Thursday, April 16, 2015
From the New York Times on April 14, an article from the business section, As Nursing Homes Chase Lucrative Patients, Quality of Care is Said to Lag.
Promises of “decadent” hot baths on demand, putting greens and gurgling waterfalls to calm the mind: These luxurious touches rarely conjure images of a stay in a nursing home.
But in a cutthroat race for Medicare dollars, nursing homes are turning to amenities like those to lure patients who are leaving a hospital and need short-term rehabilitation after an injury or illness, rather than long-term care at the end of life.
Even as nursing homes are busily investing in luxury living quarters, however, the quality of care is strikingly uneven. And it is clear that many of the homes are not up to the challenge of providing the intensive medical care that rehabilitation requires. Many are often short on nurses and aides and do not have doctors on staff.
Some colorful quotes here ("patients are leaving the hospital half-cooked"), but a lot of this well-written article nonetheless seems like old news to me (okay, perhaps that's because of my chosen research focus), with reporting on trends influenced by operating margins on the "nonprofit" side of care, and "return on investment" for shareholders on the for-profit side. Perhaps "intensity" of the pressures is the theme here?
Tip of the hat to George Washington University Law student Sarah Elizabeth Gelfand ('16) and GW Professor Naomi Cahn for making sure we saw this article!
Tuesday, April 7, 2015
St. Louis University's Journal of Health Law and Policy has recently released a theme issue, focused on "Health Care Reform, Transition and Transformation in Long-Term Care." A great line-up of articles and authors, including:
- Home & Community-Based Long-Term Services and Supports: Health Reform's Most Enduring Legacy? by Marshall B. Kapp
- Care Coordination for Dually Eligible Beneficiaries, by Katie M. Dean and David C. Grabowski
- The Challenge of Financing Long-Term Care, by Judy Feder
- Rationalizing Home and Community-Based Services Under Medicaid, by Laura D. Hermer
- The Broken Promise of OBRA '87: The Failure to Validate Survey Protocol, by Malcolm J. Harkins III
In addition, there are two relevant Notes written by SLU students:
- Short-Stay, Under Observation. or Inpatient Admission? How CMS' Two Midnight Rule Creates More Confusion and Concern, by Rachel A. Polzin
- Disclosure for Closure? Why the Self-Referral Disclosure Protecol Process Paired with the 60-Day Overpayment Rule Creates More Headaches than Solutions, by Peter J. Eggers
April 7, 2015 in Discrimination, Ethical Issues, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Medicare, Social Security, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (1) | TrackBack (0)
Wednesday, April 1, 2015
The AARP Public Policy Institute has recently published an Insight Report (March 2015) on older workers and unemployment following the recent economic crisis. The report draws upon surveys of persons aged 45 to 70 affected by unemployment during the last 5 years. The primary focus of the analysis is on "reemployment," including what strategies were used in successful efforts to find jobs.
Lots of interesting information here. Even though the rate of unemployment is lower for older workers, those losing their jobs later in life stayed unemployed longer than younger job seekers, and their recovery jobs reportedly paid less. Some of the findings, however, are of equal relevance to younger job seekers. One set of responses was especially sobering, on a question about possible working life regrets:
"When asked whether there was anything they wished they had done differently over their working lives or careers to better position themselves for dealing with unemployment, 52 percent said 'yes.' The most common answer —65 percent — was a wish that they had saved more money. Also of note, 48 percent wished they had gone back to school to complete or get another degree, and 38 percent wished they had chosen a different field. The unemployed and the long–term unemployed were more likely than the other groups to wish they had chosen a different field. Those who elected that regret also tended to be younger (56 percent were ages 45 to 54)."
Many thanks to Professor Naomi Cahn at George Washington Law for alerting me to this report, and sending a link to related Wonk Blog coverage of the study from the Washington Post -- lots of well-explained graphs from an oral presentation that accompanied the launch of AARP's written report.
Monday, March 16, 2015
GW Law Professor Naomi Cahn and Amy Zeittlow, affiliate scholar with the Institute of American Values, have collaborated on a new article that is fascinating. In "Making Things Fair: An Empirical Study of How People Approach the Wealth Transmission System," to be published in a forthcoming issue of the Elder Law Journal, they ask fundamental questions about whether traditional laws governing testate and intestate wealth transmission reflect and serve the wishes of most Americans. Professor Cahn previews the article as follows:
Based on an empirical study of intergenerational care for Baby Boomers, the article shows how the inheritance process actually works for many Americans. Two fundamental questions about the wealth transfer system guided our analysis of the data: 1) does the contemporary inheritance process respond to the changing structure of American families; and 2) does it reflect the needs of the non-elite, who have not traditionally been the focus of the system?
Our study shows that the formal laws of the inheritance system are largely irrelevant to how property is transferred at death. While the contemporary trusts and estates canon focuses on the importance of planning for traditional forms of wealth in nuclear families, this study focuses on the transmission of wealth that has high emotional, but low financial, value. We illustrate how the logic of “making things fair” structured how families navigated the distribution process and accessed the law. Consequently, the article recommends that law reform should be guided by the needs of contemporary families, where not only is wealth defined broadly but also family is defined broadly, through ties that are both formal and functional. This means establishing default rules that maximize planning while also protecting familial relationships.
The article is part of a new book by the authors titled "Homeward Bound," with planned publication in 2016, and the authors welcome comments and suggestions.
March 16, 2015 in Books, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Property Management, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (0) | TrackBack (0)
Wednesday, March 11, 2015
Julie Childs, Project Manager for the U.S. Department of Justice's Elder Justice Website shared with us the resources now available to researchers, students and advocates. Some of the highlights:
Here, victims and family members will find information about how to report elder abuse and financial exploitation in all 50 states and territories. Simply enter your zipcode to find local resources to assist you.
Federal, State, and local prosecutors will find three different databases containing sample pleadings and statutes.
Researchers in the elder abuse field may access a database containing bibliographic information for thousands of elder abuse and financial exploitation articles and reviews.
Practitioners -- including professionals of all types who work with elder abuse and its consequences -- will find information about resources available to help them prevent elder abuse and assist those who have already been abused, neglected or exploited.
This website is intended to be a living and dynamic resource. It will be updated often to reflect changes in the law, add new sample documents, and provide news in the rapidly evolving elder justice field.
It will be interesting to watch this site develop.
March 11, 2015 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Statutes/Regulations, State Statutes/Regulations, Statistics | Permalink | Comments (1) | TrackBack (0)
Monday, March 2, 2015
Alzheimer's Research UK is releasing a report this month about the impact of dementia on women. Details released in advance of the formal launch are eye-opening.
As reported in The Guardian, “'Dementia is a life-shattering condition and represents a ‘triple whammy’ for women,' said Hilary Evans, director of external affairs at Alzheimer’s Research UK. 'More women are dying of dementia, more women are having to bear the burden of care, while a disproportionate number of women currently working in dementia research are having to leave science.'”
The full study calls for the government to make a significant increase in its funding of dementia research and an improved investment in care. Further, the report will explain that:
■ More than 500,000 women [in the U.K.] are now affected by dementia. About 350,000 men have the condition.
■ Women over 60 are now twice as likely to get dementia as breast cancer.
■ Women are more than two-and-a-half times more likely than men to be care-givers of people with dementia.
■ Most care- givers do not choose or plan to take on this role and often find the experience highly stressful.
Thanks to friends at CARDI, the Centre for Ageing Research and Development in Ireland for sharing this news. The formal launch of the Alzheimer's Research UK report appears timed to coincide with their "sold-out" 2015 Conference on March 10-11 in London.
Thursday, February 26, 2015
A new research project on demographics of the U.S., with funding from The William and Flora Hewlett Foundation, brings together the Center for American Progress, the American Enterprise Institute, and demographer William H. Frey of the Brookings Institution. The project goals are:
- To document and analyze the challenges to democracy posed by the rapid demographic evolution from the 1970s to 2060
- To project the race-ethnic composition of every state to 2060, which has not been done for 20 years
- To promote a wide-ranging and bipartisan discussion of America’s demographic future and what it portends for the nation’s political parties and policy
The team's first report identifies a Top Ten list of demographic factors likely to impact the future of both policy-decisions and politics, including #6 on the "Graying of America." Graphics illustrate each of the projections, including this one on aging.
For more complete results, see The States of Change: Demographics and Democracy, 1974 to 2060.
Thanks to GW Law Professor Naomi Cahn for sending this report! The statistics should be useful for generating student discussion in a wide range of courses.
Tuesday, February 24, 2015
USA Today reports on home care workers "joining a nationwide movement" to raise wages, with rallies planned for "more than 20 cities in the next two weeks."
As described by journalist Paul Davidson,
"Like the fast food workers, the 2 million personal care and home health aides seek a $15 hourly wage and the right to unionize, which is barred in some states. Their median hourly wage is about $9.60 and annual pay averages just $18,600 because many work part-time, according to the Labor Department and National Employment Law Project. That puts the industry among the lowest paying despite fast-growing demand for home-based caregivers to serve aging Baby Boomers over the next decade.
'Home care providers living in poverty don't have a stable standard of living so they can provide quality care,' says Mary Kay Henry, president of the Service Employees International Union, which is spearheading the home care aides' movement and backed the fast-food worker strikes."
According to a representative of "Home Care Association of America, which represented agencies that employ personal-care aides," companies attempt to "balance the ability to keep care affordable with attracting employees."
Thanks to Dickinson Law 3L student Jake Sternberger for pointing me to this news item.
February 24, 2015 in Consumer Information, Discrimination, Ethical Issues, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (0) | TrackBack (0)
Sunday, February 15, 2015
George Washington University Law Professor Naomi Cahn sent us a link to an interesting study that seeks to demonstrate the impact of income equality -- and wage stagnation for low and middle income workers -- on the long-term solvency of Social Security.
In a release accompanying the release of its study, the Center for American Progress (CAP) explains:
"Specifically, CAP’s issue brief finds that the trust funds would be $753.8 billion larger had the average worker’s wages kept pace with productivity growth between 1983 and 2013, thereby reducing the expected 75-year shortfall of the trust funds by 6.8 percent. The brief also shows that the trust funds would be greater by more than $1.1 trillion had the maximum taxable wage base remained fixed at 90 percent of earnings over the same time period, reducing the expected 75-year shortfall by 10.1 percent. Both scenarios would have added years of additional solvency to the Social Security trust funds. These findings come on top of Social Security trustees’ projections that, looking ahead, freezing the taxable wage base at 90 percent today would on its own close more than one-quarter of the projected 75-year shortfall....
CAP’s brief outlines how, as a result of the [existing] cap on taxable earnings--$118,500 for 2015—Social Security’s funding is tied directly to the full wages that low- and middle-income workers earn—but not to the full wages that higher-earning workers receive. The brief finds that in 2013, the top 1 percent of earners took home nearly the same share of the nation’s total wage income as the entire bottom half of workers. As a result, income has shifted away from workers whose full earnings are subject to payroll taxes and toward high-income workers whose additional dollars are exempt."
Thursday, February 12, 2015
We know there are a lot of Boomers and we expect the Boomers to have a significant impact on aging issues. But, although there are a lot of Boomers, the Boomers aren't the largest cohort of the U.S. population, In fact, the Millennials are #1. According to an article in the New York Times, Millennials Set to Outnumber Baby Boomers. The Millennials are the cohort born between 1981-1997. according to the article, they will hit 75.3 million living members, which will make them a larger cohort than the Boomers. Here's a question-since we are c18 years out, how does this generation continue to grow? According to the article, it is because of "[a]n influx of immigrants, according to a new report from the Pew Research Center. And, of course, members of the boomer generation, currently at 74.9 million, are beginning to die in greater numbers."
The article goes on to discuss how demographers determine the years that define a cohort and what is expected regarding the actions of Millennials. Boomers, take heart. The Millennials may outnumber us, but we still rock on! The Pew Research article, This Year, Millennials Will Overtake Baby Boomers, referenced in the NY Times piece may be accessed here.
Friday, February 6, 2015
H. R. Moody edits an electronic newsletter, called "Teaching Gerontology," under the auspices of the Creativity, Longevity & Wisdom Program at Fielding Graduate University in Santa Barbara, California. It is distributed by the Association for Gerontology in Higher Education. A recent newsletter contained this interesting item:
"We've all heard that famous statistic: only 4% of people over 65 are in a long-term care facility (sometimes called simply "nursing home"). But there's a reason why this statistic has been called the "4 Percent Fallacy." The reason is that it's simply a cross-sectional figure, a snapshot at a single point in time. What is the likelihood of being in a long-term care facility when we look at it longitudinally, that is, over the life-course? The bad news is that the risk is not 4% but more like 50%: 44% for men and 58% for women. The good news is the stays in a nursing home may not necessarily be long: 11 months for a single man and 17 months for a single woman."
H.R. Moody suggests that for more details, visit:http://crr.bc.edu/briefs/long-term-care-how-big-a-risk/
Further, he notes that CRR's calculation of average length-of-stay has been challenged and is worth closer examination: http://centerltc.com/bullets/latest/1070.htm
Thursday, January 29, 2015
Jenica Cassidy, a recent graduate of Wake Forest University School of Law, has been serving as a Fellow with the ABA Commission on Law and Aging since August 2014. It appears she's been making very good use of her time, working on a study that examines termination of guardianships and restoration of rights for adults.
BiFocal, the journal of the ABA Commission is publishing a short overview of the study -- a sneak peek -- in its February issue. What I especially appreciate is the clear documentation provided by the author on the methodology, including "(1) statutory review; (2) case law search and analysis; (3) online questionnaires for attorneys and judges; and (4) stakeholder interviews." Jenica and the Commission staff analyzed 104 cases, including 57 cases occurring between 1984 and 2014, where individuals petitioned for restoration of rights. The study highlights the challenges that face any individual seeking to terminate a guardianship, as well as the impact of guardian testimony or opposition to such petitions.
The full report will be published in the Elder Law Journal (University of Illinois), but in the meantime, read the intriguing summary available through BiFocal.
Thursday, January 22, 2015
We have written many posts about underfunded benefit programs at the federal and state levels (see e.g., here), but another looming problem is underfunding of pension programs at the local levels. The potentially affected employees include firefighters and sanitation workers and police officers.
This week WITF-Radio's Smart Talk program explored the issue in Pennsylvania:
"More than 500 Pennsylvania municipalities' pension funds are considered "distressed" because they're funded at less than 90%. Some Pennsylvania cities, boroughs, and townships currently have pension funds at lower than 50%. State law impacts public employees' ability to negotiate their contracts, making this issue of particular concern to lawmakers in Harrisburg.
Last week, Pennsylvania Auditor General Eugene DePasquale announced that in total Pennsylvania's municipal pension funds have a $7.7 billion liability. Legislation is expected to be proposed this year that will seek to eliminate some of the liability over the long term."
It seems unlikely that Pennsylvania is the only state with a local-level pension funding problem.
The primary speaker on the program, Pennsylvania Municipal League Executive Director Richard Schuettler, pointed to an interesting aspect of the problem, what he sees as unrealistic decisions by arbitrators in collective bargaining labor disputes over pay and retirement benefits.
Wednesday, December 10, 2014
Earlier this year, Kim Dayton reported in our Blog (here) about the new CARE Act, enacted in Oklahoma as a means to provide better transition from facility-based care to home care for individuals needing support. The CARE Act is a nation-wide project sponsored by AARP and thus I was excited to be invited to participate in an AARP Pennsylvania Family Caregiver Summit, as part of the discussion about introduction and passage of a CARE Act in my state.
The Summit was held yesterday with administrative agency heads, legislators and their staff invited to attend. The turnout was probably a bit affected by the weather reports for the day. (What happened to the predicted Nor'easter, anyway? Not that I'm complaining about winter weather that proves to be milder than predicted!) I found the event very interesting. As so often happens, I ended up being more of a student than a teacher, even while serving as a panelist.
It was quickly clear that virtually everyone in the room had experience with or personal awareness of the challenges of serving as a family caregiver under stress. The room was practically vibrating with stories about how tough it can be to know what to do when you confront the reality that a parent or other aging family member needs significant support. The keynote speaker, Cate Barron, a vice president of the PennLive and Patriot-News media group and by her own admission a take-charge kind of gal, spoke with great candor and humor about the process of realizing that a "diagnosis" of what is wrong did not necessarily provide answers to her mother's need for assistance. We are so pre-programmed to believe that if we can find the right diagnosis of the problem, there must be a "solution" worth pursuing.
The opening presentation by Glenn Fewkes from the AARP National office provided the latest statistics and graphics about aging in the U.S. What I found especially interesting were his graphics about Long-Term Services and Supports (LTSS) for individuals with caregiving needs. It turns out Pennsylvania ranks near the bottom (42nd, according to the most recent statistics) on a national scorecard. evaluating LTSS for affordability and access. That means the state with the fourth "oldest" population has some real challenges ahead.
That is where AARP's CARE Act project comes into play as a first step to improve supports for individuals needing care. As we reported earlier, CARE is an acronym for "Caregiver Advise, Record and Enable" and AARP's model has straight-forward objectives. To me, a key goal in adopting the model CARE Act is to create smoother transitions. This can be facilitated by making sure that hospitals or rehab facilities have clear information about any designated "caregiver," that they give notifice of discharge at least 4 hours in advance, and that they offer practical instruction on any medical tasks that will need to be performed in the home. For example, under the model CARE Act, the instruction shall include:
- a live demonstration of needed "after-care tasks"
- an opportunity for caregiver and patient to ask questions
- answers to the caregiver and patient questions "provided in a culturally competent manner and in accordance with the hospital's requirements to provide language access services under state and federal law."
My own research has shown that family members often cite "access to accurate information" as one of the most important first needs for families responding to caregiving crises. The CARE Act is clearly intended to respond to a critical first window of need -- hospital discharge -- by requiring facilities to give useful information and relevant instruction.
During the Family Caregiver Summit, there were a lot of good questions about the CARE Act, and it was great to have Pennsylvania State Representative Tim Hennessey on the panel. In his role as majority chair of the House Aging and Older Adult Services Committee, it is likely he will be able to provide early analysis and support for the CARE Act in Pennsylvania.
As part of my own preparation for the Summit, I took a closer look at Oklahoma's result with the CARE Act. Title 63 Okla. St. Ann. Sections 3113- 3117 (the statutory provisions created by the April 2014 passage of Senate Bill 1536) became effective on November 1, 2014. The law requires that hospitals "provide each patient or patient's legal guardian with an opportunity to designate one lay caregiver" following admission, and to record the designated caregiver and the caregiver's contact information in the patient's medical record. Such a choice then triggers the hospital to "request the written consent" of the patient or guardian to release medical information to the patient." Only if the patient both designates a lay caregiver AND gives "written" consent is the hospital then obligated to do anything further with respect to discharge planning with the caregiver.
But what happens in Oklahoma when the written consent to share information with the designated caregiver is given?
Friday, December 5, 2014
I've written often in our Blog, including here and here, about our growing awareness and national concern about the issue of financial exploitation of older persons. In brainstorming a bit with another attorney about a thorny case -- and trying to decide where a parent/child relationship went wrong -- I was reminded of the work of Professor Karen Hooker, PhD at Oregon State University's School of Social and Behavioral Sciences. A major focus of Professor Hooker's work is the influence of "personality" in aging across the lifespan. She has examined spousal caregivers for persons with dementia, looking to see how the individual's view of self and the relationship affects "success," including successful caregiving. Another part of her work has examined closely the issue of "ambivalence" in family relationships.
For example, in Dr. Hooker's research, her team used qualitative study methods to examine older parent/adult child relationships. One of the major themes emerging when parents (each aged 67+) talked about their children was awareness that their children were "busy," and thus there were often ambivalent feelings of need and dissatisfaction about the parent's interactions with their children. The study revealed feelings both of resentment and pride about their busiest children.
That has led me to think that "ambivalence" may also be a component of voluntary "principal and agent" relationships, where the adult children are asked by the parent to serve as an agent under a power of attorney, for example. But as the adult child exercises more control over financial matters, might that parent also begin to have second thoughts, thoughts that are not acted on until "too late." The children believe they had authority to "pay themselves" for their roles in handling matters for their aging parent; the parent initially agrees, or at least does not object, and only later, after the money is gone, asserts some "agreement" about the financial matters, arguing there was an "understanding," even if never express at the outset? There is room for more research here, yes?
Monday, November 17, 2014
On November 17, 2014, following more than a year of study and consultation, the Pennsylvania Supreme Court's Elder Law Task Force issued a comprehensive (284 pages!) report and recommendations addressing a host of core concerns, including how better to assure that older Pennsylvanians' rights and needs are recognized under the law. With Justice Debra Todd as the chair, the Task Force organized into three committees, focusing on Guardianships and Legal Counsel, Guardianship Monitoring, and Elder Abuse and Neglect. The Task Force included more than 40 individuals from across the state, reflecting backgrounds in private legal practice, legal service organizations, government service agencies, social care organizations, criminal law, banking, and the courts.
From the 130 recommendations, Justice Todd highlighted several "bold" provisions at a press conference including:
- Recommending the state's so-called "Slayer" law be amended to prevent an individual who has been convicted of abusing or neglecting an elder from inheriting from the elder;
- Recommending changes to court rules to mandate training for all guardians, including, but not limited to, family members serving as guardians;
- Recommending adoption of mandatory reporting by financial institutions who witness suspected elder abuse, including financial abuse.
The full report is available on the Pennsylvania Supreme Court website here. As a consequence of the Task Force study, the Supreme Court has approved the creation of an ongoing "Office of Elder Justice in the Courts" to support implementation of recommendations, and has created an "Advisory Council on Elder Justice to the Courts" to be chaired by Pennsylvania Superior Court Judge Paula Francisco Ott.
Thursday, October 2, 2014
Afghanistan is the worst country to live in as an older person, an annual index on the wellbeing of the elderly showed on Wednesday. The Asian country was ranked bottom for the second consecutive year in HelpAge International's Global AgeWatch Index, its health situation in particular the poorest in the world. Norway topped the index - up one place from last year - followed by Sweden, Switzerland, Canada and Germany, all of which remained in the top 10. Apart from Japan - ranked ninth - the 10 best performers were again in western Europe, North America and Australasia. The report, which focused on pensions and warned that half the world’s population faces a bleak future without one, comes at a time when life expectancy continues to rise. Toby Porter, chief executive of HelpAge International, said governments worldwide need to implement specific policies to respond to "this unequovical demographic shift". "Only if they act now will they have a chance to meet the needs of their citizens and keep their economies going," Porter told the Thomson Reuters Foundation.
Wednesday, October 1, 2014
A few days ago I blogged about an article in The Atlantic explaining one person's thinking of 75 being his optimal "old age". In that same issue of The Atlantic is another article--about longevity and 100 year olds--what it will mean for society as more of us reach that age. What Happens When We All Live to 100? was published on September 17, 2014.
The article starts with a history of sorts of life expectancies from human origins and notes that
Viewed globally, the lengthening of life spans seems independent of any single, specific event. It didn’t accelerate much as antibiotics and vaccines became common. Nor did it retreat much during wars or disease outbreaks. A graph of global life expectancy over time looks like an escalator rising smoothly. The trend holds, in most years, in individual nations rich and poor; the whole world is riding the escalator.
Projections of ever-longer life spans assume no incredible medical discoveries—rather, that the escalator ride simply continues. If anti-aging drugs or genetic therapies are found, the climb could accelerate. Centenarians may become the norm, rather than rarities who generate a headline in the local newspaper.
The article then moves to a discussion of those institutions intentionally working on increasing life spans, the Buck Institute, the U of Michigan, the U of Texas, UC-San Francisco, and the Mayo Clinic for example. Long-term readers of this blog may also remember a post about CALICO (Google's "spin-off called the California Life Company (known as Calico) to specialize in longevity research."). The article has a fascinating section about the research being done, including some interesting consideration of other life forms that excel in longevity (worm genes, anyone?).
I particular enjoyed reading the quote of one of the leaders in the field in describing the nascent nature of the research. "'[M]edically, we do not know what ‘age’ is. The sole means to determine age is by asking for date of birth. That’s what a basic level this research still is at.'” There seems to be some debate amongst the experts about whether life expectancy will continue to rise at the steady escalator-smooth rate as in years past. The article also mentions some of the theories advanced over time on increasingly longevity: vitamins, low calorie diets, education, exercise, etc.
One section of the article bears significant possibilities for class discussion, the political implications of an older society.
Society is dominated by the old—old political leaders, old judges. With each passing year, as longevity increases, the intergenerational imbalance worsens. The old demand benefits for which the young must pay, while people in their 20s become disenchanted, feeling that the deck is stacked against them. National debt increases at an alarming rate. Innovation and fresh thinking disappear as energies are devoted to defending current pie-slicing arrangements.
The author reveals this is a description of what is actually occurring in Japan. Consider as the author does, what increased longevity may also do to the judicial branch--especially the Supreme Court with lifetime appointments.
This article may be viewed as a bit of a wake-up alarm, although I suspect many of the folks in the US will just hit the snooze button
People’s retirement savings simply must increase, though this means financial self-discipline, which Americans are not known for. Beyond that, most individuals will likely need to take a new view of what retirement should be: not a toggle switch—no work at all, after years of full-time labor—but a continuum on which a person gradually downshifts to half-time, then to working now and then. Let’s call it the “retirement track” rather than retirement: a phase of continuing to earn and save as full-time work winds down.
Widespread adoption of a retirement track would necessitate changes in public policy and in employers’ attitudes. Banks don’t think in terms of smallish loans to help a person in the second half of life start a home-based business, but such lending might be vital to a graying population. Many employers are required to continue offering health insurance to those who stay on the job past 65, even though they are eligible for Medicare. Employers’ premiums for these workers are much higher than for young workers, which means employers may have a logical reason to want anyone past 65 off the payroll. Ending this requirement would make seniors more attractive to employers.
Back to the reasons for increasing longevity. One in the list above, education, seems to have a solid correlation and maybe not as obvious as other reasons that come to mind (vaccines, antibiotics, improved health care, public services, etc.). The author considers the role of education in longevity and examining budget cuts by states, suggests
Many of the social developments that improve longevity—better sanitation, less pollution, improved emergency rooms—are provided to all on an egalitarian basis. But today’s public high schools are dreadful in many inner-city areas, and broadly across states ... Legislatures are cutting support for public universities, while the cost of higher education rises faster than inflation. These issues are discussed in terms of fairness; perhaps health should be added as a concern in the debate. If education is the trump card of longevity, the top quintile may pull away from the rest
The last section of the article hypothesizes on the impact of an aging society if the escalator continues its ascent, achieving perhaps a "grey utopia" of sorts. The article is well worth reading, but it makes me think about how society values, or devalues, aging. Is getting old a challenge or disease to be conquered? For example, the author writes, "[i]f the passage of time itself turns out to be the challenge, interdisciplinary study of aging might overtake the disease-by-disease approach. As recently as a generation ago, it would have seemed totally crazy to suppose that aging could be “cured.” Now curing aging seems, well, only somewhat crazy." Read this article and have your students read it, too.
Tuesday, September 30, 2014
Kudos again to my friend and colleague, Professor Mark Bauer (current chair of the AALS Aging & Law section, btw) for sending me this article, The Great Senior Sell-Off Could Cause the Next Housing Crisis. The article appeared in The Atlantic's CityLab, and although the article was published in 2013, I think it is still important to read (if you didn't when it was first published) because it predicts the busting of another housing "bubble" starting in 2020, just 6 years from now.
The article opens with looking at the various names of animals being swallowed by the python (that is, the Boomers and the American population). (As an aside, the article lists a number of animals--I'd only heard of the pig, but now I know we Boomers might also be compared to a bunny (cute) or "a really big rat" (ugh)). But I digress.
The focus of the article is on what will happen when the Boomers reach a certain age where they decide to sell their homes...and hope there are buyers galore for them. A researcher quoted in the article indicates that in certain larger metro areas, there should be buyers, but in less populous areas, not so much. He describes what he calls "the “great senior sell-off” .... sometime later this decade ... [that] he predicts that it could cause our next real housing crisis."
Changing demographics will also affect the housing market and demand will not be in sync with supply as housing preferences change with age and demographics. There is something of a bleak housing future ahead for many elders, according to the expert, who predicts "there will be two classes of seniors in America: those “aging in place” voluntarily, and those “aging in place” involuntarily because they can’t sell their homes." His concerns about aging in place are best summarized by how a person's abilities change once s/he gets to an advanced age and becomes unable to do basic upkeep or maintenance yet the housing market will tumble, leaving some only the choice of abandoning their homes.
Thursday, September 4, 2014
George Washington Law Professor Naomi Cahn alerted us to the Washington Post coverage on new research analyzing causation factors to explain why 2/3 of all persons with Alzheimer's Disease are women. Lots of opportunities here for important classroom discussions:
"It has long been known that more women than men get the deadly neurodegenerative disease, and an emerging body of research is challenging the common wisdom as to why. Although the question is by no means settled, recent findings suggest that biological, genetic and even cultural influences may play heavy roles.....
Because advancing age is considered the biggest risk factor for the disease, researchers largely have attributed that disparity to women’s longer life spans. The average life expectancy for women is 81 years, compared with 76 for men. Yet 'even after taking age into account, women are more at risk,' said Richard Lipton, a physician who heads the Einstein Aging Study at Albert Einstein College of Medicine in New York.
The area of inquiry has been growing in part because of a push by female Alzheimer’s researchers, who have formed a group to advocate for a larger leadership role in the field and more gender-specific research. 'Scientific workforce diversity is very important because it’s much more likely to shape the research agenda,' said Hannah Valantine, the chief officer for scientific workforce diversity at the National Institutes of Health and a professor at Stanford University’s medical school.
Running counter to the longevity argument, Lipton’s research suggests that women who are 70 to 79 years old are twice as likely as men the same age to develop Alzheimer’s or other forms of dementia. After 80, the risk is identical and remains similar throughout the rest of life, Lipton said."
For more on emerging issues and indictors, see "Why Do More Women Get Alzheimer's?" by Frederick Kunkle. Thanks, Naomi!