Wednesday, November 25, 2015
With Thanksgiving looming, it seemed appropriate to take a moment to say thanks to all the family caregivers. And on the subject of caregivers, I wanted to share this 5 Facts about Family Caregivers published by Pew Research Center.
Here are the five facts:
- In the US there are 40.4 million unpaid caregivers for those 65 and older.
- The caregivers are most likely between 45-64 years old.
- The most common caregiving kids perform helping around the house, doing errands and fixing things around the house.
- A major segment of caregiving is providing emotional support.
- Most kids find helping their parents rewarding, although a few find it stressful.
This is good information to share with your students as well. So read the full document, thank a caregiver and have a Happy Thanksgiving!
Thursday, November 19, 2015
On November 26, 2015, the University of Leeds' School of Law in England will be host to a program on "Yours, Mine or Ours: Who is Responsible for Social Care of Older Persons?" I'm very pleased to be part of the panel, under the leadership of Professor Subhajit Basu, PhD. We will use a research report we completed with colleagues in 2015 for the Commissioner of Older People in Northern Ireland (COPNI), to offer comparative international examples of legislation and public policy initiatives that support the wide array of potential care needs for older persons. We'll be looking beyond the needs for health care.
One likely focus of the discussion is a proposal for a state-supported home visits by trained professionals, including social work professionals, for individuals age 75 or older, with a goal of providing advance assistance to the individual or family in meeting needs. The proposal now under consideration in Northern Ireland has roots in other jurisdictions we studied, including Denmark.
In Denmark, one of the inspirational leaders for "preventative home visits" is Mikkel Vass, M.D. at the University of Copenhagen. Beginning in 1998, Danish laws established an obligation for municipalities to offer "all citizens 75 years and older two annual preventative home visits." A great deal of freedom to design the content of the home visits was given to the municipalities, but the goals are:
- to support personal resources and networking; and
- to offer social support, thereby preserving functional ability
In his study of 15+ years of home visit operations, Dr. Vass concludes that with a nationally-supported home visitation program:
- Functional decline can be prevented;
- Education of professionals makes a difference to the interview success;
- Interdisciplinary education makes a greater difference to the program success;
- To maintain effectiveness, education must be ongoing and based on simple messages and professional routines that respect local healthcare cultures; and
- Operation can be cost-neutral.
Cost neutrality -- that will be important to every element of modern social care programs -- including home visits.
Monday, November 16, 2015
I've heard periodically some conversations about attorneys practicing law much longer than they should because they develop significant cognitive deficits. I've also heard similar conversations occasionally about judges, primarily in the context of judges who hold lifetime appointments. The AP ran a story in early November on this topic, featuring the efforts of the 9th Circuit to address the issue of judges who experience significant cognitive declines while still sitting the bench.
[T]he 9th U.S. Circuit Court of Appeals, which includes federal courts in California and eight other Western states, has taken a more pro-active approach to the problem of mental decline by trying to get its judges to think about the condition, plan for it and handle it appropriately if it comes up.
The circuit court holds regular seminars led by neurological experts to teach its chief judges about the signs of cognitive impairment. It has set up a hotline where court staff and judges can get advice about dealing with signs of senility in colleagues. It has also encouraged judges to undergo cognitive assessments and designate colleagues, friends or family who can intervene if concerns arise about their mental health.
The article discusses the pros and cons of mandatory retirement or term limits and notes that the 10th Circuit had two cases that might fall in the category of cognitive decline. The article quotes a 9th Circuit judge who decided to stop hearing almost all cases in an abundance of caution. This judge noted that "'if the goal is to work until you are no longer able, you will work a couple of years too long...'"
The AP story was picked up by a number of publications, including the ABA Journal
Thursday, November 12, 2015
The ABA is offering a webinar on VA Pension: Income Security for Veterans and Their Family. The 90 minute webinar is scheduled for November 17th, 2015 from 1-2:30 p.m. est. The website offers the following description of the webinar
This webinar will cover eligibility of veterans and their dependents for VA pension.
Panelists will discuss how to get the best results for a client looking to obtain a VA pension. Practical pointers on obtaining the highest amount for pension will be discussed, as well as how a client can keep that amount each year. Practice tips on dealing with a VA debt—due to an overpayment issue related to a VA pension—will also be provided. This presentation will give practitioners an understanding of the law and provide practical tips on how to work within the confines of the VA.
To register, click here.
Kudos to my Stetson colleague, Stacey-Rae Simcox, one of the panelists!
Wednesday, November 11, 2015
I was reading a recent article in the New York Times on estimating longevity in the context of the Social Security Trust Fund. Your Kids Will Live Longer Than You Thought ran in the NY Times on November 10, 2015. The article discusses statistics and probabilities, explaining how life expectancies are calculated. Looking at the Social Security projections of life expectancy, the article notes that SSA is likely too conservative in their longevity projections.
The Technical Panel on Assumptions and Methods established by the Social Security Advisory Board, an independent government agency that advises Social Security’s trustees on matters including actuarial assumptions, says Social Security is systematically underestimating future declines in mortality rates, and therefore underestimating the likely life spans of young Americans.
So this is a good news-bad news scenario. Good news for those who get more years of life, bad news for Social Security. "[O]ne quirk of Social Security is that a piece of obvious good news (People will live longer than we thought!) is bad news from the narrow perspective of paying for retirement benefits (The government will have to pay benefits longer!)." So how to handle Social Security's too conservative projections? The Congressional Budget Office "tweaked" them by increasing them.
Thursday, November 5, 2015
The U.S. Treasury announced the creation of a new retirement savings vehicle, myRA. According to the blog post announcing this, myRA is a "retirement savings account for individuals looking for a simple, safe, and affordable way to save for their retirement. Over thirty percent of all American households have no retirement savings. myRA provides a way to start saving for retirement."
MyRA is designed for those who don't have an option for a retirement savings plan through their jobs. There are some benefits to myRA:
There’s no cost and no fees to open and maintain an account;
The investment will not lose money;
U.S. Treasury backs the investment;
Account owners choose how much to save ($2, $20, $200 – whatever fits their budget);
If account owners change jobs, the account stays with them; and
Account owners can withdraw the money they put in without tax and penalty.
Sunday, November 1, 2015
At the opening general session for LeadingAge's 2015 Annual meeting on November 1, the results of two years of research into consumer preferences for LTC and senior housing, including consumer and provider surveys and focus groups, has culminated in a new identity for Continuing Care Retirement Communities (CCRCs). And -- drum roll, please -- the new name is Life Plan Communities.
The thinking is interesting. First, LeadingAge researchers learned that while current residents embrace the name "Continuing Care Retirement" for their communities, younger persons reject the notion of both "retirement" and "care." Thus, Life Plan Communities are viewed as playing to the "engagement" model of aging, where individuals have more control over their options, and are less likely to be passive in their response to provider-defined theories of care.
In announcing the new name, outgoing LeadingAge CEO Larry Minnix and other leaders emphasized that the change is intended to be part of a conversation, to stimulate thinking and reaction to what it means to plan for future needs. They recognize that states may or may not embrace the name change, including whether state laws will be amended to reflect the new identity for purposes of licensing and regulation.
Will a rose by any other name smell as sweet -- or, perhaps, even sweeter?
Wednesday, October 21, 2015
The ABA Section on Family Law has devoted the entire Fall 2015 issue of its Family Advocate magazine to "Crossing Paths with a Trust." The paper copy of the issue just appeared on my desk. The opening editorial advises family law attorneys advising clients considering divorce not to fear trusts:
Lawyers who simply take a deep breath and read the trust will often be surprised to learn that they have in their hands a road map for how assets will be managed, who gets what, when they get it, and under what terms.
The articles in the issue include a "plain English guide to trusts as a means of orchestrating assets in divorce cases," how trusts can interact with disclosure requirements for premarital agreements, how to address equitable division of interests assigned to trusts, the use of child support or alimony trusts, and the unique potential advantages for using trusts for "special needs" planning for disabled children. The issue ends with a bonus -- a primer on "will basics."
The articles underscore what I sometimes find myself saying to law students, that courses on "wills, trusts and estates" are about advanced family law issues, and that if families fail to address disputes among family members while they are still living, the issues may not be any less complicated when the asset-holding family member passes away.
The entire issue seems like a good resource for a wide audience, including law students. Unfortunately, the on-line version of Family Advocate issues is restricted to ABA Family Law Section members, at least during the first few weeks of publication. Apparently you can purchase paper copies (see for example the rates for the previous issue, for Summer 2015) , including bulk orders, although I find there is often a lag time for specific issues to become available to purchase. I guess you have to keep checking!
October 21, 2015 in Estates and Trusts, Ethical Issues, Health Care/Long Term Care, Housing, Legal Practice/Practice Management, Property Management, Retirement, State Cases, State Statutes/Regulations | Permalink | Comments (0)
Monday, October 19, 2015
Recently I was reading an issue of The Senior Care Investor, a subscription-based news service that reports on the "World of Senior Care Mergers, Acquisitions, and Finance," and doing so since 1948.
For approximately the last three years, most of the M & A activity has been in assisted living (AL) and memory care (MC). Senior Care Investor reports that CCRCs are "beginning to make a comeback" as the housing market recovers and prospective residents are again able to use equity in their homes to finance transitions into CCRCs. The most recent issue also indicates some development money is returning to the skilled nursing facility market, even as overall M & A activity in senior housing is lower in 2015 than in 2014.
I've been watching quite a bit of activity over the last few years in conversions of nonprofit senior housing operations to "for profit" and there is more evidence of that in the latest report. But the most recent issue (Issue 9, Volume 27) also reports on a "rare for-profit to not-for-profit deal," with a New Mexico-based company, Haverland Care LifeStyle Group, purchasing a new AL/MC community in Oklahoma.
Also, the Senior Care Investor reports on a faith-based, not-for-profit CCRC provider that has decided to sell an entrance fee model (one that's in transition to an "all rental" model) that will offer independent living, AL, MC units and nursing home beds. What happens when senior housing operations are fully "private pay" AND "rental" models AND disconnected from a faith-based organization? Can they maintain their tax-exempt status? In other words, if the public is paying market rates (and thus higher rates based on any market increases) with no promises of future care if the residents run out of money, is that senior housing enterprise still a nonprofit operation entitled to be treated as exempt from federal income taxes?
Monday, October 12, 2015
AARP ran an article on the impact that livable communities have on local economies. The Livability Economy Livable Communities bring financial benefits to homeowners, business and local governments. covers a new report from AARP on The Livability Economy: People, Places and Prosperity.
This 28 page report focuses on 4 domains for livability: compactness, transportation, diversity of housing and land use integration. This is how livability is explained in the report
Livability is a high-level performance measure of neighborhood design factors that are critical to high quality of life for people of all ages. The Livability Economy identifies a framework based on these design factors that includes four essential livability outcomes, and documents how communities have benefited economically by focusing on these outcomes ....
Friday, October 2, 2015
I've long been fascinated by the history of Atlantic Philanthropies (AP), starting when I first became aware of the behind-the-scenes role of the founder, Chuck Feeney, in funding extraordinary educational endeavors in Ireland, and, as I soon learned, also funding important social and health advocacy movements around the world. The end of AP as a multi-million dollar grant-making foundation is near at hand, although not the end of its impact.
Linked here is the latest report from the CEO of AP, Christopher Oechsli, with linked reports on AP's final grants, including its support for a groundbreaking National Dementia Strategy in Ireland.
Thursday, October 1, 2015
The National Academies Press has issued a new report, The Growing Gap in Life Expectancy by Income: Implications for Federal Programs and Policy Responses. Here is a description from the book
he U.S. population is aging. Social Security projections suggest that between 2013 and 2050, the population aged 65 and over will almost double, from 45 million to 86 million. One key driver of population aging is ongoing increases in life expectancy. Average U.S. life expectancy was 67 years for males and 73 years for females five decades ago; the averages are now 76 and 81, respectively. It has long been the case that better-educated, higher-income people enjoy longer life expectancies than less-educated, lower-income people. The causes include early life conditions, behavioral factors (such as nutrition, exercise, and smoking behaviors), stress, and access to health care services, all of which can vary across education and income.
Our major entitlement programs ? Medicare, Medicaid, Social Security, and Supplemental Security Income ? have come to deliver disproportionately larger lifetime benefits to higher-income people because, on average, they are increasingly collecting those benefits over more years than others. This report studies the impact the growing gap in life expectancy has on the present value of lifetime benefits that people with higher or lower earnings will receive from major entitlement programs. The analysis presented in The Growing Gap in Life Expectancy by Income goes beyond an examination of the existing literature by providing the first comprehensive estimates of how lifetime benefits are affected by the changing distribution of life expectancy. The report also explores, from a lifetime benefit perspective, how the growing gap in longevity affects traditional policy analyses of reforms to the nation?s leading entitlement programs. This in-depth analysis of the economic impacts of the longevity gap will inform debate and assist decision makers, economists, and researchers.
You can download the report as a pdf for free, read the report online, or purchase a hard copy of the report for $64. Click here for more information.
Wednesday, September 30, 2015
Jeff Guo, writing for the Washington Post, recently offered a provocative look at "tontines" as a theoretical retirement planning alternative to "annuities." Apparently these are advocated by some modern legal and financial experts:
Economists have long said that the rational thing to do is to buy an annuity. At retirement age, you could pay an insurance company $100,000 in return for some $5,000-6,000 a year in guaranteed payments until you die. But most people don’t do that. For decades, economists have been trying to figure out why....
But there’s also some evidence that people just irrationally dislike annuities. As behavioral economist Richard Thaler wrote in the New York Times: “Rather than viewing an annuity as providing insurance in the event that one lives past 85 or 90, most people seem to consider buying an annuity as a gamble, in which one has to live a certain number of years just to break even.”
Here is where tontines come in. If people irrationally fear annuities because them seem like a gamble on one's own life, history suggests that they irrationally loved tontines because they see tontines as a gamble on other people's lives.
A simple modern tontine might look like this: At retirement, you and a bunch of other people each chip in $20,000 to buy a ton of mutual funds or stocks or whatever. Every year, the group withdraws a predetermined amount and divides it among the remaining survivors. You might get a bonus one year, for instance, because Frank and Denise died....
Want to know more? Read It's Sleazy, It's Totally Illegal, and Yet It Could Become The Future of Retirement. Hat tip to David Pearson for sharing this story.
Friday, September 25, 2015
The Center for Retirement Research at Boston College released an issue brief this month on How Do Inheritances Affect the National Retirement Risk Index?
You might immediately conclude that receiving an inheritance would definitely improve one's retirement security, but the answer really is the classic law school "it depends" answer. "The bottom line is that, while anything that boosts households’ assets is beneficial to their financial situation, inheritances are not likely to be decisive in determining retirement preparedness for many households." The report notes that the very wealthy have achieved retirement security so an inheritance won't make much difference.
On the one hand, past research has shown that higher-income households – who are less likely to be unprepared for retirement – are more likely to receive inheritances and to receive larger amounts than their lower-income counterparts. On the other hand, the anticipated inheritance receipts of low- and middle-income households represent a much larger percentage of their current wealth, suggesting that inheritances could potentially be more influential in boosting their retirement security.
Friday, September 11, 2015
Transamerica Center for Retirement Studies announced the release of the 2015 Aegon Retirement Readiness Survey, Inspiring a World of Habitual Savers. The 60 page report is available as a pdf here. An infographic that accompanies the report is available here. Materials from a webinar, many other infographics and country-by-country reports (as well as previous surveys and reports) can all be accessed from here. You can also access their May, 2015 report on Retirement Throughout the Ages: Expectations and Preparations of American Workers and supporting materials here.
Tuesday, September 8, 2015
Merrill Lynch, in conjunction with AgeWave released a new report on housing in retirement. Home in Retirement: More Freedom, New Choices covers six hot topics in housing for retirement, including relocation, popular locations for retirement, renovation, health issues and housing and "choices and challenges" in housing and retirement. The report opens with this paragraph
Today’s retirees have more freedom and options when choosing where and how they want to live in retirement. With the possibilities presented by unprecedented longevity, and often fewer work and family obligations than before retirement, according to the study two-thirds (65%) of retirees say they are living in the best home of their lives. However, retirees today also face challenges, and must consider how their needs may change throughout a 20-, 30-, or even 40-year retirement.
The 22 page report is available for download as a pdf here.
Monday, August 31, 2015
The Pew Research Center on August 18, 2015 released the FactTank 5 facts about Social Security (the FactTank is "[r]eal-time analysis and news about data from Pew Research writers and social scientists."). So what are those 5 facts? Here you go!
Social Security touches more people than just about any other federal program.
Social Security is, and always has been, an inter-generational transfer of wealth.
Right now, Social Security has plenty of assets.
But since 2010, Social Security’s cash expenses have exceeded its cash receipts.
Social Security’s combined reserves likely will be fully depleted by 2034....
Tuesday, August 25, 2015
An interesting approach to the topic of aging faculties in higher education recently came across my virtual desk in the form of an advertisement for an upcoming webinar (with an interesting price tag to match). The title of the program is "Managing and Supporting an Aging Workforce," offered by Academic Impressions (a company I'm not familiar with) on November 15, 2015 from 1 to 2:30 p.m. EST.
The brochure advises "Given the nature of this topic, this online training is appropriate for human resources professionals, department chairs, deans, and senior administrators who deal with faculty and personnel issues."
Here's the description, which strikes me as charting a careful approach to helping (encouraging?) older faculty members make the decision to retire, without running afoul of age discrimination laws.
Experienced academic and administrative employees are the pillars for many institutions in higher education. However, with many faculty and staff members working well into their 60’s and 70’s, administrators face the challenge of supporting an aging workforce while having the appropriate policies and procedures in place.
Learn how to better balance the interests of your employees with the needs of your institution. This webcast will cover:
Laws governing discrimination and how to remain in compliance
Appropriate steps for dealing with diminishing capabilities
Performance reviews, policies, and procedures
Monday, August 10, 2015
The Public Policy Institute (PPI) of California recently profiled demographic changes likely to affect that state in coming decades, including the impact of a projected increase, to 20%, of the proportion of the population aged 65+. One especially interesting component is the impact of seniors who are likely to be "single," especially those without the assistance of children, spouses, or other close family members, a trend that seems likely to be true nationwide. From PPI's report (minus charts and footnotes):
Family structures in this age group will also change considerably—in particular, marital status will look quite different among seniors in 2030 than it does today.... The fastest projected rates of growth are among the divorced/separated and never married groups. Between 2012 and 2030, the number of married people over age 65 will increase by 75 percent—but the number who are divorced or separated will increase by 115 percent, and the number who are never married will increase by 210 percent....
Another significant change will be in the number of seniors who have children. Those who have never been married are much less likely to have children than those who have been married at some point. As a result, seniors in the future will be more likely to be childless than those today.... In 2012, just 12 percent of 75-year-old women had no children. We project that by 2030, nearly 20 percent will be childless. Since we know that adult children often provide care for their senior parents, these projections suggest that alternative non-family sources of care will become more common in the future.
Thus, just as we're making noise about supporting seniors' preference to "age at home," we may be over-assuming that family members will be available to provide key care without direct cost to the states. Hmmm. That's problematic, right?
More from the California PPI report, including some conclusions:
California's senior population will grow rapidly over the next two decades, increasing by an estimated 87 percent, or four million people. This population will be more diverse and less likely to be married or have children than senior are today. The policy implications of an aging population are wide-ranging. We estimate that about one million seniors will have some difficulties with self-care, and that more than 100,000 will require nursing home care. To ensure nursing home populations do not increase beyond this number, the state will need to pursue policies that provide resources to allow more people to age in their own homes....
The [California In-Home Service & Supports] IHSS program provides resources for seniors to hire workers, including family members, to provide support with personal care, household work, and errands. One benefit of hiring family members is that they may provide more culturally competent care. Medi-Cal is already the primary payer for nursing home residents, and the state could potentially save money by providing more home- and community-based services that support people as they age, helping to keep them out of institutions. Finally, the projected growth in nursing home residents and in seniors with self-care limitations will require a larger health care workforce. California’s community college system will be a critical resource in training qualified workers focused on the senior population.
The San Diego Union-Tribune follows up on this theme in California Will Have More Seniors Living Alone, by Joshua Stewart.
August 10, 2015 in Consumer Information, Dementia/Alzheimer’s, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Medicaid, Retirement, State Statutes/Regulations, Statistics | Permalink | Comments (0)
Wednesday, August 5, 2015
In recent weeks, I've been doing background research on "cross-border retirement" issues and therefore I was interested to read that ElderLawGuy Jeffrey Marshall's brother has retired to Mexico and "loves it."
For some, the reasons may include comparative costs for a range of services, including support for "independent" living, or more skilled care, as documented by the PBS News Hour program on "Why Foreign Retirees Are Flocking to Mexico." The program interviews retirees in central Mexican communities near Lake Chapala. The program compares "average cost for independent living" in U.S. retirement communities of "about $2,500 per month, with one Mexican community's prices for "rent, all utilities, connections for internet, television ... plus three meals a day" at "just a little over $1,000 a month."
But, as the program touches on (only briefly), Medicare benefits don't apply in Mexico (although, perhaps they should?). And there are also important questions about reciprocity in care for Mexican retirees who may have spent many working years in the U.S.