Thursday, February 28, 2019
With the recent death of Karl Lagerfeld who is survived by his famous cat, Choupette, it is timely to think about pet trusts as part of estate planning. The story was covered by many news outlets. Here is info about the one that ran in CBS News, Karl Lagerfeld's cat to inherit a fortune, but may not be richest pet.
Choupette, a Burmese cat, stands to inherit a chunk of the designer'sestimated $300 million net worth, after he wrote her into his will in 2015, according to Le Figaro. Lagerfeld confirmed in an interview with Numéro last year that she, among others, would be an heiress to his vast fortune. "Don't worry, there is enough for everyone," he said. Among Choupette's most admired traits? "She doesn't talk," Lagerfeld told Numero in an earlier interview... Though Lagerfeld is German, the pair resided in France, where the law prohibits pets from inheriting their owners' wealth. German law, however, allows one's wealth to be transferred to an animal.
In the U.S., as the article notes, pet trusts are recognized but there may be limits on the amount, referencing the case of Leona Helmsely's dog, Trouble.
Wednesday, February 27, 2019
McKnight's Long Term Care News reported that Nursing home employees indicted for involuntary manslaughter after patient’s death from bedsores. "The Ohio attorney general has indicted seven former Columbus nursing facility workers on dozens of charges following a patient’s 2017 death from bedsores ... against six employees and a contracted nurse practitioner at the Whetstone Gardens and Care Center. All told, the seven individuals have been hit with 34 charges, including involuntary manslaughter, with some stemming from alleged neglectful care of a second patient." One of the patients died of septic shock and the second received insufficient care. The SNF takes a different view of the incidents.
Tuesday, February 26, 2019
The Washington Post recently published an article, Changing ‘the tragedy narrative’: Why a growing camp is promoting a more joyful approach to Alzheimer’s. This article examines a different point of view about the disease, "coming at it with a sense of openness, playfulness and even wonder" although there still is a substantial number of folks who take a different approach. The article explains this different point of view promoted by various experts. "Without dismissing the difficulties of the disease, especially in the late stages, [experts] are promoting a more adaptive approach, which they say can help caregivers and patients alike. It involves a lot of flexibility and willingness to expand one’s ideas of how things are supposed to be — even, crazy though it might sound, to see Alzheimer’s as a kind of gift."
The article highlights several programs that use humor, among other things, to help those with the disease. It is worth reading and our students will find it informative. Check it out.
Monday, February 25, 2019
The 2019 Oscars are behind us. Prior to the awards being announced, there was some attention given to the potential for recipients breaking the "age ceiling." The NYC Elder Abuse Center published this blog post, 2019 Oscar Watch: Actors Set to Break the Silver Ceiling. Noting the issues of ageism and the ability of computers to make folks look years younger, the post references a recent study showing lack of progress on inclusivity in film. "While adults 50 and older make up more than 30 percent of all moviegoers, the study found less than one-third of the highest-grossing films of 2017 featured a male 45 years of age or older at the time of theatrical release. Only five films featured a woman in the same age bracket, including Meryl Streep, Amy Poehler, Judi Dench, Halle Berry, and Frances McDormand." The blog post lists various nominees who are older, and also points out that the documentary about Justice Ginsburg is also up for an award.
Sunday, February 24, 2019
A new article, published by Professor Naomi Cahn and Amy Zietlow, The Sandwich Generation on Wheels: Tips for Long-Distance Family Caregivers discusses the all too common issue of caregiving from afar. Based on their respective research and experiences, they note "that it is helpful for family caregivers to define the "sandwich" layers they face in order to proactively plan for what role they can and should play." The first layer is what we might analogize to client identification in law practice, that is "clarify who in your older generation depends on you in some way. List your parents, stepparents, in-laws, grandparents, aunts or uncles, etc. In conversation with them, formalize your caregiving role. This is particularly important in stepfamily situation." With this layer, not only do you identify who needs help, you identify the needed documents but articulate the limitations that arise from long-distance caregiving. The authors briefly explore the potential for caregiving to help in such situations.
The second layer, "your job, " focuses on caregivers who are employed and how to juggle your job and your caregiving responsibilities. The third layer, "spouse and child" recognizes the sandwich issue-you have responsibilities to your own immediate family as well as the elders for whom you are caregiving. "Communicating with your spouse and your children about your goals for this season of life is critical. Acknowledging how you will be dividing your time, and why, will help them feel engaged and involved. You will need their moral support in your role as caregiver."
Thanks to Professor Cahn for sending us this!
Thursday, February 21, 2019
Kiplinger published a slide show that focuses on reasons why folks may outlive their retirement savings. 15 Reasons You'll Go Broke in Retirement include explanations, some of which are out of an individual's control but most are not. These explanations include: abandoning stocks or investing too heavily into stocks, not saving enough for your anticipated life span, living beyond your means, only having one source of income, not working long enough, getting sick, failing to take state taxes into account, financially supporting the kids, being under-insured, falling victim to a consumer scam, using retirement savings as collateral and lacking a rainy day fund.
Wednesday, February 20, 2019
Recently the New York Times ran an opinion piece about the amount of debt from social programs. Your Grandchildren Are Already in Debt focuses on some of the new social programs being proposed by presidential candidates. But how will we pay for these programs, as well as existing programs? "On present course and speed, the United States is on track to experience the highest deficits in its history, reaching more than $2 trillion a year by 2029. Those annual gaps are projected to bring America’s total debt to nearly $33 trillion by that date, according to the Committee for a Responsible Budget. That’s double today’s level and more than the size of our economy, a peacetime record."
Here are some thoughts from the author about the situation and its impact
[M]y principal fear is that all this irresponsible borrowing amounts to intergenerational theft. America is simultaneously indulging in two deficit-busting desires: for lower taxes and for robust government programs. Eventually, the interest on all the debt will force the governments of future generations to reverse those fiscally imprudent policies in order to pay for today’s profligacy.
It’s like a couple in their 40s deciding to borrow money to sustain a lavish lifestyle and then leaving the debts for their kids to pay off after they’re gone.
But that’s not all. The generally accepted measure of America’s national debt doesn’t include obligations for future retirement and health care benefits.
Tuesday, February 19, 2019
Kaiser Health News ran a story recently, Seniors Aging In Place Turn To Devices And Helpers, But Unmet Needs Are Common details the use of caregivers and assistive devices to help them age in place. Reporting on a new study, the article notes that there are a substantial majority of elders with insufficient help and adapt their living in order to get by. The study, published in the Commonwealth Fund, Are Older Americans Getting the Long-Term Services and Supports They Need? explains this issue "[o]lder adults’ needs have evolved and are no longer met by the Medicare program. With the recent passage of the Bipartisan Budget Act of 2018 (BBA), Medicare Advantage (MA) plans can now provide beneficiaries with nonmedical benefits, such as long-term services and supports (LTSS), which Medicare does not cover."
The key findings and the conclusion from the study abstract show:
Two-thirds of older adults living in the community use some degree of LTSS. Reliance on assistive devices and environmental modifications is high; however many adults, particularly dual-eligible beneficiaries, experience adverse consequences of not receiving care. Although the recent policy change allowing MA plans to offer LTSS benefits is an important step toward meeting the medical and nonmedical needs of Medicare beneficiaries, only the one-third of Medicare beneficiaries enrolled in MA plans stand to benefit. Accountable care organizations operating in traditional Medicare also should have the increased flexibility to provide nonmedical services. from the study.
Monday, February 18, 2019
MedicalXPress ran a story about a New tool for documenting injuries may provide better evidence for elder abuse cases. which opens noting that "[a]n estimated 10 percent of older adults experience some form of abuse each year. However, the link between injuries and possible elder abuse may take months or years to establish and is often difficult to investigate due to poor documentation during prior medical visits." To improve the process, Dr. Laura Mosqueda and her team have created "the Geriatric Injury Documentation Tool (Geri-IDT)." The tool was a result of a study done by her team, the results of which were recently published in the Journal for General Internal Medicine, Developing the Geriatric Injury Documentation Tool (Geri-IDT) to Improve Documentation of Physical Findings in Injured Older Adults.
An excerpt of the abstract offers this insight
Experts agreed that medical providers’ documentation of geriatric injuries is usually inadequate for investigating alleged elder abuse/neglect. They highlighted elements needed for forensic investigation: initial appearance before treatment is initiated, complete head-to-toe evaluation, documentation of all injuries (even minor ones), and documentation of pertinent negatives. Several noted the value of photographs to supplement written documentation. End users identified practical challenges to utilizing a tool, including the burden of additional or parallel documentation in a busy clinical setting, and how to integrate it into existing electronic medical records.
A practical tool to improve medical documentation of geriatric injuries for potential forensic use would be valuable. Practical challenges to utilization must be overcome.
Wednesday, February 6, 2019
AARP's research has an update on tech use among older adults. Older Americans’ Technology Usage Keeps Climbing shows adoption of technology by a fair number of older adults. "Today, 91 percent of those age 50+ report using a computer and 94 percent say technology helps them keep in touch with friends and family. And notably, the assumption that older individuals rely less on technology than others may be increasingly inaccurate. More than 80 percent of Americans age 50 to 64 have smartphones, which is about the same as the population at large. Grandparents are also spending a considerable amount on gifts — many likely tech-focused — for their grandkids." Perhaps, unsurprisingly, is the interest in technology's impact on cars and driving with almost 25% keen on "advanced driver assistance technology." As well, about 25% of those surveyed were atrracted to online learning.
One important note from the survey: lack of confidence in security. and privacy online. "Privacy and security issues remain a concern for many in the older age bracket, with Americans over 50 not placing much trust in institutions to keep their personal data safe. AARP finds fewer than 1 in 4 trust online retailers, the federal government, and telecom service providers, among others. A related finding, meanwhile, highlights an opportunity to provide more education to older adults specifically on safe tech practices: Nearly 1 in 5 indicates they have low confidence in their safety online."
Monday, February 4, 2019
Kaiser Health News published a story, Frail Seniors Find Ways To Live Independently. The focus of the story is on "a program for frail low-income seniors: Community Aging in Place — Advancing Better Living for Elders (CAPABLE). Over the course of several months last year, an occupational therapist visited Jeffery and discussed issues she wanted to address. A handyman installed a new carpet. A visiting nurse gave her the feeling of being looked after."
A study of the project, recently published in the Journal of the American Medical Society (JAMA) Internal Medicine shows promising results. "New research shows that CAPABLE provides considerable help to vulnerable seniors who have trouble with “activities of daily living” — taking a shower or a bath, getting dressed, transferring in and out of bed, using the toilet or moving around easily at home. Over the course of five months, participants in the program experienced 30 percent fewer difficulties with such activities, according to a randomized clinical trial...."
The article also explores the costs of the program-and it saves money! There are efforts to expand this program's reach, including approaching "Medicare Advantage plans, which cover about 19 million Medicare recipients and can now offer an array of nonmedical benefits to members, to adopt CAPABLE. Also, Johns Hopkins and Stanford Medicine have submitted a proposal to have traditional Medicare offer the program as a bundled package of services. Accountable care organizations, groups of hospitals and physicians that assume financial risk for the health of their patients, are also interested, given the potential benefits and cost savings."
Sunday, February 3, 2019
The BBC ran a story recently about elders in Japan committing crimes, to spend time in jail. The elders may be lonely, or may have outlived their savings and can't afford to live independently anymore. Why some Japanese pensioners want to go to jail
[One individual noted in the story] represents a striking trend in Japanese crime. In a remarkably law-abiding society, a rapidly growing proportion of crimes is carried about by over-65s. In 1997 this age group accounted for about one in 20 convictions but 20 years later the figure had grown to more than one in five - a rate that far outstrips the growth of the over-65s as a proportion of the population (though they now make up more than a quarter of the total).
Further, recidivism is an issue with this age group: "2,500 over-65s convicted in 2016, more than a third had more than five previous convictions." The article notes that shoplifting is the most common crime. One researcher "[i]n a paper published in 2016 he calculates that the costs of rent, food and healthcare alone will leave recipients in debt if they have no other income - and that's before they've paid for heating or clothes. In the past it was traditional for children to look after their parents, but in the provinces a lack of economic opportunities has led many younger people to move away, leaving their parents to fend for themselves." The article explains low pensions are part of the issue as well as increasing isolation and loneliness.
Thanks to two of our alums for alerting me to this article.