessary.
One takeaway message from the history of more than 8 years of consideration by states of the Uniform Law on POAs, and more than 3 years of consideration in Pennsylvania about how or whether to adopt some or all of UCL's specific approach, is that achieving uniformity of state civil laws is not an easy task. That makes me even more appreciative of the effort and comparative "ease" of adoption of early efforts at uniformity, such as the uniform commercial code and the recognition that interstate sales transactions would benefit from consistency.
Portions of Pennsylvania Act 95 of 2014, including the grant of immunity for good faith reliance on POAs by third-parties, are immediately effective, while other portions of the law take effect on January 1, 2015. The Pennsylvania Elder Law Institute on July 24-25 in Philadelphia will have several sessions addressing the effect of the new law.
ElderLawGuy Jeff Marshall also has a great overview of the new Pennsylvania law on his blog. Hat tip also goes to Pennsylvania attorney Bob Gerhard for keeping Pennsylvania practitioners up-to-date on the bill numbers and enactment details.
July 8, 2014 in Advance Directives/End-of-Life, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Programs/CLEs, State Cases, State Statutes/Regulations | Permalink | Comments (0) | TrackBack (0)
Monday, July 7, 2014
The Population Reference Bureau released a recent story on retirement: No One-Size-Fits-All Path to a Secure Retirement for U.S. Elderly. Of course we know that with the boomers, the number of those reaching retirement age will be larger than before. We also know people are living longer. So what does this mean for saving for retirement? According to this report
[I]ndividuals saving for retirement should consider more than average life expectancy as their planning horizon... "There's a wide range of life outcomes." For those turning 65 in 2015 (born in 1950), one in five men is expected to live beyond his 90th birthday, while one in five women will still be alive at 93.
And income plays a role in longevity. Higher-earning people tend to live longer, and the gap has widened, he points out. Hilary Waldron of the Social Security Administration examined the remaining life expectancy of those turning 65 between 1977 and 2006, based on their lifetime earnings.1 Over nearly four decades, life expectancy rose roughly one year for the bottom half of earners, but almost six years for the upper half. Among those who turned 65 in 2006, men in the top half of earners could expect to live more than five years longer than men in the bottom half.
Discussing the sources of income and the "three-legged stool", the article notes the role of Social Security
Sources of income in old age vary widely across the income spectrum ... Social Security is the primary or only source of old-age income for elderly with below-average incomes, representing more than 80 percent of this group's income. This half of the elderly population is most affected by changes in Social Security benefits. Policymakers examining potential Social Security reforms should give careful consideration to the impact on those in the bottom half of the income distribution....
Noting the change in employer pension plans, the article discusses the availability of a pension and how such affects retirement-readiness.
What about the chance of outliving one's savings? The article discusses this and notes several studies on this issue. "Nearly half (46 percent) of older Americans die with less than $10,000 in financial assets, according to a study ..." Another study found that "[s]ingle people were less likely to be adequately prepared for retirement than married people, and those with lower levels of education were also more likely to fall short."
Of course, all of us could do more about saving for retirement, but the story notes that a certain segment of the population in particular could do more
The middle-income population could benefit the most from initiatives that would further encourage saving.... Many could use expanded access to retirement savings mechanisms. For example, smaller firms could be offered tax incentives to provide DC retirement plans to their employees. Financial education could help more people understand the advantages of participating in DC plans that have contributions matched by employers and the long-term consequences of liquidating retirement saving before reaching retirement age. Additionally, research is showing that automatically enrolling new employees in employer-sponsored plans, and providing them with an opportunity to opt out rather than requiring them to opt in, increases their participation
Sunday, July 6, 2014
I'm back from a fun and productive time in Northern Ireland, and feeling invigorated. In addition to enjoying beautiful weather, great craic, and time spent with friends exploring the north Antrim coast via foot, boat and a friend's snazzy red convertible, I participated in working meetings in Belfast conducted by Claire Keatinge, the Commissioner of Older People for Northern Ireland (COPNI). The topics were prospective laws and guidance regarding safeguarding and social care policies for older adults, connected to commissioned research by two academic teams headed by members of Queens University Belfast.
I've been thinking about one particular theme that emerged for me from the working sessions: does a government's commitment to assess need for services obligate the government to meet those needs? In a perfect world, of course that would be the goal, but this is hardly a perfect world. Claire Keatinge (pictured in the center, with members of the social care research and advisory teams) raised the point that too often governments may be driven by "what services are available" as the definition of need. In other words, there is a tendency to recognize an individual's need only if the government actually has a program or package of services available. Thus, for example, even if the individual needs one-on-one monitoring and assistance to avoid serious risk of injury from falling, the tendency of social care programs would be to indicate 4 hours per day of "need" if that was the limit of government funding. Such "backwards" assessment leaves the person vulnerable, not just from the limitations on public funding, but from the inaccurate record of need.
We spent time talking about whether legislation or policy guidance should address both assessment of need and programs of service. The COPNI discussion helped me to realize that accurate assessment and recording of all need is critical to coordination of family, volunteers, nonprofit or church-based assistance, and government funding to meet the true needs of disabled or frail individuals. However, assessment of need still carries implications for government funding.
The implications of assessment are addressed in an important recent decision of the European Court of Human Rights in McDonald v. United Kingdom (Application No. 4241/12). In the case, a British woman born in 1943 sustained a disabling stroke in 1999, followed by a badly broken hip from a later fall. Ms. McDonald, who was not incontinent, applied for assistance at night with toileting; eventually she was assessed as being in "substantial need" of nighttime personal assistance and provided a funding package that permitted her to have nighttime assistance. However, later the government office reduced the funding, appearing to conclude the cost was excessive and "incontinence pads" for nighttime use was sufficient, reducing the number of hours of service.
Ms. McDonald challenged the reduction of services under Article 8 of the European Convention on Human Rights, arguing the decision violated her right to respect for her private life, and that the local authority was "unreasonably and unlawfully failing to meet her assessed and eligible needs." Several months later she was reassessed by the local authority, which then determined that Ms. McDonald's needs for "safety" at night could be adequately met by the use of incontinence pads and sheets. Ms. McDonald framed an emotionally persuasive case that the ability to toilet in a dignified manner was a core human right.
Ms. McDonald's appeal was addressed by high courts in England, before reaching the European Court of Human Rights, which issued a decision in May 2014. Ultimately the court concluded that during the period of time between the initial assessment of "substantial" need and the later reassessment, a period of about a year during which Ms. McDonald was provided with limited nighttime assistance, was a violation of Article 8. She was therefore deemed entitled to a relatively nominal sum of damages (explained in a detailed portion of the opinion). However, once the local authority's "reassessment of need" occurred, the Court determined it was without the power to find a human rights violation under Article 8. This outcome strikes me as demonstrating the potential for governments to be driven by finances to avoid making independent, candid assessments of need. Ms. McDonald's physical conditions and nighttime needs had not changed; only the "assessed needs" had changed.
For more on the implications of the McDonald ruling, viewed by many as a "win" because it recognized a personal right protected under Article 8, see English Barrister Steve Broach's thoughtful commentary, "Context is Everything: Why McDonald v. UK is a Stepping Stone on the Road to a Dignified Future for Disabled People."
Thursday, July 3, 2014
This was a cool idea. Governing reported on a project in Atlanta where for 2 days, regional planners took over a neighborhood and marked it up to show what it would look like if it were an elder-friendly community. Atlanta Shows What a Senior-Friendly Neighborhood Looks Like explains how this happened
The Atlanta Regional Commission, the area’s metropolitan planning organization, took over two blocks of the city's Sweet Auburn neighborhood to demonstrate that features that cater to an older population also make life better for children and young adults too. Volunteers marked off wider sidewalks and a protected bike lane ... They set up a health clinic and a farmer’s market. The courtyard in a 14-story retirement home featured an oversized chess board, gardening classes and other activities aimed at giving residents accessible entertainment.
According to the story, Atlanta is facing a particular challenge as a result of a recent report showing that almost 90% of elders in Atlanta would not have good access to transportation by 2015. The planners joined with "Mike Lydon, a leader in the “tactical urbanism” movement. The idea is to use low-cost, local resources to demonstrate potential changes that could improve a neighborhood."
Wednesday, July 2, 2014
The Administration for Community Living, Centers for Disease Control and Prevention, and the National Institute on Aging are collaborating to host a webinar series to increase knowledge about Alzheimer’s disease and related dementias, and resources that professionals in the public health, aging services, and research networks can use to inform, educate, and empower community members, people with dementia, and their family caregivers.
You can register for all the webinars or just the one that most interests you. You must register separately for each webinar. If you plan to view the webinar in a central location with others, we encourage only one person to register for the group.
Each webinar is from 1:30 p.m.–3:00 p.m. ET/12:30 p.m.–2:00 p.m. CT/ 11:30 a.m.–1:00 p.m. MT/10:30 a.m.–12:00 p.m. PT. The schedule is as follows:
Tuesday, July 22, 2014: Updates on Alzheimer’s Disease and Related Dementias Resources
Thursday, August 28, 2014: Community Collaborations for Assisting People with Alzheimer’s and Dementias: The Steps to Success
Thursday, September 25, 2014: Alzheimer’s Research Updates
Click here for additional information on the series and each webinar session.
We have posted previously on the story about nursing home inspections in LA County reported in the Kaiser Health News (KHN) in conjunction with the LA Daily News. The most recent story explains a report from the Calif. Department of Public Health. The story, Review Finds Flawed Management Of Nursing Home Inspections In Los Angeles County ran June 20, 2014. Among other findings,
After reviewing a sampling of 136 cases received since 2009, the state health department found that LA. County officials did not properly prioritize or track investigations. The county faces a backlog of hundreds of nursing home safety complaints...The state also verified that L.A. County was using an unsanctioned policy for closing backlogged cases – called the “Complaint Cleanup Project” -- but determined that it had limited impact....
The story reports that "[t]he state recommended that the county develop a system for supervisors to track open cases and do more training on documenting and prioritizing cases..."
Tuesday, July 1, 2014
While rates of smoking and excessive drinking have declined among older Americans, prevalence of chronic disease has risen, and many older Americans are unprepared to afford the costs of long-term care in a nursing home, according to a report from the U.S. Census Bureau commissioned by the National Institutes of Health.The report highlights those trends and others among America’s older population, now over 40 million and expected to more than double by mid-century, growing to 83.7 million people and one-fifth of the U.S. population by 2050. Population trends and other national data about people 65 and older are presented in the report, 65+ in the United States: 2010. It documents aging as quite varied in terms of how long people live, how well they age, their financial and educational status, their medical and long-term care and housing costs, where they live and with whom, and other factors important for aging and health.Funded by the National Institute on Aging (NIA), part of NIH, the report draws heavily on data from the 2010 Census and other nationally representative surveys, such as the Current Population Survey, the American Community Survey and the National Health Interview Survey. In addition, data from NIA-funded research was included in the report.“The National Institute on Aging is pleased to support this 65+ in the United Statesreport,” said Richard Suzman, director of the Division of Behavioral and Social Research at NIA. “This report series uniquely combines Census Bureau and other federal statistics with findings from NIA-supported studies on aging. The collaboration with Census has been of great value in developing social, economic and demographic statistics on our aging population with this edition highlighting an approaching crisis in caregiving — since the baby boomers had fewer children compared to their parents.”A key aspect of the report is the effect that the aging of the baby boom generation—those born between 1946 and 1964—will have on the U.S. population and on society in general. Baby boomers began to reach age 65 in 2011; between 2010 and 2020, the older generation is projected to grow more rapidly than in any other decade since 1900.The report points out some critical health-related issues:
- Rates of smoking and excessive alcohol consumption have declined among those 65 and older, but the percentage of overweight and obese people has increased. Between 2003-2006, 72 percent of older men and 67 percent of older women were overweight or obese. Obesity is associated in increased rates of diabetes, arthritis, and impaired mobility, and in some cases with higher death rates.
- Research based on NIA’s Health and Retirement Study suggests that the prevalence of chronic diseases, such as high blood pressure, heart disease, chronic lung disease, and diabetes, increased among older people between 1998 and 2008. For example, in 2008, 41 percent of the older population had three or more chronic conditions, 51 percent had one or two, and only 8 percent had no chronic conditions.
- The cost of long-term care varies by care setting. The average cost of a private room in a nursing home was $229 per day or $83,585 per year in 2010. Less than one-fifth of older people have the personal financial resources to live in a nursing home for more than three years and almost two-thirds cannot afford even one year. Medicare provides coverage in a skilled nursing facility to older and disabled patients for short time periods following hospitalization. Medicaid covers long-term care in certified facilities for qualifying low-income seniors. In 2006, Medicaid paid for 43 percent of long-term care.“Most of the long-term care provided to older people today comes from unpaid family members and friends,” noted Suzman. “Baby boomers had far fewer children than their parents. Combined with higher divorce rates and disrupted family structures, this will result in fewer family members to provide long-term care in the future. This will become more serious as people live longer with conditions such as cancer, heart disease and Alzheimer’s.”Other areas covered in the report include economic characteristics, geographic distribution, social and other characteristics.
The GAO has released a new report, Financial Characteristics of Approved Applicants and Methods Used to Reduce Assets to Qualify for Nursing Home Coverage. The highlights of the report summarize that from the "review of 294 approved Medicaid nursing home applications in three states showed that 41 percent of applicants had total resources—both countable and not countable as part of financial eligibility determination—of $2,500 or less and 14 percent had over $100,000 in total resources." Further, "[n]early 75 percent of applicants owned some noncountable resources, such as burial contracts; the median amount of noncountable resources was $12,530." The report reviews the methods of Medicaid eligibility and notes that the Medicaid workers thought bank statements to be the most helpful in determining an applicant's eligibility. A pdf of the report is available here.
Monday, June 30, 2014
According to a June 4, 2014 report from Economic Modeling Specialists Intl, or EMSI (a CareerBuilder company), titled Interactive Metro Map: Baby Boomers Gaining Jobs, Millennials Standing Pat, those Boomers are working away. The article states that "[t]he number of young workers aged 22-34 nationwide is basically unchanged since 2007, while the number of jobs for boomers (55-64) — fueled by mega population growth — has climbed 9% over that time..." The article is accompanied by very cool interactive maps. The report notes that the health care field is growing well for boomer jobs and, here is one that may surprise you "[c]omputer jobs grew 10 times faster for boomers than millennials..."
The report does address the reasons behind the discrepancies for these two groups. Of course, we can suggest the sheer number of baby boomers are the cause, but it isn't that simple
The decline of millennial jobs and upswing of baby boomers in the workforce can be explained, at least in part, by demographic and behavioral factors. As our colleagues at CareerBuilder noted, the population of 55 and older Americans has grown 20% since 2007 — four times as fast as prime-working age millennials (ages 25-34). The same 55-and-over age group is the only to increase its labor force participation rate and employment-to-population ratio over that time.
Friday, June 27, 2014
The National Guardianship Network (NGN) in collaboration with the American Bar Association Commission on Law & Aging, has announced the release of their new publication, WINGS Tips: State Replication Guide for Working Interdisciplinary Networks of Guardianship Stakeholders. The publication may be downloaded as a pdf from the ABA website here. The accompanying description explains the publication's importance
Working Interdisciplinary Networks of Guardianship Stakeholders (WINGS) are broad-based, collaborative working groups that drive changes that affect the ways courts and guardians practice, and improve the lives of people who have or may need guardians.
This publication, produced by the Commission on behalf of the National Guardianship Network, highlights the hallmarks of successful WINGS groups and outlines ten steps for launching and maintaining your own WINGS program.
For those of you unfamiliar with NGN, their website explains it "is a collaborative group of national organizations dedicated to effective adult guardianship law and practice. First convened in 2002, the National Guardianship Network has played a leadership role in advancing guardianship standards, best practices and education."
Tuesday, June 24, 2014
The U.S. Department of Health and Human Services’ Administration for Community Living (ACL) is proud to announce the release of a new online learning tool: Building Respect for LGBT Older Adults. The tool is designed to increase awareness of the issues faced by lesbian, gay, bisexual, and transgender (LGBT) individuals living in long term care (LTC) facilities.
After completion of the online training, program participants will be prepared to:
- Increase visibility of the issues facing LGBT individuals in LTC facilities.
- Provide easy access to information on serving LGBT individuals in LTC facilities.
- Encourage LTC facilities to provide opportunities for staff to take the online training.
- Change the way individuals and facilities approach older LGBT adults.
The Building Respect for LGBT Older Adults tool was developed in collaboration with the HHS Office of Public Affairs, the Centers for Medicare & Medicaid Services, and the ACL-funded National LGBT Resource Center, with input from aging and LGBT advocates.Read more.
Additional LGBT Resources for the Aging Services Network
Since 2010, the ACL Administration on Aging has funded Services and Advocacy for Gay, Lesbian, Bisexual and Transgender Elders (SAGE) to develop and operate the National Resource Center on LGBT Aging (NRC), the country's first and only technical assistance resource center aimed at improving the quality of services and supports offered to LGBT older adults. This resources clearinghouse website was recently revamped and includes great local and national resources, as well as a new database of all the organizations that have received one of NRC’s trainings. Also, the NRC’s most popular guide, A Practical Guide to Creating Welcome Agencies is now available in Spanish titled Servicios Inclusivos Para Personas Mayores LGBT. Request a copy today!
Also, read the Presidential Proclamation -- Lesbian, Gay, Bisexual, and Transgender Pride Month, 2014.
Friday, June 20, 2014
I'm at the mid-point in a three-week period of fairly intense focus on elder protection issues.
Last week, I accepted the invitations of Dickinson Law alum Bob Gerhard and Judge Lois Murphy to join them at the Montgomery County Elder Justice Roundtable to discuss practical concerns about elder abuse at the local level. Bob and I conducted two sessions on Powers of Attorney.
This week, I've had the privilege of being part of working sessions of the Pennsylvania Supreme Court's Elder Law Task Force. Judge Murphy, right, is also a part of this effort. A fascinating mix of trial and appellate level judges, district attorneys, legal aid specialists, solo practitioners, "big firm" lawyers, court administrators, state officials, protective service case workers, social workers (and a couple of us academic types) spent two intense days discussing a year's worth of research on how better to serve the interests and needs of adults who may be at risk of neglect or intentional harm, including financial abuse. Guided by the charge of Justice Debra Todd of the Pennsylvania Supreme Court, we're looking to issuance of a comprehensive report and recommendation for actions, probably in the early fall 2014.
Next week, I land in Belfast, Northern Ireland for several days of working group meetings on law and aging topics. On Tuesday, June 24, I am part of a research team's Roundtable discussion on recommendations regarding "social care" for older persons. hosted by the independent Commissioner of Older Persons in Northern Ireland (COPNI). Our team leader for that project is Dr. Joseph Duffy of Queen's University Belfast. The following day, I will attend the COPNI's launch of "Protecting our Elder People in Northern Ireland: A Call for Safeguarding Legislation in Northern Ireland." Commissioner Claire Keatinge and her team have been tireless in pursuing a full agenda of safeguarding, care and dignity goals for seniors. Last winter I worked on research findings and recommendations with team leader Dr. Janet Anand, also of Queens University Beflast, that served as a base for the Safeguarding Law proposals. These two projects have involved amazingly talented scholars from diverse backgrounds, including social work and law in Scotland, England, Wales, Australia and, of course, both the north and south of Ireland. The truth is that I've been an avid "student" during my opportunities in Northern Ireland, often facing the reality that those on the other side of the Atlantic are ahead of the U.S. in thinking about key concepts, especially "social care" goals. I look forward to more work, writing several follow-up articles in collaboration with team members as a result of the rich research environment of the last year.
Following this schedule, I'm probably going to take a break from "daily" blogging for a few weeks. I fear my brain may explode if I don't give it a bit of a rest, and I hear the green hills and fields of Ireland calling to me.
June 20, 2014 in Current Affairs, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, Housing, Property Management, Social Security | Permalink | Comments (0) | TrackBack (0)