Yet, no matter how good-natured everyone is, sacrifices are inevitable. [One generation] wanted a washer and dryer on the main living level for their parents’ easy access, but that required making the living space smaller. So laundry facilities went downstairs.... “Melding design, finance and emotion is an art, not a science,” said the president of one design firm interviewed for the article. "Nevertheless, 'if you’re creative, you’re willing and you have good relationships, you can make it happen. We’re average Joes and we did it,'" said another generation while a member of the third generation offered that “It’s not like some fairy tale where everyone is always happy and gets their way, but the benefits are better than the costs.”
Monday, May 21, 2018
Lisa Stegall, Assistant Professor of Biology at Hamline University, reports on positive results from a study where adults aged 60 to 80 participated in a weekly program of simple dance moves. From her report for Academic Minute:
Once a week for nine weeks, seniors aged 60 to 80 years old participated in an hour of music and movement training called Dalcroze eurhythmics. Led by a certified instructor who played improvised music on a piano, the seniors walked in time with the music, changed directions, and handled and passed objects rhythmically. They moved individually, with a partner, and in small groups to increase social interaction.
Our research team, made up of faculty and students from the Exercise Science, Music, and Public Health programs, tested the participants’ walking ability before and after the intervention, and found that gait (or walking) speed significantly improved. This held true even when participants were asked to walk and perform another task at the same time, called dual tasking. This latter finding is important because most falls occur while walking, especially when also performing other tasks.
Why did this intervention improve dual-task walking speed by 20%? We hypothesize that the improvement was due to the multicomponent movement training that’s unique to Dalcroze eurhythmics. Stepping to the beat of the music while carrying a ball, and passing that ball to another person in time with the music requires awareness, attention, balance, and coordination. These are the same skills needed when navigating the home, neighborhood, or the grocery store.
I expect we will see Dalcroze Eurhythmics classes coming soon to a gym or dance studio near you! My thanks to Dickinson Law colleague Laurel Terry for this tip.
From Singapore, comes a recent article in The Independent titled "Asia's Ageing Crisis Calls for Innovative Senior Housing Models and Foreign Investment." The article begins:
Asia is facing an ageing crisis with rising life expectancies and record low birth rates in some countries, as a result there is an increasing need for senior housing to cater to Asia’s ageing population. In a new report released today, Colliers International identified key trends in Asia’s demographic shift as well as innovative senior housing models around the globe which may be applicable to this region. . . .
Mr. Govinda Singh, Executive Director, Valuation and Advisory Services at Colliers International, said, "Singapore's greying population presents many opportunities for both policymakers and private developers to further invest in senior housing solutions. Demand for such accommodation will be also spurred by the rising awareness of healthcare and wellness benefits, and retirees having the financial capacity to take advantage of senior living services and facilities." . . .
On May 12, 2018, Singapore Prime Minister Lee Hsien Loong officially opened the country’s first retirement community Kampung Admiralty in Woodlands – an integrated residential development with a range of healthcare, elder and childcare facilities, together with commercial space to serve residents of the area. The concept was conceived by the Housing and Development Board more than four years ago.
The article noted population trends in the region, including the prediction that Asia's population of people over age 65 will "nearly triple by 2050 to 945 million, while the percentage of people over age 75 will often be "staggering," especially in Japan (36.4%), South Korea (35.3%), Hong Kong (33.9%), and Thailand (29%) by 2050.
Sunday, May 13, 2018
News publication sites affiliated with USA Today and the Associated Press have been running a recent piece on "bullying" among older persons, often with a provocative headline such as "It's like 'Mean Girls,' but everyone is 80": How nursing homes deal with bullies. The title undoubtedly catches many a reader's eye, simply because of the heightened discussions of bullying at a national level, including Melania Trump's recent announcement of her Be Best platform for younger persons. The topic isn't actually all that new from a journalism perspective. Paula Span wrote on "Mean Girls in Assisted Living" for the New York Times in 2011, and the same publication carried a granddaughter's Op Ed on "Mean Girls in the Retirement Home" in 2015.
On a parallel track, and perhaps more disturbing, are reports of bullying among nurses, a profession normally associated with empathy and caring. See e.g., "When 'Mean Girls' Wear Scrubs," a 2013 post on DiversityNursing Blog, tracking a several studies and a book.
More important than the clever headlines, however, are the reports of affirmative efforts to counter the bullying, which at the older end of the spectrum of life, seems to focus on name-calling, gossip, and ostracising behavior, rather than physical intimidation. From the most recent USA Today writer's article:
After the cafeteria exiles and karaoke brouhahas, the 30th Street [Senior] Center [in San Francisco] teamed up with a local nonprofit, the Institute on Aging, to develop an anti-bullying program. All staff members received 18 hours of training that included lessons on what constitutes bullying, causes of the problem and how to manage such conflicts. Seniors were then invited to similar classes, held in English and Spanish, teaching them to alert staff or intervene themselves if they witness bullying. Signs and even place mats around the center now declare it a “Bully Free Zone.”. . .
Robin Bonifas, a social work professor at Arizona State University and author of the book “Bullying Among Older Adults: How to Recognize and Address an Unseen Epidemic,” said existing studies suggest about 1 in 5 seniors encounters bullying. She sees it as an outgrowth of frustrations characteristic in communal settings, as well a reflection of issues unique to getting older. Many elderly see their independence and sense of control disappear and, for some, becoming a bully can feel like regaining some of that lost power.
I think that last line rings true. I've certainly seen older adults sudden strike a "meaner" demeanor as their freedom is limited by physical health issues and as their frustrations increase. But I also think it can be important to assess whether a "mean" trait -- or at least a "meaner" dynamic -- is a reflection of cognitive impairment, such as disinhibition associated with certain types of neurocognitive impairments.
On an even more worrisome level, is there a danger of misinterpreting fear or irritation as "meanness," perhaps arising from compelled interactions in a congregated living situation? In one instance, I've seen an older woman who had regularly chose to sit with the same group of 3 other individuals at meals for several weeks, suddenly reject one member of their informal club. It took careful listening to realize the rejection was actually uneasiness bordering on fear -- on some level not completely rational -- but associated with that targeted individual's tendency to wander at night into others' rooms and thus to lead the "mean girl" to try to keep the other away from her around the clock. Targeting the "bullying" behavior could be addressing the wrong problem in the latter case.
Finally, I think there is a danger associated with the admittedly clever tendency to use the "Mean Girls" movie as the analogy for older bullying, thus implying this is only an issue (and problem) associated with women, not men. As a later paragraph in the most recent article makes clear, bullying behavior among older adults is not "just" about women. But perhaps that is obvious from the larger national news?
May 13, 2018 in Books, Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, Retirement | Permalink | Comments (0)
Tuesday, May 8, 2018
Most commentaries on funding for retirement years point to insufficiency of savings or other resources. But here's a different take, drawing upon a recently published report from the Employee Benefit Research Institute (EBRI) that suggests retirees with significant savings are often exercising restraint in spending, From the St. Louis Post-Dispatch on The Myth of Outliving Your Retirement Savings:
In the EBRI study, those with the most savings — a median of $857,450 shortly after retiring — still had $756,300 two decades later. The decrease amounts to just 11.8 percent of the original sum.
The largest drop in retirement nest eggs, 24.4 percent, was among those with the least savings, or a median of $29,975.
Frugal behavior is consistent with research led by Anna Rappaport for the Society of Actuaries. She and her team found that most people do not plan for retirement or know what they should spend, but they adapt — even when shocked by high dental bills or a roof repair.
What can devastate financially are divorce, caring for a mentally or physically ill adult child who cannot work, and long-term care expenses, according to the actuarial society’s research.
Still, debilitating health care costs are far more rare than people fear, according to the EBRI research. Half of retirees face no nursing home expenses because Medicare covers short recoveries after hospital stays and Medicaid can help when resources run out.
The medical annual out-of-pocket spending for 90 percent of retirees is just $2,000, and the big nursing home costs over $87,000 hit only 10 percent of people living longer than 95, according to the EBRI study.
For the EBRI study itself, see the April 2018 report on Asset Decumulation or Asset Preservation? What Guides Retirement Spending?
Thursday, May 3, 2018
Frequent reader Karen Miller from Florida made a timely catch by sending me two articles that both mention the "peace of mind" that can accompany living in purpose-planned retirement communities, including CCRCs or LPCs. Thanks, Karen!
In last Sunday's edition of the New York Times, reporter Peter Finch offered "How to Talk About Moving to a Retirement Home: It's a Journey." He includes admissions by once highly reluctant residents, including one who finally gave in to his wife's desire for a new setting:
For the once-skeptical Mr. Strumsky, it took only days for him to start feeling certain that he and his wife, who is 72, had made the right decision. About a week after moving in at Charlestown [a retirement community outside of Baltimore], he went out to walk the dog at night and ran into a pair of women he didn’t know who were chatting amiably in the parking lot. About 25 minutes later, he returned home and saw the same women, still talking.
“They were so unconcerned about their personal safety, they were oblivious to anything going on around them,” Mr. Strumsky said. “And it just hit me: I really wished my mother or my sister or my aunt could have had this experience, to feel that safe and secure. At that point, it was like a light bulb going on. It was an instant turnaround for me.”
By contrast, Patricia Hunt, a columnist for the News Leader (part of the USA Today Network), writes about "friends whining about the rules of their . . . subdivision," noting that the security that some people seek can come with a regulatory price tag, even if the regulator isn't the government. She writes in part:
In retirement many people with the means to do so choose a “continuing care retirement community.” There is a big price range, but basically you pay an entrance fee, and most require that you be well enough to live independently to be admitted. They provide food service, activities, and stepped up sections for “assisted living” and for the most debilitated, “skilled nursing care.” This is the most expensive option for one’s last years.
But the rules for the residents of CCRCs are set entirely by people who do not live in them. And flexibility is the most restricted of all options. If you grandson who ran away to join the circus can be talked into living with you for a few months until he can sort things out with his parents, you cannot let him do that. If you decline in health and your granddaughter is willing to come live with you so you don’t to go to assisted living or skilled nursing care, you can’t do that either. You can hire people to come in night and day, but your family member cannot simply move in. She must have another permanent address. At least this is how most of them work.
If you[r] adult child gets sick or loses a job and needs to stay with you, it is not allowed. And you may not have the money to help him or her out if you have spent it all on the entrance fee and monthly fees.
Hunt concludes by questioning whether people "really" do hate regulation, noting "there is plenty of evidence of that some of them are not only willing to live with more regulations than many other people, they are willing to pay a lot of money to do so."
For more from Hunt, read the full column "We Hate Regulation, But We Willingly Trade Away Our Basic Freedoms for Comfort, Security."
May 3, 2018 in Consumer Information, Current Affairs, Estates and Trusts, Ethical Issues, Health Care/Long Term Care, Housing, Property Management, Retirement, State Statutes/Regulations | Permalink | Comments (0)
Monday, April 30, 2018
Recently the Washington Post ran an article about multigenerational homes increasing in popularity. Homes with multigenerational family members are a growing trend begins with a story of a three-generation family living in one household. So is that what it means to have a multigenerational household? "Pew Research Center defines a multigenerational household as one with grandparents and grandchildren or with two or more adult generations. The trend since 1980 is more people living in multigenerational homes, and a higher number of multigenerational households...." according to a Pew expert quoted for the article. In 2016 the article notes, 20% of Americans live in multigenerational households. This trend has even affected builders who are designing some homes to accommodate these families. But it's not all about the design, the article notes. There are costs, real and emotional, that come with multigenerational households. Design typically includes communal living spaces, such as a kitchen or living room. Compromise is the key to success here. As one of the families feeatured in the story offered
Wednesday, April 25, 2018
On April 24, 2018, members of the Organization of Residents Association of New Jersey, or ORANJ, held a plenary meeting at Cedar Crest Retirement Community in Pompton Plains, New Jersey. ORANJ President Ron Whalen began the meeting with an update on pending legislation attempting to resolve residents' concerns about timeliness of payments on "refundable fee agreements." Part of the message is reflected in the history of Pat Lund, a resident of a CCRC in Waterford Township, New Jersey, who waited eight years for her "refundable fee" to be paid after moving out of her apartment. Under the terms of her contract, the refund was not "payable" until someone else occupied her specific unit but the facility seemed to have little interest or incentive to market her particular unit. For more on this topic, see my update post from last week. As summarized by Ron Whalen, "many of the 10,000 New Jersey residents in CCRCs (also known as Life Plan Communities or LPCs) have this type of contract."
James McCracken, the new president and CEO of LeadingAge New Jersey was the afternoon speaker and he provided a roundup of topics affecting older adults in New Jersey as the legislative season draws to a close, including concerns about "earned sick leave," delayed Medicaid payments by the state to care facilities, proposed minimums on CNA staffing at care facilities, and changes to minimum wage.
I spoke in the morning about issues I see affecting CCRCs and LPCs nationally and in New Jersey, including topics that challenge tax-exempt CCRCs, such as pressure to make payments in lieu of taxes to state and local authorities. On the topic of resident concerns, I addressed what I call the "big three": lack of transparency on cost and funding issues, the need for effective resident voices in governance, and excessively paternalistic attitudes of some management.
This is at least my third time speaking with ORANJ members over a period of several years, and each time I visit I'm impressed with the strength of their resident organization and their ability to get the state legislature to listen. ORANJ helped their state to be one of the first to get legislative support for CCRC residents gaining the statutory right to serve as voting members on boards of governance, and ORANJ advocacy was also instrumental in passage of an enhanced "bill of resident rights" for CCRC operations.
New Jersey has approximately 40 CCRC/LPC communities within the state. Some 87 percent operate as not-for-profit, while another 13 percent are for profit. The majority of the communities are now part of "multi-site" organizations, and I spoke with several residents who reported on pending conversions of not-for-profit to for-profit.
April 25, 2018 in Consumer Information, Current Affairs, Estates and Trusts, Ethical Issues, Health Care/Long Term Care, Housing, Property Management, Retirement, State Cases, State Statutes/Regulations | Permalink | Comments (0)
Kiplinger offers a quiz for you to test your knowledge of Social Security. Do You Really Understand Social Security? offers a ten question quiz with explanations. After you take that quiz, then take the Do You Know the Best Social Security Claiming Strategies? another 10 question quiz with explanations. These would also be really good to have students take to test their knowledge after you have covered Social Security in your courses.
Friday, April 20, 2018
Recently the Washington Post published an article comparing generational alcohol intake. Teenagers and college-age people drink less while this group pours another round opens with this observation "[e]xperts on alcohol abuse have found one demographic group that’s drinking at an alarming rate. Not teenagers. Not college-age people. It’s baby boomers." The first few paragraphs of the article focus on younger individuals and then turns to Boomers, noting that it's "been known for half a century is that baby boomers tend to like alcohol more than the “silent generation” that preceded them."
"Researchers see a steady rise in alcohol use and binge drinking — as well as what’s known as Alcohol Use Disorder (AUD), an umbrella term for mild, moderate and severe abuse of alcohol — in the 65-plus demographic. Between 2005 and 2014, the percentage of older Americans who reported engaging in past-month binge drinking (defined as women consuming four or more drinks in about two hours, and men consuming five or more) increased from 12.5 percent to 14.9 percent ... [and] [t]he increase in drinking among older Americans is most pronounced among people with greater levels of education and income, and among women.... At continuing care communities, alcohol is typically available as a social lubricant for the majority of residents who haven't graduated to assisted living...."
according to one expert quoted in the article.
One thing that is implicated in this is the perception or impression that moderate alcohol consumption is healthy. "[M]any boomers have embraced the notion that moderate drinking is good for them, compared to abstaining. The evidence there is mixed. A number of studies have shown a reduction in heart attacks among moderate drinkers. But a new study published in the Lancet last week showed no overall improvement in life expectancy among people who had one drink a day compared to those who abstained, and a decrease in life expectancy with any additional drinking. The study's authors concluded that the reduction in heart attacks was offset by other health risks."
Tuesday, March 27, 2018
The Hidden Brain is a great radio program with frequent stories relevant to aging. A recent episode is titled Guys, We Have A Problem: How American Masculinity Creates Lonely Men. Frankly, I think the title doesn't do the episode justice, as although the episode focuses primarily on the potentially disproportionate likelihood of isolation and loneliness for men as they get older, many of the program's most important points strike me as applying equally to anyone who finds his or her life becoming more isolated.
One interview explored the moving personal history of a lawyer, Paul Kugelman, as he went through life, starting with disconnections connected to frequent military-service-connected family relocation, followed by his own divorce and struggles with work/life balance, a temptation to drink, and a a recovery strategy that included completing an Iron-Man Marathon. But running wasn't enough. Over-reliance on a spouse put enormous pressure on the relationship. He had to learn new skills to create new friendships.
The program also explored findings from an early Harvard study of American men, now known as the Harvard Study of Adult Development, a study that has been on-going, with various adjustments based on funding sources, for 8 decades. One question asked over the entire course of the study's history was deceptively simple:
Who would you call in the middle of the night if you were sick or afraid?
It turns out that if men had a solid answer to that question, they were happier with their lives and their marriages. "There were also connections with the men's answers to that question and their physical health. Very strong connections."
The program dug deeper into physical health and emotional connections, suggesting that we should think about how coming into work on a Monday morning. Do you look forward to seeing people you like? That connection is energizing. And calming.
The program explained that studies show that the people who are "happiest in retirement are those who actively work to replace colleagues with friends." "Spending time building and nurturing your friendships might be just as important to your health as eating right and exercising."
Bottom line: Don't miss the warning signs that your social circles are shrinking, regardless of gender.
The New York Times has a good overview on 7 Ways to Judge a Retirement Community's Financial Health, by Peter Finch, published on March 9, 2018. Many of the tips come from savvy residents at Continuing Care Retirement Communities (CCRCs, also called LifePlan Communities) around the country, as well as from actuaries and industry experts.
As consumers grow more aware of risk at all levels of financial markets, senior living providers are facing good questions about how upfront entrance payments and monthly fees are used. Other topics include appropriate occupancy levels, the history of rate increases, debt ratings that can affect cost of operations and loans, capital improvements, reserves and the right of residents to be engaged on governance issues.
From the article:
Retirement community managers will not be shocked by these sorts of questions, promised Stephen Maag, director of residential communities at LeadingAge, an association of aging-service providers. “As we get the people born in the late ’30s and the baby boomers, they’re much more thorough in their research” than their parents and grandparents were, he said.
My thanks to my colleague Laurel Terry, for sending me this article. I especially enjoyed seeing two friends highlighted in the article, Jack and Valerie Cumming, residents of a CCRC in Carlsbad, California. When I visited with them a few years ago, I was happily amused to realize their lovely CCRC was once the hotel where my own parents spent their honeymoon. How about that for a sign of the times - - honeymoon spots that become retirement villages!
Thursday, March 15, 2018
Margaritaville, at least the Jimmy Buffett version, is no longer a state of mind. The Washington Post ran a story about Jimmy Buffett's foray into senior housing. Adopting a laid-back attitude at Latitude Margaritaville explains that the "Key West-inspired houses are being built along streets linked to lyrics of Buffett’s 1977 hit 'Margaritaville.'" Continuing the them, the pet spa is "Barkaritaville" and the fitness center is "Fins up!" Guess what's on the menu at the local restaurant? If you guessed "Cheeseburger in Paradise" you'd be right! And as the article makes clear, Buffett is a significant business entrepreneur.
How's this for fun in a 55+ community. "[O]ne element of Latitude Margaritaville that makes it unusual for an active-adult community: Live music shows will be scheduled five to seven nights a week." But why a 55+ community for Jimmy Buffett? "he decision to expand the Margaritaville brand into active-adult communities seems like a natural fit, particularly because Buffett’s fans tend to be aging baby boomers who have followed his career for decades." And fans have come-with over 100,000 requesting information about the planned community. The homes are selling like hot cakes (or maybe sponge cake would be better to say) with over 225 selling within two months. However, there's a ways to go to full occupancy once the 2 developments of 7,000 are finished over the next decade. The community is around 10 miles away from Daytona Beach and close to hospitals and other services. Many other amenities are planned, and of course, there is always the chance that Jimmy Buffett might perform!
Who would want to pass up the chance to live on Spongecake Court? Come on-admit it, that song is going through your head now....
Wednesday, January 31, 2018
The Washington Post ran an article looking at the longer-term impact of the increasing costs of health care on any COLAs from SSA. Out-of-pocket health-care costs likely to take half of Social Security income by 2030, analysis shows discusses a recent Kaiser Family Foundation which "found out-of-pocket health-care costs for Medicare beneficiaries are likely to take up half of their average Social Security income by 2030." The KFF report, Medicare Beneficiaries’ Out-of-Pocket Health Care Spending as a Share of Income Now and Projections for the Future was published January 26, 2018. Here is the executive summary
Medicare helps pay for the health care needs of 59 million people, including adults ages 65 and over and younger adults with permanent disabilities. Even so, many people on Medicare incur relatively high out-of-pocket costs for their health care, including premiums, deductibles, cost sharing for Medicare-covered services, as well as spending on services not covered by Medicare, such as long-term services and supports and dental care. The financial burden of health care can be especially large for some beneficiaries, particularly those with modest incomes and significant medical needs. Understanding the magnitude of beneficiaries’ current spending burden, and the extent to which it can be expected to grow over time, relative to income, provides useful context for assessing the implications of potential changes to Medicare or Medicaid that could shift additional costs onto older adults and younger people with Medicare.
In this report, we assess the current and projected out-of-pocket health care spending burden among Medicare beneficiaries using two approaches. First, we analyze average total per capita out-of-pocket health care spending as a share of average per capita Social Security income, building upon the analysis conducted annually by the Medicare Trustees. Second, we estimate the median ratio of total per capita out-of-pocket spending to per capita total income, an approach that addresses the distortion of average estimates by outlier values for spending and income. Under both approaches, we use a broad measure of Medicare beneficiaries’ total out-of-pocket spending that includes spending on health insurance premiums, cost sharing for Medicare-covered services, and costs for services not covered by Medicare, such as dental and long-term care. We present estimates of the out-of-pocket spending burden for Medicare beneficiaries overall, and by demographic, socioeconomic, and health status measures, for 2013 and projections for 2030, in constant 2016 dollars.
A pdf of the report is available here.
Tuesday, January 30, 2018
The New York Times ran an article about recent research regarding the correlation between early retirement and longevity. The Connection Between Retiring Early and Living Longer looks at a number of studies here and abroad.
That retirement promotes health and prolongs life isn’t obvious. After all, work provides income and, for some, health insurance — both helpful for maintenance of well-being. It also can provide purpose and camaraderie. Evidence is mounting that loneliness and social isolation are linked to illness, cognitive decline and death. One study of American retirees found them less likely to be lonely or depressed.
For some, retirement doesn't have a healthy impact. Developing, or continuing, good eating habits and exercise are critical. "Retirees are more likely to exercise, and those who do are better off for it. One study found retirees get more sleep and spend more time doing household work and gardening — both of which are more active than a desk job. Another study found that better health in retirement may be because of the reduced likelihood of smoking." Those are all good things, but for many, retirement is outside of their financial ability. "[A]ccording to a recent national survey by the Board of Governors of the Federal Reserve System, many Americans don’t have the resources to retire. About 20 percent of Americans over 44 years old have no retirement savings. Half of Americans are at risk of being unable to maintain their standard of living in retirement. If you want to retire, whether for health benefits or otherwise, you’ll have to start preparing when you’re still young."
Tuesday, January 23, 2018
Pennsylvania Attorney Charles Shields and former Dickinson Law Librarian [now West Virginia Law Librarian] Mark Podvia have teamed to present a provocative history of public pensions and public corruption, using Pennsylvania as the focus. The first of their two-part series is available in the January 2018 issue of the Pennsylvania Bar Association Quarterly. For an overview, the authors write:
On June 12, 2017, Pennsylvania Governor Tom Wolf signed a bill authorizing significant reform of the Commonwealth's public pension system. The law will replace the current traditional pension system with three 401(k) style options for future state employees and public school teachers. This is the first article in what will be a two-art series on the laws regulating public pensions and pension forfeitures in the Commonwealth of Pennsylvania. This part will examine the historical development of public pensions and provide an overview of the public corruption in the Commonwealth [tied to these pension systems]. The second part will examine the adoption and application of the Pennsylvania pension forfeiture law.
To provide more incentive for our readers to track down this disturbing history, here's a concluding line from part one of the series:
The combination of a corrupt political system with public pension funds -- ranging from local retirement systems, small but with little oversight, to large statewide funds -- created a situation open to graft and corruption.....
January 23, 2018 in Consumer Information, Crimes, Current Affairs, Estates and Trusts, Ethical Issues, Property Management, Retirement, State Cases, State Statutes/Regulations | Permalink | Comments (0)
Thursday, December 21, 2017
Filial Friday: Can Americans be Compelled by Germany to Contribute to Costs for a Parent's Care in Germany?
It has been awhile since I've written a "Filial Friday" post. Perhaps any question about legal obligations for family members to pay for care of another is an unfair topic during the holiday season. A bit too downbeat, yes? But, in fairness it is a topic that has reemerged in my "inbox," as I've recently received two communications from American adult children of biological parents in Germany. In each instance, the reason is that Germany authorities are writing to American citizens to notify them that an aging German parent is or may be in need of "social welfare benefits" in Germany. As one demand letter puts it:
"The above person is your mother. According to [the Germany Civil Code] you have a basic obligation to pay maintenance for your mother. According to Section 94 of the [Social Security Code] the maintenance obligations of a person eligible for benefits are passed on to [the Germany regional authorities] up to the amount of the expenses we incur in so far as this is not excluded for legal reasons."
In other words, it appears the German social service agency is saying that if it is called upon to incur expenses for welfare of a Germany citizen, it has the legal authority to seek contribution or reimbursement from the family members identified in German statutory law as having a maintenance obligation, including any children living in other countries.
As readers of this Blog know, I have a long-standing interest in such filial support claims, in large part because I live and work in Pennsylvania, the U.S. state that most frequently enforces a colonial-era law, permitting third-party providers of care in certain instances to compel adult children to pay reimbursement for costs of care, usually nursing home care. The 2012 Pennsylvania Superior Court decision in Health Care & Retirement Corporation of America v. Pittas, where an adult son was found to be liable for more than $90,000 for his mother's nursing home care, is one of the most dramatic modern example of domestic enforcement in the U.S.
The letters from Germany undoubtedly surprise, and perhaps frighten, the American children who have probably never heard of such a claim coming from public authorities. (In the U.S., in the modern era the occasional claim usually comes from a nursing home that isn't being paid for long-term care by private or public means, and the claims are not coming from public agencies.)
Wednesday, December 6, 2017
California Law, Amended in 2017, Sets Process for Contesting Transfer Decisions in Continuing Care Communities
Following my recent post about "evictions" in Continuing Care and Life Plan Communities, Margaret Griffin, the president of the California Continuing Care Residents Association (CALCRA) provided me with a copy of legislation that was signed into law by the Governor in October this year, amending California law on Continuing Care Retirement Community (CCRC) contracts. This history is another window on how to handle involuntary transfers of residents. California's law already provided detailed topics that must be addressed in admission contracts. The newest provision requires greater sharing of any reasons for an involuntary transfer. For "disputed" transfers the law now mandates that the provider:
"... shall provide documentation of the resident's medical records, other documents showing the resident's current mental and physical function, the prognosis, and the expected duration of relevant conditions, if applicable. The documentation shall include an explanation of how the criteria [supporting the involuntary transfer decision] are met. The provider shall make copies of the completed report to share with the resident and the resident's responsible person. "
Further, the amended law provides that even though the CCRC has the right -- under certain conditions -- to transfer the resident, the resident may "dispute" the decision and have the reasons reviewed in a timely manner by the "Continuing Care Contracts Branch of the State Department of Social Services" in California. That office has statutory authority to determine whether the facility has followed its own contractual basis and process for transfers, and "whether the transfer is appropriate and necessary."
Ms. Griffin explains that the law "basically . . . requires an assessment be done to establish a functional reason for the transfer (as opposed to merely having the administrator’s whim be sufficient), and it allows the resident to appeal the actual decision (previously we were limited to requesting a review of the process)."
Thank you, Margaret, both for sharing the latest information on CALCRA's successful advocacy with California Assembly Bill 713, and for your additional commentary.
Monday, December 4, 2017
In the Wall Street Journal, there is a recent, wonderful profile of Boston University Law Professor Tamar Frankel, who has been fighting the good fight to gain adoption of "The Fiduciary Rule" for financial advisors, investment brokers and others in positions of trust for her entire academic career.
And, at age 92, she's still fighting the good fight, as the Trump administration recently delayed full implementation.
When Ms. Frankel began researching fiduciary law in earnest in the 1970s, she dwelled on that idea: A fiduciary is someone trusted by others because he or she has superior knowledge and expertise. People hire brokers because the brokers know what they’re doing and the clients don’t. That gives fiduciaries power and responsibility over those who trust them.
The unconditional trust that clients place in a fiduciary creates a paradox, argues Ms. Frankel. “When you get power, you lose the power you might otherwise have,” she says.
A fiduciary adviser can’t abuse the relationship of trust by collecting unreasonable compensation or harboring avoidable conflicts of interest. The relationship is meant to satisfy only the needs of the client.
Professor Frankel appears to be remarkably sanguine about the latest delays:
With the Trump administration putting parts of the fiduciary rule on hold, Ms. Frankel counsels patience.
“What the rule has done is sown the seed, and the longer it takes the better off we are, because what we must change is the culture and the habits in the financial industry,” she says. “Habits don’t change in one day. It takes time.”
After she turns 93 next July 4, Ms. Frankel says, she will stop teaching—although she will continue to research and write. What accounts for her longevity? “Caring less and less about what other people think,” she says, “and more and more about questions you don’t have answers to.”
I have a copy of Professor Frankel's thoughtful treatise on Fiduciary Law (Oxford Univ. Press, 2011) on the shelf behind my desk, complete with sticky notes and much yellow and red highlighting. I've been meaning to write Professor Frankel to thank her for her work over the years -- and now this article reminds me to get to that task!
My thanks to my always eagle-eyed friend and correspondent, Karen Miller, in Florida for this latest find and reminder.
December 4, 2017 in Books, Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Property Management, Retirement | Permalink | Comments (0)
Thursday, November 16, 2017
Recently I had a good chat with a former student, who has already retired from practicing law. I was surprised as I had assumed he was younger than I am. Why? Because I was the teacher, right? But, as it turned out, he was about 10 years older than I was when he was my student, and, of course, that margin remains. I was guilty of a form of reverse-ageism.
I have another friend who teaches non-law courses on aging-related topics for Oregon State University. She uses cartoons effectively in the course -- handing out provocative cartoons without any captions that include some imagery associated with aging and inviting the students to provide their own captions. Pretty quickly the students get to see the difference between humor that both old and young could chuckle about -- and ageist humor. She also admits to her students that her courses get more relevant with every year -- to her, of course -- as she and her friends are rapidly reaching silver or gold status as "older" adults.
Along that line, The New Yorker magazine has a current piece addressing ageism that is both thoughtful and eclectic. Amusingly, it begins with scenes from a classic movie, where a young Paul Newman is toiling away in a Philadelphia law firm, resenting his elders. Of course, for readers of a certain age, they might find it impossible to imagine a "young" Newman as all they know is his gray haired image (or, perhaps, his salad dressing bottles).
The author suggests that perhaps our biggest problem with ageism starts with ourselves -- our own unwillingness to confront the realities of our own aging. He uses an example from retirement communities, where residents sometimes attempt to ban walkers and wheelchairs from the dining areas. Ironic, yes?
Lots of good food for discussion in Why Ageism Never Gets Old, written by Tad Friend, for the November 20 issue of The New Yorker.
Our thanks to Dick Kaplan at University of Illinois Law for sending the link our way.
Tuesday, November 14, 2017
Kiplinger ran a story promoting the idea of practicing for retirement. 4 Reasons to Hold a Retirement Dress Rehearsal suggests you take a trial run at retirement before making it permanent. For example, thinking about moving to a warmer climate, buying a condo on a golf course, moving into a senior housing complex, or something else, the article suggests trying out the plan temporarily. The advantages of doing so allow you to get a better idea of the expenses of living this new life, whether you physically can manage this new life, discover if more hours for hobbies translate into more (or less) fun, and learn whether you want to be closer or farther away from your family. The article offers this list of things to check out when thinking about moving:
- Availability of health care
- Recreational opportunities
- Access to transportation (area airports, major highways, etc.)
- Community and potential friendships
- Ease of visiting family (or visa versa)