Wednesday, May 30, 2018
I promised more information about the consumer protection measures signed into law by President Trump on May 24, 2018. Here's the more detailed update I wrote for WealthManagement.com: The New Senior $afe Act Encourages Reporting Senior Financial Abuse.
May 30, 2018 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Federal Statutes/Regulations, Property Management | Permalink | Comments (0)
Tuesday, May 29, 2018
With hurricane season looming (it starts June 1), this notice about an upcoming webinar is particulary timely. The National Center on Law & Elder Rights has scheduled a free webinar for June 20, 2018 at 2 p.m. edt, Assisting Older Homeowners After a Natural Disaster. The announcement explains this about the webinar
Older adults face unique challenges and exhibit different vulnerabilities during and after a natural disaster. Older homeowners, for example, may need additional assistance securing their homes and moving out of a storm's path. Recovering from the disaster may also be a challenge for older adults on fixed or limited income. This free webcast will address both the practical challenges and resources available to aid older homeowners after a disaster. The discussion will highlight the loss mitigation and other options available to prevent mortgage foreclosure, and housing and other related assistance from FEMA. Closed captioning will be available on this webcast. A link with access to the captions will be shared through GoToWebinar’s chat box shortly before the webcast start time. Presenters: • Odette Williamson, Staff Attorney, National Consumer Law Center • Sapna Aiyer, Managing Attorney, Housing & Consumer Unit, Lone Star Legal Aid
As we reported last week, a trial court judge in California held that the California physician-aid-in-dying law was invalid. The state appealed, according to an article in the LA Times. A subsequent article in the New York Times reports that the appellate court declined a stay of the trial court's ruling pending the appeal, No Stay of Ruling That Tossed California Assisted-Death Law. "California's 4th District Court of Appeal refused to grant an immediate stay requested by state Attorney General Xavier Becerra. However, the court gave Becerra and other parties time to "show cause" — that is, provide more arguments as to why the court should grant the stay and suspend the lower court ruling.” Since no injunction was entered, the law still is in effect, as noted in the article. The California AG " argued that the measure was legitimately passed and asked [the appellate court] for quick action so that terminally ill people seeking options under the law wouldn't die "an excruciating, painful death" before the issue is finally decided."
A book I co-authored on The Law of Financial Abuse and Exploitation was inspired, sadly, by several cases we had in our Elder Protection Clinic at Dickinson Law in Carlisle Pennsylvania.
In one case, at first the relationship between great niece and great aunt had seemed to friends and neighbors to be loving and protective. It wasn't until the elder's care needs increased, and it turned out there was no money to pay for care by professionals, that the truth was uncovered. The aunt's money, close to a million over three years, was gone.
With the benefit of hindsight, you could see how the exploitation began -- with the younger woman asking for permission to use the elder's accounts for a few improvements and upgrades around the house. Then she stopped asking for permission. Eventually her spending was for fur coats, jewelry and a luxury car (actually, two). Her aunt no longer could see to review her accounts and there weren't any other relatives to ask questions. The niece probably didn't count on her aunt living past 100 -- or testifying against her at the criminal trial about the unauthorized spending, when she was 101. The younger woman tried to justify her behavior, testifying at trial that "she wanted me to have the money. She was going to leave it to me in her will."
Several friends, including Karen Miller, in Florida, sent me copies of another tragic tale, this time from Brooklyn via the New York Times. I suspect, that in this account of a relationship between an older widow and a local waitress, the younger woman probably told herself her "friend"wanted her to have the money. She too will be thinking about this in jail. Read She Found Comfort in a Brooklyn Diner, Then Lost Everything.
May 29, 2018 in Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, Property Management, State Cases, State Statutes/Regulations | Permalink | Comments (0)
Monday, May 28, 2018
One of my heroes, Alfred "Chip" Chiplin, who died last year, was the 2018 recipient of the NAELA Theresa Award. The award is presented by the Theresa Foundation and was awarded at the 24th Annual Theresa awards as well as at NAELA's 2018 annual meeting. The award "is an annual community service award presented by the Theresa Alessandra Russo Foundation to a NAELA member in recognition of his or her advocacy and support of individuals with disabilities." The award was accepted by Chip's sister.
More information about the amazing work of the Theresa Foundation is available here.
Here's a challenging but potentially important topic for many families on this holiday weekend.
Becky has a post last week about the importance of doctors asking older patients about guns as a safety risk. I've posted in the past, here and here, about related issues, including laws affecting registration of gun ownership when intervivos or testamentary trusts are used as the legal vehicle to pass down weapons to succeeding generations.
The New York Times continues the conversation with In Elderly Hands, Firearms Can Be Even Deadlier. From Paula Span's article:
While older adults make many fewer suicide attempts than younger cohorts, they die more often, in part because they use such lethal methods. Yet health care providers who ask older patients about driving and wandering may not ask about guns.
“Safety planning for adults with dementia is something every clinician thinks about, but I don’t think firearms are often on the radar,” said Dr. Donovan Maust, a psychiatrist at the University of Michigan Medical School and co-author of a recent article on guns and dementia in the Annals of Internal Medicine.
They should be. At various stages of dementia, people may grow unable to distinguish loved ones from intruders. Their decision-making ability deteriorates. They can become paranoid, depressed, impulsive, agitated or aggressive.
Dr. Maust's co-authored commentary, linked above, is worthy of closer reading. Perhaps in an attempt to allay the fears of gun owners that dementia is not an automatic disqualifier for gun ownership, the piece suggests that doctors consider the stage of any neurocognitive impairment as part of a multi-party discussion about access:
A diagnosis of cognitive impairment or dementia does not in itself mean that a person should not have access to firearms—the level of cognitive impairment is probably most important. In a recent review, Patel and colleagues proposed using the clinical dementia rating scale to estimate the stage of dementia and the person's ability to safely complete complex tasks, including firearm handling.
For patients with minimal cognitive impairment, approaches could be similar to those related to driving, including acknowledging the emotions involved and allowing the PWD [person with dementia] to maintain agency in the decision for as long as it is safe. As with an “advance driving directive”, PWDs, their family members, and their health care providers may proactively discuss firearm access and consider setting a “firearm retirement date”. This patient-centered approach may allow an older adult to maintain decisional control and identify trusted family members or providers as future surrogate decision makers. To our knowledge, no one has tested the acceptability or efficacy of this approach.
May 28, 2018 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Ethical Issues, Health Care/Long Term Care, Property Management, State Statutes/Regulations, Statistics | Permalink | Comments (0)
Friday, May 25, 2018
Of course, I'm supposed to be finishing my exam grading. Instead, while stopping by my office, I find a copy of a short story from one of my colleagues. The accompanying note says,"Not even my sci-fi 'escape' is untouched by elder care issues. Thought you'd get a kick out of this."
And indeed, I do. I definitely recommend "Today I Am Paul," by Martin L. Shoemaker. The author draws upon his personal experiences in visiting his mother-in-law in a nursing home to craft a true tale ... with a difference ... as the narrating caregiver is an android.
While my printed-page-loving self recommends reading the short story, I also found a great podcast of the story being read aloud by Kate Baker and I'm linking it here, from Clarkesworld Magazine.
I now plan to use this story to introduce my Elder Law course in the autumn. So much to talk about, including the roles of family, caregivers, technology, fear..... I suspect my co-blogger Becky Morgan, with her often expressed enthusiasm for tech including driverless cars, will appreciate this story too. Happy reading or listening for Memorial Day weekend!
Many thanks to Dickinson Law Professor Matthew Lawrence for this unique, caring experience.
Thursday, May 24, 2018
Believe it or not, there are those in the US who are not on the Internet. Although the numbers are growing, some still haven't gotten onto the information highway. We are seeing an increase in the use of the Internet by those we consider elders, but there are still others who don't use it.
Pew Research periodically releases a report on internet use. The last one, a Fact Tank from a couple of months ago, showed a gradual increase. 11% of Americans don’t use the internet. Who are they?explains that "[t]he size of this group has changed little over the past three years, despite ongoing government and social service programs to encourage internet adoption in underserved areas. But that 11% figure is substantially lower than in 2000, when the Center first began to study the social impact of technology. That year, nearly half (48%) of American adults did not use the internet."
The report looks at all age groups, but since this is the elderlawprof blog, I'm interested in the internet usage by elders. The report gives us that: "[s]eniors are the age group most likely to say they never go online. Although the share of non-internet users ages 65 and older decreased by 7 percentage points since 2016, about a third today do not use the internet, compared with only 2% of 18- to 29-year-olds."
So basically one-third of elders still are off the information highway. As more and more Boomers move past age 65, it will be interesting to see if that number drops or holds steady. Our students need to understand that figure, too, since so many of them are online non-stop.
The "Senior Safe Act," part of a federal banking reform law that will modify Dodd-Frank, has been passed by both houses of Congress with bi-partisan support. Note the sometimes clever spelling for "Safe" as "$afe," used by proponents. From a McKnight's Senior Living report on May 23, 2018:
A bipartisan bill intended to help protect older adults from financial exploitation and fraud is on its way to the president's desk to be signed into law.
The Senior $afe Act, authored by U.S. Sens. Susan Collins (R-ME) and Claire McCaskill (D-MO), passed in the House of Representatives on Tuesday as part of a bipartisan banking reform package after previously being passed by the Senate in March. President Trump tweeted on Wednesday that he plans to sign the legislation into law.
Collins and McCaskill had introduced the Senior $afe Act in 2017 when they were chairman and ranking member, respectively, of the Senate Special Committee on Aging. Collins still leads the committee, and McCaskill remains a member.
The legislation protects banks, credit unions, investment advisers, broker-dealers, insurance companies and insurance agencies from being sued for reporting suspected exploitation or fraud as long as they have trained their employees about how to identify the warning signs of common scams and make reports in good faith to the proper authorities.
“The Senior $afe Act, based on Maine's innovative program, will empower and encourage our financial service representatives to identify warning signs of common scams and help prevent seniors from becoming victims,” Collins said in a statement.
I'll report more once I have a close look at the language, as enacted.
May 24, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Federal Statutes/Regulations, Statistics | Permalink | Comments (0)
Wednesday, May 23, 2018
As we all know, CMS has been rolling out the new Medicare cards without SSN on them. AARP Research conducted a survey about the new cards, and the results are quite interesting. 2018 AARP Survey: Experience and Knowledge of Medicare Card Scams explains:
n March 2018, AARP engaged Alan Newman Research to conduct a national research study among U.S. adults ages 65 and older about their experience and knowledge around the new Medicare cards being issued in April 2018 and potential vulnerability to scams related to the new card and benefits.
Key findings include the following:
Most (76%) U.S. adults ages 65 and older indicate they have not seen, read, or heard much or anything at all about the new Medicare cards (or are not sure).
Three in four (75%) Medicare beneficiaries are not sure or are incorrect about the key change with the new cards being new identification number.
Nearly two-thirds (63%) of Medicare beneficiaries are unsure or are incorrect in believing that Medicare will charge new beneficiaries a $25 processing fee for the new card.
Over half (56%) are not sure or are wrong in thinking that Medicare will call them to verify their Social Security number before they can receive their new card.
At least one in three are extremely/very concerned about being a target of Medicare scam (33%) or victim of identity theft (40%).
A pdf of the survey results is available here.
Both Becky and I have written about a California trial court's recent ruling that a California's law permitting physician assistance in death was enacted in an unconstitutional manner. The judge granted a window of five days before the ruling would become effective, to permit any appeal. That appeal has now been filed by the California Attorney General. From the Los Angeles Times:
California Atty. Gen. Xavier Becerra on Monday filed an appeal against a judge's recent ruling overturning the state's physician-assisted suicide law. . . .
Becerra's action Monday moves the case to an appeals court, which will decide the future of the law. He also asked that the law stay in place while the matter is further litigated, a request that will most likely be granted, said Kathryn Tucker, an attorney who heads the End of Life Liberty Project at UCSF/UC Hastings Consortium on Law, Science & Health Policy.
As Becky says, stay tuned. But probably best not to hold your breath while awaiting the next ruling.
The 2019 conference will have a strong focus on critical and emergent topics facing the field of aging, as well as cutting-edge and responsive programmatic, research, policy and advocacy efforts. Potential interest areas include: emergency/disaster readiness, housing and transportation access, caregiving, substance use/opioid crisis, multiple aspects of dementia, technology and aging, intergenerational models, population health, and shifting policy and legislative issues affecting older adults. Additionally, we welcome proposals spanning the theme of aging that offer innovative policies, programs, practices, models, businesses and learning.
A Closer Look at Continuing Care at Home Contracts (Sometimes Known as Continuing Care Without Walls)
As I prepare for some summer writing and speaking projects, I've been taking a closer look at Continuing Care at Home (CCaH), sometimes also called Continuing Care Without Walls. Pennsylvania was among the early states to license CCaH providers, doing so under the Pennsylvania Department of Insurance's regulatory authority for Continuing Care Retirement Communities (CCRCs).
CCaH is something of a hybrid, contract-based product, sort of a combination of “home care agency” and “long-term care insurance.” The customer makes a prepayment for access to specific services, to be provided in the customer's own home, The services offered tend to emphasize care coordination; several different types of plans may be offered by a single provider.
From the providers I've reviewed, CCaH contracts typically have an upfront “entry” or membership fee, plus monthly service fees. In some of the plans there is also cost sharing and deductibles for services. Overall, the fees, as one would expect, are lower than for traditional CCRCs, but can still be significant.
For example, in a recent report I reviewed, one operation described a series of contracts available. One contract involved a 90% "refundable" entry fee plan. In 2012, a prospective member who qualified at age 88 could expect to pay an entry fee of $147,160, plus monthly service fees ranging from $290 to $584.
In some instances, the company may charge annual fees, rather than a single entry fee plus monthly fees. For example, another Pennsylvania CCaH provider offers "life care plans," "home care plans," and "traditional life care plans." The first two contracts have annual fees, while the third, "traditional life care plan," is structured with a single upfront entry fee, plus monthly fees of 1% of the entrance fee.
At that company, for the "life care plan" with annual fees, a prospective member could select a "life time benefit" of between 1 and 7 years, plus a maximum daily benefit of between $75 per day to $250 per day, with options for a waiting period, cost of living adjustments, and "shared care." As of April 2016, if a prospective member at age 80 chose a life care plan with a 7 year "maximum life time benefit," no waiting period, no cost of living adjustment and no shared care, he or she could expect to pay annual fees of around $7,880 for a $100 per day benefit -- or up to $15,60o per year for a $200 per day benefit. Fees would be discounted by 20% for two or more people per household and the benefits and annual fee "may vary based on the member's health status at time of enrollment." Further, the provider cautions, "though not anticipated, the annual fee for members of life care and home care plans may be adjusted after the fifth anniversary of their continuing care agreement," and any such adjustments would be on a uniform basis for all members in a specific plan.
In Pennsylvania, all of the current providers of CCaH are connected to or developed by operators of brick and mortar CCRCs, and therefore the CCaH contracts sometimes offer priority admission to the related CCRC if resident care is desired. I don't think this connection between a CCaH program and a CCRC facility is necessarily required in other states.
Traditional long-term care insurance has had a troubled history nationally and in Pennsylvania, CCaH providers seem to avoid that history by staying closely tied to the positive reputation of a visible, attractive brick and mortar CCRC. However, CCaH contracts do not necessarily promise to use the staff or services from the related CCRC, and if so, the CCaH provider may turn to third parties, such as home care agencies, in the search for workers. The contract terms are key and require careful reading.
Pennsylvania currently licenses five CCaH providers. The longest operating provider is Friends Life Care at Home, a not-for-profit operation in southeastern Pennsylvania. It was organized in 1985 and according to registration information at the Pennsylvania Department of Insurance it has approximately 2,500 contracts in existence. Friends Life Care recently entered into a joint marketing agreement with SpiritTrust Lutheran Life.
Tuesday, May 22, 2018
NAELA celebrated its 30th year with its annual conference in New Orleans, LA on May 17-19, 2018. The conference consisted of three tracks: legal tech, advocacy and public benefits. The well-attended conference packed in a great amount of programming in two and a half days. Speakers included leaders from the field of elder law, consultants, cyber security experts, researchers and more. NAELA members unable to attend may check the NAELA website for more information.
In addition, Michael Amoruso was sworn in as the next NAELA president by outgoing president Hy Darling. Congrats NAELA!
(In the interest of full disclosure, I'm a former president of NAELA and co-chair of the planning committee for this conference.)
May 22, 2018 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Legal Practice/Practice Management, Medicaid, Medicare, Programs/CLEs, Property Management, Social Security, State Cases, State Statutes/Regulations | Permalink | Comments (0)
Monday, May 21, 2018
Lisa Stegall, Assistant Professor of Biology at Hamline University, reports on positive results from a study where adults aged 60 to 80 participated in a weekly program of simple dance moves. From her report for Academic Minute:
Once a week for nine weeks, seniors aged 60 to 80 years old participated in an hour of music and movement training called Dalcroze eurhythmics. Led by a certified instructor who played improvised music on a piano, the seniors walked in time with the music, changed directions, and handled and passed objects rhythmically. They moved individually, with a partner, and in small groups to increase social interaction.
Our research team, made up of faculty and students from the Exercise Science, Music, and Public Health programs, tested the participants’ walking ability before and after the intervention, and found that gait (or walking) speed significantly improved. This held true even when participants were asked to walk and perform another task at the same time, called dual tasking. This latter finding is important because most falls occur while walking, especially when also performing other tasks.
Why did this intervention improve dual-task walking speed by 20%? We hypothesize that the improvement was due to the multicomponent movement training that’s unique to Dalcroze eurhythmics. Stepping to the beat of the music while carrying a ball, and passing that ball to another person in time with the music requires awareness, attention, balance, and coordination. These are the same skills needed when navigating the home, neighborhood, or the grocery store.
I expect we will see Dalcroze Eurhythmics classes coming soon to a gym or dance studio near you! My thanks to Dickinson Law colleague Laurel Terry for this tip.
A number of news outlets reported that a trial court judge has overturned California's aid-in-dying law. As an example, the LA Times reported Riverside judge overturns California's doctor-assisted suicide law. The judge ruled "that the California Legislature violated the law by passing the End of Life Option Act during a special session dedicated to healthcare issues, according to the plaintiffs in the case as well as advocates for the law." The law, which has been in effect about 6 months, has already been used, according to sources quoted in the article. "In the first six months California's law was in effect, more than 100 people made use of it to end their lives. Fifty-nine percent of them had cancer, according to state data." Both sides on this issue are quoted in the article. The state attorney general has 5 days from the order's entry to file an appeal.
From Singapore, comes a recent article in The Independent titled "Asia's Ageing Crisis Calls for Innovative Senior Housing Models and Foreign Investment." The article begins:
Asia is facing an ageing crisis with rising life expectancies and record low birth rates in some countries, as a result there is an increasing need for senior housing to cater to Asia’s ageing population. In a new report released today, Colliers International identified key trends in Asia’s demographic shift as well as innovative senior housing models around the globe which may be applicable to this region. . . .
Mr. Govinda Singh, Executive Director, Valuation and Advisory Services at Colliers International, said, "Singapore's greying population presents many opportunities for both policymakers and private developers to further invest in senior housing solutions. Demand for such accommodation will be also spurred by the rising awareness of healthcare and wellness benefits, and retirees having the financial capacity to take advantage of senior living services and facilities." . . .
On May 12, 2018, Singapore Prime Minister Lee Hsien Loong officially opened the country’s first retirement community Kampung Admiralty in Woodlands – an integrated residential development with a range of healthcare, elder and childcare facilities, together with commercial space to serve residents of the area. The concept was conceived by the Housing and Development Board more than four years ago.
The article noted population trends in the region, including the prediction that Asia's population of people over age 65 will "nearly triple by 2050 to 945 million, while the percentage of people over age 75 will often be "staggering," especially in Japan (36.4%), South Korea (35.3%), Hong Kong (33.9%), and Thailand (29%) by 2050.
Friday, May 18, 2018
Kaiser Health News published a compilation of recent stories about gun safety and one caught my eye: the advantage of doctors discussing gun safety with elder patients. Doctors Should Be Discussing Gun Safety With Aging Patients, Researchers Say.
The reference to the story from the LA TImes, As more older Americans struggle with dementia, what happens to their guns?seemed particularly on point and the KHN story published the opening from the LA Times article
The man had been a patient for decades, retired now from a career in which firearms were a part of the job. He was enjoying his days hunting, or at the shooting range with friends. But episodes of confusion had led to a suspicion of dementia, and the nights were the worst: At sundown, he became disoriented, anxious and a little paranoid, and had started sleeping with his loaded pistol under the pillow. One night, he pointed it at his wife as she returned from the bathroom. It wasn't clear whether he recognized her, but he was certainly confused — and she was terrified. Thankfully, the incident did not end in disaster.
Regardless of your position on the gun control debate, consider these statistics from the LA Times article
Roughly 1 in 3 adults over 65 in the United States is thought to own a gun. An additional 12% live in a household with someone who does.
As seniors turn 70, their odds of developing Alzheimer's disease in a given year jump from less than 1% (among those 65 to 69) to 2.5% (among those 70 to 74), and keep rising from there. By 2050, the number of older Americans with Alzheimer's is expected to reach 13.8 million.
The article discusses driver safety and draws corollaries to gun safety. The article highlights the lack of response to this issue at the state level:
No federal laws prohibit the purchase or possession of firearms by a person with dementia. Only two states, Hawaii and Texas, explicitly mention dementia or similar conditions in their firearms statutes.
In Hawaii, any person under treatment for "organic brain syndromes" is prohibited from owning a gun. Texas law makes individuals diagnosed with "chronic dementia" ineligible for a license to carry a handgun in public. But it does not limit such a person's right to purchase or possess firearms.
One expert quoted in the article describes this as not an issue of taking away someone's guns but instead a decision that focuses on the person's safety.
May 18, 2018 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Other, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (0)
Thursday, May 17, 2018
On May 15, 2018, a state judge issued a long-awaited ruling, concluding that the California Legislature violated the state constitution by enacting the state's End of Life Option Act that became effective in 2016 during a 2015 special session dedicated to healthcare issues. From the Los Angeles Times:
A Riverside County judge overturned California's physician-assisted suicide law on Tuesday, giving the state attorney general five days to file an appeal to keep the law in place.
California's law, which allows terminally ill patients to request lethal medications from their doctors, has been the subject of a fierce and emotional debate since it was approved in 2015. The state was the fifth in the nation to legalize the practice.
Superior Court Judge Daniel A. Ottolia said Tuesday that the California Legislature violated the law by passing the End of Life Option Act during a special session dedicated to healthcare issues, according to the plaintiffs in the case as well as advocates for the law.
"We're very happy with the decision today," said Alexandra Snyder, head of the Life Legal Defense Foundation, one of the groups that filed the lawsuit. "We will now wait and see what the attorney general does."
In a statement emailed to The Times, California Atty. Gen. Xavier Becerra said: "We strongly disagree with this ruling and the state is seeking expedited review in the Court of Appeal."
We all can sing along to that fabulous Beatles song, When I'm 64. Perhaps the Beatles were prescient, as now Kaiser Health News has published an article about remaining relevant in your life when you are 64 and beyond.... Will We Still Be Relevant ‘When We’re 64’? opens with this description
A gnawing sense of irrelevancy and invisibility suddenly hits many aging adults, as their life roles shift from hands-on parent to empty nester or from workaholic to retiree. Self-worth and identity may suffer as that feeling that you matter starts to fade. Older adults see it in the workplace when younger colleagues seem uninterested in their feedback. Those who just retired might feel a bit unproductive.
The article then segues into a discussion of various recent studies that bears out this fear of becoming irrelevant. Whether it's being important at work or important in your personal life, there is a value to being relevant, or even being needed, even if it's just giving advice to a younger person. "Having purpose and meaning forestalls loneliness, which takes an emotional and physical toll. Studies by ... researchers have found that loneliness is associated with weaker immune systems and poorer physical health."
One group in Austin, Texas (the slogan, "Keep Austin Weird") took initiative by "finding their purpose with a community created by Aging is Cool, an active-aging company founded just over a year ago." The article discusses this community initiative as well as some other ones across the country, volunteering and continued employment. The article closes with an example for all of us: "96-year-old actress Betty White ... [who] still produces good work and she has a great amount of energy... Her entire package promotes a youthful and optimistic attitude.”