Tuesday, October 25, 2016

Refusing Foods & Fluids as a Right to Die?

The New York Times ran an article recently on individuals voluntarily refusing nutrition and hydration as a way to speed up the end of life. The VSED Exit: A Way to Speed Up Dying, Without Asking Permission focuses on individuals who voluntarily give up eating and drinking. We know that only a handful of states offer Physician-Aided Dying and even in states where that is legalized, not everyone fits within the parameters of the statute.  "In end-of-life circles, [the] option [voluntarily giving up food and fluids] is called VSED (usually pronounced VEEsed), for voluntarily stopping eating and drinking. It causes death by dehydration, usually within seven to 14 days. To people with serious illnesses who want to hasten their deaths, a small but determined group, VSED can sound like a reasonable exit strategy."

The article notes that for individuals who avail themselves of VSED, no law seems to be needed (although there is still some uncertainty on that point), no court intervention is required, but the individual needs a lot of fortitude, “'It’s for strong-willed, independent people with very supportive families,' said Dr. Timothy Quill, a veteran palliative care physician at the University of Rochester Medical Center." 

One unanswered question is whether VSED is "legal".

For a mentally competent patient, able to grasp and communicate decisions, probably so, said Thaddeus Pope, director of the Health Law Institute at Mitchell Hamline School of Law in St. Paul, Minn. His research has found no laws expressly prohibiting competent people from VSED, and the right to refuse medical and health care intervention is well established.

Still, he pointed out, “absence of prohibition is not the same as permission.” Health care professionals can be reluctant to become involved, because “they want a green light, and there isn’t one of those for VSED,” he added.

The question grows much murkier for patients with dementia or mental illness who have specified VSED under certain circumstances through advance directives. Several states, including Wisconsin and New York, forbid health care surrogates to stop food and fluids. (Oregon legislators, on the other hand, are considering drafting a bill to allow surrogates to withhold nutrition.)

The article reports on a recent conference and some of the issues discussed there.  The article also explains that with VSED, death doesn't come as quickly as with PAD, leading to issues for patients and caregivers. The article also notes there are (or likely could be) obstacles to using VSED, such as positions taken by long term care facilities or specific religions.

This topic would be great for a class discussion.


October 25, 2016 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Health Care/Long Term Care, Programs/CLEs, State Statutes/Regulations | Permalink | Comments (1)

Friday, October 21, 2016

LeadingAge's Annual Meeting Begins October 30 in Indianapolis

LeadingAge, the trade association that represents nonprofit providers of senior services, begins its annual meeting at the end of October.  This year's theme is "Be the Difference," a call for changing the conversation about aging.  I won't be able to attend this year and I'm sorry that is true, as I am always impressed with the line-up of topics and the window the conference provides for academics into industry perspectives on common concerns.  For example, this year's line up of workshops and topics includes:

October 21, 2016 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, International, Legal Practice/Practice Management, Medicaid, Medicare, Programs/CLEs, Property Management, Retirement, Science, Social Security, State Cases, State Statutes/Regulations, Veterans | Permalink | Comments (0)

Friday, September 23, 2016

Planning: Mid-Atlantic Works-in-Progress Retreat Opportunity for Health Law Scholars

Professor Carl H. Coleman at Seton Hall Law School in Newark, New Jersey, sent us advance news about a works-in-progress retreat scheduled for February 10, 2017.  Professor Coleman explained:

Seton Hall Law School’s Center for Health & Pharmaceutical Law & Policy is pleased to announce the inaugural Mid-Atlantic Health Law Works-in-Progress Retreat, which will be held on February 10, 2017, at Seton Hall Law School in Newark, New Jersey.  The purpose of the retreat is to give regional health law scholars an opportunity to share their work and exchange ideas in a friendly, informal setting.  The retreat is open to anyone with an academic appointment in health law (including professors, fellows, and visitors) in any institution of higher education in the mid-Atlantic area.

The retreat will consist of an in-depth discussion of approximately 5-6 draft papers.  A designated commentator will first provide a 10-15 minute overview of each paper, as well as his or her reactions.  The author will then have 5 minutes to respond, following which all retreat participants will participate in a general discussion of the draft.

Persons interested in having their papers presented should submit a preliminary draft or, if that is not possible, a detailed abstract, no later than November 18 to Carl Coleman at carl.coleman@shu.edu, using the description "Mid-Atlantic Health Law Retreat" in the regarding line of the emailed submission.   Papers to be presented will be selected by December 9, and final drafts will be due on January 20.  Drafts will be made available to all participants on a password-protected website.

Contact Professor Coleman with any questions. This looks like a fabulous workshop opportunity. Thanks, Carl!

September 23, 2016 in Ethical Issues, Health Care/Long Term Care, Programs/CLEs | Permalink | Comments (0)

Thursday, September 22, 2016

Inspiring Conversations about Aging -- a Florida Example

Karen Miller, a lawyer and former administrative law judge from New York who has become a very good friend, recently shared with me reports about a long-time project of hers, to inspire direct dialogue between generations about aging.  As an engaged resident of a CCRC in Gainesville, Florida (Oak Hammock which is affiliated with the University of Florida), Karen and others in her community embody the notion of active, healthy, and realistic aging.  Karen knows that "aging in the right place" is a better goal than simply "aging in place."  The right place may or may not be the long-time family home.   

Over the course of three days in mid-September, Temple Shir Shalom and Oak Hammock hosted conversations on "Giving and Receiving Care" that were open to the public.  From the Gainesville-Sun coverage of the events:

[Rabbi Michael] Joseph said joking around with his wife about his forgetfulness becomes less funny, as he grows older. “It becomes a real anxiety, it becomes harder to talk about,” Joseph said. “Because I don’t really want to know the answer, part of me.”


Saturday’s festivities will address Joseph’s anxiety head-on. The Oak Hammock retirement community will serve as the backdrop to a lecture about age-related cognitive changes. The 3 p.m. non-clinical presentation by guest speaker Dr. Steven DeKoskey of the University of Florida's McKnight Brain Institute will take a look at what is and isn’t normal when aging.


[Karen] Miller said that as people age they may need help with numerous things, ranging from simple things like writing a check, to more complicated things, like making medical decisions. “There will come a time, unless you get hit by a car, where your faculties are not as sharp as they were at one time,” she said.


Concluding Sunday at the temple, the program will open its doors at 10:30 a.m. to a wider audience spanning at least three generations, Joseph said.

The combination of community hosts, professional caregivers, science-based speakers, and public round tables strikes me as an inspiring model for effective conversations about aging. Well done, Karen.

September 22, 2016 in Consumer Information, Ethical Issues, Health Care/Long Term Care, Programs/CLEs | Permalink | Comments (0)

Wednesday, September 21, 2016

18th Annual CLE: Special Needs Trusts & Special Needs Planning: Early Bird Ends 9/23/16

Stetson's 18th annual National Conference on Special Needs Trusts & Special Needs Planning takes place on October 19-21, 2016 at the Vinoy Hotel in St. Petersburg, Florida.  Early Bird Registration rates end September 23, 2016. The national conference spans two days, with general sessions in the mornings and three tracks of breakout sessions in the afternoons (basics, advance and administration) Information about the conference, including the agenda, speakers, and links to register is available here. (Full disclosure, I'm the conference chair. Hope to see you at the conference!)

September 21, 2016 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Medicaid, Medicare, Other, Programs/CLEs | Permalink | Comments (0)

Monday, September 19, 2016

Upcoming Conference to Focus on Dispute Resolution in the Face of "Medical Futility"

On Friday, November 18, 2016, Mitchell Hamline School of Law and Children's Minnesota are hosting a one day seminar on "Ethics, Law and Futility" in Minneapolis.  The target audience is described as "Nurses, Physicians, Social Workers, Lawyers, Patient Advocates, Parents/Guardians or anyone interested in ethics, law and futility."  The premise is intriguing, as explained in conference promotion materials:

There is a knowledge gap between what is presumed as one’s ethical and legal obligations to patients during cases of futility and what actually their responsibility is. This conference will assist in clarifying these issues and provide the audience with tools for managing futility cases.

Speakers include: 

  • Thaddeus Pope, Director of the Health Law Institute at Mitchell Hamline School of Law, speaking on "When may you stop life-sustaining treatment without consent?  Leading Dispute Resolution Mechanisms for Medical Futility Conflicts.”

  • Emily Pryor Winston, Associate General Counsel at Children’s Hospitals and Clinics of Minnesota, on "Minnesota Law and Medical Futility Analysis."

  • Jack Schwartz, Adjunct Professor at the University of Maryland School of Law and Former Maryland Assistant Attorney General, on "The Ethics of Legal Risk.

For more, see the home page for the symposium, which provides registration materials.

September 19, 2016 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Ethical Issues, Health Care/Long Term Care, Programs/CLEs, State Statutes/Regulations | Permalink | Comments (0)

Monday, July 25, 2016

19th Annual Elder Law Institute in Pennsylvania Includes Trend Analysis in Senior Living

19th Pennsylvania Elder Law InstituteLast week, Lancaster Pennsylvania was host to the 19th Annual Elder Law Institute, co-sponsored by the Pennsylvania Bar Institute and the Pennsylvania Bar Association's Elder Law Section.  As the image of the two, fat volumes of course materials demonstrates, there was a lot of content for  participants to digest. More than 400 professionals attended,not counting walk-ins.  (And yes, the course materials will be available for purchase eventually, from the PBI catalog here.) 

I had the privilege of welcoming two new speakers to the Pennsylvania conference, Stephen J. Maag, J.D., Director of Residential Communities for LeadingAge and Brad C. Breeding, President of My LifeSite.  Both speakers addressed options available for senior living, and focused on trends affecting Continuing Care Retirement Communities (CCRCs), now also known as Life Plan Communities.

Steve noted that with close to 2,000 communities across the nation identifying under the CCRC or Life Plan label, a majority are "still" nonprofit, especially in so-called "Type A" operations, but that there is clearly a trend in the direction of change to "for profit" ownership or management. Communities are coping with what he termed "unprecedented" change on many fronts, including changing consumer demographics, the impact of health care reform, and use of technology that can affect or delay timing of decisions to move into a Life Plan Community.  

Brad outlined the development of his company as a site for comparative information for consumers considering CCRC or Life Plan communities.  The company has a data bank with detailed, comparative information on over 400 communities, offering consumers a fee-paid option of getting side-by-side statistics on contract options, pricing, services available and more.  But he also said that collecting the information is not easy, as some state regulators, including Pennsylvania, do not "share" information in a transparent way.   Remember Medicare.gov's Nursing Home Compare?  Brad's company is working to provide consumers with comparative information beyond that narrow focus on skilled nursing care.  One of the hot topics Brad identified is the extent to which consumers can use "long-term care insurance" in the CCRC setting, and we all discussed whether such insurance should be paying a pro-rata share of entrance fees, especially in Type A life-care contracts. 

My special thanks to Steve and Brad for traveling from D.C. and North Carolina, respectively, to share their knowledge and predictions. 

July 25, 2016 in Books, Health Care/Long Term Care, Housing, Programs/CLEs | Permalink | Comments (0)

Tuesday, July 19, 2016

Register Now for the 18th Annual National Conference on Special Needs Trusts

Registration is now open for Stetson's 18th annual National Conference on Special Needs Planning and Special Needs Trusts (full disclosure-I'm the conference chair).  The program is scheduled for October 18-20. October 18th has 2 pre-conferences, one on tax issues and one on pooled SNTs. The National Conference starts on October 19th with general sessions on both mornings and break-out sessions in the afternoons. Afternoon sessions offer 3 tracks: basics, administration and advanced.  For more information, click here.  Registration information is here.

July 19, 2016 in Consumer Information, Current Affairs, Programs/CLEs | Permalink | Comments (0)

Tuesday, July 12, 2016

Register Now: Hot Topics In Elder Law Webinar

Stetson Law (full disclosure-my school) offers a new webinar on Tuesday July 19 at noon edt. This first Hot Topics in Elder Law webinar covers the subject of nursing home resident discharge. The Right or Wrong Way? Involuntary Discharge of Nursing Home Residents is a 90 minute webinar.  Here is a description about the webinar

 A recent AP story suggested that "Nursing homes are increasingly evicting their most challenging residents." Nursing home owners assert that the homes are following the discharge rules and more importantly protecting vulnerable adults from violent residents. This interactive debate will feature advocates from both sides of the issue. 

Moderated by Professor Roberta  K. Flowers, the debate will feature Eric Carlson, directing attorney of  Justice in Aging in Los Angeles, California, and Sheila Nicholson, who specializes in nursing home defense and is a partner at Quintairos, Prieto, Wood & Boyer P.A., in Tampa, Florida.

Registration information is available here.

July 12, 2016 in Consumer Information, Current Affairs, Health Care/Long Term Care, Programs/CLEs, Webinars | Permalink | Comments (0)

Tuesday, July 5, 2016

Special and Supplemental Needs Trust To Be Highlighted At July 21-22 Elder Law Institute in Pennsylvania

In Pennsylvania each summer, one of the "must attend" events for elder law attorneys is the annual 2-day Elder Law Institute sponsored by the Pennsylvania Bar Institute.  This year the program, in its 19th year, will take place on July 21-22.  It's as much a brainstorming and strategic-thinking opportunity as it is a continuing legal education event.  Every year a guest speaker highlights a "hot topic," and this year that speaker is Howard Krooks, CELA, CAP from Boca Raton, Florida.  He will offer four sessions exploring Special Needs Trusts (SNTs), including an overview, drafting tips, funding rules and administration, including distributions and terminations.

Two of the most popular parts of the Institute occur at the beginning and the end, with Elder Law gurus Mariel Hazen and Rob Clofine kicking it off with their "Year in Review," covering the latest in cases, rule changes and pending developments on both a federal and state level.  The solid informational bookend that closes the Institute is a candid Q & A session with officials from the Department of Human Services on how they look at legal issues affected by state Medicaid rules -- and this year that session is aptly titled "Dancing with the DHS Stars." 

I admit I have missed this program -- but only twice -- and last year I felt the absence keenly, as I never quite felt "caught up" on the latest issues.   So I'll be there, taking notes and even hosting a couple of sessions myself, one on the latest trends in senior housing including CCRCs, and a fun one with Dennis Pappas (and star "actor" Stan Vasiliadis) on ethics questions.

Here is a link to pricing and registration information.  Just two weeks away!


July 5, 2016 in Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Legal Practice/Practice Management, Medicaid, Medicare, Programs/CLEs, Property Management, Social Security, State Cases, State Statutes/Regulations, Veterans | Permalink | Comments (0)

Friday, June 3, 2016

"He Died with Guns in His Closet"

"He Died with Guns in His Closet."  That's the provocative (and effective) title of an upcoming  continuing legal education program  (3 credits) in Pennsylvania.  The half-day Pennsylvania Bar Institute program will be offered live in Pittsburgh on June 8, and both in-person (Mechanicsburg) and by webcast/simulcast on June 16.  The program will address "new regulations for gun trusts that go into effect on July 13, 2016;" acquisition, possession disposition and transportation of firearms; how people become disqualified to interact with firearms; gun trusts; and the National Firearms Act's implications for trust and estate practitioners.

Last fall, I was at a statewide meeting of continuing care community residents in the Southeastern part of the US, and I admit I was startled when residents raised the topic of "what to do about guns" in their CCRCs.  

Here's a link to the CLE details.   My thanks to Pennsylvania practitioner and great estate planning adjunct professor Vicky Trimmer for alerting me both to the changes in the law and this upcoming program.  

June 3, 2016 in Estates and Trusts, Ethical Issues, Programs/CLEs, Property Management, Webinars | Permalink | Comments (0)

Tuesday, May 31, 2016

American Society on Aging Call for Proposals

The annual American Society on Aging (ASA) conference is scheduled for March 20-24, 2017 in Chicago. The planning committee is now accepting proposals to present at the conference.  For more information or to submit a proposal, click here. The deadline for submitting a proposal is June 30, 2017.

May 31, 2016 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care, Programs/CLEs | Permalink | Comments (0)

Monday, May 30, 2016

Call for Abstracts-Association for Gerontology in Higher Education

The Association for Gerontology in Higher Education's (AGHE) annual conference is scheduled for March 9-12, 2016 in Miami, Florida. The call for abstracts for one of the six themes for the conference closes at noon on June 1, 2016. For more information, click here.


May 30, 2016 in Consumer Information, Current Affairs, Programs/CLEs | Permalink | Comments (0)

Monday, May 23, 2016

Association for Gerontology in Higher Ed Conference

The Association for Gerontology in Higher Ed annual meeting is set for March 9-12, 2017 in Miami.  The call for abstracts closes June 1, 2016 with the conference's theme  "The Future is Here: Educating a New Generation of Professionals in Aging Worldwide." A number of tracks will be offered, including on these topics:

Global Aging

Curriculum and Policy Issues

Age-Friendly Environments

Translating Research to Education and Training

Workforce Development

Program and Curriculum Development

Diversity and Social Justice for Older Persons

More information about submitting an abstract is available here.

May 23, 2016 in Current Affairs, Other, Programs/CLEs | Permalink | Comments (0)

Wednesday, April 20, 2016

Save the Date - Sept. 23-24 for the Central States Law Schools Scholarship Conference

Recently we received an early reminder that the The Central States Law Schools Association (CSLSA) 2016 Scholarship Conference will be held on Friday, September 23 and Saturday, September 24 at the University of North Dakota School of Law in Grand Forks, ND.  More details are forthcoming, but here are preliminary details plus a link to use if you would like direct, emailed updates:
CSLSA is an organization of law schools dedicated to providing a forum for conversation and collaboration among law school academics. The CSLSA Annual Conference is an opportunity for legal scholars, especially more junior scholars, to present working papers or finished articles on any law-related topic in a relaxed and supportive setting where junior and senior scholars from various disciplines are available to comment. More mature scholars have an opportunity to test new ideas in a less formal setting than is generally available for their work. Scholars from member and nonmember schools are invited to attend. 
Registration will formally open in July. Hotel rooms are already available, and more information about the CSLSA conference can be found on our website at www.cslsa.us.

April 20, 2016 in Programs/CLEs | Permalink | Comments (0)

Thursday, April 14, 2016

Seattle University School of Law Receives ABA Approval for LLM in Elder Law

As reported in The National Jurist, Seattle University School of Law has been approved by the ABA for an LLM program in elder law.  The Elder Law LLM will be "added soon," along with new LLM programs in tribal law and technology.  Details include:

The elder law LL.M. will train attorneys to provide representation, advocacy, and leadership in the areas of law that impact seniors and people with disabilities. Courses will cover a wide range of legal issues, including health care coverage, age discrimination, and protection from abuse and neglect.

According to an ABA website here, other law schools with LLMs in Elder Law include (of course!) Stetson University, University of Kansas, Touro University and Western New England University. Review of the linked websites suggests to me that at Touro, the LLM program may have evolved into or merged with a resource center and research platform with the title Aging & Longevity Law Institute.  I was unable to find any current information on an LLM at University of Kansas.  

April 14, 2016 in Current Affairs, Programs/CLEs | Permalink | Comments (0)

Friday, March 11, 2016

Elder Abuse in Australia

Elder Abuse knows no geographic boundaries, as a recent story in the Brisbane, Australia Times showed. Australia's ageing population prey to abuse was published on February 24, 2016 and explains

The abuse of older people is likely to worsen as Australia's population ages and relatively wealthy baby boomers become vulnerable to mercenary family members and carers.

The federal government is "appalled" at the extent of elder abuse and has asked the Australian Law Reform Commission to find ways to safeguard older Australians....

The article discusses the number of victims, risk factors, and perpetrators. Similar to the U.S., Australia doesn't have good data on elder abuse as far as how big a problem it is, "has to extrapolate from international research. "We say that it frequently is a form of family violence - because it happens within families - but the significant difference is that it's most often between generations," said Jenny Blakey from Seniors Rights Victoria. "  The 4th annual national conference on elder abuse  was held in Melbourne, Australia in late February. More information about the conference can be found here.

March 11, 2016 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, International, Programs/CLEs | Permalink | Comments (0)

Tuesday, March 8, 2016

Continuing Legal Education Courses on Alzheimer's Disease

The promotional material catches your eye: "Every 67 seconds someone in the U.S. develops Alzheimer's Disease.  5.3 million Americans have the disease."

I'm seeing more programming being offered to practicing lawyers on dementia-related issues generally and specifically about Alzheimer's Disease.  An example is an upcoming program (June 2016) from the Pennsylvania Bar Institute, describing a program on Alzheimer's Disease: "From diagnosis to legal documents, everything you need to counsel your client."  The speakers for the day include three medical professionals, Paul J. Eslinger, PhD from Penn State Hershey Medical Center, Barry V. Rovner, M.D. from Thomas Jefferson University in Philadelphia, and Oscar L. Lopez, M.D., from University of Pittsburgh.

For more about the program, see PBI's website here.  


March 8, 2016 in Cognitive Impairment, Dementia/Alzheimer’s, Estates and Trusts, Health Care/Long Term Care, Programs/CLEs | Permalink | Comments (0)

Friday, February 26, 2016

Call for Presentations-2016 National Aging & Law Conference

The 2016 National Aging & Law Conference is set for October 27-28, 2016 in Alexandria, Va.  Here is an excerpt from the conference announcement .

On October 27-28, 2016, the Commission on Law and Aging and the Center for Professional Development will sponsor the National Aging and Law Conference in the Washington, DC, area at the Hilton Alexandria Old Town in Alexandria, VA. 

Conference attendees will enjoy:

  • Low registration rates and a two-day agenda to minimize travel time and costs
  • An expanded agenda with 4 plenary sessions and 30 workshops
  • A focus on core substantive legal issues affecting older Americans with the greatest economic and social needs
  • Programming on legal service development and delivery
  • High-quality written materials

A call for presentations is also included in the announcement. If you are interested in presenting, the RFP can be downloaded from here.

February 26, 2016 in Consumer Information, Current Affairs, Programs/CLEs | Permalink | Comments (0)

Friday, February 19, 2016

Call for Papers: Aging & Society: Sixth Interdisciplinary Conference

The 2016 Aging & Society: Sixth Interdisciplinary Conference has released a call for papers for the October 6-7, 2016 conference to be held in Sweden. The call for papers includes papers,  poster presentations, workshops/interactive sessions, or colloquia on one of the four conference themes.  The themes are economic and demographic perspectives,  social and cultural perspectives, medical perspectives and public policy perspectives. More information is available here.

February 19, 2016 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, International, Programs/CLEs | Permalink | Comments (0)