Tuesday, June 18, 2019

Paying for Aging in Place with Payroll Tax: State's Ideas

Kaiser Health News recently ran a story, Payroll Tax Is One State’s Bold Solution To Help Seniors Age At Home. According to the article,

[T]wo states — Washington and Hawaii — are experimenting with taxpayer-funded plans to help older residents remain in their homes.

Washington state’s ambitious plan, signed into law in May, will employ a new 0.58% payroll tax (or “premium,” as policymakers prefer to call it) to fund a $36,500 benefit for individuals to pay for home health care, as well as other services — from installing grab bars in the shower to respite care for family caregivers.

Hawaii’s Kupuna Caregivers Program, which was initiated in 2017, is also publicly funded, but state budget allocations limit enrollment and benefits. It provides up to $210 a week for services when family caregivers work outside the home at least 30 hours a week.

As the article notes, there is a growing need for caregivers. 

The number of Americans 65 and older will double to 98 million by 2050, and studies show few have the financial resources to pay for care in old age. More than half of adults 65 and up will require long-term assistance at some point with everyday activities, for an average duration of about two years, according to a 2015 study by the Department of Health and Human Services. Finding a way to help people stay in their homes — and not move to nursing homes — can keep them happier and save them and the state money. Medicaid programs help cover the costs of 62% of nursing home residents.

The article notes that other states are watching the results of these two innovative programs, but it will take some time to see the results. In Washington state, "[t]he state will begin collecting the payroll tax in 2022, and starting in 2025 residents can collect benefits if they have paid into the system for at least three of the previous six years or five consecutive years within a decade. The details will be set over the next few years, but to qualify for a benefit of up to $100 a day, which will be adjusted for inflation, a person must show they need help with at least three activities of daily living."  The program is projected to be a money-saver, to the tune of "$3.9 billion in state Medicaid costs by 2052."

Other states are exploring other solutions:

Minnesota is considering allowing people to convert life insurance plans to long-term care insurance.

...

Maine voters rejected a ballot proposal to provide free long-term care to residents, funded by a 3.8% income tax on residents making more than $128,400 a year. Instead, the state government is educating people about the need to buy long-term care insurance, including an awareness campaign in high schools.

The California Aging and Disability Alliance, an advocacy group, is considering a ballot initiative for a state program to provide long-term services and support.... Michigan and Illinois are also studying proposals.

New York lawmakers have debated a graduated income tax to pay for comprehensive long-term care for its citizens. The Assembly has passed such a bill repeatedly, but the state’s Senate has refused to approve it.

June 18, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, State Statutes/Regulations, Statistics | Permalink | Comments (0)

Monday, June 17, 2019

GAO Report on Elder Justice

The Government Accounting Office released a new report on Elder Justice.  Elder Justice: Goals and Outcome Measures Would Provide DOJ with Clear Direction and a Means to Assess Its Efforts explains the reason for this report

Why GAO Did This Study

Researchers estimate that as many as 1 in 10 older adults in the United States—age 60 or older—experience abuse each year. Elder abuse may involve physical, sexual, emotional, or financial abuse or neglect. It can occur by family, guardians, or caregivers as well as by strangers and international criminal enterprises, which operate schemes for monetary gain or to facilitate other criminal activities. According to media reports and congressional testimony, some older U.S. citizens who have traveled abroad have unwittingly participated in illicit activities, and in some cases, have been arrested in foreign countries.

EAPPA included a provision for GAO to review elder justice efforts in the federal criminal justice system. This report examines (1) the ways DOJ works to address crimes against older adults, and to what extent DOJ is planning for and assessing its efforts; and (2) how the Departments of State and Homeland Security address the arrest of older U.S. citizens abroad, including arrests involving international criminal enterprises. GAO reviewed agency policy documents, and interviewed agency officials, as well as a nongeneralizable sample of elder abuse stakeholders and state and local officials selected for their experience in this area.

Along with offering examples of scams and frauds targeting elders, the GAO report included a recommendation for DOJ "that DOJ develop and document elder justice goals and outcome measures to better guide its elder justice efforts."

The full report is available here.

 

 

June 17, 2019 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Cases, Federal Statutes/Regulations, Other | Permalink | Comments (0)

Friday, June 14, 2019

Ageism in Medicine? One Doctor's Thoughts

Kaiser Health News (KHN) ran a story last month, A Doctor Speaks Out About Ageism In Medicine.

Society gives short shrift to older age. This distinct phase of life doesn’t get the same attention that’s devoted to childhood. And the special characteristics of people in their 60s, 70s, 80s and beyond are poorly understood.

Medicine reflects this narrow-mindedness. In medical school, physicians learn that people in the prime of life are “normal” and scant time is spent studying aging. In practice, doctors too often fail to appreciate older adults’ unique needs or to tailor treatments appropriately.

The story focuses on a new book by a doctor, Elderhood"  which is "an in-depth, unusually frank exploration of biases that distort society’s view of old age and that shape dysfunctional health policies and medical practices." The rest of the article is a Q&A interview with the author focusing on her idea of "elderhood", how she sees her concepts working, and ageism.  Using an anecdote, the author offers it as an example of "ageism: dismissing an older person’s concerns simply because the person is old. It happens all the time."  Here is another example the author offers

Recently, a distressed geriatrician colleague told me a story about grand rounds at a major medical center where the case of a very complex older patient brought in from a nursing home was presented. [Grand rounds are meetings where doctors discuss interesting or difficult cases.]

When it was time for comments, one of the leaders of the medical service stood up and said, “I have a solution to this case. We just need to have nursing homes be 100 miles away from our hospitals.” And the crowd laughed.

The interview does have some optimistic insights, including "the age-friendly health system movement, which is unquestionably a step in the right direction. And a whole host of startups that could make various types of care more convenient and that could, if they succeed, end up benefiting older people."

June 14, 2019 in Books, Consumer Information, Current Affairs, Health Care/Long Term Care, Other | Permalink | Comments (0)

Thursday, June 13, 2019

Update on Litigation of Medicare's 2 Midnight Rule

The Center for Medicare Advocacy (CMA-full disclosure, I'm on their board) has been litigating with CMS on the observation status issue. The latest litigation on the observation status, Alexander v. Azar, has a new opinion decided on June 4, 2019.  On a motion for clarification and reconsideration filed by CMS, as well as a motion to seal, the Court in the June 4 order grants in part and denies in part the motion to seal and denies the motion for reconsideration and clarification.

Stay tuned.  This case is going to trial in the fall!

June 13, 2019 in Consumer Information, Current Affairs, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare | Permalink | Comments (0)

Wednesday, June 12, 2019

GAO Report on Disaster Assistance for Individuals With Disabilities and Elders

GAO has issued a new report, Disaster Assistance: FEMA Action Needed to Better Support Individuals Who Are Older or Have Disabilities. According to the GAO findings,

A range of officials from entities that partner with the Federal Emergency Management Agency (FEMA)—including states, territories, localities, and nonprofits)—reported challenges providing assistance to individuals who are older or have disabilities following the 2017 hurricanes. For example, officials said that many of these individuals required specialized assistance obtaining food, water, medicine, and oxygen, but aid was sometimes difficult to provide.Officials in Puerto Rico and the U.S. Virgin Islands cited particular difficultiesproviding this assistance due to damaged roads and communication systems, as well as a lack of documentation of nursing home locations. Based on GAO’s analysis of FEMA data and interviews with FEMA officials and stakeholders, aspects of the process to apply for assistance from FEMA after the 2017 hurricanes were challenging for older individuals and those with disabilities. According to stakeholders and FEMA officials, disability-related questions in the registration materials are confusing and easily misinterpreted. For example, FEMA’s registration process does not include an initial question that directly asks individuals if they have a disability or if they would like to request an accommodation for completing the application process (see figure below). While FEMA has made efforts to help registrants interpret the questions, it has not yet changed the language of the questions to improve clarity. As a result, individuals with disabilities may not have requested accommodations or reported having disabilities, which may have hindered FEMA’s ability to identify and assist them.

. . .
FEMA did not establish objectives before implementing its new approach to disability integration, which includes adding new disability integration staff in the regions and decreasing the number of disability integration advisors deployed to disaster sites. Without documented objectives for the new approach, regional leadership across the nation may implement changes inconsistently. In addition, the new approach shifts the responsibility for directly assisting individuals with disabilities to all FEMA staff. FEMA has taken some initial steps to provide training on the changes; however, it has not established a plan for delivering comprehensive disability-related training to all staff who will be directly interacting with individuals with disabilities. Developing a plan to train all staff would better position FEMA to achieve its intended goals and better equip deployed staff to identify and assist these survivors.

The full report is available here as a pdf.

June 12, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, Other | Permalink | Comments (0)

Tuesday, June 11, 2019

Maine May Pass MAD

Maine may be the latest state to pass medical aid-in-dying according to the Washington Post. The article explains the Maine House passed the bill by a one vote margin, Maine could allow terminally ill to get life-ending meds. Two days later, CNN reported that the bill has been sent to the Maine governor, Maine legislature sends bill effectively legalizing assisted suicide to governor. "The legislation, called the "Maine Death with Dignity Act," would allow mentally-competent patients over the age of 18 'to make a request for medication prescribed for the purpose of ending the person's life.'"  The vote in the Maine Senate was also close, but not quite as close as in the Maine House, passing the Senate 19-16.  The article notes that the bill "states that it does not legalize medically-assisted suicide, though if enacted, it would effectively do so."

June 11, 2019 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Health Care/Long Term Care, State Statutes/Regulations | Permalink

Monday, June 10, 2019

Dementia & the Ethics of Choosing to Die

The Hastings Center has announced a new and very important research project. Dementia and the Ethics of Choosing When to Die will focus on basic issues surrounding an individual's ability to exercise end of life choices when suffering from dementia. As the announcement explains

As the American population ages and dementia is on the rise, The Hastings Center is embarking on pathbreaking research to explore foundational questions associated with the dementia trajectory and the concerns of persons facing this terminal condition. This new research is made possible by a major grant to The Hastings Center from The Robert W. Wilson Charitable Trust as part of its visionary support for the Center’s research and public engagement on ethical challenges facing aging societies.

...

During the dementia trajectory, a person experiences progressive impairment of cognitive abilities – including memory, problem-solving, and language – as well as changes in behavior and physiological functions. As cognition deteriorates, a person with dementia will need daily assistance and eventually total care, often in an institutional setting, for several years before physical deterioration progresses to death from pneumonia or another condition associated with severe dementia. There are no effective treatments to cure or halt the progression of dementia. Alzheimer’s disease, the most common form, is the sixth leading cause of death in the U.S.  Vascular dementia, the second most common form, may develop following stroke.

In 2018, 5.7 million Americans were living with dementia. An estimated 12 million others will be at high risk for developing dementia over the next 30 years as the baby boom generation lives into their 80s and 90s.

In the U.S., the basic legal right to be free of unwanted treatment is long established. People with decision-making capacity have the right to forgo life-sustaining treatment they do not want. People who lack decision-making capacity have the same right through the use of an advance directive or a surrogate decision-maker. However, this longstanding legal framework and ethical consensus does not fully reflect the situation of a person facing dementia if this person has no medical treatments to refuse. Also, the timeframe in which a terminally ill person with decision-making capacity can request and use medical aid-in-dying (MAID), now legal in nine U.S. jurisdictions, does not correspond to the dementia trajectory.

...

Through literature review and workshops, a Hastings Center work group will conduct an ethical analysis of end-of-life choices in the context of dementia, identifying areas where further research or policymaking is needed. In exploring these emerging issues, the work group will also consider how the field of bioethics should contribute to research, policy solutions, and public understanding to improve the experiences of living with dementia and caring for people with the condition. Products will include a special report, to be published in 2021.

“Population aging raises profound questions about how a society values the experiences of aging and caregiving,” says Berlinger. A separate Wilson Trust grant will build on a recent Hastings Center special report to support events and publications on how policymakers, practitioners, and the public can promote inclusion and equity for older adults and caregivers. Learn more about the dementia project and the aging societies project.

June 10, 2019 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Statistics | Permalink | Comments (1)

Friday, June 7, 2019

Elder Justice Resources Hub from ACL

The Administration for Community Living (ACL) unveiled the Elder Justice Resources Hub which incorporates the work of several agencies, including NCEA (National Center on Elder Abuse),  NCLER, (National Center on Law & Elder Rights), NAMRS,(National Adult Maltreatment Resource Center),  NORC (National Long-Term Care Ombudsman Resource Center), PHA (Pension Help America), NRCWRP (National Resources Center on Women & Retirement Planning) and APS-TARC (APS Technical Assistance Resource Center) The website explains

No matter how old we are, justice requires that all people are equal and full members of our communities, and the safety and dignity of all its members are preserved, including older adults and people with disabilities. Unfortunately, we do not always live up to this ideal. Committed to developing systems and programs that encourage justice, prevent abuse, and provide protection and support to those in need, the Administration of Community Living (ACL) seeks to change how our society thinks of older people and those with disabilities and what we can do to enable their participation. Just like a stable building requires a strong set of support beams, we need a solid social structure so that older people and those with disabilities can live their lives to the fullest, participate in our communities, and live free from abuse and neglect.

Don't forget as well, the DOJ Elder Justice Initiative, which also has a lot of research and resources!

This website highlights some of ACL’s efforts to build public and professional understanding about elder abuse and strengthen the social supports needed to prevent it. Strong, stable communities with structures to support people of all ages and abilities not only ensure justice and dignity for older people and adults with disabilities, but also secure the wellbeing and quality of life for us all.

June 7, 2019 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Health Care/Long Term Care | Permalink | Comments (0)

Thursday, June 6, 2019

Good News Out of Alabama for SNT Beneficiaries

One piece of good news from Alabama that caught my eye was the passage of a new law regarding pensions and Special Needs Trusts.   Here is the press release from the firm of one of the attorneys integrally involved in this legislative effort:

A new act has been passed by the Alabama Legislature and signed into law by the Governor that will allow participants in the Retirement Systems of Alabama (“RSA”) pension plan to direct proceeds to pass to a special needs trust for a beneficiary with a disability who receives government benefits.  Sirote & Permutt shareholder, Katherine N. Barr, a member of the firm’s Private Clients Trusts and Estates Group, recognized the need for this important statutory change when doing estate planning for RSA employees and retirees who wanted to leave their RSA pensions to children with disabilities receiving SSI and Medicaid.  The RSA provisions required the pension payment to be paid directly to the child, which caused a loss of these critical government benefits in most cases.  With input from RSA, Ms. Barr prepared legislation to correct this problem.  State Senator Cam Ward from Alabaster, Alabama introduced the legislation as SB 57 this session and State Representative Matt Fridy from Montevallo, Alabama introduced to it the House.  Both the House and Senate passed it unanimously. Governor Ivey signed the legislation on May 22, 2019.  The Act covers all RSA retirement plan participants and will become effective August 1, 2019.  Ms. Barr states that it took more than three years to obtain this result.  This legislation will benefit individuals with disabilities for years to come by allowing them to receive the pension payments in a manner that will not affect their Medicaid and SSI payments. The pension can now be directed to a certain type of special needs trust upon the death of the plan participant.  The trust can be set up in advance or following the participant’s death.  The Alabama Family Trust can be designated to receive the benefit, as can a private trust. 

Well done Katherine!

June 6, 2019 in Consumer Information, Current Affairs, Estates and Trusts, Health Care/Long Term Care, Retirement, State Statutes/Regulations | Permalink

Tuesday, June 4, 2019

Stan Lee-Another Victim of Elder Abuse?

Stan Lee may have created a superhero universe, but he had no superhero to protect him from alleged elder abuse, according to a recent article in the Washington Post. As Stan Lee’s ex-caregiver is arrested, last year’s videos provide an illuminating lens on his elder-abuse case explains that Mr. Lee's "adviser and confidant" had  been arrested and "appeared in [an Arizona court] on a charge of being a fugitive of justice,  ... accused of 'fleeing California charges of fiduciary elder abuse....'”   According to the article, the charges filed in California include "theft, embezzlement, forgery/fraud against an elder and false imprisonment of an elder."  One twist in this case is a video made by Mr. Lee some time ago in which he claimed he was not a victim of elder abuse.  Now there are claims that the video wasn't done of his own free will.  You can view the video in the article.

All I can say is stay tuned....

 

June 4, 2019 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Monday, June 3, 2019

Caregivers and the Impact on Their Financial Security

The GAO recently released a study examining the financial implications to caregivers.  Retirement Security: Some Parental and Spousal Caregivers Face Financial Risks explains

[a]bout 10% of Americans per year cared for an elderly parent or spouse from 2011 through 2017. These family caregivers may risk their long-term financial security if they have to work less or pay for caregiving expenses such as travel or medicine.

More than half of people who cared for parents or spouses said they went to work late, left early, or took time off for care

Spousal caregivers at or near retirement age had less in retirement assets or Social Security income than non-caregivers

Experts and studies identified ways to potentially improve caregivers' retirement security, such as increasing their Social Security benefits

The full 71 page report is available here as a pdf, while the highlights are available here.  Here is a synopsis of the highlights

Some caregivers experienced adverse effects on their jobs and had less in retirement assets and income.

  • According to data from a 2015 caregiving-specific study, an estimated 68 percent of working parental and spousal caregivers experienced job impacts, such as going to work late, leaving early, or taking time off during the day to provide care. Spousal caregivers were more likely to experience job impacts than parental caregivers (81 percent compared to 65 percent, respectively).
  • According to 2002 to 2014 data from the Health and Retirement Study, spousal caregivers ages 59 to 66 had lower levels of retirement assets and less income than married non-caregivers of the same ages. Specifically, spousal caregivers had an estimated 50 percent less in individual retirement account (IRA) assets, 39 percent less in non-IRA assets, and 11 percent less in Social Security income. However, caregiving may not be the cause of these results as there are challenges to isolating the effect of caregiving from other factors that could affect retirement assets and income.

 

June 3, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, Other, Retirement, Statistics | Permalink | Comments (0)

Friday, May 31, 2019

Check out the 2018 Profile of Older Americans

Yes, yes, we are almost half-way through 2019, but here is the 2018 Profile of Older Americans!   The Administration for Community Living (ACL) explains that "[t]he Profile of Older Americans is an annual summary of critical statistics related to the older population in the United States. Relying primarily on data offered by the U.S. Census Bureau, the Profile illustrates the shifting demographics of Americans age 65 and older. It includes key topic areas such as income, living arrangements, education, health, and caregiving. The 2018 Profile also incorporates a new special section on emergency and disaster preparedness." You can access the 20 page profile as a pdf here or access the data in a spreadsheet here.  You can also access the data for prior years from the landing page.

The highlights reveal some interesting stats, including

Older women outnumber older men at 28.3 million older women to 22.6 million older men.

In 2017, 23% of persons age 65 and over were members of racial or ethnic minority populations--9% were African-Americans (not Hispanic), 4% were Asian (not Hispanic), 0.5% were American Indian and Alaska Native (not Hispanic), 0.1% were Native Hawaiian/Pacific Islander (not Hispanic), and 0.8% of persons 65 and older identified themselves as being of two or more races. Persons of Hispanic origin (who may be of any race) represented 8% of the older population.

A larger percentage of older men are married as compared with older women---70% of men, 46% of women. In 2018, 32% older women were widows.

About 28% (14.3 million) of older persons lived alone (9.5 million women, 4.8 million men).

Among women age 75 and over, 44% lived alone.

Among adults age 75 and over, 42% report the television is their first source of emergency information as compared with 31% for the total population. The percentage of older adults receiving information from the internet (9%) is much lower than for the total population (31%).

May 31, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Other, Statistics | Permalink | Comments (0)

Thursday, May 30, 2019

Rocking On Regardless of Age!

Here's an inspiration for you. Whether you are a big band aficionado, love swing, rock 'n roll, metal, classical, rap, or something else, your appreciation of music has no age limit.  This story made me happy! 2 elderly men sneak out of nursing home to attend heavy metal festival covers the story.

You're never too old to rock on. Two elderly men managed to slip away from their nursing home in Germany to attend the Wacken Open Air, the largest heavy metal festival in the world, over the weekend, authorities said. 

According to Itzehoe police, the pair was eventually found Friday at 3 a.m. local time at the festival after their retirement home in Dithmarscher reported them missing. Police told the Deutsche Welle the men were found "disorientated and dazed."

The metalheads were apparently reluctant to leave the four-day festival in Wacken. They had to be escorted home with a taxi and a patrol car as a "precaution," police said.

Of course, safety is an issue.  I don't mean to make light of what might have happened. But dudes, rock on!  (P.S. One of my colleagues who is a big music fan offered to represent them for free if they need lawyers).

 

May 30, 2019 in Current Affairs, International, Music | Permalink | Comments (0)

Wednesday, May 29, 2019

Denver's Dementia-Friendly Initiative

A number of cities have undertaken to become dementia-friendly as part of the dementia-friendly America initiative. Denver's efforts are aimed at "improv[ing] the quality of life for people with dementia and their families in the Denver area." The national initiative, started in 2015 is a "grass roots not for profit project [that] is spreading throughout the US with hundreds of cities participating and more joining every month."  The community's efforts are unique to the community and fall within these areas "Business, Legal, Financial, Government, Healthcare, Independent Living, Care Communities, Academia, Community Services, and the Faith Community."

age-friendly_dementia-firendly

Denver's projects range from community education to resource guides, to recognizing businesses that are making efforts and more.

 

May 29, 2019 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Other | Permalink | Comments (0)

Monday, May 27, 2019

End of Life Case in France

Dr. Jay Wolfson, who served as the guardian ad litem in the Schiavo case, recently sent me a link to a BBC story about Vincent Lambert. Vincent Lambert: Life support must resume after court reverses ruling explains that after the Paris Appeals Court ruling, doctors had to resume life support for Mr. Lambert, in a vegetative state since an accident in 2008. His spouse supports terminating life support, while his parents oppose it.  When reading the article, I couldn't help but notice the similarities to some occurrences in Schiavo.  

The dispute has spread beyond the family of Mr. Lambert.  "The UN's Committee on the Rights of Persons with Disabilities had called on France to intervene and delay the move to withdraw the life support while they investigated his case further. France's ministry of health said it was not bound by the committee."

A follow up article was published in the Sunday Times (subscription required).

May 27, 2019 in Advance Directives/End-of-Life, Health Care/Long Term Care, International | Permalink | Comments (0)

Sunday, May 26, 2019

The Science of Being Susceptible To Scams

Marketplace recently ran a story about fascinating research on whether there is a correlation between age and susceptibility to scams.  Age of fraud: Are seniors more vulnerable to financial scams? opens with the story of one individual who fell victim to a "gift card" scam of almost $200,ooo. Think it can't happen to you? Here is where the science comes in.

[A researcher] and his colleagues have put a label on what they see as an all-too common condition: “age-associated financial vulnerability.”

“We are learning that there are changes in the aging brain, even in the absence of diseases like Alzheimer’s disease or other neurodegenerative illnesses, that may render older adults vulnerable to financial exploitation.

The science is showing that older folks

ability to detect sketchy situations may decline. Or, we may become prone to seeing the upside of a risky deal and blow off the downside. Some people are more inclined to believe the last person they spoke to. Others may lose the ability to push back on a high-pressure predator. Researchers emphasize that this phenomenon goes way beyond changes in the brain.

“It also involves all of these other social and environmental factors like social isolation, like cultural factors and societal factors, like older adults having more wealth compared to younger generations,” said Marti DeLiema, a research scholar at the Stanford Center on Longevity.

Still think it can't happen to you? The researchers are examining "age-related financial vulnerability[and]  are very interested in physical changes to the aging brain, the way eyesight and hearing can get less keen. In some cases, a new pattern of making mistakes with money may be a harbinger of cognitive bad things to come, the “first thing to go,” as it were"

Still think it can't happen to you? Read on.  The optimal age for money management is 53 years old, according to the article.  There is some advantage to age; the life experiences we acquire.  Now we all know, as the article reflects, that scams don't just target older persons.   There is no easy answer to the issue. How do you protect people from making bad decisions  or from falling for a scam?  The article references various state approaches and the federal Elder Abuse Prevention and Prosecution Act. FINRA is also asking brokers to "encourage customers to list the name of a trusted person to contact if something signals “scam.” Banks have no such rule."

The remainder of the article focuses on the responses and need for more work. Several experts offer suggestions for responses. I thought this one response was poignant: "abuse of the elderly is, at its core, lack of social support. The cure is social support. It’s possible that the best way to help vulnerable loved ones is just to be there, to be present in their lives."

Think this can't happen to you? Think again. And read this article.

May 26, 2019 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Science, State Statutes/Regulations, Statistics | Permalink | Comments (0)

Saturday, May 25, 2019

Decision-Making Supports Guardianship Course

The National Center for State Courts has announced the release of a new guardianship course, Finding the Right Fit: Decision-Making Supports and Guardianship.

According to the press release, this interactive on-line course covers

How to support friends and loved ones in making their own choices about their health, finances, and lifestyle.

Legal options, including powers of attorney and advance directives. How to become a guardian.

How a guardian can support a person’s decision-making.

Identifying and understanding the risk of abuse, neglect, and exploitation that comes with any of the above options.

The course takes about 2 hours to complete and you have to create an account to access it. Check it out!

May 25, 2019 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Programs/CLEs, Webinars | Permalink | Comments (0)

Thursday, May 16, 2019

Needing LTC but Unable to Afford It

The New York Times ran an article recently that doesn't bode well for many elder Americans.  Many Americans Will Need Long-Term Care. Most Won't be Able to Afford It reviews what is referred to as

the middle-class bind ... [where the elder has t]oo much money to qualify for Medicaid or subsidized housing, but not enough to pay for long-term care, an industry that has primarily pursued the well-off. ...

A recent analysis in Health Affairs, pointedly titled “The Forgotten Middle,” investigated how many middle-income seniors will be caught in that bind. The numbers were grim.

Using data from the national Health and Retirement Study, including personal income and assets and health status, the researchers defined the middle-income cohort as Americans from the 41st to the 80th percentile in terms of financial resources....

In 2029, for people 75 to 84 (ages when they’re likely to need long-term care), that would mean access to about $25,000 to $74,000 a year in current dollars. Over age 85, the middle-income category extends to $95,000.

The projection is that two-thirds are going to need some type of long-term care, yet "more than half will be unable to pay assisted living fees and medical costs in 2029, the study found." Even those owning a home aren't as house-rich as they may think.  Plus this group has a lot of debt, and not that much in savings.

Consider this:

The United States, unlike many Western democracies, has never created a broad public program covering long-term care. Medicare pays for doctors, hospitals, drugs and short-term rehab after hospitalization — not for independent or assisted living.

That could change one day — imagine a new Medicare Part LTC — but “that will be incredibly difficult to achieve politically,” [said one expert].

Policy types instead suggest more incremental changes by both government and industry. Perhaps Medicaid could cover seniors with slightly higher incomes, or modify its regulations to include housing costs along with health care.

May 16, 2019 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Medicare | Permalink | Comments (0)

Wednesday, May 15, 2019

Maps of America Aging

Professor Naomi Cahn sent us the link to this recent article, 7 maps that tell the incredible story of aging in America. "Census projections show a major demographic shift already underway and accelerating in the years to come. ...At the same time, populations are not aging evenly, and issues related to aging will impact individual communities in vastly different ways, boosting economic opportunity in some areas while putting a strain on social services in others."

One way to sort out who will be most impacted by aging is to look at age demographics across the country and how they will change over time. Using data from the U.S. Census Bureau and its own updated demographics, spatial-analytics firm Esri put together for Fast Company an exclusive map series that examines the issue from a number of angles, including a district-by-district breakdown of the median age in 2010 and the projected median age in 2023. The result is a compelling visual record of both who we are right now and where we are heading–a temporal snapshot for the ages, so to speak.

 

There are links to maps on the following topics:

May 15, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Other | Permalink | Comments (0)

Tuesday, May 14, 2019

California ALF Resident Evicted for Not Paying Rent

That headline may have elicited a shoulder shrug from you and a fleeting thought as to why I thought this was newsworthy enough to be the subject of a blog post.  So how about if I add some info for you?  What if the story's title is this? Medi-Cal recipient, 101, evicted from Santa Rosa assisted living facility for being unable to pay. This is a situation where the elder outlived her savings. As the story explains

[The resident] like most people, probably never thought she’d live to be 101, and she clearly did not expect to be paying nearly $7,000 a month to be living in a senior residential care facility.

The expense drained her of all the money she had after selling her modest home in Santa Rosa’s Holland Heights neighborhood in 2013. By November of last year, all [the resident] could afford to give ...  the assisted living facility, was her monthly Social Security check of about $1,300 — it wasn’t enough. ...

On April 18, [the resident], who suffers from dementia, was wheeled into Sonoma County eviction court on Cleveland Avenue. With her bank account drained, the former real estate agent was now receiving Medi-Cal, the state’s version of Medicaid health insurance, which the private-pay [ALF] le did not accept.

The story ultimately has an ending-a Medi-Cal bed was located for the resident. The story goes on to focus on the lack of beds in the area, the cost of long-term care, and the problem for folks like the elder in this story who outlives her savings.

Thanks to Julie Kitzmiller for alerting me to this story.

May 14, 2019 in Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Housing, Medicaid, State Cases | Permalink | Comments (0)