Elder Law Prof Blog

Medicaid-It's Complicated and Important

Huffington Post's Post50's blog on November 29 featured the post, 5 Common Misconceptions About Medicaid.  The author, Anne Tumlinson,opens the post

I have a confession. I've been avoiding writing about Medicaid. It's so complicated it scares me. But, Medicaid can be really important to daughterhood because someday you might have to decide if it's right for your parent. So you have to get smart about it.

She explains the importance of the Medicaid program as a "safety net for when everything falls apart" and after a brief description, moves into a discussion of the 5 misconceptions:

1. "Medicaid is a lot like Medicare...
2. Medicaid is available to everyone...
3. Medicaid Will Take Your Parents' Home...
4. Medicaid is a national program that's the same for everyone...
5. Medicaid only covers nursing homes...."

With each she offers explanations as to what Medicaid really covers and concludes her post noting

When is Medicaid right for your parent? It depends on so many individual and family circumstances. And, it depends on your state. There are no hard and fast rules. But, if you've been walking down this caregiving road for a long time and you are looking at nursing home care, Medicaid may be necessary to pay for the care. OR, if your parent's money is running out because of expensive care --- even if he or she isn't in a nursing home --- then it could be helpful, especially if there's a good community program in your parent's local area... [a]nd, figuring this program out for your family is not easy. Just remember that it's a crazy complicated hard situation. Not that you are failing.

Note, you can also access her post on her blog here.

 

Fighting Robocalls

Ever received a robocall? Of course you have. Even if you are on the do-not-call list, you still get robocalls. Want to do something about robocalls?  Then read the following 

Consumers Union issued a report, Dialing Back: How Phone Companies Can End Unwanted Robocalls.  Here is an excerpt from the executive summary:

The Do Not Call list, federal law enforcement efforts, and actions by the states have not been enough to protect Americans from the flood of unwanted robocalls that have become rampant in recent years. Hundreds of thousands of people complain each month to the Federal Trade Commission (FTC) about unwanted calls, and it’s estimated consumers lose $350 million a year to phone scams. Thanks to rapid advances in Internet technology, robocallers can make thousands of auto-dialed calls per minute for a relatively low cost. Robocall scammers easily escape detection and punishment by operating overseas or using software to disguise—or spoof—their name and number. The problem is so bad that federal agencies and Congress have been exploring solutions to the unwanted robocall problem.

Technological solutions are necessary to address this problem. A number of leading experts agree that phone companies have the power right now to implement technologies to dramatically reduce robocalls.

Consumers Union surveyed a variety of experts and innovators and found there are at least four proposed and existing robocall filtering technologies that phone companies could pursue to help protect their customers from unwanted robocalls. One solution, the Primus Telemarketing Guard, has been successfully implemented for traditional and broadband phone lines in Canada, which calls into question why similar technologies have not been offered in the United States.

The executive summary reviews call-blocking technologies that phone companies may provide and then offers the following recommendations:

● Phone companies should immediately offer free robocall-filtering services to all of their customers based on latest available technology.

● Phone companies should immediately develop "Do Not Originate" techniques to reduce spoofing by fraudulent callers.

● Phone companies should continue to pursue call authentication strategies as a long-term solution to the spoofing problem

 

 (citations omitted).

To read more about Consumers Union's efforts to fight robocalls, click here.

Good News on Thanksgiving: Gratitude is a Heart-Healthy Habit

NPR's Morning Edition carried a recent story about studies conducted by University of California San Diego researcher Paul Mills that is timely for all of us on this Thanksgiving Day:

A positive mental attitude is good for your heart. It fends of depression, stress and anxiety, which can increase the risk of heart disease, says Paul Mills, a professor of family medicine and public health at the University of California San Diego School of Medicine. Mills specializes in disease processes and has been researching behavior and heart health for decades. He wondered if the very specific feeling of gratitude made a difference, too.

 

So he did a study. He recruited 186 men and women, average age 66, who already had some damage to their heart, either through years of sustained high blood pressure or as a result of heart attack or even an infection of the heart itself. They each filled out a standard questionnaire to rate how grateful they felt for the people, places or things in their lives.

 

It turned out the more grateful people were, the healthier they were. "They had less depressed mood, slept better and had more energy," says Mills.

Happy Thanksgiving to all -- all year round!

Giving Thanks for Family Caregivers

With Thanksgiving looming, it seemed appropriate to take a moment to say thanks to all the family caregivers.  And on the subject of caregivers, I wanted to share this 5 Facts about Family Caregivers published by Pew Research Center. 

Here are the five facts:

• In the US there are 40.4 million unpaid caregivers for those 65 and older.
• The caregivers are most likely between 45-64 years old. 
• The most common caregiving kids perform helping around the house, doing errands and fixing things around the house.
• A major segment of caregiving is providing emotional support. 
• Most kids find helping their parents rewarding, although a few find it stressful.

This is good information to share with your students as well. So read the full document, thank a caregiver and have a Happy Thanksgiving!

A Vivid Example of the Importance of Home Visitor Programs

While preparing for my part of a program this week in England on comparative social care policies, I was encouraged to look at a visiting health services  program in New York City, under the supervision of the Mount Sinai Health System.  Karen Miller, a lawyer and former New York administrative judge who now lives in Florida, told me how helpful it had been to have the assistance of a Mount Sinai social worker to coordinate medication, treatment and doctor's visits for her elderly aunt in New York City. 

Reading about the Mt. Sinai program, in turn, lead me to a short and very moving essay by David Muller, M.D., a physician and Dean for Medical Education at The Icahn School of Medicine at Mount Sinai, based on his home visit in "Haiti." 

Make sure you read your way to page two....the message is eye-opening.

Can a health care instruction be too precise?

We have all heard stories of an elder making the family promise to never admit the elder into a nursing home.  Sometimes, however, people need that level of care, and well-meaning family members are not always able to provide the needed care.  That is part of the story of When to Ignore a Promise to ‘Never Put Me in a Home’ which ran in the New York Times on November 9, 2015. The article features an unidentified patient with a huge bedsore, who had extracted such a promise from her family.  Following that promise to the letter, the family members did their best to care for her, but despite their best efforts, complications occurred.   The doctor authoring the story explained some background

Our patient came from a poor immigrant household without much community support. For years, as she felt herself slipping, she had emphasized over and over again that she never wanted to go into a “home” or be tended by strangers. She wanted to stay at home with her children. Nothing unusual there.

What was unusual was the precision with which her children followed her wishes. As their mother became really confused, then silent, then bedbound, they continued to care for her themselves in the back bedroom.

Turning the focus of the article onto advance directives, and the pros and cons of directives, the doctor writes

[Advance directives] are supposed to give people some control over the future. More often than not, perhaps, the future refuses to be controlled.

Directives may not be detailed enough to help organize a patient’s care. They may be so detailed that doctors and relatives cannot agree on how to interpret the minutiae. Directives may be overlooked in the heat of emergency, ignored out of pure lassitude, or lost somewhere in the closet.

Or, as in our patient’s case, they may be clear and simple, and followed to the letter. And look what happened to her.

The doctor considers health care agents as a better choice, but notes the questions agents must ask principals but frequently don't: "'Do you really want me to do exactly what you are telling me to do? How much wiggle room do I get?'"  This is important for many reasons, not the least of which is what you believe and prefer when you sign your directive may not be the same when it is time to use the directive (what the author refers to as the past you and present you).

Our own patient and her family got all bolluxed up in obligations to their past selves. The bottom line was clear — the patient never would have wanted what she got. But even given that, we wondered, when should her children have changed course?

...

We had no good answers. Our patient spent a few days in the hospital and then went straight to a nursing home to finish a long course of antibiotics and, presumably, to live there for the duration.

Mass. Appellate Court Reinstates Legal Malpractice Verdict Following Flawed Medicaid-Planning Advice

In October 2015, the Massachusetts Court of Appeals addressed the question of whether there were damages flowing from a lawyer's Medicaid advice to an older couple. The lawyer had counseled that, for Medicaid planning reasons, the couple should not retain a life estate in a house purchased with their money but held in the name of their adult children. The court found the surviving mother suffered real damages, even if eviction from the house by her children was unlikely.  Key allegations included:

Thirteen years later, in July of 2007, the Brissettes [the parents] and two of their four children, Paul Brissette and Cynthia Parenteau, met at [Attorney] Ryan's office to discuss the Brissettes' desires to sell the South Hadley home and to buy property located in Springfield. They discussed the prospect of putting the Springfield property in the names of Paul and Cynthia. Ryan told the Brissettes that if they reserved life estates in the Springfield property, they could be ineligible for Medicaid if they applied any time within five years of getting the life estates. He also told them that if they took life estates in the Springfield property, there could be a Medicaid lien against that property when they died. There was evidence that the Brissettes asked about “protection,” but Ryan told them that he did not feel that the Brissettes needed protection because they could trust their children to do what they wanted them to do. In reliance on Ryan's advice, the Brissettes decided that the Springfield property would be bought with their money  but put in Paul's and Cynthia's names, and that the Brissettes would not have life estates in the Springfield house.

After her husband's death. Mrs. Brissette concluded she wished to own "her" home in her own name, but the children declined to re-convey the property to her. 

During the malpractice trial, Lawyer Ryan conceded his advice about the effect of a life estate on Medicaid and/or a Medicaid lien was wrong, and expert witnesses also testified that the incorrect Medicaid advice was "below the standard of care applicable to the average qualified attorney advising clients for Medicaid planning."

Continue reading

Understanding the 2016 Medicare Part B premiums

Prior to the Bipartisan Budget Act of 2015 , all indications pointed to a pretty significant increase in the 2016 Part B premiums for Medicare. However, the increase was much less than expected in part because of the compromise in the Budget Bill. The Kaiser Family Foundation released a very helpful issue brief on November 11, 2015, explaining  the developments and the impact on beneficiaries.  What's in Store for Medicare's Part B Premiums and Deductible in 2016, and Why? explains the premium increase, the hold harmless provision and a $3 repayment surcharge to make up the deficit Part B will incur in 2016 because of the lower premium. ("includes a $3 repayment surcharge, which will be added to monthly premiums over time to cover the cost of the reduced premium rate in 2016.")

The brief explains the hold harmless provision, identifies the categories of beneficiaries who will have to pay the higher premiums (and why) and the amount of premiums paid by higher income beneficiaries. The brief also offers a projection for 2017 and concludes that but for Congressional intervention, "in the face of flat Social Security benefits and rising out-of-pocket costs, many people on Medicare could have greater difficulty affording their medical care costs in the coming year."

£2.9Bn Funding Gap for UK Care Homes May Cause Half to Close

As I prepare to speak at a program at the University of Leeds this week on comparative social care systems and legal policies, a headline in The Guardian caught my eye: "Half of UK Care Homes Will Close Unless £2.9bn Funding Gap Is Plugged, Warn Charities."  The Guardian reports:

In a joint letter, 15 social care and older people’s groups urge Osborne to use his spending review on Wednesday to plug a funding gap that they say will hit £2.9bn by 2020. They warn that social care in England, already suffering from cuts imposed under the coalition, will be close to collapse unless money is found to rebuild support for the 883,000 older and disabled people who depend on personal care services in their homes.

 

[Chancellor of the Exchequer] Osborne has already decided to use his overview of public finances to give town halls the power to raise council tax by up to 2% to fund social care, in a move that could raise up to £2bn for the hard-pressed sector. However, the signatories of the letter, such as Age UK and the Alzheimer’s Society, want him to commit more central government funding to social care.

 

The looming £2.9bn gap “can no longer be ignored”, the letter says. “Up to 50% of the care home market will become financially unviable and care homes will start to close their doors,” it adds. “Seventy-four per cent of domiciliary home-care providers who work with local councils have said that they will have to reduce the amount of publicly funded care they provide. If no action is taken, it is estimated that this would affect half of all of the people and their families who rely on these vital services.”

 

Osborne’s endorsement of a hypothecated local tax to boost social care comes after intense lobbying behind the scenes and public warnings from bodies such as the King’s Fund health thinktank.

The authors warn the "NHS will be overwhelmed by frail elderly people" in search of care. I was struck by implications that without funding reallocation, England will face staggering hordes of near zombies.  There is irony in this imagery, of course, because we spend a heck of a lot of real money on best-selling books, movies and top-rated television shows about fictional zombies, while failing to come to terms with the funding needs for real people.  See e.g., this estimate that "Zombies Are Worth Over $5 billion to Economy."

Filial Friday: Court Finds Less Than "Ideal" Childhood Not Enough to Release Duty to Support Indigent Parent

It is, perhaps, a mark of the growing acceptance of filial support obligations in Pennsylvania courts -- although not necessarily equating with understanding by the general public in Pennsylvania -- that a recent appeal from a filial support ruling resulted merely in a "nonprecedential" opinion by the appellate court, one that adopts the findings of the lower court.

In Eori v. Eori, 2015 WL 6736193, (Aug. 7, 2015) the Pennsylvania Superior Court affirmed the trial court's award of $400 per month in support with a short opinion.  This ruling obligates one son, the defendant, to contribute financially towards the care of his 90-year old mother, being provided in the home of another brother. The incorporated findings of fact, from the lower court, track a sad family story.  One point in dispute was whether the mother's alleged actions during the son's childhood constituted the defense of "abandonment":

Defendant’s next error complained of on appeal pertains to the second defense Outlined in 23 Pa. C.S.A. Section 4603(2)(ii), which negates the obligation of filial support when it is established that the parent seeking support abandoned the child during a ten year period of the child’s minority. In this case, the Defendant argued that he was abandoned and raised as error number six that the trial court failed to consider said testimony. The term “abandoned” is not defined in the act itself, However, the Custody Act at 23 Pa.C.S.A. Section 5402 defines “abandoned” as “left without provision for reasonable and necessary care or supervision.” Defendant testified that he did not have the greatest family growing up and he wanted to get away. . . . He testified that his grandmother cared for him more than his Mother; however, they were never far apart because he testified that his grandmother either lived with Mother or beside Mother. . . .  Although he testified that Mother was abusive, left and caused them to move many times, and was either gone or fighting, he never established that she left for a ten year period. He did not provide details or time periods on any of the testimony presented.

The lower court concluded:  "Therefore, it was not clear from [son's] testimony that Mother ever left for a ten year period without provision for his reasonable and necessary care or supervision. Although it may not have been an ideal childhood, there was no evidence of abandonment to release Defendant from his obligation to support Mother."

Procedural note:  In Pennsylvania, trial judges have the option of waiting to write "opinions" explaining their "orders" until after a notice of appeal is filed by a party.  Pennsylvania Rule of Appellate Procedure, Rule 1925. Further, the trial judge can also require the appealing party to file a "statement of errors," in advance of the trial judge's obligation to write an opinion.  I don't know how many states use this process, but certainly by comparison to the Federal Rules of Civil Procedure, it is a rather unique opportunity for judges to write an opinion, as did the trial judge in the Eori case, that, in essence, expresses views on the merits of the "appeal." 

For those gathering together as family for Thanksgiving next week, perhaps this case history provides lessons.

They're Out...CMS releases 2016 premium and co-pay amounts

CMS has released the 2016 amounts for deductibles, premiums, and co-pays for Medicare A and B.  The Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts  are available in the Federal Register here. (The inpatient deductible is $1,288 for 2016). The Part B amounts are available here.  Remember because there is no COLA this year, the hold harmless provision keeps the Part B premium the same as last year for many Medicare Beneficiaries.  For those not protected by the hold harmless provision, their Part B premiums will be $121.80+ $3.  Don't forget that higher income beneficiaries will pay a higher premium, referred to as the income-related monthly adjustment.  The higher premium amounts can be found here as well.

Yours, Mine or Ours: Who is Responsible for Social Care of Older Persons?

On November 26, 2015, the University of Leeds' School of Law in England will be host to a program on "Yours, Mine or Ours: Who is Responsible for Social Care of Older Persons?"  I'm very pleased to be part of the panel, under the leadership of Professor Subhajit Basu, PhD.  We will use a research report we completed with colleagues in 2015 for the Commissioner of Older People in Northern Ireland (COPNI), to offer comparative international examples of legislation and public policy initiatives that support the wide array of potential care needs for older persons.  We'll be looking beyond the needs for health care. 

One likely focus of the discussion is a proposal for a state-supported home visits by trained professionals, including social work professionals, for individuals age 75 or older, with a goal of providing advance assistance to the individual or family in meeting needs.  The proposal now under consideration in Northern Ireland has roots in other jurisdictions we studied, including Denmark. 

In Denmark, one of the inspirational leaders for "preventative home visits" is Mikkel Vass, M.D. at the University of Copenhagen. Beginning in 1998, Danish laws established an obligation for municipalities to offer "all citizens 75 years and older two annual preventative home visits."   A great deal of freedom to design the content of the home visits was given to the municipalities, but the goals are:

• to support personal resources and networking; and
• to offer social support, thereby preserving functional ability

In his study of 15+ years of home visit operations, Dr. Vass concludes that with a nationally-supported home visitation program:

• Functional decline can be prevented;
• Education of professionals makes a difference to the interview success;
• Interdisciplinary education makes a greater difference to the program success;
• To maintain effectiveness, education must be ongoing and based on simple messages and professional routines that respect local healthcare cultures; and
• Operation can be cost-neutral.

Cost neutrality -- that will be important to every element of modern social care programs -- including home visits.

SNF rooms to hot for residents

Living in a Sunbelt state, I know how hot it can get in the summer months.  I recently ran across a July 2015 decision from HHS' Departmental Appeals Board (DAB) reviewing the imposition of a "per instance" monetary penalty CMS assessed against an Arizona SNF.

CMS’s allegations in this case are predicated on complaints that portions of Petitioner’s facility – including several residents’ rooms – were uncomfortably hot. Those allegations are supported by the complaints of several residents and by temperature readings taken by a surveyor on July 16, 2014. Readings taken by the surveyor showed portions of some of the residents’ rooms being as hot as 90 degrees Fahrenheit.... Such temperatures plainly exceed what any reasonable person would consider to be "comfortable." On their face they comprise violations of 42 C.F.R. § 483.15(h)(6).

After discussing the ways the surveyor and the SNF measured the temperatures inside the SNF, the ALJ in the opinion notes

The overwhelming evidence is that rooms at Petitioner’s facility were uncomfortably hot due to the failure of the facility’s air conditioning system. Arizona in July is a very hot place. Building interiors in that State that are not adequately air conditioned can become dangerously hot. As Petitioner admits, the air conditioning in its facility had failed to work adequately in July 2014. The failure prompted residents to complain that their rooms had become uncomfortably hot.... The staff took various measures to address the failure of the air conditioning system, including closing curtains in residents’ rooms and conducting random temperature checks....

"The evidence that residents were not comfortable is overwhelming, beginning with these residents’ complaints and further evidenced by the fact that Petitioner’s own staff recognized that there were problems with overheating in the residents’ rooms."  The ALJ upheld the penalty.

 

 

Health Affairs Publishes Report on New Models for Long-Term Services and Supports

Coinciding with the presentation yesterday at the National Press Club in Washington, D.C., the journal Health Affairs released a report  by Melissa Favreault, Howard Gleckman, and Richard W. Johnson, titled "Financing Long-Term Services And Supports: Options Reflect Trade-Offs For Older Americans And Federal Spending."  Noting the history of weak buy-in for existing long-term care insurance products, the authors' study, funded by the SCAN Foundation, AARP and LeadingAge, looks to future alternatives.  From the abstract:

To show how policy changes could expand insurance’s role in financing these needs, we modeled several new insurance options. Specifically, we looked at a front-end-only benefit that provides coverage relatively early in the period of disability but caps benefits, a back-end benefit with no lifetime limit, and a combined comprehensive benefit. We modeled mandatory and voluntary versions of each option, and subsidized and unsubsidized versions of each voluntary option. We identified important differences among the alternatives, highlighting relevant trade-offs that policy makers can consider in evaluating proposals. If the primary goal is to significantly increase insurance coverage, the mandatory options would be more successful than the voluntary versions. If the major aim is to reduce Medicaid costs, the comprehensive and back-end mandatory options would be most beneficial.

The full article is linked here. Several related pieces are also on the Health Affairs website.  Much to read and evaluate here and helpful for those planning spring Elder Law courses. 

Opinion: Might California's New Law on Assisted Suicide Facilitate Elder Abuse?

Washington State Elder Law Attorney Margaret Dore has shared with us her interesting analysis of "California's Assisted Suicide Law: Whose Choice Will It Be?," published here in JURIST, the on-line platform by University of Pittsburgh Law.  She criticizes California's new law as inviting misuse, including elder abuse, observing:

The bill, ABX2-15, has an application process to obtain the lethal dose, which includes a written lethal dose request form with two required witnesses. Once the lethal dose is issued by the pharmacy, there is no oversight over administration. No one, not even a doctor, is required to be present at the death. 
 
ABX2-15 allows one of the two witnesses on the lethal dose request form to be the patient's heir, who will financially benefit from the patient's death. This is an extreme conflict of interest. Indeed, under California's Probate Code, similar conduct (an heir's acting as a witness on a will) can create a presumption that the will was procured by "duress, menace, fraud or undue influence." ABX2-15, which specifically allows the patient's heir to be a witness on the lethal dose request form, does not promote patient choice. It invites duress, menace, fraud and undue influence.

Further, she notes the potential trauma for family members, citing examples from her practice:

Two of my clients, whose fathers signed up for the lethal dose in Washington and Oregon, suffered similar trauma. In the first case, one side of the family wanted the father to take the lethal dose, while the other side did not. The father spent the last months of his life caught in the middle and torn over whether or not he should kill himself. My client, his adult daughter, was severely traumatized. The father did not take the lethal dose and died a natural death. In the other case, it is not clear that administration of the lethal dose was voluntary. A man who was present told my client that the client's father had refused to take the lethal dose when it was delivered, stating: "You're not killing me. I'm going to bed." But then took the lethal dose the next night when he was already intoxicated on alcohol. My client, although he was not present, was traumatized over the incident, and also by the sudden loss of his father.

Ms. Dore is a former Chair of the Elder Law Committee of the American Bar Association Family Law Section. She is also president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia. 

Webinar on Protecting Bank Accounts

The National Consumer Law Center (NCLC) has announced a free one hour webinar set for November 24, 2015 from 2-3 p.m. est.  Protecting Your Bank Account from Unauthorized and Recurring Payments will cover consumers rights in protecting accounts.

The constant news about data breaches and scams targeting seniors has left people worried about their rights if an unauthorized charge is taken out of their account.  Consumers also face problems when a gym, unwanted membership club or payday lender will not stop debiting the account.  This webinar will cover consumers' rights to challenge unauthorized payments and to stop recurring payments.

The webinar is limited to the first 3000 registrants so don't delay. Click here to register.

Nudging an Older Co-Worker to Retire? Think Twice....

The Washington Post's magazine section runs a Work Advice column by Karla Miller.  A recent question was intriguing:

As a longtime colleague of Susan’s, I’ve been asked by her boss to feel out whether she really means to leave the office only if “taken out in an ambulance or a coffin” (the boss’s words). I agree that it is probably time for her to retire (she is financially well off), but I also know she gets great satisfaction from her work. Should I broach the subject with Susan as a caring co-worker?

The response urges caution in participating in the employer's plan, observing bluntly "that smells like a steaming heap of age discrimination."

For the full discussion, See @Work Advice: Putting the Old, Gray Co-Worker Out to Pasture.

When is long enough enough for a judicial term?

I've heard periodically some conversations about attorneys practicing law much longer than they should because they develop significant cognitive deficits.  I've also heard similar conversations occasionally about judges, primarily in the context of judges who hold lifetime appointments. The AP ran a story in early November on this topic, featuring the efforts of the 9th Circuit to address the issue of judges who experience significant cognitive declines while still sitting the bench.

[T]he 9th U.S. Circuit Court of Appeals, which includes federal courts in California and eight other Western states, has taken a more pro-active approach to the problem of mental decline by trying to get its judges to think about the condition, plan for it and handle it appropriately if it comes up.

The circuit court holds regular seminars led by neurological experts to teach its chief judges about the signs of cognitive impairment. It has set up a hotline where court staff and judges can get advice about dealing with signs of senility in colleagues. It has also encouraged judges to undergo cognitive assessments and designate colleagues, friends or family who can intervene if concerns arise about their mental health.

The article discusses the pros and cons of mandatory retirement or term limits and notes that the 10th Circuit had two cases that might fall in the category of cognitive decline. The article quotes a 9th Circuit judge who decided to stop hearing almost all cases in an abundance of caution. This judge noted that "'if the goal is to work until you are no longer able, you will work a couple of years too long...'"

The AP story was picked up by a number of publications, including the ABA Journal

 

Stanford Researchers Tackle Questions About Aging With Purpose

Psychology Researchers, William Damon and Anne Colby, in  Stanford University's Graduate School of Education, are teaming with a San Francisco-based nonprofit organization, Encore.org, on a three phased study to understand the nature and determinants of "purposeful" living in the so-called "encore" years of life, ages 50 to 75.  

The $1.8 million study was inspired by a troubling fact: Relatively few older adults have found purposeful engagements that they act on in a sustained way. Yet research suggests that there is significant untapped potential for this kind of engagement. In one recent Encore.org survey, 87 percent of older respondents said they felt a responsibility to help those less fortunate than themselves, and 70 percent said that it was important to leave the world a better place.

The projects phases include:

• Part 1 is a study to be conducted by the Stanford research team which will include a national survey and in-depth interviews to investigate how Americans with varied histories, values, needs, and opportunities make sense of their lives between midlife and old age, what they wish for, and whether they’re able to realize their aspirations. 
• Part 2 is a data collection effort to create an up-to-date database of existing programs that help people in their later years develop and maintain purposeful lives.
• Part 3 is an engagement and implementation phase, which will bring the insights of Part 1 and the resources identified in Part 2 to the general public and to many different kinds of organizations and programs that support purpose in later life. In doing so, Part 3 intends to shift popular conceptions of the encore years and strengthen institutional mechanisms that support many varieties of purposeful aging.

Thanks to Dickinson Law Professor Laurel Terry for sharing news of this interesting study.

Wearable Technology-Personal "airbags"

One of my regular "must reads" is Aging In Place Technology Watch. I love reading about all the new cool tech and how companies are innovating to make lives better for us as we age.  So catching up on reading emails, I was reading the post on the LeadingAge2015 Annual meeting.  The technologies reported in this post were fascinating, but the one that really caught my attention was HipHope.   Looking at the website, the best way I can describe the technology is wearable air bags.  

The website describes the device. "Hip-Hope™ is a revolutionary active hip protector device, providing unprecedented fall impact absorption effectiveness, combined with highly reliable real-time fall detection capability.  Hip-Hope™ unique achievements are a result of “out-of-the-box” design concepts and technological innovations."

According to the website, the device deploys in the blink of the eye, and it looks compact and easily wearable.  Check out the video demonstrating it.