Tuesday, January 5, 2016
Over the holidays in December, I spent time with family in a hospital, responding to an emergency health situation. One of the staff told me it is "always" busier at the holidays, and she attributed this to family members gathering together and "realizing" that a loved one's health was declining. However, there may be more to it than that. Former New York Administrative Law Judge Karen Miller shared a very interesting Wall Street Journal article reporting on the trends in deaths at the holidays. While some of the information is, perhaps, expected, as you think about stress and weather contributing to health risks, the spike in deaths in early 2015 was unusual, when "nearly a third more senior citizens died than normal in the first two weeks of the new year." For more data, read "Why Death Doesn't Take a Holiday This Time of Year."
Thankfully, in our family we weren't dealing with a death! Thanks for sharing this article, Karen.
Tuesday, December 15, 2015
JP Morgan Chase & Co. Institute released a December 2015 report, Profiles of Local Consumer Commerce, Insights from 12 Billion Transactions in 15 U.S. Metro Areas. The report reviews "how the growth of local consumer commerce is shaped by the age and income of the consumer, the products sold by the business and its size, and the residence of the consumer relative to the business." Age is addressed in Finding One. The executive summary explains Finding One: "[m]iddle- and high-income consumers, and consumers ages 65 and older, were responsible for most of the slowdown in growth, while low-income consumers and those under 35 maintained relatively stable spending growth."
The report expands on the findings, explaining with Finding One
We first explore the simultaneous impact of consumer age and income on local consumer commercial spending. Spending is largely driven by income, which for many consumers is strongly related to their age. We define five age and income segments that best explain this pattern (see Data and Methodology for details of this segmentation). Based on these segments, our analyses show that middle-income and high-income consumers ages 35 to 64, and consumers 65 and older, were responsible for most of the slowdown in growth, while low-income consumers 35 to 64 and those under 35 maintained relatively stable spending growth.
Pages 10 - 11 of the report discuss Finding One, along with graphs and charts that accompany the discussion. This 32 page report is heavily data driven and provides good visual aids to accompany each finding.
Sunday, December 13, 2015
I don't know whether the issue of elder abuse is just getting more coverage or whether cases of elder abuse are increasing. We all know that elder abuse is a global issue. I ran across a few recent articles about elder abuse that I wanted to share in this post.
First, The Conversation published Why are we abusing our parents? The ugly facts of family violence and ageism . The article opens with the story of Gwen, who was being abused by her son. The article suggests that "[o]lder people experiencing abuse from family members share the same experience as women suffering intimate partner violence in having someone close to them, whom they ought to be able to trust, perniciously erode their sense of safety and wellbeing through excessive use of power and control." But, when its a child who is the perpetrator, "feelings of parental love and responsibility coupled with shame and guilt for having “failed” as a parent often stop the parent from seeking help and protecting themselves." Turning to Australia, the article examines the prevalence and frequency of multiple abuses of a victim. "For example, financial abuse was coupled with another form of abuse in 65% of cases." Linking abuse and ageism, the article offers that "[promoting the dignity and inherent value of older people is a crucial component of elder abuse prevention." The article calls for educating professionals, elders and society about the issues.
Next, a newspaper in Bend, Oregon ran the story, Financial exploitation hits close. Report: Most financial exploitation done by someone the victim trusts. "A report by Oregon’s Office of Adult Abuse Prevention and Investigations found nearly three-fourths of Central Oregon’s financial-exploitation cases involved someone known or trusted by the victim." The cases in Oregon are similar to what is happening across the country:"[s]tate investigators recorded 1,059 cases in which people 65 or older, who lived on their own or with a loved a one, were victims of theft or someone had misused their money, medication or property...Financial exploitation for seniors living outside of a long-term care facility was the most common type of elder abuse for the third year running in 2014."
Finally (but finally only for this post; I have no doubt that there will be more posts on elder abuse, unfortunately) CNBC ran a story on elder abuse with a headline that caused me to do a double-take. Why seniors don't fear elder financial abuse discusses a new report from Allianz Life that "queried over 1,200 seniors and more than 1,000 people ages 40 to 64 about seniors' finances and found that among the seniors, 89 percent were confident they could handle their money on their own. At the same time, 22 percent of the younger group said they were not confident in their own ability to recognize elder financial abuse, or were not sure."
The CNBC story indicates that family members worry more about the elder being a victim than the elder does. "The confidence of the seniors may make them even more vulnerable to financial scams or financial abuse by friends or family members, said Walter White, president and CEO of Allianz Life. ..."Everything we understand about the prevalence of the issue would suggest that confidence is misplaced," he said." The CNBC story cites some other reports that provide good statistics and discusses the connection between financial exploitation and ultimately a nursing home placement.
That kind of loss can devastate a person's finances, and elder financial abuse is often a major reason why seniors wind up in nursing homes and assisted living facilities on public assistance. Dr. Mark Lachs, co-chief of the division of geriatrics and gerontology at Weill Medical College, has studied the issue and found that an older person who falls victim to abuse, including financial exploitation, is four times more likely to be placed in a nursing home, after adjusting for other known risk factors for nursing home placement.
Discussing the reasons a victim may fail to report financial exploitation, the story adds overconfidence as a reason, citing to the Allianz report. The CNBC story concludes with some links to resources to help fight elder abuse.
December 13, 2015 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care, Property Management, Retirement, Statistics | Permalink | Comments (0)
Monday, December 7, 2015
During my recent visit in England, I had the fortunate experience of having lunch with Bernard Casey, Associate Professor at the Personal Social Services Research Unit at the London School of Economics and Principal Research Fellow at the University of Warwick. He has deep interest and experience as a social economist in evaluation of the economic implications of societal ageing. We could have talked for hours -- so much so that I almost missed my train from London to Leeds.
Bernard introduced me to a fascinating network of academics and policy makers with related interests, the International Long Term Care Policy Network. I encourage you to check out their website, and especially to browse the short interviews with international experts who are following long-term care system developments around the world.
Mark Your Calendars: The ILP Network is hosting its 4th International Conference on Evidence-based Policy in Long-term Care at the London School of Economics and Political Science (LSE) in London from the 4th to the 7th of September in 2016. Key themes of the conference will include: care models, case management, economics of long-term care, equity and efficiency, funding systems, health and social care integration, housing, institutional dynamics, local vs. central policy interactions, personalization of the care system, policy implications of dementia, technology and long-term care, unpaid carers, and workforce and migrant workers. More information about registration and submission of abstracts will be available in the near future.
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.
Sunday, November 1, 2015
The four-day annual meeting for LeadingAge, a trade association for providers of senior services with "6,000+ members and partners including not-for-profit organizations representing the entire field of aging services, 39 state partners, hundreds of businesses, consumer groups, foundations and research partners," starts today, November 1, in Boston The program offerings are impressive with as many as two dozen choices per educational session and keynote addresses by high profile individuals, such as Monday's speaker, Dr. Atul Gawande, famed author of a best selling and much discussed book that challenges thinking on end-of-life case, Being Mortal.
I find LeadingAge as an organization to be fascinating, not least of all because of the scope of providers under its umbrella, but also because it has proven itself to be very responsive to changes in the market place. It was once known as AAHSA or American Association of Homes and Services, but voted to change its name to LeadingAge in 2010.
More changes are in the works, as long-time and much respected Larry Minnix is retiring as the head honcho of LeadingAge. Nonprofit Continuing Care Retirement Communities (CCRCs) were once a major (perhaps even the most dominate) part of the membership, but as the senior care and services market is changing that is less and less true, especially with trends in favor of mergers and acquisitions, including not infrequent transitions to for-profit operations. Interestingly, during this year's meeting, LeadingAge is announcing a new for name for CCRCs. Stay tuned!
This organization clearly understands the need for change to stay attractive to consumers. At the same time, name changes can also complicate understanding by consumers of the choices available to them -- and can complicate state efforts to evaluate and, where appropriate, regulate different models of senior and adult housing and care services.
Monday, October 26, 2015
Recently I witnessed a nighttime accident on Interstate-81 in Cumberland County, Pennsylvania. There was an unmistakable "boom" signaling a rear-end collision. One truck (that appeared to be a large rental truck) had rear-ended an 18-wheeler behind me -- and I watched the faster moving rental truck continue past me on the road with heavy damage on its right side, before eventually veering to a shaky halt in the median. As far as I could tell, both drivers were alive, but at the first safe spot, I called 911.
I got off of I-81 at the next exit. I paused both for gas and to take a breath of crisp night air, before taking a back road the rest of the way home. While I was fueling, an older man in the car next to me, a car with West Virginia license plates, pointed to the I-81 overpass where traffic was crawling through more flashing lights. He asked, "Is it safe for us to get on the road to get home? We live about 75 miles from here." Frankly, I had no way to answer that with any confidence. He shook his head and said to his companion, "I think we should stay in a motel tonight."
Monday, October 19, 2015
Oregon Health & Science University (OHSU) announced the forthcoming publication of a report on elders and depression and the differences when they had in-person interactions vs. virtual interactions. Research: Face-to-face socializing more powerful than phone calls, emails in guarding against depression in older adults is published in the Journal of the American Geriatrics Society (free to members). The release on the study described the findings: "Study participants who regularly met in person with family and friends were less likely to report symptoms of depression, compared with participants who emailed or spoke on the phone. The gains people derived from face-to-face socializing endured even years later."
Here are some more details about the study from the news release:
Researchers examined the frequency of in-person, telephone and written social contact, including email. Then they looked at the risk of depression symptoms two years later, adjusting for potential confounding factors including health status, how close people lived from family and preexisting depression.
The researchers found that having little face-to-face social contact nearly doubles your risk of having depression two years later. They also reported that having more or fewer phone conversations, or written or email contact, had no effect on depression.
Study participants who met up with family and friends at least three times a week had the lowest level of depressive symptoms two years later – 6.5 percent – than those who had less frequent contact. Individuals who met up just once every few months or less frequently had an 11.5 percent chance of depressive symptoms.
Wednesday, September 2, 2015
UCLA's Center for Health Policy Research has issued its August 2015 report on "The Hidden Poor," using county-by-county data to demonstrate that "federal" definitions of poverty are not a sufficient measure of true poverty for seniors. What are the "hidden poor?" The UCLA report explains: "The Hidden Poor are defined as those who have incomes above 100 percent of the Federal Poverty Level (FPL), but who do not have enough income to make ends meet as calculated by the Elder Index."
A recent article in the Sacramento Bee highlights key components of the analysis:
More than 300,000 elderly Californians are officially poor, as measured by the federal government, but their numbers triple to more than 1 million when the “hidden poor” are counted, according to a new study from UCLA’s Center for Health Policy Research.
National poverty guidelines say that for a single elderly adult living alone, the poverty line is $10,890 a year, but UCLA’s “elder index” puts it at $23,364 in California.
Those “hidden poor” Californians over 65 tend to be Latino or black. Their greatest concentrations are found in rural counties with overall low income levels, topped by Imperial County, where more than 40 percent of the elderly are the hidden poor....
The study said population groups with especially large proportions of the hidden poor include grandparents raising grandchildren, elderly with adult children living at home, and single elders.
Accurate measurements of poverty are core to planning of resources for any age group, including seniors. How does your state account for needy seniors?
Wednesday, August 12, 2015
The Pew Research Center released a map showing the aging of America by county. Where do the oldest Americans live? provides a map of the U.S. that shows the percentage of a county's population 65 and older. As the website explains, due to the aging of the Boomers and increased longevity,
more counties across America are graying. A new Pew Research Center analysis of the Census Bureau’s 2014 population estimates finds that 97% of counties saw an increase in their 65-and-older population since 2010.
On average, a U.S. county’s 65-and-older population grew by 12.4% from 2010 to 2014. (Our analysis of population change over time included only counties or county equivalents with a population of 1,000 or more adults ages 65 and older in 2014.)
And yes, Florida is still one of the "grayest" states, with 3 Florida counties ranking in the top 4 of the grayest counties. The report notes as well that some states are getting "younger" with
a tiny share of counties (3%) saw a drop in the 65-and-older demographic since 2010. Oklahoma’s small Alfalfa County, on the Kansas border, had the highest rate of decrease in the 65-and-older population, at 9.5%... North Dakota ... had two counties, Williams and Wells, rank among the top five for rate of decrease of adults 65 and older. Three counties experienced no change since 2010... Alaska is the “youngest” state based on its share that is 65 and older (9.4%). Fully 26 of 29 Alaska counties have percentages of people 65 and older that fall below the U.S. average.
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)
Monday, July 27, 2015
Law Reform: A Proposed Remedy for "Deeply Toxic" Damage to Higher Ed Caused by Abolition of Mandatory Retirement
Bentley University Professors Beverley Earle and Marianne Delbo Kulow have a nicely provocative article in the Spring 2015 issue of the Southern California Interdisciplinary Law Journal, titled The "Deeply Toxic" Damage Caused by the Abolition of Mandatory Retirement and its Collision with Tenure in Higher Education: A Proposal for Statutory Repair. From the introduction:
There are very few positions that offer the level of protection that tenure does. One such position is a federal judgeship, which is distinguishable because of the very public nature of the work. If a judge performs inadequately, community backlash may quickly develop that could usher in a publicly coerced retirement. For example, a state judge, who recently gave a lenient sentence to a convicted rapist of a minor who committed suicide, has announced his retirement following pubic outrage.Tenured faculty members, unlike judges, labor in the relative isolation of the classroom, where feedback comes at the end of the semester and then only via student evaluations. This creates the first of two problems for higher education in the United States stemming from the abolition of mandatory retirement: the difficulty of removing a tenured professor for poor performance.
In most universities, only egregiously poor performance by a tenured professor is flagged for termination; outdated, boring, or barely adequate, teaching may not sufficiently stand out to warrant a more intense review. There is also a slow feedback loopdue to minimal, if any, post-tenure peer classroom evaluations and skepticism about student evaluations of teaching. Therefore, often many semesters pass before there is sufficient evidence to persuade a professor or her superiors that the tenured professor's employment status should be reevaluated. Inadequacies in scholarship can be even more difficult to discern, given the common time lag between research and publication, as well as the variations between disciplines in frequency, length, and format of publications.
The second distinct challenge faced by higher education caused by the coupling of the abolition of mandatory retirement with the institution of tenure is the prospect of stagnant departments: no new faculty may be hired because there are no vacancies....
The authors' proposed reforms include "expiration" of tenure for professors reaching age 70, while permitting continued employment opportunities on the same evaluative standards as non-tenured faculty.
Wednesday, July 22, 2015
The Associated Press and the NORC Center for Public Affairs Research are doing a series of polls on Americans' experiences and views of long-term care. As described on the website, the AP-NORC "is undertaking a series of major studies on the public’s experiences with, and opinions and attitudes about, long-term care in the United States."
Demographic projections show the population age 65 and over nearly doubling by the time the last baby boomers have reached 65. Specifically, while seniors made up only 12 percent of the U.S. population in 2000, they are expected to comprise about 22 percent by 2040, with roughly 82 million Americans over the age of 65. How to plan for and finance high quality long-term care will remain a key policy question for lawmakers in the years to come.
The AP-NORC Center, with funding from the SCAN Foundation, is conducting annual nationally representative surveys of Americans age 40 and older to monitor a series of long-term care issues. Future studies will continue to examine awareness of older Americans' understanding of the long-term care system, their perceptions and misperceptions regarding the likelihood of needing long-term care services and the cost of those services, and their attitudes and behaviors regarding planning for long-term care.
The results from 5 polls, ranging from 2013 to 2015 can be accessed here. The most recent poll, conducted in April-May, 2015, focuses on Long-Term Care in America: Americans’ Outlook and Planning for Future Care which "explores new issues, including person-centered care experiences, the role of private health insurance plans in financing long-term care, and the special challenges faced by those who provide ongoing living assistance to elderly loved ones while also providing financial support to children. At the same time, the survey continues to track long-term care attitudes and planning behaviors." A quick take away summary from this
Five Things You Should Know From The AP-NORC Center’s Long-Term Care Poll Among adults age 40 and older:
- Nearly 1 in 10 are both supporting a child and providing ongoing living assistance for a loved one.
- Only a third say they are very or extremely confident in their ability to pay for ongoing living assistance they may need in the future.
- 54 percent report doing little or no planning for these needs.
- 1 in 5 do not know if private health insurance plans cover ongoing care in a nursing home, and over a quarter do not know if Medicare does.
- Majorities support a variety of policy options that would help Americans finance long-term care.
Wednesday, July 15, 2015
Community Legal Services of Philadelphia (CLS) recently issued an important report, examining statistics on complaints and enforcement actions under the purview of Pennsylvania's Department of Health, the chief regulatory body for nursing homes. To put it bluntly, the regulators are getting a failing grade here, with a new Governor (and an uncooperative Legislature on funding issues) facing the need for action. From the executive summary:
The Pennsylvania Department of Health (DOH) has been failing to protect elderly and disabled nursing home residents. Community Legal Services of Philadelphia (CLS) regularly advocates on behalf of nursing home residents, representing them in matters relating to the preservation and protection of their rights. Over the past several years, under the previous governor’s administration, CLS has witnessed DOH significantly decrease its enforcement of nursing home regulations and patient protections. In an analysis of DOH nursing home investigations and inspections that occurred in Philadelphia from 2012-2014, CLS has found that DOH’s conduct has put elderly and disabled Pennsylvanians at risk of physical harm or death.
During this time period, DOH dismissed an extraordinary number of complaints against nursing homes, failed to properly follow up when a violation was found, mischaracterized harm against patients, and dramatically decreased its penalties against nursing homes. Unfortunately, DOH’s failures have not only placed residents at risk, but they have also resulted in inaccurate publicly available information that forces potential residents and their families to make major life decisions without all of the important facts. Pennsylvania must fix this crisis and ensure the safety of elderly and disabled nursing home residents.
The CLS authors make recommendations for change, including a commitment to "better transparency to the public regarding investigations and characterization of harm."
Monday, July 13, 2015
McKnight's News has an interesting essay reporting on the potential significance of a research project underway in Kansas:
In 2002, Kansas created a pay-for-performance Medicaid program designed to improve residents' lives. Starting this month, the Center for Applied Research at LeadingAge and Kansas State University will delve into statistical evaluation of whether the program has helped resident health, resident quality of life and employee job satisfaction. The $149,776 grant was awarded by the Retirement Research Foundation.
The 18-month CFAR project will be one of a few large-scale analyses of the potential benefits of adopting culture change. Smaller-scale studies have shown, modestly, that resident quality of life improves with culture change, and larger studies have suggested some positive outcomes related to a decrease in physical restraints and feeding tubes, says researcher Linda Hermer, Ph.D.
“I am hoping one of the things we will be able to tell, with finer precision, is to be able to understand whether there are truly benefits from culture change to a resident's health and quality of life,” she told McKnight's.
Thursday, July 9, 2015
In Alzheimer's Spurs the Fearful to Change Their Lives to Delay It, Washington Post writer Fredrick Kunklen details various ways that individuals and groups are working to buy more time from genetic profiles or family histories that suggest a greater likelihood of dementia:
When Jamie Tyrone found out that she carries a gene that gives her a 91 percent chance of developing Alzheimer’s disease beginning around age 65, she sank into a depression so deep that at times she wanted to end her life.
Then she decided to fight back. She exercised. She changed her diet. She began taking nutritional supplements, including fish oil, vitamin D, vitamin B12, curcumin, turmeric and an antioxidant called CoQ10. She started meditating and working mind-bending puzzles, such as Brain HQ. She joined a health clinic whose regimen is shaped by a UCLA medical study on lifestyle changes that can reverse memory loss in people with symptoms of dementia. She started a nonprofit group, Beating Alzheimer’s By Embracing Science (BABES), to raise money and awareness about dementia.
“I found my voice,” said Tyrone, 54, a registered nurse who lives in San Diego.
Here is the link to "BABES" for those who want to read more about that group.
Friday, June 19, 2015
The Spring 2015 issue of the ABA publication Law & Social Inquiry has a great symposium review section offering a broad array of essays, commenting on Hendrik Hartog's important book Someday All this Will Be Yours: A History of Inheritance and Old Age (Harvard University Press: 2012).
The impressive list of contributors includes:
- Naomi Cahn (George Washington Law), Continuity and Caregiving: Comments on Someday All This Will Be Yours
- Mary Anne Case (University of Chicago Law), When Someday is Today: Carrying Forward the History of Old Age and Inheritance into the Age of Medicaid
- Nina A. Kohn (Syracuse Law), The Nasty Business of Aging
- Dorothy E. Roberts (University of Pennsylvania Law), Race, Care Work, and the Private Law of Inheritance
Plus, historian Hendrik Hartog provides his own commentary and response!
- Hendrik Hartog (Princeton), Somedays I Have Second Thoughts.
Suffice it to say if you appreciated Hartog's book, you will thoroughly enjoy his additional musings on how he came to write it and what it might mean for the future.
The comments are engaging and relatively brief -- but should still keep you busy on a summer weekend.
June 19, 2015 in Books, Cognitive Impairment, Dementia/Alzheimer’s, Discrimination, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Property Management, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (0)
Tuesday, June 16, 2015
During the last two years I have had the fascinating opportunity to work on two major studies of laws and government policies affecting older persons and their families in Northern Ireland, studies initiated by the Commissioner for Older People for Northern Ireland (COPNI). The earlier study looked at safeguarding systems. Now the second study has been made public, with Northern Ireland Commissioner Claire Keatinge using the work to recommend major reforms of Adult Social Care laws in her country. The formal launch of her "call for change" occurred on June 16 in Belfast.
Two of my four research colleagues, Dr. Joe Duffy (far left, who led the research team) and Dr. Gavin Davidson, (far right) both of Queens University Belfast, were present for the launch, with Joe giving introductory remarks to the audience of government officials and community stakeholders. The fourth member of our team is Dr. Subhajit Basu of the University of Leeds in England. Our research evaluated government policies and law in more than ten nations, looking for legal trends, best practices and cutting edge social care programs.
Significantly, in addition to recommending a comprehensive legislative framework and funding structure to coordinate services for all adults in need of assistance, one key recommendation announced by Commissioner Keatinge (left center above) and highlighted in our investigative report, is to implement a "Support Visit" for any interested person age 75 years or older, by an appropriately trained health and social care worker. This recommendation, which draws upon Denmark's successful experience with a "preventative home visitor" program, would create an opportunity for a psychosocial dialogue aimed at advance planning. The goal is to help individuals and family members anticipate needs in the event of functional impairment, thus reducing the need for crisis planning.
I've become a big fan of Commissioner Keatinge; she is clear, creative, realistic, and determined to see Northern Ireland become a world leader in recognizing not just the needs but the contributions made by older adults. She does so from a platform of respecting older persons' contributions, citing research to demonstrate that over the next several decades, older adults will contribute more than £25 billion to the Northern Ireland economy through formal work, volunteering, and their roles as caretakers for both adults and children.
It had been an honor for me to work on this social care reform project. The work has given me -- and Dickinson Law students serving as research assistants, Ryan Givens and Tucker Anderson (who used his ability to speak and translate Danish to help in our field research) -- important new perspectives on proactive ways to identify and address potential needs triggered by age-related changes in demographics. Frankly, in the U.S. we spend far more time (and arguably too much time) on issues of medical care. This report is a reminder that many health-care crises could be avoided or mitigated through more proactive implementation of social care networks.For more on the Duffy, Davidson, Basu, Pearson report (June 2015), see Review of Legislation & Policy Guidance Relating to Adult Social Care in Northern Ireland.
For more on Commissioner Claire Keatinge's call for reform, see Commissioner Calls for Overhaul of Adult Social Care.
See here, for more on Denmark's approaches to services, communication and programming for older people.
Special thanks to Ryan and Tucker for their research, proofreading, editing and translation skills!
June 16, 2015 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Health Care/Long Term Care, Housing, International, Retirement, Science, Social Security, Statistics | Permalink | Comments (0)
Wednesday, June 3, 2015
The Employee Benefits Research Institute (EBRI) has released the results of their annual retirement confidence survey. The 2015 Retirement Confidence Survey is available here. There are also 7 fact sheets that highlight specific findings, including caregivers, retirement confidence, changing expectations, preparing for retirement, age comparisons, gender & marital status, and attitudes about Social Security & Medicare.
Friday, May 29, 2015
Light blogging ahead for me, as I will be leaving in a couple of days for my first visit to Cuba, as part of a small Penn State University faculty group. I'm confident I will have plenty of things to do with my time other than searching for an elusive internet café!
Seriously, I'm excited, on a number of levels. First, I lived for several years in a Cuban-immigrant neighborhood in Miami at the end of law school, and many of my fellow judicial clerks and friends were the first generation sons and daughters of Cuban refugees. Second, I've been educated by my Irish friend, Dr. Una Lynch, to appreciate the world-wide significance of the Cuban health care system, and I'm eager to see how they accomplish much with comparatively few resources. Third, my Elder Law colleague, Amos Goodall Esq., State College, PA, has shared great suggestions for art and food. Plus, Attorney Karen Miller (NY and Florida) has shared her contacts with me from her travels and studies about law in Cuba. ¡Gracias a todos!
Here are a couple of items from some of my background reading on Cuba, including health care and aging statistics:
Turning to Cuba, let us examine the possible consequences of the tendency towards population aging that we have described. In the economic field, the consequences include an accelerated demand for the funds to cover social security expenditures. In fact, since 1970 funds budgeted for old-age, disability and death benefits have quintupled. National budget expenditures for social security are higher than those of any other sector (e.g. education, health, defense, etc.) (Cuban National Statistics Office, 1999 "c").
At the same time, as the average age of Cuba's workforce increases over the coming years, we will see a deficit of workers for labor requiring greater physical effort, especially for agriculture, construction and industry, among others. Consequently, the main economic difficulty Cuba faces today-as it did during the colonial period and at the beginning of the 20th century-is an insufficient workforce.
From Aging in Cuba, Realities and Challenges, byAlberta Duran Gondar and Ernesto Chavez Negrin.
During her recent visit to Havana in July of 2014, Margaret Chan, Director-General of the World Health Organization (WHO), impressed by the country's achievements in this field, praised the Cuban health care system: "Cuba is the only country that has a health care system closely linked to research and development. This is the way to go, because human health can only improve through innovation," She also praised "the efforts of the country's leadership for having made health an essential pillar of development."