Thursday, May 12, 2016
The latest issue of Biofocal from the American Bar Association Commission on Law & Aging is out, and the cover story is an article by Erica Wood on Evaluating the Capacity to Drive. Ms. Wood explores the question of what is the needed capacity to drive, and notes the skills one needs to be a safe driver.
[E]valuating capacity to drive is of course different from evaluating capacity to make decisions or execute legal transactions. First, driving involves a mix of mental, physical, and sensory abilities. Second, driving has serious risk not only for oneself but also for others as well. And third, the determination of capacity to drive initially rests not with a judge but with the commissioner of the state department of motor vehicles—although judges may well be involved in decisions about drivers licenses, as described in the “View from the Bench” by Judge Lyle. While state laws vary, the Uniform Vehicle Code provides that a license may be denied if the state commissioner finds that a person “by reason of physical or mental disability would not be able to operate a motor vehicle with safety upon the highways” (National Committee on Uniform Traffic Laws and Ordinances).
Using the ABA/APA handbook for psychologists "general capacity evaluation framework," Ms. Wood breaks down the assessment elements for capacity to drive: the legal element, the functional component, diagnosis, values, mental health assessment, risk assessment, and clinical judgment that is needed in order "to integrate all of the evidence from the previous steps on supports, conditions, risks, abilities and limitations." The article underscores the need to examine the driver's values, consider emotional factors such as hallucinations and whether the person has capacity with support. Capacity with support is explained as "supports and accommodations that might enhance ability."
In the driving context, this might mean a change of eyeglasses, a higher seat or pillow, a revolving seat, or pedal modifications. With such supports, a functional assessment will test for visual acuity; flexibility to look behind and check blind spots on the road; and strength for control of the steering wheel, brakes, accelerator, and clutch. An assessment also will test the driver’s knowledge about driving rules and what to do in emergency or unexpected situations.
A pdf of the article is available here.
Wednesday, March 30, 2016
The most recent issue of Experience, the magazine of the Senior Lawyers Division of the ABA, is focused on elder driving. There are nine articles on the topic, each taking a different focus. The topics include a view from the bench, licensing, psychology issues and technology. Great resources!
Monday, December 14, 2015
Ok, that title was supposed to be somewhat tongue in cheek, but there is some reality to it as well. According to an article in the Wall Street Journal on December 8, 2015, The Fastest-Growing Group of Licensed Drivers: Americans Age 85 and Up, "[n]ew data from the Federal Highway Administration shows people age 60 and above represented almost 26% of all driver’s license holders in 2014, up from 20.6% in 2004. Those younger than 30, on the other hand, make up about 21% of drivers, down slightly from 22% in 2004." Discussing the trend that younger generations are moving away from driving, the article notes
[S]ince 2000, people of every age cohort under 60 have been slowly letting their driver’s licenses lapse or have not been getting them in the first place.
Those 60 and above, meanwhile, are now more likely than before to have a valid driver’s license in their wallet.
People age 85 and up represent the fastest-growing group of licensed drivers, the FHWA said.
The article explains this trend is slow moving and offers reasons for its occurrence, especially costs. The article concludes with a comment that this changing demographic is also changing the highways: "[t]o help older drivers navigate the roads, the agency said it is working on new laminates to make highway signs brighter from further away."
Information about the Federal Highway Administration report is available here. The Administration's Handbook for Designing Roadways for the Aging Population is available here. The 2014 Highway Statistics Report is available here.
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, September 7, 2015
I hope everyone is lucky enough to have a colleague such as Professor Laurel Terry here at Dickinson Law. In addition to being the guru on regulation of lawyers, particularly for lawyers working across international borders, she's a good friend, organized, AND a guru of travel. Whenever I have a travel question, I know she probably has sorted out the options and will have great advice.
So, I wasn't surprised on this holiday Labor Day weekend that she had considered "generational" travel issues, including whether you can devise or inherit "frequent flyer miles."
Turns out you can ... depending. Professor Terry pointed to this Smarter Travel blog, addressing which airlines have clear policies on inheritance. You will want to look for your own favorite (least unfavored?) airline, but to summarize: "In sum, American, Continental, and US Airways say "yes," Air Canada says "maybe," Jet Blue and United say "no way," and the others ignore the issue."
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."
Thursday, October 2, 2014
Naomi Cahn, our colleague at GW Law who frequently alerts us to interesting stories, sent me a note about this recent story from the Washington Post on suicide tourism. Tourism to Switzerland for assisted suicide is growing, often for nonfatal diseases reports on an ongoing study in Switzerland that shows an increases in tourists in the Zurich area seeking assisted suicide.
The study, on "Suicide Tourism", was reported in the Journal of Medical Ethics. The August volume contains the article about the study: Suicide tourism: a pilot study on the Swiss phenomenon. The full article requires purchase (or subscription) but the abstract of the article is available and summarizes the article:
While assisted suicide (AS) is strictly restricted in many countries, it is not clearly regulated by law in Switzerland. This imbalance leads to an influx of people—‘suicide tourists’—coming to Switzerland, mainly to the Canton of Zurich, for the sole purpose of committing suicide. Political debate regarding ‘suicide tourism’ is taking place in many countries. Swiss medicolegal experts are confronted with these cases almost daily, which prompted our scientific investigation of the phenomenon. The present study has three aims: (1) to determine selected details about AS in the study group (age, gender and country of residence of the suicide tourists, the organisation involved, the ingested substance leading to death and any diseases that were the main reason for AS); (2) to find out the countries from which suicide tourists come and to review existing laws in the top three in order to test the hypothesis that suicide tourism leads to the amendment of existing regulations in foreign countries; and (3) to compare our results with those of earlier studies in Zurich. We did a retrospective data analysis of the Zurich Institute of Legal Medicine database on AS of non-Swiss residents in the last 5 years (2008–2012), and internet research for current legislation and political debate in the three foreign countries most concerned. We analysed 611 cases from 31 countries all over the world. Non-terminal conditions such as neurological and rheumatic diseases are increasing among suicide tourists. The unique phenomenon of suicide tourism in Switzerland may indeed result in the amendment or supplementary guidelines to existing regulations in foreign countries.
The Washington Post story discusses some possibilities for individuals seeking assisted suicide when they are not terminal; traveling while they are still able and having a terminal condition but not yet in the terminal phase were two of the reasons mentioned in the story. The Post story was produced by NewScientist and is also available here.
Tourism to Switzerland for assisted suicide is growing, often for nonfatal diseases
Tuesday, September 9, 2014
In Psychiatric Times, Dr. Anandhi Narasimhan, California-based and board certified in psychiatry and neurology, compares her professional and personal experiences with grieving following the death of her father. She writes well, and in additional to offering suggestions for coping, she shares this poignant detail from her father's life, which also served to introduce me to a new and intriguing idea, "dialysis at sea." She writes:
"My father was a distinguished scientist who placed value on education. Although he did not believe in lavishness, he always liked to present himself in a well-groomed fashion. I miss his sense of humor, and I have discovered how important such a quality can be when faced with tough times. Remembering his witty repertoire reminds me to celebrate his life.
The picture I have included [with her essay in Psychiatric Times] is from an Alaskan cruise my family took. We had talked about taking a cruise as a family in the past; this had been a dream of my father’s. When he was placed on regular dialysis treatments, he said, 'I guess now I won’t ever be able to go on a cruise.'
It wasn’t until I saw a poster advertising 'Dialysis at Sea' that I realized we could make his dream come true. With some logistical planning, transferring of medical records and such, we were able to take my father on an Alaskan cruise, an experience he both treasured and loved.When I was growing up, my father had a sort of utilitarian view of vacations—we often had to be doing and seeing things; they had to be productive. This vacation was different—it was nice to see him relax and enjoy the awesome beauty of Alaskan glaciers. His smile in the picture is how I would like to remember him: intelligent, positive, humorous, and charming."
Read more of "My Father's Influence" here.
Monday, September 1, 2014
The NY Times ran an article a few days ago about retirees who are spending the rest of their lives (or a substantial part thereof) traveling...abroad. The August 29, 2014 article, Increasingly, Retirees Dump Their Possessions and Hit the Road focuses on the rising number of individuals who choose to travel when they retire. The article cites to statistics from the Commerce Department that "[b]etween 1993 and 2012, the percentage of all retirees traveling abroad rose to 13 percent from 9.7 percent...." As well, over a quarter of a million Social Security recipients receive their benefits at an oversees address, close to "48 percent more than 10 years earlier...." The article discusses the value of post-retirement travel, from checking items off one's bucket-list, to quoting experts on how today's retirees are changing the notion of a "typical" retirement. One expert describes the travel value this way: "an extended postretirement trip can assuage a sense of loss from ending a career." Of course, many chose domestic travel over international, but the opportunities are there-whether to see the world, or to give back to a global community.
The article highlights a trend of sorts. Of course, not everyone may choose this path for retirement. But it does make for an interesting question when deciding where to spend the holidays when mom is now living in another country ....
Thanks to Stetson Law student Erica Munz for bringing the article to my attention.
Monday, August 18, 2014
Ever try to cross a busy street within the time of the walk light at a normal pace? Ever cross with someone using a walker or a manual wheelchair? Is the light long enough? If the light seems too short, perhaps it's not timed for the users. I ran into an article recently that studied this. Published in 2012 in Age & Ageing, Most older pedestrians are unable to cross the road in time: a cross-sectional study concludes that
most older adults either cannot walk 8 feet safely or cannot walk fast enough to use a pedestrian crossing in the UK. The health impacts on older adults include limited independence and reduced opportunities for physical activity and social interaction. An assumed normal walking speed for pedestrian crossings of 1.2 m/s is inappropriate for older adults and revision of these timings should be considered.
Although this is a UK study, it's instructive if we are to move more toward walkable communities and away from communities designed around cars.
Sunday, April 6, 2014
I was in Washington D.C. over the weekend and stopped by one of my favorite theaters, the Arena Stage. I was hoping to get a ticket for the much talked about play Camp David, but I'm happy to report it was sold out and instead I saw a play I knew nothing about.
Ann Randolph's play, Loveland, is "outrageous." But before you make assumptions, let me suggest the multiple ways the word applies. Loveland includes outrageously funny moments, justifiably outraged anger, and rage-worn poignancy. You are laughing one minute, and wiping away a tear in the next. And Randolph, the playwright and actress, manages to pull all of this off while seated on the north side of an airplane flying east, a spot chosen so that she can have the best views of our National Parks ... and remain close to her mother's ashes.
It is a one woman play -- but not a one character play. The articulation and pacing of the 75 minute show are brilliant. I guarantee you will join in (even if you feel very guilty for doing so) when she teaches you the latest tune for sing-alongs at your parent's nursing home.
Hurry to see it, especially if you want to catch the play in D.C., as Loveland is booked for just one more week at the Arena Stage's newest and most intimate venue, the Kogod Cradle.
Wednesday, January 29, 2014
From Afghanistan to Zimbabwe, bird watchers from more than 100 countries are expected to participate in the 17th annual Great Backyard Bird Count (GBBC), February 14–17, 2014. Anyone anywhere in the world can count birds for at least 15 minutes on one or more days of the count and enter their sightings at www.BirdCount.org. The information gathered by tens of thousands of volunteers helps track the health of bird populations at a scale that would not otherwise be possible. The GBBC is a joint project of the Cornell Lab of Ornithology and the National Audubon Society with partner Bird Studies Canada.
Thursday, November 14, 2013
U.S. Transportation Secretary Anthony Foxx today announced that the U.S. Department of Transportation (DOT), in its ongoing effort to ensure equal access to air transportation for all travelers, is requiring airline websites and automated airport kiosks to be accessible to passengers with disabilities. In addition, DOT will allow airlines to choose between stowing wheelchairs in a cabin compartment on new aircraft or strapping them to a row of seats, an option that will ensure that two manual, folding wheelchairs can be transported at a time.
The new rules are part of DOT’s continuing implementation of the Air Carrier Access Act of 1986.
“All air travelers should be treated fairly when they fly, regardless of any disabilities they may have,” said Secretary Foxx. “These new rules build on our past work in ensuring that our air transportation system is accessible for everyone, while balancing both airlines’ and passengers’ need for flexibility.”
Under the new websites-and-kiosks rule, covered airlines are required within two years to make pages of their websites that contain core travel information and services accessible to persons with disabilities, and to make all of their web pages accessible within three years. Websites are required to meet the standards for accessibility contained in the widely accepted Website Content Accessibility Guidelines (WCAG). The requirement applies to U.S. and foreign airlines with websites marketing air transportation to U.S. consumers for travel within, to or from the United States.
The rule also requires ticket agents to disclose and offer web-based discount fares to customers unable to use their sites due to a disability starting within 180 days after the rule’s effective date. Airlines are already required to provide equivalent service for consumers who are unable to use inaccessible websites. Under the new rule, airlines must also offer equivalent service to passengers with disabilities who are unable to use their websites even if the websites meet the WCAG accessibility standards.
In addition, any automated kiosks installed at U.S. airports for services -- such as printing boarding passes and baggage tags --must be accessible to passengers with disabilities until at least 25 percent of all kiosks at each airport location are accessible. Even if no new kiosks are installed, 25 percent of kiosks at each airport location must be accessible within 10 years. The standards for accessible kiosks are based on those set by the U.S. Department of Justice for ATM and fare machines in its 2010 Americans with Disabilities Act rule as well as the Section 508 standards for self-contained closed products, such as copiers.
Tuesday, October 1, 2013
Sweden is the best place in the world to be old and Afghanistan the worst, according to a UN-backed global study. The Global AgeWatch Index examined the quality of life of the elderly in 91 countries. It warns that many countries do not have adequate support in place for their ageing populations. By 2050, older people will outnumber children under 15 for the first time, with most of the elderly in developing countries, it said. The Global AgeWatch Index was complied by the UN Population Fund and advocacy group HelpAge International, and released to mark the UN's Day of Older Persons. Researchers used 13 different indicators - including income and employment, health provision, education, and environment - in what they said was the first study of kind to be conducted on a global scale. The study's authors say countries across the world face an ongoing challenge from the rapidly ageing global population.
Thursday, January 28, 2010
The Minnesota Gerontological Society has developed a program with Minnesota public television station tpt and other partners entitled "Love of Car: Transportation as We Age". Find the program at
www.mngero.org as well as additional resources about transportation issues implicating older people.
Monday, November 2, 2009
Help national leaders devise affordable, reliable public transit for seniors and persons with disabilities
Do you have suggestions and ideas that you would like to share with national leaders that can assist communities to increase access to affordable and reliable transportation services for people with disabilities, older adults, and people with limited incomes?
If so, you are invited to join a Federal Government
online outreach effort to develop new ideas for transportation access for
people with disabilities, older adults and persons of limited income! For more information, and to register, visit
the Dialogue website at www.UWRdialogue.org
The Federal Interagency Coordinating Council on Access
and Mobility (CCAM) invites you to participate in the United We Ride National
Dialogue. This groundbreaking, web-based interactive dialogue is designed to
allow a broader range of opinions and ideas to inform future policies, the CCAM
Strategic Plan and to strengthen the CCAM's relationship with its vast array of
partners and stakeholders, including state, local, and tribal governments,
transportation agencies, human service agencies, healthcare providers,
employment specialists, educators, and consumers.
In order to capture this critical feedback, the CCAM is
seeking your participation in a 2 week long, web-based dialogue that will begin
on November 2nd and end on November 13th. The dialogue will allow participants
to submit, comment, and rate ideas interactively on how to increase access to
affordable and reliable transportation services for people with disabilities,
older adults, and people with limited incomes. Your invaluable participation
will directly inform the work of the CCAM on future policy decisions and the
This dialogue is being organized by the National Academy of Public Administration and Easter Seals, in partnership with the National Resource Center for Human Service Transportation Coordination, the Federal Transit Administration, and the Office of Disability Employment Policy.