Elder Law Prof Blog

Florida Health Care Association issues report on protecting elders during hurricanes

A newly issued report titled "Caring for Vulnerable Elders During a Disaster: National Findings of the 2007 Nursing Home Hurricane Summit," contains ten agreed upon key recommendations to improve how frail and elderly citizens are cared for during a major disaster.

The report, funded by the John A. Hartford Foundation, is a result of two years of research and two planning summits where state, federal, and local emergency planning teams, including representatives from FEMA, CMS, and HHS, shared information and ideas with nursing home leadership.

"We all agree that integrating the needs of the elderly into regional emergency planning processes can save lives." said LuMarie Polivka-West of the Florida Healthcare Association, which convened the Hurricane Summits of 2006 and 2007 that led to the development of the report. "Now, with a greater understanding of everyone's needs, we have developed better solutions to care for our most vulnerable citizens."

The CDC determined that the elderly accounted 70 percent of the deaths in New Orleans from Hurricane Katrina, with at least 139 storm-related fatalities having occurred in nursing homes.

Some of the  key recommendations include:

 

1. Nursing homes must be incorporated into disaster response systems at all levels--national, state, and local.
2. Disaster response systems, including Emergency Operations Centers (EOCs), must designate nursing homes as "health care" facilities. These facilities must receive the same priority status for restoration of utilities (e.g., power, phone service) as hospitals, and may need enhanced police protection during community recovery.
3. Shelter in place, when possible, and harden the physical plant to withstand hurricane winds and provide emergency power.
4. Long-term care providers must know their storm surge/flood zone, the capacity of the facility's infrastructure to withstand hurricane winds, and must develop viable plans for evacuation or sheltering in place in accordance with their facility's risk.

Conference on legal and medical issues with capacity

SWAP-C GEC: South, West, and Panhandle Consortium Geriatric Education
Center at

            The University of Texas Health Science Center at San Antonio
            2007 Medico~Legal Issues in Aging "Competence and Capacity"
            San Antonio, TX
            September 28, 2007

*    Register for the Conference Now!

Woodbury College in VT to offer MS in "law" focusing on elder and health law issues

Woodbury College has announced the addition of a master of science in law degree, designed to help non-law professionals gain legal knowledge and skills to enhance their marketability.  College President Larry Mandell announced the new program this week.  Woodbury's M.S. in law will be the nation's only fully online program that focuses on managerial, human resource, elder and health law. The program will eqiup human resource workers, health professionals and educators with knowledge in the areas of contracts, employment law,the administrative and regulatory dimensions of their work, liability and privacy and other constitutional issues.  Mandell says the program also has special value for foreign attorneys and foreign business executives who want to understand the American legal system, and for paralegals who want advanced training and an advanced degree.

Source/more:  Burlington (VT) Press, http://www.burlingtonfreepress.com/apps/pbcs.dll/article?AID=/20070828/NEWS/70828015/-1/NEWS05

Number of uninsured Americans climbs

New Census data show that in 2006, both the number and the percentage of Americans who are uninsured hit their highest levels since 1999, the first year for which comparable data are available, with 2.2 million more Americans — and 600,000 more children — joining the ranks of the uninsured in 2006.  Today’s figures also show that while the overall poverty rate declined slightly (from 12.6 percent to 12.3 percent) between 2005 and 2006, the decline was largely concentrated among the elderly.   The poverty rates for children and for working age adults remained statistically unchanged as compared to 2005, and well above their levels in 2001, when the last recession hit bottom Similarly, while median income rose modestly (by 0.7 percent, or $356) for households in general, this merely brought median income back to where it stood in the 2001 recession year.  In addition, median income for working-age households — those headed by someone under 65 — remained more than $1,300 below where it stood when the recession hit bottom.

Read more at the Center for Budget and Policy Priorities

Not elder law: world's oldest bling tells tales about Earth's early years

Earth is roughly 4.5 billion years old, but her early eons were tempestuous. Not even rock survives from the first 500 million years of her life—an eon known as the Hadean—because geologists speculate the planet's surface boiled and bubbled with molten lava under a steady bombardment of comets and meteorites. But tiny diamonds discovered in antediluvian zircon crystals sprinkled in three-billion-year old rocks from Australia hint that the planet's surface fire might have ceased much earlier than previously believed.

Mineralogy graduate student Martina Menneken of the Westfälische Wilhelms–University of Münster in Germany and her colleagues probed 1,000 of these ancient zircon crystals for inclusions—tiny outcroppings of other minerals hidden in the unusually stable lattice. They discovered diamonds of different shapes and sizes in 45 of the old crystals by using a laser technique called Raman spectroscopy.

Source/more:  Scientific American, http://www.sciam.com/article.cfm?articleID=8F37399C-E7F2-99DF-30361B86A598909B&chanID=sa007

Fabulous new elder law casebooks now available!!!

Elder Law: Cases and Materials, Fourth Edition, 2007   

Lawrence A. Frolik, Professor of Law, University of Pittsburgh School of Law;
Alison McChrystal Barnes, Professor of Law, Marquette University Law School

Elder Law: Readings, Cases, and Materials, Third Edition, 2007 

A. Kimberley Dayton, Professor of Law, William Mitchell College of Law
Molly M. Wood, Esq., Stevens & Brand, LLP, Lawrence, KS
Julia Belian, Visiting Associate Professor of Law, University of Missouri at Kansas City School of Law

Elder Law: Selected Federal Statutes and Regulations, 2007 Edition

Lawrence A. Frolik, Professor of Law, University of Pittsburgh School of Law;
Alison McChrystal Barnes, Professor of Law, Marquette University Law School

Elder Law: Statutes and Regulations, 2007

A. Kimberley Dayton, Professor of Law, William Mitchell College of Law
Molly M. Wood Esq., Stevens & Brand, LLP, Lawrence KS
Julia Belian, Visiting Associate Professor of Law, University of Missouri at Kansas City School

And feel free to contact me if you'd like a recommendation (ik, just kidding,  Larry)...

And thanks to Jon Forman for making this so easy for me...

Upcoming conferences

UNIVERSITY OF SOUTH FLORIDA SYMPOSIUM/CONTINUING PROFESSIONAL EDUCATION COURSE: "The Art of Medicine At The End Of Life," to be held Nov. 2, 2007 in New York, New York. For more information see:  http://www.cme.hsc.usf.edu/artofmedicine/

UNIVERSITY OF WISCONSIN-MADISON INSTITUTE ON AGING: "19th Annual Colloquium on Aging," to be held in Madison, Wisconsin, Oct. 18, 2007). For more information see:  http://www.aging.wisc.edu/

Schwartzenegger budget cuts funding for elder abuse prevention

California Governor Arnold Schwartzenegger used his line-item veto to cut a funding increase of $12 million to Adult Protective Services, a statewide program to protect elder and dependent adults from physical abuse and neglect and financial abuse.  “I know that this was a tough budget year, but I cannot believe that the governor chose to abandon the elderly and the disabled,” Lee Collins, director of the San Luis Obispo County Department of Social Services, said in a statement.  County APS investigators respond to 70 reports of abuse a month—up 45 percent from a year ago, according to Collins.

Tax breaks for wealthy ranchers remained intact, however.

Source:  San Luis Obispo dot com, http://www.sanluisobispo.com/news/local/story/126005.html

Recent publications on end of life issues

Kathryn L. Tucker, Privacy and Dignity at the End of Life: Protecting the Right of Montanans to Choose Aid in Dying, 68 Mont. L. Rev. 317-333(2007).

CBO projects deficit...again

CBO expects the 2007 deficit to total $158 billion--a $90 billion decline from the deficit recorded for 2006. Nevertheless, the budget outlook for the long term remains daunting, primarily because of rising costs for health care.

The Budget and Economic Outlook: An Update,  August 2007  pdf  data  charts

Britain's High Court upholds limits on treatment for Alzheimer's disease

Campaigners and drug makers failed last week in their High Court bid to overturn guidance recommending only limited coverage on the NHS of drugs to treat Alzheimer's disease. This was the first major legal challenge to guidance issued by the National Institute for Health and Clinical Excellence (NICE), the body that recommends which drugs are available on the NHS in England and Wales.
Mrs Justice Dobbs ordered NICE to amend the existing guidance, having ruled that its diagnostic criteria breached the Disability Discrimination Act and the Race Relations Act. NICE undertook to make the relevant changes within 28 days—but the core of the guidance will remain unchanged. The guidance recommends against the use of donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl) in patients with mild to moderate Alzheimer's disease and against the use of memantine (Ebixa) in moderately severe to severe disease.

Source:  High Court upholds NICE (National Institute for Health and Clinical  Excellence) decision to limit treatments for Alzheimer's disease," by Owen  Dyer (Vol. 335, No. 7615, Aug. 18, 2007, p. 319).

http://www.bmj.com/cgi/content/extract/335/7615/319

Sex, seniors, and rock n roll

....on the sex lives of seniors...reader discretion advised!

  AStudy of Sexuality and Health among Older Adults in the United States," by Stacy Tessler Lindau, L. Philip Schumm, Edward O. Laumann, Wendy Levinson, Colm A. O'Muircheartaigh, and Linda J. Waite (Article abstract, Vol. 357, No. 8, Aug. 23, 2007, p. 762-774).

http://content.nejm.org/cgi/content/abstract/357/8/762

Related US National Institutes of Health News Release: "Study Sheds New Light on Intimate Lives of Older Americans: Older Adults Are Active Despite Increased Sexual Problems with Age" (Aug. 22, 2007).

http://www.nih.gov/news/pr/aug2007/nia-22.htm

"Sex and Aging," by John H.J. Bancroft (Editorial extract, Vol. 357, No. 8, Aug. 23, 2007, p. 820-822).

http://content.nejm.org/cgi/content/extract/357/8/820

New statistical reports of interest

UNITED NATIONS POPULATION DIVISION REPORT: "World Population Ageing:  2007" (August 2007)

http://www.un.org/esa/population/publications/WPA2007/wpp2007.htm

POPULATION REFERENCE BUREAU ARTICLE: "Disability and Aging," by D'Vera Cohn, Mark Mather, and Marlene Lee (August 2007).

http://www.prb.org/Articles/2007/DisabilityandAging.aspx

 

The Dayton family reunion

Probably not appropriate to the mission of the Law Professors Blog Network, but with the "baby " (Uncle Philip) among my father's eight siblings now eligible for Medicare, I guess it is close enough to "elder law" to include here:  an account of the Dayton family reunion, which I missed this time, by my cousin Jim Bishop: 

A similar scenario unfolded as descendants of the late Robert P. and Rhoda Y. Dayton, my maternal grandparents, held another family gathering at this site the weekend of Aug. 4-5.A good turnout — 112 out of a possible 147 relatives came from Pennsylvania, Maryland, Virginia, Ohio, North Carolina, and the farthest came from Colorado. We represented a broad spectrum of ages, occupations, special interests and travel experience as revealed in a family directory assembled by cousin Linda Dayton Thompson.The Dayton homestead, nestled in the heart of Fairview Valley in Mineral County, W.Va., looms ahead, with its long red barn with white trim, Holstein cattle, towering silos, rows of electric fence, everything in neat order and inviting. I regretted that my 85-year-old mom, Ann Dayton Bishop, oldest of the nine Dayton siblings, wasn’t able to attend for physical reasons, but I sensed her presence. The other lament: For myself, a family reunion is over by the time things really get fired up. I determined to try to talk with every person present, but fell miserably short.  The last Dayton reunion, in 2002, opened with my Uncle Art Dayton presenting a scroll that he had prepared and mounted on a wall. The large parchment was a timeline with photographs of Dayton family members no longer living — 11 in all — including Uncle Art’s son, Artie Jr., who died in a car accident in 1983.

Read more:  http://www.dnronline.com/saturdaymagazine_details.php?AID=11745&sub=Bishop's%20Mantle

Ed:  Art is my dad, and Artie Jr. is my brother. 

Nigeria's--and maybe the world's--oldest law student!

At an age close to 80 years with a child of his already a lawyer, Pa Benedy Ogbole Igene has just finished his first session second semester law examination.   PAPA:  That is his sobriquet among his peers. No other sobriquet appears more apt. He is a Papa among other Papas and Mamas at the Ibadan Centre of the National Open University of Nigeria (NOUN). Though blessed with a boyish and sportsmanlike figure, both the centre overseer, facilitators and other grandpa students call him Papa and bow when greeting him. A close contact with him will show that, indeed, the difference is clear. If former President Olusegun Obasanjo were to be in his centre, he would have no option than to call him Egbon, meaning elder. 

His sojourn in life has not had much of pleasant experiences. Rather, his life has been like someone who had his umbilical cord tied to crises when coming to the world. Said he to Mid-Week Tribune: “The period I was in my mother’s womb was a mystery. I was born long before what doctors now call Expected Delivery Date (EDD). When I was born, villagers who knew of my birth did not rejoice with my mother. Some days after, some of them came to my mother and asked Ogbole? meaning can he survive? Others called me Izagodo, meaning empty vessel. For four months, I was not christened. My mother addressed me as Omo, meaning my baby. It was when I grew up that my mother told me all these.”  In his resume, he has to his credit, so to say, work experiences as a house boy, gardener, cook and shop sweeper to mention a few. But he was resolute and dogged. “As a houseboy, I was eager to go to college. When they sent me out to go and sell kerosene or bread, I will stop at the market and help some women to sweep their shops for a fee. I used this money to purchase form and wrote entrance examination into Immaculate concession, Benin but I didn’t have money to go for the interview. This propelled me to take a job at the Ministry of Agriculture, Irrua as a general labourer for about three years”, he recalled.

Read more in the Nigerian Tribune. 

Canadian docs call for health care insurance to cover LTC

       

Canada's doctors are calling on the federal government to create new legislation to ensure that prescription drugs, home care and long-term care are publicly funded just like physician and hospital care.  Brian Day, president-elect of the Canadian Medical Association, said there is no question that many of these services are medically necessary and should be covered by [Canadian] medicare.  A poll commissioned by the CMA showed that many Canadians agree, and see this expansion as a necessity. The survey found that only 55 per cent of Canadians are confident they will have adequate savings to afford their own long-term care.  Those surveyed said that, should medicare be expanded, the priority should be funding long-term care such as nursing homes, followed by home care, prescription drugs, dental care and vision care.  Dr. Day said the best way to modernize medicare would be to update the Canada Health Act, the legislation that sets out the principles of medicare.  But delegates to the CMA meeting called instead for parallel legislation to expand the scope of the Canada Health Act instead of reopening the CHA itself.

Read more in the Globe and Mail, http://www.theglobeandmail.com/servlet/story/LAC.20070821.CMASIDE21/TPStory/National

Ed:  As in most nations that have universal health care access, Canada does not currently treat long term care services as health care.  Two important exceptions are Japan and Germany, both of which have adopted national long term care insurance programs to provide care for disabled seniors.

Recent elder law articles

Harp, Wendell M.  Comment.  America's promise to provide health care access to the elderly and the Medicare Modernization Act.  50 How. L.J. 515-540 (2007).

Business Law Forum:  The Aging of the Baby Boomers and America's Changing Retirement System.  Forum overview by Henry H. Drummonds; articles by Susan J. Stabile, Samuel Estreicher, Laurence Gold, Kathryn L. Moore, Dorothy A. Brown, Richard L. Kaplan and Katherine V.W. Stone; commentary by Jeffrey N. Gordon.  11 Lewis & Clark L. Rev. 267-494 (2007).

15 ELDER LAW JOURNAL,
NO. 1, PP. 1-321, 2007.

Doron, Israel and Tal Golan.  Aging, globalization, and the legal construction of "residence":  the case of old-age pensions in Israel.  15 Elder L.J. 1-50 (2007).

Jorgensen, Mike E.  The convicted felon as a guardian:  considering the alternatives of potential guardians with less-than-perfect records.  15 Elder L.J. 51-122 (2007).

Marmor, Theodore R. and Jerry L. Mashaw.  Understanding social insurance:  fairness, affordability, and the "modernization" of Social Security and Medicare.  [Reprint.]  15 Elder L.J. 123-151 (2007).

Satel, Sally L., M.D., and Benjamin E. Hippen, M.D.  When altruism is not enough:  the worsening organ shortage and what it means for the elderly.  15 Elder L.J. 153-204 (2007).

Al-Heeti, Roaa M.  Note.  Why nursing homes will not work:  caring for the needs of the aging Muslim American population.  15 Elder L.J. 205-231 (2007).

Goelitz, Jeffrey C.  Note.  Answering the call to support elderly kinship caregivers.  15 Elder L.J. 233-263 (2007).

Kim, Helen Y.  Note.  Do I really understand?  Cultural concerns in determining diminished competency.  15 Elder L.J. 265-292 (2007).

Wilson, David S.  Note.  First-aid for housing the low- and fixed-income elderly:  the case for resuscitating cooperative housing.  15 Elder L.J. 293-321 (2007).

Bridgeman, Jacquelyn L.  Seeing the old lady:  a new perspective on the age old problems of discrimination, inequality, and subordination.  27 B.C. Third World L.J. 263-323 (2007).

Grossman, Paul, Paul W. Cane Jr. and Ali Saad.  "Lies, damned lies, and statistics":  how The Peter Principle warps statistical analysis of age discrimination claims.  22 Lab. Law. 251-270 (2007).

Note: list compiled by Jonathon Forman (Oklahoma)

Commission on Law and Aging seeks input on mandatory arbitration clauses in NH contracts

The ABA Commission on Law and Aging is collecting information about the impact of mandatory arbitration clauses in nursing home and other consumer contracts.  Please contact

Holly Robinson
Associate Staff Director
ABA Commission on Law and Aging
740 15th Street NW
Washington, DC 20005
Phone: (202) 662-8694
Email:[email protected] <mailto:[email protected]>

with examples and stories about your own experiences with arbitration clauses in nursing home contracts.

World's oldest polar bear alive and kicking in Winnipeg

Debby, who lives in a rocky enclosure at Winnipeg's Assiniboine Park Zoo, was recently named the world's oldest polar bear by Guinness World Records.  "We like to boast that we're the polar bear capital of the world, with all of the polar bears up at Churchill and along the coast," said zoo curator Bob Wrigley.  At 40, Debby has doubled the life expectancy of most polar bears. In the wild, the massive Arctic bears usually live about 20 years.  Like many 40-year-olds, Debby likes her beauty rest.  "She'd probably still be sleeping right now if I hadn't thrown some food out," remarked zookeeper Harold Masters after tossing bread into the bear's enclosure Friday.

Source:  CBC.ca, http://www.cbc.ca/cp/Oddities/070810/K081013AU.html

Long term care expert Liu dies at age 63

Korbin Liu, 63, a health policy research associate at the Urban Institute for more than two decades, died Aug. 12 of esophageal cancer at Washington Home hospice. He lived in Washington.  Dr. Liu was a nationally recognized expert on health care after acute hospitalizations and on Medicare and Medicaid coverage.  His work focused on long-term-care services, and he studied the likelihood of patients' entering nursing homes, the duration of their stays and their risks of depleting personal resources and becoming eligible for Medicaid coverage.  At the time of his death, he was working on a multiyear study to examine approaches to improving Medicare payments for skilled nursing facilities.

More in the Washington Post.