Monday, November 25, 2019
With Thanksgiving just two days away, I thought we should remember to give thanks to caregivers and to reflect on implications of what that means. This perspectives piece from the Washington Post from a few weeks ago is worth reading In My family faces an impossible choice: caring for our mom, or building our future the author writes from personal experience about her mother's need for care. Consider this information the author offers:
Sixty percent of people caring for adult relatives or friends also have full- or part-time jobs, according to the AARP’s Public Policy Institute. More than half of caregivers report a decline in exercise , poor diet and not seeing their doctor as needed. Chronic stress in caregivers has been shown to increase the risk of high blood pressure and heart disease . Compared with their peers, elderly individuals who serve as overburdened caregivers are 1.6 times more likely to die within four years. Only 13 percent of caregivers are between the ages of 18 and 29, according to Gallup-Healthways, so fewer studies exist on the effects on younger people. From my own experience, I can say that I routinely missed meals and sleep during my adolescence, and that I strove to hide my exhaustion, weight loss and social isolation from the people around me.
The author also writes about the financial impact that caregiving may have on the caregivers:
Caregiving fuels generational poverty, disproportionately affecting millennials and women who take on that role in their families. ... Millennial caregivers are more likely than previous generations to be passed over for promotions, forced to reduce their job responsibilities or fired, according to the TransAmerica Institute. Just a few years of caregiving early in life creates cumulative financial setbacks for women, making them less likely to have retirement savings and more likely to require government assistance. A 50-year-old woman earning $40,000 a year who leaves the workforce to care for a family member for five years loses 11 percent of her potential lifetime earnings ($256,753), according to the Center for American Progress. If she does the same at 25, she loses 20 percent of her lifetime earnings ($679,000). When women become caregivers, they also become 2.5 times more likely to live in poverty.
The author reflects on existing caregiving support programs, and mentions a new law from Washington that provides "a publicly funded long-term-care benefit... [of] $100 a day, with a lifetime cap of $36,500, to pay for services including caregiving, meal delivery and nursing home fees." The state expects to save an enormous amount of Medicaid money as a result of this new benefit.
Know any family caregivers? Right now, thank them for doing this and ask them what help they need.
Sunday, November 24, 2019
In case you missed this, a couple of weeks ago CMS released the Medicare premium and deductibles amounts for 2020.
Here are some of the more important numbers for 2020 from the CMS notice:
The Medicare Part A inpatient hospital deductible that beneficiaries will pay when admitted to the hospital will be $1,408 in 2020, an increase of $44 from $1,364 in 2019. ... In 2020, beneficiaries must pay a coinsurance amount of $352 per day for the 61st through 90th day of a hospitalization ($341 in 2019) in a benefit period and $704 per day for lifetime reserve days ($682 in 2019). For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $176.00 in 2020 ($170.50 in 2019).
As for Part B, "[t]he standard monthly premium for Medicare Part B enrollees will be $144.60 for 2020, an increase of $9.10 from $135.50 in 2019. The annual deductible for all Medicare Part B beneficiaries is $198 in 2020, an increase of $13 from the annual deductible of $185 in 2019."
The release also includes the 2020 Part B monthly premium adjusted amounts for higher-income beneficiaries.
Thursday, November 21, 2019
WINGS (the Working Interdisciplinary Network of Guardianship Stakeholders) 2019 Replication Guide has been released by the American Bar Association Commission on Law & Aging. The replication manual makes a case for reform, gives an update and then provides info on the 10 core principles of WINGS. It then provides a step-by-step guide for launching a WINGS project in a state, and concludes with this thought
WINGS can breathe fresh air into the drive by courts and community stakeholders to advance adult guardianship reform and promote less restrictive options. WINGS have sparked numerable interactions that can have ripple effects in the lives of vulnerable people. WINGS is collective impact at work!
The full replication manual is available here.
Wednesday, November 20, 2019
I received an email last week announcing the below summer conference on Law Teaching & Learning
Institute for Law Teaching and Learning—Summer 2020 Conference
Effective Instruction in Online and Hybrid Legal Education
June 11—13, 2020
University of Arkansas at Little Rock William H. Bowen School of Law
Little Rock, Arkansas
Conference Theme: The future of legal education has arrived, with more and more law schools moving toward teaching part or all of their J.D. program online. During this conference, we will explore how law professors can design and implement methods for teaching effectively in online environments, including both synchronous and asynchronous formats. After an opening plenary examining data regarding the effectiveness of online education, the subsequent plenaries and concurrent workshops will address the following topics in the context of online and hybrid courses and programs: course and program design, assessment of student learning, active learning and student engagement, teaching methods, providing feedback, and collaborative learning.
Conference Structure: The conference will consist of three plenary sessions and a series of concurrent workshops that will take place on Thursday, June 11; Friday, June 12; and the morning of Saturday, June 13. The conference will open with an informal reception on the evening of Wednesday, June 10. Details about the conference will be available on the website of the Institute for Law Teaching and Learning, www.lawteaching.org.
Registration Information: The conference fee for participants is $285, which includes materials, meals during the conference (three breakfasts and three lunches), and the welcome reception on Wednesday, June 10. The conference fee for presenters is $185. Details regarding the registration process will be provided in future announcements.
Tuesday, November 19, 2019
The Kaiser Family Foundation has released its November, 2019 issue brief, focused on the costs of Medicare Part D. Medicare Part D: A First Look at Prescription Drug Plans in 2020 offers these key findings
The average Medicare beneficiary will have a choice of 28 PDPs in 2020, one more PDP option than in 2019, and six more than in 2017, a 29% increase.A total of 948 PDPs will be offered in the 34 PDP regions in 2020(plus another 11 PDPs in the territories),an increase of 202 PDPs since 2017.
PDP premiums will vary widely across plans in2020, as in previous years(Figure 1). Among the 20 PDPs available nationwide, average premiums will range sixfold from a low of $13 per month for Humana Walmart Value Rx Plan to a high of $83 per month for Express Scripts Medicare Choice
Two-thirds of Part D enrollees without low-income subsidies (9.0 million enrollees) will see their monthly premium increase in 2020 if they stay in their same plan, while one-third (4.3 million) face premium decreases. As an example, the 1.9million enrollees without low-income subsidies in the Humana Walmart Rx Plan, the third most popular PDP in 2019,will see their monthly premium double in 2020, from $28 to $57, unless they switch plans.This is due to plan changes and consolidations, with Humana consolidating two of its DPs (Humana Walmart Rx and Humana Enhanced) into one PDP or 2020 and renaming it Humana Premier Rx, with a $57 monthly premium.
The estimated national average monthly PDP premium for 2020 is projected to increase by 7% to $42.05, weighted by September 2019enrollment. The actual average premium in 2020 may be lower if current enrollees switch to, and new enrollees choose, lower-premium plans during open enrollment.
In 2020, all PDPs will have a benefit design with five or six tiers for covered generic, brand-name, and specialty drugs,and cost sharing other than the standard 25% coinsurance, similar to 2019. More than eight in 10 PDPs (86%) will charge a deductible, with most PDPs charging the standard deductible of $435 in 2020.
Among all PDPs, median cost sharing is $0 for preferred generics and just $3 for generics, but$42 for preferred brands and 38% coinsurance for non-preferred drugs(the maximum allowed is 50%), plus 25% for specialty drugs (the maximum allowed is 33%).
Medicare beneficiaries receiving the Low-Income Subsidy (LIS) will have a choice of seven premium-free PDPs in 2020, on average, one more than in 2019. In 2020, nearly 20% of all LIS PDP enrollees who are eligible for premium-free Part D coverage(1.3 million LIS enrollees) will pay Part D premiums averaging $18 per month unless they switch or are reassigned by CMS to premium-free plans.
The full issue brief is available here.
Monday, November 18, 2019
The National Adult Protective Services Assoc (NAPSA) and the Philly Corp. on Aging have released National Guidelines for Financial Institutions: Working Together to Protect Older Persons from Financial Abuse.
The Guidelines and forms were introduced at the World Elder Abuse Awareness Day event on June 11, 2019 at the Securities and Exchange Commission designed to promote standardization and clarity among financial institutions and Adult Protective Services. We are asking that all APS programs use this form to request records from financial institutions.
The full guidelines are available here.
Judgment Dismissing Suit Against University's Elder Law Clinic & Government Officials Affirmed by Louisiana Appellate Court (But There Is More to the History for Professors to Discuss)
Last week, the Louisiana Court of Appeals affirmed the dismissal of a lawsuit involving a will that was allegedly prepared by someone in the Southern University Elder Law Clinic. The complicated proceedings involve a challenge by an elderly decedent's only surviving child, who was not named as a beneficiary in the new plan. Instead the new will created a testamentary trust benefiting the decedent's great-grandchildren and great-niece. The daughter's first suit sought to annul her mother's will and remove the person nominated in the will to be executor and trustee. In addition, the Elder Law Clinic's Director was allegedly named in the will to serve as the estate's attorney. That suit was reportedly settled after a third person was named by the court as executor and trustee for the mother's estate, presumably also ending any role for the Clinic or the Clinic Director in the estate administration.
Less than a year later, the daughter initiated a second suit "for damages," naming the Director of the Elder Law Clinic and government officials as defendants and alleging, in essence, the defendants conspired to cause the decedent to believe immediate family members were stealing from her. In the most recent ruling, the core issue was whether the daughter had standing to bring such a cause of action, after dropping her challenge to the will itself. The Court of Appeals concluded the only party with standing to bring such a suit was the executor of the decedent's estate, explaining:
Furthermore, Ms. Antoine [the daughter] acknowledged she is not a named legatee in her mother’s will. Additionally, she is not a forced heir since she was over the age of twenty-three when her mother died, and she does not allege she was permanently incapable of caring for herself due to mental incapacity or physical infirmity.... Because Ms. Antoine is neither a forced heir nor a legatee named in Ms. Plummer’s will, she has no interest in her mother’s estate. Despite Ms. Antoine’s arguments to the contrary, any rights she may have had if her mother had died intestate are irrelevant since her mother died testate.... Accordingly, the trial court correctly found that Ms. Antoine had no right of action and sustained the exceptions of no right of action.
For more, see Antoine v. East Baton Rouge Council on Aging, et al, at 2019 WL 6044634 (Ct. App. First Cir., Louisiana, November 15, 2019).
As a former director of an elder law clinic, I can empathize with challenges that can arise in student-staffed clinics. We used to caution our law students that there is no such thing as a "simple will" that seeks to disinherit a close family member -- emotions run high in those cases, especially if there are significant assets -- and we recommended seasoned attorneys for such matters.
It turns out the Louisiana matter is even more of a cautionary tale than I first thought, and not one with a clear message.
While researching some of the history of the will contest, I learned there was a third suit, a civil rights claim, in which the Director of Southern University's Elder Law Clinic, a tenured professor, is the plaintiff, alleging she was wrongfully terminated by the University because of matters alleged in the Antoine suits.
In September 2019, the United States District Court for the Northern District of Louisiana dismissed the former faculty member's suit. For more on that, see Jackson v. Pierre, et al., 2019 WL 4739294 (U.S.D.C., N.D. Louisiana, September 27, 2019). Although the dismissal turns on fairly standard procedural issues, those who teach estate planning courses, or who supervise either law school clinic programs or law school-affiliated will-drafting programs, should find it worth reading and discussing.
This is a serious question, although your reaction may be to think it's a tongue in cheek question. It's actually the subject of a New York Times article from a few months back. Think Your Aging Parents Are Stubborn? Blame ‘Mismatched Goals’ reports on a study of middle-aged adult kids about their views of their parents. Even the parents may refer to themselves as stubborn. But isn't this really just normal behavior when parents and their adult kids reach an impasse about something regarding the parent? "The more polite social science term for such skirmishes: mismatched goals. “If the goal is not shared — the older adult wants to walk to the grocery store himself and the child says, ‘I don’t think it’s a good idea’ — that’s when conflict can arise,” Dr. Heid explained. Such clashes, and related reports of stubbornness, increase when the parent and child live together, she found." Are the kids trying to be too controlling, too helpful? Are the parents not being sensible about their decisions? "These familiar, probably universal, safety-versus-autonomy debates have led some critics to object that adult children overemphasize the former, when what matters more to their parents is maintaining independence and pursuing what they find meaningful." Stubbornness has it's pros and cons, according to the article. The researcher offers some thoughts on defusing a battle of the wills: "[s]he suggests trying to equalize power in the relationship, allowing the parent to also provide support, even by just listening empathetically to a child’s account of her tough week. “It could be beneficial for the relationship to not have it all be one-sided... She’s also a fan of incremental progress, a negotiation that leads to a more reciprocal exchange." It's a very interesting article regarding a tough subject.
Saturday, November 16, 2019
I always love reading about the cool things our elder law grads are doing. Last week Stephanie Edwards, Elder Law LL.M. grad and adjunct professor in our MJ Aging, Law & Policy program, held a wonderful event for caregivers, those in their care and shelter pets. The Caregivers Holiday Paws Pause included staffed respite caregiving for those who needed care while their caregivers got a little break to visit with exhibits, interact with shelter pets seeking homes and having a meal. The event also included a presentation for caregivers on strategies for caregivers during the holidays. One shelter pet even found a new home. Stephanie Edwards ROCKS!!
Friday, November 15, 2019
Two articles in the news are worth mentioning, in case you missed them. First, the New York Times ran an article, Why Didn't She Get Alzheimer's? The Answer Could Hold a Key to Fighting the Disease. "Researchers have found a woman with a rare genetic mutation that has protected her from dementia even though her brain has developed major neurological features of the disease." The article highlights a recently published study "in the journal Nature Medicine, [in which] researchers say the woman, whose name they withheld to protect her privacy, has another mutation that has protected her from dementia even though her brain has developed a major neurological feature of Alzheimer’s disease." The article reminds us to not expect instant therapies-this is going to take time, but even so, it's still very positive news. "[T]his case comes at a time when the Alzheimer’s field is craving new approaches after billions of dollars have been spent on developing and testing treatments and some 200 drug trials have failed. It has been more than 15 years since the last treatment for dementia was approved, and the few drugs available do not work very well for very long."
Thanks to Professor Naomi Cahn for alerting me to this article.
Frontotemporal dementia attacks people in their fifth or sixth decade, just as retirement comes within reach. Doctors believe the disease affects 60,000 people in the United States alone. Neurons in the front and side of the brain wilt, and along with them, images of peacefully growing old fade. Judgment and complex planning yields to chaotic disorganization. Inhibitions give way to impulsivity and hypersexuality, so that longtime faithful partners look to affairs and excessive pornography. Empathy turns to apathy. Obsessions and compulsions erupt. Language can become laborious; the meaning of words and objects can be lost, and fluent speech can dissolve into fragments of sentences with nonsensical grammar. Jarringly, memory remains largely untouched. Since brain areas that dictate personality are often the first to suffer, most people end up on a therapist’s couch long before finding their way to a neurologist.
The article examines the importance of support groups and how some individuals present with the disease. There are some trials underway; "'[b]ecause frontotemporal dementia is often familial, we can get people into a trial before they have symptoms,' [according to one expert] 'By sequencing genes from a blood sample, we know which family members are probably going to get the disease. If we can slow down progression in those people, it’s virtually a cure.'”
Wednesday, November 13, 2019
HR 4334, Dignity in Aging, which provides appropriations for the Older Americans Act through 2024, passed the House of Representatives on October 28, 2019. The text of the bill is available here. According to a press release from the Elder Justice Coalition which brought this good news to my email box,
EJC National Coordinator Bob Blancato said, “The bill retains the all-important Title VII of the Older Americans Act, especially maintaining funding for the work of the long-term care ombudsman program. We support a new provision in the bill which updates elder justice activities to include community outreach and education and ensures innovative projects capture programs and materials for developing partnerships in communities.”
Blancato continued, “Further, we are hopeful that the 35 percent increase in authorization provided for the five-year life of the bill will be followed by adequate appropriations to allow this new initiative to go forward without reducing any existing funding related to elder abuse prevention.”
The EJC also appreciates the continued authority contained in the bill for the National Center on Elder Abuse and the National Long-Term Care Ombudsman Resource Center, as well as the new codification of the National Resource Center on Women and Retirement.
Other new provisions in the bill include first-time social isolation screening, further coordination of services to address this issue, and creation of an advisory council on social isolation. Since social isolation is a leading risk factor for elder abuse, neglect, and exploitation, these interventions are critical to preventing abuse and neglect.
You can sign up to track the bill and get updates here.
Blancato also had special praise for the Education and Labor Committee’s Civil Rights and Human Services Subcommittee Chair Suzanne Bonamici for her leadership on this bill and noted that she is also the co-chair of the House Elder Justice Caucus.
Tuesday, November 12, 2019
As the semester winds down, I have a few more posts from my students giving us updates on current events. Here's a happy and inspiring story from Shelby Reinwald:
“Love a Senior Day”
On Saturday, October 26, Jacksonville, Florida hosted its first-ever “Love a Senior Day.” This “not-so-typical” senior expo event’s primary purpose was to bring together people of all ages to recognize and celebrate older Americans and their care providers. Guest speakers at the event, including Bill Thomas, a renowned geriatrician and co-founder of the Eden Alternative and Green House Project, hoped to inform attendees of three major issues faced by the senior population: health, wealth, and dignity.
Thomas sought to pose questions to attendees with the goal of getting them to think about ways to communicate with loved ones while aging and to consider various financial management strategies to help with long-term care planning. Further, Thomas hoped to destigmatize the concept of aging as a “decline,” and to instead get more people to realize aging is just another phase of growth.
Attendees were also provided valuable information on local politics, health care and Medicare.
What made this event especially unique, though, was that music, yoga, and games were offered alongside the informative presentations in an effort to get people to “live [their] lives and forget age.”
I believe events like this will help pave the way in combating ageism and to foster relationships between people of all ages. “Love a Senior Day” is a fantastic way to gather people and educate them on ways to better care for themselves and loved ones while aging – which is something we all do – in one united space.
Aging should be celebrated, so keep an eye out for future “Love a Senior” events that you could attend at http://loveasenior.com/love-a-senior-day-events/.
The Jacksonville Times-Union article on “Love a Senior Day”: https://www.jacksonville.com/news/20191023/jacksonvilles-first-love-senior-day-is-not-your-typical-senior-expo
For information on the Eden Alternative, visit: https://www.edenalt.org/
For information on the Green House Project, visit: https://www.thegreenhouseproject.org/about/visionmission
Maddison Cacciatore writes about the important of exercise in cases of cognitive decline:
The New York Times recently published Steps to Prevent Dementia May Mean Taking Actual Steps, which discusses the preventative and mitigating effects exercise can have on cognitive decline diseases for people of a more advanced age. The article also rebuts the common presumption that brain-training apps are a reliable way to prevent or slow the development of cognitive decline. I think this a topic SNF’s need to be aware of in order to provide better care for their residents. I realize that in this risk averse society, brain training apps may be more appealing to SNF’s, as they have a far lower ability to cause physical harm to residents, however, does this it really a lower risk of harm in the long run. Reducing or avoiding necessary exercise and replacing this with a lacking alternative the SNFs are setting their residents up for a faster decline in health.
The above-referenced article outlines a few of the reasons why exercise is beneficial in regard to cognitive deterioration, one of which is common sense but not often mentioned in this discussion. Exercise brings people together in a social environment, which in turn provides them with social interaction and a need to use their brain. This is so important. SNF’s need to realize the importance of incorporating exercise and social interaction into residents’ care plans, when applicable. Any movement is better than nothing.
The New York Times included some very persuasive information regarding the prevalence of dementia in the US:
“A recent study in Health Services Research found that the additional cost of dementia to Medicare is nearly $16,000 per person over five years. About 14 percent of people in the United States over the age of 71 have some form of dementia. Alzheimer’s disease is the leading cause, afflicting 5.7 million people.”
As someone who has personally seen the toll these diseases cause on a family, as well as the positive effects of exercise on the slowing of its progression, this topic is of great importance to me and think it should be on every SNF’s radar in the future. One of my grandfathers is 92 and has very advanced Alzheimer’s. Our family opted to have a family member live with/provide him care. Pat, the caretaker, forces my Grandpa to walk around the yard a few times throughout the day. Grandpa is always more coherent after he walks, and it is especially noticeable what days he does not get some sort of exercise. We all know and agree that if he were in a SNF, not being forced to exercise on a daily basis, he would not be here today. Additionally, my other grandfather, in my opinion, has prevented (or at least put off) his development of this disease. All three of his younger siblings developed and passed away from Alzheimer’s. Because my grandfather is terrified of the disease, he is constantly exercising and playing the brain development apps. He is 77 and exercises for at least an hour every day. I am not an expert by any means, but it is my opinion that he has not been diagnosed due to this constant exercise.
The prevalence of cognitive decline is a very important problem, needing more attention. They are a great emotional and financial burden on a community, and if there is a way to prevent and/or mitigate their progression, SNFs and families need to take note. It may be more work, and not the most financially appealing option, but the end result is much more important.
Monday, November 11, 2019
The National Center on Law & Elder Rights has announced the release of the Elder Justice Toolkit. According to the website
The Elder Justice Toolkit is a resource created by the National Center on Law & Elder Rights. It contains practical information on civil legal remedies, practice tips, and sample pleadings for attorneys seeking protection and redress for their clients who have experienced elder abuse. Multiple states’ perspectives are considered and used as examples, but the Toolkit is designed for national use.
Some of the resources contained in the Elder Justice Toolkit have come from legal assistance organizations and have been re-formatted or re-purposed by NCLER...
This resource will continue to grow and have materials added to it over time. To receive NCLER communications and updates on resources, sign up here.
To find additional resources on elder justice topics, please read our Elder Justice Compendium.
A collection of our elder abuse webcast trainings can be found here.
Each topic includes a summary, an issue brief and step-by-step guide and a video. Here's an example of an issue brief on mandatory reporting for elder abuse cases.
Check it out and bookmark the webpage!
Sunday, November 10, 2019
ProPublica ran an in-depth story about a case of mistaken identity and the removal of life support.The Wrong Goodbye covers the story of removal of life-support from a patient, after which the family learns that the patient was not in fact their relative. The must-read story offers examples of how and why mis-identification of patients may occur. After writing about the facts and both families, the story turns to the litigation.
“The defendants negligently misinformed the plaintiff that her brother ... was admitted to the hospital in an unconscious state. The defendants negligently misinformed the plaintiff that her brother had died on July 29, 2018. As a result of the defendant’s misinformation and negligent conduct the plaintiff has suffered severe emotional harm and injuries.”
[The hospital] ... did not deny the mix-up, but argued it was not liable for any damages because no member of the Williams family ... had actually been a patient at the hospital. The hospital asked a judge to dismiss the case.
[The] lawsuit was reported in a daily story inside the New York Post on Jan. 27, 2019. It did not report the identity of the person taken off life support, but the story was reproduced on a slew of news websites.
[The widow] found the article on her Facebook feed. It had been aggregated on a website called Dearly.com. She eventually realized the story involved [her husband's] death, that he was the unidentified dead man in the article. Months into her efforts to figure out the details of her husband’s death, she saw in [the attorney], who’d been quoted in the article, someone who might help. Maybe [the attorney] would represent her, too.
She met [the attorney] in his Brooklyn office. He was quite certain she had a case. He was less certain he could represent both families. He arranged for her to call [a member of the other family] to see if everyone was comfortable with the idea....
When the conversation was over, [the attorney] was representing both families.
The article ponders the oversight from the law and various state and federal agencies and the impact this has had on the families. In the epilogue to the article, we are updated
More than a year after her husband’s death [the decedent's spouse] feels deeply frustrated, and increasingly doubtful that her husband’s death will ever be fully explained or that anyone will ever be held accountable. The police have all but stopped speaking to her. [The hospital] seems to have been cleared by the Health Department.
[The widow's] remaining chance at what she wants — a full explanation and punishment if warranted — appears to rest with ... the lawyer....
This summer, a judge in the Bronx rejected [the hospital's] motion to dismiss [the] lawsuit. [The attorney] is eager to start collecting more material in discovery.
. . ..
Read this article, realizing the story has not yet ended. It provides an important teaching point for us with our students.
Everyone agrees that we need a stronger national commitment to "retirement security" in America. But what, exactly does that mean? This topic will be a central focus for discussion during a Public Forum hosted at Penn State's Dickinson Law on Tuesday, November 12, 2019. The keynote speaker is former Maryland Lt. Governor Kathleen Kennedy Townsend, who is currently the Director of Retirement Security at the Economic Policy Institute, as well as serving as a research professor at Georgetown University.
Along those very lines, last week I read a news article about the latest stalemate at the federal level on specific legislation that could promote better retirement savings. The measure in question is H.R. 1994, the "Setting Every Community Up for Retirement Enhancement" Act -- and of course that name was chosen to reinforce the goal of SECURE futures. The bill passed the House with strong, bipartisan backing in May 2019, but is now mired in the Senate. Excerpts from The Hill describe the roadblocks to passage:
GOP senators on Thursday attempted to bring a House-passed retirement savings bill to the Senate floor with votes on a limited number of amendments, but the effort was rejected by Democrats.
The Republican effort and Democrats' rejection highlighted how, despite widespread bipartisan support and backing from industry groups, it is still unclear when the retirement bill will be enacted.
The House in May in a nearly unanimous vote approved the bill, known as the SECURE Act. The bill includes a host of provisions aimed at making it easier for businesses to offer retirement plans and for people to save for retirement. It also reverses a provision in the 2017 Republican tax-cut law that inadvertently raised taxes on military survivor benefits paid to children....
Sen. Patty Murray (D-Wash.) objected to the Republican request, saying that Senate Democrats want the chamber to pass the House-passed bill as-is, without any amendments.
“We have a few Republican senators who want to sidetrack it with last-minute amendments, including proposals that are not in the interest of working families and will kill any chance this bill has of becoming law,” she said.
Murray asked Toomey to modify his request in order to allow the bill to pass as-is, but Toomey said he wouldn’t modify his request.
For another perspective, see "What is the SECURE Act? How Could It Affect Your Future?"
Friday, November 8, 2019
Maybe it's just me, but there seems to be a lot of items in the news of late about elder abuse. Here are some new tools to add to your toolbox in the fight against elder abuse. The National Center on Elder Abuse (NCEA) and National Asian Pacific Center on Aging (NAPCA) have released 3 new fact sheets:
- Six Ways to Care for Yourself When Caring for Someone with Dementia
- NAPCA: Emotional Abuse and
- NAPCA: Neglect
All of the fact sheets are available in several languages and are added to an extensive library of fact sheets.
Thursday, November 7, 2019
The Federal Trade Commission (FTC) recently sent a report to Congress, Protecting Older Consumers 2018-2019: A Report of the Federal Trade Commission. Here is the introduction to the 40 page report:
As the nation’s primary consumer protection agency, the Federal Trade Commission (“FTC” or “Commission”) has a broad mandate to protect consumers from unfair, deceptive, or fraudulent practices in the marketplace.1 It does this by, among other things, filing law enforcement actions to stop unlawful practices and, when possible, returning money to consumers. The FTC also protects the public through education and outreach on consumer protection issues. Through research and collaboration with federal, state, international, and private sector partners, the FTC strategically targets its efforts to achieve the maximum benefits for consumers, including older adults. Protecting older consumers in the marketplace is one of the FTC’s top priorities. Unfortunately, in numerous FTC cases, older adults have been targeted or disproportionately affected by fraud. For example, the FTC has brought numerous enforcement actions in federal court to stop deceptive technical support schemes that affected older consumers.As the population of older adults grows,the FTC’s aggressive efforts to bring law enforcement action against scams that affect them, as well as provide useful consumer advice, become increasingly important.
The FTC submits this second annual report to the Committees on the Judiciary of the United States Senate and the United States House of Representatives to fulfill the reporting requirements of Section 101(c)(2) of the Elder Abuse Prevention and Prosecution Act of 2017. The law requires the FTC Chairman to file a report listing the FTC’s enforcement actions “over the preceding year in each case in which not less than one victim was an elder or that involved a financial scheme or scam that was either targeted directly toward or largely affected elders.” Given the large number of consumers affected in FTC actions, this list includes every administrative and federal district court action filed in the one-year period. Appendix A to this report lists all of the FTC’s enforcement actions over the preceding year. In addition to the list, the FTC files this report to provide detail on the agency’s efforts to protect older consumers, including its research and strategic initiatives, its law enforcement actions that noted an impact on older adults, and its targeted consumer education and outreach.
The full report is available here.
Wednesday, November 6, 2019
Student George Thurlow found this story about athletes helping elders with their utilities:
The Jacksonville Jaguars NFL team and linebacker Myles Jack recently made headlines by helping to keep utilities on for several elderly Jacksonville residents in October 2019. While this donation made a difference in helping 31 elderly customers to keep their electricity on, it also speaks to a larger societal issue—there are many older Americans (ages 65 and above) that face financial hardship.
According to a 2008 study from the Center for American Progress, 22.4% of older Americans have family incomes that would be considered poor—within 150% of the poverty line (which in 2019 is $12,490 for a single person or $16,910 for a couple). This measure also likely underestimates the elderly poverty rate as it fails to consider thing like high medical costs (which nearly would double the figure for New York state). These individuals struggle the most with paying their utility bills. While programs such as Florida’s Low-Income Home Energy Assistance Program (LIHEAP) and Emergency Home Energy Assistance for the Elderly Program (EHEAP) can help older Americans meet this need, they require substantial documentation to apply and leave out some older Americans struggling but with income above 150% of the poverty line. Also, older Americans are more likely to live in older homes with insufficient insulation and not have newer, more efficient heating and cooling systems, only increasing their costs. The end result of this is that a lot of older Americans are struggling balancing their utility bills with other necessities.
While this is a good dead by the Jaguars and Myles Jack, how do we help other older Americans facing this same struggle? Do we increase Social Security and Medicare benefits? Do we encourage more economical housing arrangements that would have lower utility bills? These are serious discussions that we will need to have and the need to have these conversations will not disappear anytime soon with rising medical costs, rising life expectancies, and a growing number of people nearing retirement age with insufficient savings.
Jenna Kyle writes about elders in one country who are committing crimes in order to be jailed for housing:
Jail as a Warehouse for the Japanese Elderly
It is commonly discussed how people in today’s North American society have a lack of respect for the elderly. Often, you hear how in other cultures, such as those in Asia, respect for the elderly still exists. However, this article illustrates that a lack of respect and resources for the elderly is a global problem.
Seniors in Japan are intentionally committing petty crimes as they have no money to afford food and shelter. They commit these crimes knowing how seriously Japanese courts treat petty theft, expecting to receive jail sentences; and therefore, food and shelter. In the past, children traditionally looked after their parents in Japan. But, recently in provinces that lack economic opportunities, younger people have moved away, leaving the elderly to look after themselves. It is interesting to consider whether a similar epidemic could occur in the United States. Personally, I don’t believe it is as likely. In Japan, the elderly are committing petty non-violent crimes, as they are known to come with high sentences. In the US, petty crimes, such as shoplifting are not typically given such high sentences. Therefore, American seniors would need to commit more extreme crimes to be sentenced to a jail term, crimes I feel elderly people are less likely to commit.
Further, Japan is improving their prisons, putting in handrails and special toilets and implementing special classes for older offenders. Historically, American prisons aren’t as elder friendly, making them a less desirable living situation for impoverished American elders.
This article also raises another important issue. A model in Japan has been costed to build an industrial complex retirement village where people would forfeit half their pension to get free food, free board and healthcare, etc. It has been determined that it would cost significantly less for the government to do this than to continue to put money into their jails to make them adequate for their elderly inmates. I believe this illustrates how the government and society tends to deal with issues involving the elderly in a reactive manner instead of a proactive manner. If the government and society were able to take more proactive measures in caring and aiding the elderly, it would not only benefit the government (less money spent) but would also greatly improve the quality of life for their elderly citizens.
Erin Morse writes a very personal story about looking for an ALF for a family member.
Finding an Assisted Living Facility For Your Loved One
Around this time last year, my family and I were looking into assisted living facilities for my grandma that had been diagnosed with dementia years prior. Thankfully we had time to look into these options, something many people don’t have on their side as many are being discharged from the hospital and can no longer go home.
We began looking into our options for assisted living facilities because it was becoming too hard on my grandpa to be her caregiver and unfortunately in-home care was not our best option because my grandpa, the devoted husband that he is, refused to give up on my grandma and thought he didn’t need the help.
Several things played a factor in what I looked at when assessing the different facilities. It was important to me that the facility allowed visitors whenever, with no advance notice. If a facility makes you give notice and/or only allow visitors in a certain time frame, it’s a huge red flag.
The quality of food was also top of my list. I didn’t want my loved one eating cafeteria slop. I wanted the food to be edible, fruits and vegetables that actually looked like fruits and vegetables, and a healthy well-rounded diet. I wanted the food to be made fresh daily and not come from a freezer.
I also factored into my decision what the residents were doing in the daytime when we visited. Were they sitting around watching tv? Were they just sitting in their wheelchairs and sleeping? Did they seem to never leave their room? Or were they active and participating in different types of activities?
There is obviously an extensive list of things to consider when choosing a facility for your loved one which can be found with a simple google search, one of those lists being located at the following link: https://www.aarp.org/caregiving/basics/info-2017/assisted-living-options.html. It is also helpful to make a list of things that would be important to you if you were about to enter into a facility.
Which brings me to present day, where my family and I are now potentially looking at facilities for my grandpa, who was just diagnosed with Alzheimer’s. Things that I have now added to my list are to thoroughly read the facilities contract - paying close attention to arbitration clauses and their ability to terminate the contract; observe the facility’s turnover – which I recommend looking at their open job positions and see how often new job postings are being posted; and even learn about who is on their payroll – how many registered nurses, do they have a visiting doctor, do they have a local pharmacy or a pharmacy that delivers, etc.
Tuesday, November 5, 2019
There are two upcoming webinars you won't want to miss. First, register for the How to Talk About Elder Abuse webinar on November 13 at 1 eastern. According to the announcement
Over the past few years, the FrameWorks Institute worked with the National Center on Elder Abuse to create a communication strategy that demonstrates how we can restructure our communities to put elder abuse on the public agenda, generate a sense of collective efficacy on the issue, and boost support for systemic solutions to prevent and address it. During this webinar, participants will learn about the NCEA’s Reframing Elder Abuse project; review a new evidence-based public communication strategy on elder abuse; and begin learning how to apply it in their communication practices.
To register, click here.
The next webinar, on December 3, at 2 eastern, covers New Research on Elder Abuse Among American Indian and Alaska Native Populations,
The webinar which is hosted by the National Center on Elder Abuse at the Keck School of Medicine of USC, will cover the following:
Many tribal communities are experiencing a silent epidemic of abuse of older adults. Limited research on elder abuse has suggested higher rates of abuse among tribal elders, yet little is known about promising strategies that can be implemented to prevent or manage cases of abuse. This webinar will provide an overview of elder abuse in Indian Country, including recent research identifying new national-level prevalence rates and predictors of abuse among American Indian and Alaska Native elders. Rates of various types of elder abuse for Native Americans-- almost double that of overall findings from original study findings -- will be shared. The unique, complex context that intersects to shape abuse correlates for tribal elders such as history of trauma, social support, and emotional problems will be discussed. Findings from a recent national needs assessment focused on screening and management of elder abuse in tribal health settings that included tribal health care providers, elder advocates, Title VI staff, and tribal Adult Protection Services will also be shared. Presenters will identify promising practices and strategies identified in the needs assessment, as well as a series of recommendations that can be implemented in local tribal communities to help combat elder abuse.
To register, click here.
Monday, November 4, 2019
Social Security recently posted on the SSA Blog a quick explanation of the basics of Medicare. Medicare, A Simple Explanation first explains original Medicare which "includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). If you want drug coverage, you can join a separate Part D plan. To help pay your out-of-pocket costs in Original Medicare (like your deductible and 20% coinsurance), you can also shop for and buy supplemental coverage." The blog then explains Part C (Medicare Advantage):
Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D. Part C plans may have lower out-of-pocket costs than Original Medicare. They also may offer extra benefits that Original Medicare doesn’t cover — like vision, hearing, dental, and more.
If you can’t afford to pay your Medicare premiums and other medical costs, you may be able to get help from your state. States offer programs for people eligible for or entitled to Medicare who have low income. Some programs may pay for Medicare premiums and some pay Medicare deductibles and coinsurance. To qualify, you must have limited income and resources.
I assigned the post to my students. I think it will help them get the parts right in their heads before we start drilling down into the details of each program.