Monday, January 11, 2021

2020 Summary of Guardianship Legislation

The American Bar Association Commission on Law & Aging has released its 2020 summary of guardianship legislation.  The summary, Directions of Reform: 2020 Adult Guardianship Legislation Summary, American Bar Association Commission on Law and Aging is available .here.

The summary is divided into the following: pre-adjudication issues,  multi-jurisdictional issues, guardian selection, guardian actions, fees, rights of the individual, capacity matters, guardian & fiduciary misconduct, and post-adjudication/monitoring matters. The summary includes a chart at the end for a quick reference. The link  to the archives for prior year summaries is available here.

January 11, 2021 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, State Statutes/Regulations | Permalink | Comments (0)

Thursday, December 24, 2020

Hugs in Time for Christmas

A couple of days ago, the Washington Post ran an uplifting article about a hug room in a SNF.  After months of isolation, a ‘hug room’ lets Italian nursing home residents touch family for the first time tells us about "a 7-foot-tall piece of plexiglass, molded into a three-sided booth. It had four cutout holes, where protective sleeves would be added for arms. It was known, in the strange language of the pandemic, as a “hug room,” but it was less a room than a barrier: residents on one side, relatives on the other."  Although not as ideal as living in a COVID free world (or at least a vaccinated one), this "plexiglass represented the sort of modest step some nursing homes are now taking in a year when they have faced excruciating decisions about how protective to be and how best to reduce their risks."  The article references similar efforts taken by other SNFs.

A  little bit of good news, then, for Christmas.

PS: Florida announced that the second round of vaccines will go to those 70 and older, and Texas, to those 65+ and older.

PPS-remember to thank first responders, health care professionals and all who keep us safe and going through this trying time. Stay safe and stay healthy.

 

December 24, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, International, Science | Permalink | Comments (0)

Tuesday, December 22, 2020

More on SNFs and COVID

It's going to be some time before we see good news stories about residents of SNFs---although the vaccination of SNF residents is good news.  So here are several recent articles regarding SNFS and COVID-but be forewarned, these first two are not easy to read.

51 lost lives: A portrait of the pandemic’s tragic toll in America’s nursing homes

South Dakota’s COVID-19 Surge Is Turning Nursing Homes Into A ‘Battle Zone’

There are just no words....

Then: 

An investment firm snapped up nursing homes during the pandemic. Employees say care suffered.

(Thanks to Morris Klein and Professor Bauer for sending me the link to this article).

and finally

With Vaccine Delivery Imminent, Nursing Homes Must Make a Strong Pitch to Residents.

This last article brings up some interesting issues for class discussion-such as consent, refusal of consent, and inability to consent.

Please everyone-stay safe and remember to thank our first responders, health care professionals and essential workers. And let us never forget those we have lost to this pandemic.

December 22, 2020 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Federal Statutes/Regulations, Health Care/Long Term Care | Permalink | Comments (1)

Monday, December 21, 2020

Hands on Learning From Caring For Elder Parents

JAMA network published this article, What Caring for My Aging Parents Taught Me That Medical Education Did Not is a first person account by the author of what he went through with his parents, and what he learned from the experience.

Slowly, however, things started to change. My parents seemed to have increasing difficulty staying organized. Instead of me calling them, they began calling me—at first weekly, then daily, and then multiple times per day. My father’s blood pressure was out of control, and he could not tell me what medications he was taking. My mother’s scoliosis, a problem since adolescence, now caused her to have significant difficulty walking. She looked thinner each time I saw her. Their physicians seemed not to be communicating well with each other. Finding their cell phones became a daily project.

Then came the identity theft: strange addresses on their credit card statements, charges to their accounts from Florida businesses when they were not living there, and even their telephone being answered by the identity thief himself. Managing these problems became my part-time job. Since credit card fraud departments are typically open only during business hours, I would sometimes spend afternoon hours on hold from my hospital office, waiting for someone to pick up, rather than charting, talking to a consultant, or doing research.

The move from their home of 30 years was the next step. They simply could not manage the house. Once spotlessly clean, it was now increasingly cluttered with tchotchkes from circa 1993. The garden was overgrown, the dishes dirty. After work, I typically spent an hour every day helping organize, donate, and throw away their belongings, so that we could put the house up for sale. Thankfully, the renovations went smoothly and the house sold quickly. Although not without drama, my parents moved to a retirement facility nearby.

The  author created a list of what he wished he had known as he cared for his parents:

  1. If you have the feeling that something may be an issue for your aging parents, it is almost definitely an issue.

  2. Make sure you know about all your parents’ financial accounts. 
  3. You (and they) may need emotional support from people you would not expect. 
  4. Advocate for your parents in the best way you can, but do not expect everything to be cut and dried.
  5. Use technology to help you (and them).
  6. Do not expect too much from the medical system. 
  7. You must have the difficult conversations if the physicians will not.
  8. You may need to get them daily help.
  9. Do not forget to keep some perspective and occasionally laugh.

Great article! Thanks to Amos Goodall, Esq. for sending me the link.

December 21, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care | Permalink | Comments (0)

Sunday, December 20, 2020

Podcast on End of Life Decisionmaking in Guardianship Cases

GeriPal, a geriatrics and palliative care blog, has released a podcast, Guardianship and End-of-Life Decision Making: A Podcast with Andy Cohen and Liz Dzeng, discussing  a recent study led by Dr. Cohen.

The big surprise finding of this study was veterans who were nursing home residents aged 65 and older with moderate to severe dementia and who had a professional guardian were no more likely to receive high‐intensity treatments than the same population who died with decision makers who were not professional guardians.   We talk to Andy about his study, potential reasons behind the study, and what, if anything, we should do differently knowing these results. We also talk to Liz about whether substituted judgement is really all that it’s cracked up to be.

The article, Guardianship and End‐of‐Life Care for Veterans with Dementia in Nursing Homes  and editorial, We Need a Paradigm Shift Around End‐of‐Life Decision Making,  are available here and here.

December 20, 2020 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care | Permalink | Comments (0)

Monday, December 7, 2020

Is It Bad Money Management or is it Dementia?

JAMA Internal Medicine published the results of a recent study, Financial Presentation of Alzheimer Disease and Related Dementias.

Here are the key points from the study: 

Question  Are Alzheimer disease and related dementias (ADRD) associated with adverse financial outcomes in the years before and after diagnosis?

Findings  In this cohort study of 81 364 Medicare beneficiaries living in single-person households, those with ADRD were more likely to miss bill payments up to 6 years prior to diagnosis and started to develop subprime credit scores 2.5 years prior to diagnosis compared with those never diagnosed. These negative financial outcomes persisted after ADRD diagnosis, accounted for 10% to 15% of missed payments in our sample, and were more prevalent in census tracts with less college education.

Meaning  Alzheimer disease and related dementias were associated with adverse financial events starting years prior to clinical diagnosis.

The full article is  available here.

December 7, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Other, Statistics | Permalink | Comments (0)

Friday, December 4, 2020

The COVID Crisis in One Florida LTC Facility

The Tampa Bay Times ran a profile of  a local long term care facility that experienced a significant COVID outbreak last spring.  Death at Freedom Square  is an in-depth story about the people who live and work at Freedom Square and the spread of COVID within that facility. The article provides detailed reporting (In fact the TBT refers to this story as a "project").  The article is written in a way that tells the story of the people impacted, which makes it a compelling--- and sad---- read.    

Nine months into the pandemic, the virus has killed more than 19,000 Floridians. About 40 percent of the deaths have been among senior care residents. In Pinellas County alone, more than 2 out of 3 coronavirus deaths are connected to nursing homes and assisted living centers.

Freedom Square, a 15-acre retirement complex built around a town square and a gazebo, was the early epicenter in Tampa Bay.

Of course, we all know that this is not the only facility that experienced a COVID outbreak, whether inside Florida or in other states. The human interest angle makes this a compelling read, but it also includes important information about the Florida responses and about the corporate structure for this facility.

The article is as gripping as it is saddening; the reporters use of the human interest angle helps remind us that we aren't talking about numbers---we are talking about people.

Read it!

December 4, 2020 in Consumer Information, Current Affairs, Dementia/Alzheimer’s, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Medicare, State Statutes/Regulations, Statistics | Permalink | Comments (0)

Monday, November 30, 2020

Taking Grandma Home; But What Happens When Grandma Goes Back to the SNF?

Last week with Thanksgiving, some families took their elders from the SNFs to be home for the holiday.  But if grandma then goes back to the SNF, is she bringing a hitchhiker with her (COVID).  The Tampa Bay Times discussed this in their article a few days before Thanksgiving, Residents may leave Florida facilities for Thanksgiving, could bring coronavirus back reminds us that "[a]state executive order issued in October mandates that facilities allow residents to visit their families’ homes. Experts and advocates worry that the state has not simultaneously put in place more safety protocols."  Since the state doesn't require testing of residents,  so as residents return to facilities and aren't tested, we just don't know how this is going to play out.  "[T]he Florida Health Care Association ...  reminded its member facilities that families should take coronavirus precautions if they bring their loved ones home ...  [and while] not required, some facilities may test residents upon their return or isolate them,...  and all homes will screen residents for coronavirus symptoms and potential exposure."

And on a somewhat related note, the following story from Canada examines the situation of elders who were taken home at the beginning of the pandemic. Pulled from care homes during pandemic, these seniors thrived — highlighting 'urgent' need for change: expert, 

notes that some elders have improved when taken home, but the decision to do so has many things to consider, such as the family members' ability to provide the needed care. Two of the folks interviewed for the story express frustration with what they see as elected officials' failure to resolve the problems in long-term care.  

Thanks to my dear friend and colleague Professor Feeley for sending me the link to the second story.

 

November 30, 2020 in Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, International | Permalink | Comments (0)

Tuesday, November 17, 2020

Catching up on Nursing Home Articles

It's hard to keep track of all the articles coming out, most of which are about COVID and SNFs. There have been so many recently, I decided to just list them here.

COVID-19 Is Still Devastating Nursing Homes. The Trump Administration Isn't Doing Much to Stop It  (Sept. 11, 2020)

They Work in Several Nursing Homes to Eke Out a Living, Possibly Spreading the Virus (Nov. 2, 2020)

Judge says care home residents in England are legally allowed visitors (Nov. 3, 2020) (Thanks to my dear friend Professor Feeley for sending this to me)

Nontraditional nursing homes have almost no coronavirus cases. Why aren’t they more widespread? (Nov. 3, 2020)

40 Dead, Now 40 Laid Off: Inside a Nursing Home in Crisis (Oct. 29, 2020).

It has the highest death rate of any nursing home in the US. Families want to know why (Oct. 28, 2020)

Kansas nursing home faces severe federal penalties after deadly coronavirus outbreak (Oct. 27, 2020)

and finally, but maybe most significantly, this obituary,  Carter Williams, Who Unshackled Nursing Home Residents, Dies at 97 (Oct. 5, 2020).  Thank you Ms. Williams!

With the COVID numbers skyrocketing, I expect we will see more of these stories-and restrictions on visitation that have been previously lifted, are likely going to be imposed again.

November 17, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Federal Statutes/Regulations, Health Care/Long Term Care, State Statutes/Regulations, Statistics | Permalink | Comments (0)

Monday, November 16, 2020

Making DC More Dementia-Friendly?

My friend Morris Klein sent me this article a couple weeks ago (thanks Morris). Good urban design can make Greater Washington more dementia-friendly explains that "Greater Washington’s population of older adults is growing. So too is the number of people with dementia and other age-related memory loss. That makes designing for dementia one of the key ways we can make our urban spaces work for the people using them."  The article explains that many folks with dementia live within the community rather than in a facility.  As a result, city planners need to consider this when updating their urban planning and  their zoning ordinances.

[M]ost people with memory loss age in their communities, cared for by family members who do not receive enough support. Those in nursing homes often face abusive, unhealthy, or unhappy environments. Thousands of people with dementia and memory loss died from the coronavirus pandemic in nursing homes. As a result of these trends, more families are now seeking to keep loved ones with dementia in the community.

But public spaces are often unusable by people with cognitive abilities affected by dementia. People with dementia often feel overwhelmed, get lost, have trouble, or face dangerous situations while trying to navigate cities. Skills that we take for granted are difficult for older adults with dementia, including the ability to find alternative routes, filter out extraneous sensory information, or remember directions. Much of this is unintentional: designers and planners are often unaware of these needs. That intent, however, does not change the impact.

The article discusses various suggestions and techniques, such as wayfinding, signage and invigoratingly-designed spaces. Of course, safety parking, and types of seating must also be considered.  Most importantly is "listening to people with dementia, who should be engaged in design processes in some way, even if just in informal conversations. Planners and designers can learn from social programs for older adults with memory loss."

November 16, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Other | Permalink | Comments (0)

Wednesday, October 28, 2020

COVID 19 and Dementia

COVID-19 has hit residents of nursing homes hard.  But it’s also hit hard those with dementia.   Dementia deaths rise during the summer of COVID, leading to concern was published recently in The Conversation. The article opens with this sobering observation

Deaths from dementia during the summer of 2020 are nearly 20% higher than the number of dementia-related deaths during that time in previous years, and experts don’t yet know why. An estimated 61,000 people have died from dementia, which is 11,000 more than usual within that period.

“There’s something wrong, there’s something going on and it needs to be sorted out,” Robert Anderson, chief of mortality statistics at the U.S. Centers for Disease Control and Prevention, said in a recent interview with Politico. “This is highly unusual.”

The author analyzes the four factors that may have played a role in the deaths of these individuals. Those include social isolation (“[s]ocial isolation, which essentially is little or no contact with others, is the last thing seniors with dementia need. But it’s what many have received, as caregivers are forced to limit visits during the pandemic”), caregiver burnout (“during COVID-19, caregivers have been isolated too. What help they had from the outside is now probably gone. Burnout becomes more likely”),  decreased access to medical care (“[f]or dementia patients, accessing care may even be more problematic. Telemedicine, often an option for other patients, may not be manageable for those with dementia”), and staying home or using the health care offered by the facility, when they’ve decided the risk of leaving the house is greater than the medical issue (“a good example of something we doctors call goal-concordant care: when doctors understand a patient’s health goals, and then provide them with the best they can within the scope of those goals”).

The author concludes with some advice: check on the folks with dementia whom you know, check in on the caregiver…and be a good listener, and talk to your family about your wishes if this becomes your future.

Thanks to Professor Naomi Cahn for sending the link to this article.

October 28, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Other | Permalink | Comments (1)

Tuesday, October 27, 2020

NPR aired a timely podcast on nursing homes seeking federal government funding do to the increased number of COVID cases. For-Profit Nursing Homes' Pleas For Government Money Brings Scrutiny explains that

Nursing homes have been overwhelmed by the coronavirus. Residents account for more than a quarter of all COVID-19 deaths nationwide. The industry says that facilities have also been overwhelmed by costs, and they're asking for billions in aid from the federal government… But recent studies suggest that for-profit ownership may have endangered residents by skimping on care, while funneling cash to owners and investors.

The article highlights some facilities that have had issues and focuses on the for-profit business model.  “Studies looking at thousands of nursing homes across the country have connected for-profit ownership and low nurse staffing to increased coronavirus infections.

The nursing home industry rejects those studies and promotes earlier research that concluded that outbreaks are largely caused by community spread of COVID-19 outside of nursing homes.”  With residency numbers declining but costs increasing, nursing homes are facing another hurdle. And they are seeking money from the feds. “Nursing homes have already received about $7.5 billion from federal coronavirus relief legislation and billions more in Paycheck Protection funds. Now the industry is asking for another $100 billion for all health care providers, with a "significant" amount of that going to nursing homes.”

You can listen to the accompanying podcast by clicking here to access it.

October 27, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Federal Statutes/Regulations, Health Care/Long Term Care | Permalink | Comments (0)

Monday, October 26, 2020

Weakened Memory Recall: Leading to Remembering?

Scientific American ran an article, Helping Alzheimer’s Patients Bring Back Memories Targeting recall processes could let people who are in the disease’s early stages access what they currently can’t remember.

People of all ages have moments when it feels like we’re on the edge of recalling something but can’t quite do it—where we parked our car or left our phone, for example, or what name goes with that familiar face. It’s extremely frustrating in the moment, but for most of us, we can usually remember if we try. For patients with Alzheimer’s, Huntington’s and many other dementia-causing diseases, however, memory loss is much more profound.

The article discusses two theories regarding memory loss: “one is that these patients can’t store new information properly in the brain; the other is that their ability to recall stored information has been weakened.”   The author discusses his research and how that led him to support the “weakened memory recall idea.”

The author uses great analogies to help the reader understand the science of the disease and the work. The author notes that there is a lot yet to know, “but what’s clear is that we need to take advantage of targeting recall to help treat patients in the near future.” 

Thanks to my colleague and friend, Professor Feeley, for sending me this article.

October 26, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Other, Science | Permalink | Comments (0)

Friday, October 23, 2020

Forgetting a Word Doesn't Mean Dementia

Ever find yourself saying, "what was their name again? It's on the tip of my tongue."  Then do you worry that you have dementia because you can't remember the word? The Washington Post tackled this in a recent article,  Dementia is more than occasionally forgetting a name or a word.

First, it is important to know that dementia cannot be diagnosed from afar or by someone who is not a doctor. A person needs a detailed doctor’s exam for a diagnosis. Sometimes, brain imaging is required.

And, forgetting an occasional word — or even where you put your keys — does not mean a person has dementia. There are different types of memory loss and they can have different causes, such as other medical conditions, falls or even medication, including herbals, supplements and anything over-the-counter.

There is normal age-related memory loss, and the article emphasizes that such memory loss is normal! Let’s distinguish from memory loss that is not normal---“forgetting the name of someone you see every day; forgetting how to get to a place you visit frequently; or having problems with your activities of daily living, like eating, dressing and hygiene….When you have troubles with memory — but they don’t interfere with your daily activities — this is called mild cognitive impairment. Your primary care doctor can diagnose it. But sometimes it gets worse, so your doctor should follow you closely if you have mild cognitive impairment.”

The article offers the CDC's  quick bullet-point list of warning signs for specific domains when forgetfulness is more than just normal age-related memory loss:

  • Memory.
  • Attention.
  • Communication.
  • Reasoning, judgment and problem solving.
  • Visual perception beyond typical age-related changes in vision.

Although Alzheimer’s is the dementia that most often comes to mind, the article reminds us that there are several types of dementia.  The article provides a good overview of the issues that arise from dementia and concludes with this thought-provoking observation:

But even more frightening is unrecognized or unacknowledged dementia. You must, openly and honestly, discuss changes you notice in your memory or thinking with your doctor. It’s the first step toward figuring out what is happening and making sure your health is the best it can be.

And, as with any disease or disease group, dementia is not a “character flaw,” and the term should not be used to criticize a person. Dementia is a serious medical diagnosis — ask those who have it, the loved ones who care for them or any of us who treat them.

October 23, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Science | Permalink | Comments (0)

Monday, October 19, 2020

Can Individuals with Dementia Vote?

The New York Times reported recently on a hot topic with the upcoming election: whether an individual with dementia can still vote. Having Dementia Doesn’t Mean You Can’t Vote "tells us that for some, voting is still possible. The key, "he ability to express a preference," citing to a new report from experts on this topic.  Even though the person has the right, the exercise of that right may be challenging: "[v]oting can become challenging for many older citizens, who may struggle to reach polling places, stand in lines, use computerized voting machines or read ballots printed in small type."

Further, the article notes, many believe they cannot help the voter in casting the ballot. "A diagnosis of cognitive impairment does not bar someone from voting. Voters need pass no cognitive tests. They don’t have to be able to name the candidates or explain the issues. If they need help reading or physically marking the ballot, they can be assisted, either at the polls or with mail-in ballots. In some states, even people under court-appointed guardianship don’t lose their voting rights."

So you want to help. What do you do? "If you are considering helping someone with dementia to participate in an election, and they have registered to vote, in most cases there are only two real guidelines to keep in mind.

  1. "After reminding the person that Election Day is nearing, ask whether he or she would like to vote." If the answer is no, you are done.
  2. If the answer is yes, then "you may read the voter the ballot choices, if he or she cannot read them, but cannot provide additional information or interpretation, although discussions before voting begins are permitted. “Ask them their choices and see if they answer,” ...  “If they do, they vote.”

Even in normal times, there are challenges for those who need help with voting, for examples residents of SNFs.  In the time of COVID, the challenges are even greater.  The article is really interesting and I encourage you to read it.  The study findings can be accessed here.

October 19, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Federal Statutes/Regulations, Other | Permalink | Comments (0)

Friday, October 2, 2020

National Guardianship Ass'n Releases Guardian FAQ on COVID

The National Guardianship Association (NGA) has released a September 21, 2020 FAQ for guardians about the pandemic. Frequently Asked Questions by Guardians About the COVID-19 Pandemic.
Here are the top takeaways


• Contact with My Client or Loved One – Maintaining contact is essential, whether remotely or in person.
• Special Considerations for Nursing Home Residents – New federal guidance provides ways you can safely visit a resident in person. While there still may be some restrictions on in person visits, you have a responsibility to maintain contact and monitor well-being through remote access.
• Special Considerations for Residential Groups Settings and Hospitals – While there may be restrictions on in-person visits, you have a responsibility to maintain contact and monitor well-being through remote access.
• Protections and Services for My Client or Loved One in the Community – Maintain contact with your client or loved one in the community, and make sure he or she gets services and supports to maintain health and well-being.

• Access to Courts – Each state determines its own procedures during the pandemic. Courts have made many changes, including implementing or expanding remote hearings, and there may be changes in requirements for timelines, notices, and submission of reports.
• Protecting the Rights and Well-Being of My Client or Loved One – The rights of your client or loved one have not changed, but the pandemic makes it more difficult to exercise certain rights. Take actions to ensure the person receives fair health care treatment, facilities follow safety protocols, and support the individual during this difficult time.
• Protecting the Medical Decisions for My Client or Loved One – Work with health care
providers to ensure that the health care choices and values of your client or loved one are
respected.
• Protecting the Finances of My Client or Loved One – As guardian of the estate or conservator,
ensure that your client receives all COVID-19 and other benefits for which he or she is eligible; develop and implement a financial plan that is flexible enough to accommodate demands due to COVID-19; and manage investments and financial affairs with increased vigilance during the pandemic.
• Safety Precautions – Take steps to make sure you are not exposed to or transmitting illness, and to respond if your client or loved one is exposed to COVID-10, shows symptoms, or is hospitalized. Be alert to COVID-19 frauds or scams.

The 20 page FAQ with detailed explanations is available here.

October 2, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care, State Statutes/Regulations | Permalink | Comments (0)

Wednesday, September 30, 2020

Robot Pets Combatting Isolation?

There have been lots of discussions about the impact of isolation necessitated by COVID, especially on elders.  We have previously written about robot pets, and now the New York Times has examined the role of these robots in lessening the impact of isolation during the pandemic:  In Isolating Times, Can Robo-Pets Provide Comfort?

Such devices first appeared in American nursing homes and residences for seniors several years ago. A Japanese company began distributing an animatronic baby seal called PARO in 2009, and Hasbro started marketing robotic cats in 2015.

But the isolation caused by the coronavirus, not only in facilities but also among seniors living alone in their homes, has intensified interest in these products and increased sales, company executives said. It has also led to more public money being used to purchase them.

The article discusses the adoption of the robots by various facilities, and then the interest individuals have shown in having the robots as their companions.

Of particular interest is the Joy for All brand sold by Ageless Innovation, a spinoff of Hasbro, and available from retailers like Walmart and Best Buy for about $120.

One of the largest studies, underwritten by United HealthCare and AARP, distributed free Joy for All robots to 271 seniors living independently.

All the seniors suffered from loneliness, according to a screening questionnaire. At 30 and 60 days, “there was improvement in their mental well-being, in sense of purpose and optimism,” said [the] chief medical officer of AARP’s business subsidiary and a study co-author. The study also found “a reduction in loneliness,” ... although the questionnaires showed that participants remained lonely.

Armed with such findings, Ageless Innovation has been offering discounted robots to state agencies working with seniors. (Both Joy for All and PARO robots can be sanitized to prevent viral transmission, the companies said.)

One Medicare Advantage plan covers them and Ageless Innovation is working to get other MA plans to also cover them. The article also discusses the views of fans and critics of the use of these robot pets. Of course, nothing beats human interaction!  What do you think?

September 30, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Other, Web/Tech | Permalink | Comments (0)

Monday, September 28, 2020

Guardianship Court Monitoring Survey

Two researchers are collecting data on court monitoring involving conservatorships and guardianships.

The National Center for State Courts would like to learn about your experiences with court monitoring practices of guardians and conservators.

This survey is part of the research that [two researchers] are conducting in preparation for the 4th National Guardianship Summit to be held in May 2021, at the Syracuse University Law School.

Please answer the questions with reference to the jurisdiction you are most familiar with. Responding to the survey will take less than 15 minutes of your time. You will not be identified in any manner, as findings from the study will be presented only in the aggregate.

The researchers acknowledge the assistance of the State Justice Institute in conducting this survey.

 

September 28, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (0)

Wednesday, September 23, 2020

Voting Guide for Individuals with Cognitive Impairment

The ABA Commission on Law & Aging, along with the Penn Memory Center,  has announced the release of a new voting guide, Assisting Cognitively Impaired Individuals with Voting: A QUICK GUIDE.

Here's the intro to the guide

Difficulties in communication can occur when interacting with a person who has cognitive impairment. The techniques and tips described in this guide will help make sure that your communication is as effective as possible and within the limits of assistance permitted by election laws.
These techniques and tips are especially important when interacting with persons who are diagnosed with Alzheimer’s disease or another brain illness or disorder such as stroke or head injury.

The guide discusses capacity to vote, communication challenges, and listening skills. The guide offers 10 case studies with suggestions for those who may be assisting such voters.

An underlying principle here is that people should not be treated any diferently in voting rights based on any perceived impairment or other personal characteristic. People whose mental capacities are clearly intact may vote for candidates based on any whim or reason, rational or irrational. Similarly, for persons with some level of cognitive impairment, if they can indicate a desire to participate in the voting process and they can indicate a choice among available ballot selections, their reasons for such choice are not relevant.

The full guide is available here. 

September 23, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Federal Statutes/Regulations, Other | Permalink

Dying from Isolation?

Prohibiting visitors to SNFs has hopefully helped limit the spread of COVID. But what is the impact of those in isolation? According to the Washington Post article, Pandemic isolation has killed thousands of Alzheimer’s patients while families watch from afar, for some the impact has been profound. According to the Post's research, the article states that

Beyond the staggering U.S. deaths caused directly by the novel coronavirus, more than 134,200 people have died from Alzheimer’s and other forms of dementia since March. That is 13,200 more U.S. deaths caused by dementia than expected, compared with previous years, according to an analysis of federal data....

Overlooked amid America’s war against the coronavirus is this reality: People with dementia are dying not just from the virus but from the very strategy of isolation that’s supposed to protect them. In recent months, doctors have reported increased falls, pulmonary infections, depression and sudden frailty in patients who had been stable for years.

This is an important consideration as states begin to allow visits to residences of LTC facilities.  Data is also showing increased deaths not specifically from COVID but "occur from causes such as hypertension or sepsis. But they are occurring at much higher levels than in the past, experts say, in part because of the pandemic’s indirect effects — hospitals being overrun or care being delayed."

The article highlights a number of individuals' stories and compares reopening of SNFs in other countries to that of the US.  "Countries like the Netherlands have safely reopened their nursing homes without any increase in coronavirus cases by providing ample protective equipment, testing and rigorous protocols. ... But in the United States, little of the trillions in emergency funding has gone to nursing homes. For months, the Trump administration has talked of getting more testing into nursing homes, but the effort continues to be plagued with problems."

The article includes information about the methodology used for this study. This is a helpful article to use as a basis of class discussion. I'm assigning to my students!

September 23, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Federal Statutes/Regulations, Health Care/Long Term Care, State Statutes/Regulations | Permalink