Sunday, March 29, 2020

US Has More Elders Living Alone

I blogged a couple of times about social isolation's impact on elders as we move through this pandemic. Imagine social isolation when you live alone and how that compounds your loneliness. This report from Pew Research, released before the pandemic swept the U.S., reports that elders in the U.S.  live alone in greater numbers than other countries.  Older people are more likely to live alone in the U.S. than elsewhere in the world shows that:

Living with an extended circle of relatives is the most common type of household arrangement for older people around the world, according to a recent Pew Research Center study. But in the United States, older people are far less likely to live this way – and far more likely to live alone or with only a spouse or partner.

Let me share some stats from the article:

  • "In the U.S., 27% of adults ages 60 and older live alone, compared with 16% of adults in the 130 countries and territories studied."
  • "U.S. adults ages 60 and older also are more likely than their counterparts around the world to live as a couple without young children at home. Almost half of Americans in this age group (46%) share a home with only one spouse or partner, compared with three-in-ten globally (31%)."
  • "Globally, living in extended-family households – those that include relatives such as grandchildren, nephews and adult children’s spouses – is the most common arrangement for people 60 and older. "

March 29, 2020 in Consumer Information, Current Affairs, Housing, International, Statistics | Permalink | Comments (0)

Monday, March 23, 2020

Latest Issue of BIOFOCAL, Publication of ABA- COLA

Tuesday, March 10, 2020

3-D Printed House!

3-D printers are amazing. I've read some stories about the application of 3-D printers to solve real-world problems. Now comes another one. Kaiser Health News is reporting about Around The Corner: 3D Housing Designed For The Homeless And Needy Seniors.

In a Northeast Austin neighborhood, these homes are taking their distinctive shape on the grounds of Community First Village, where about 180 formerly homeless people have found shelter and camaraderie in the most expensive city in the state. The 51-acre development (which will eventually include more than 500 homes) provides affordable permanent housing, including the 3D variety.

In this city of disruptors, Austin-based construction technology company Icon has formed a variety of partnerships to explore how 3D-printed homes could not only provide housing for people on the margins but also demonstrate how to dramatically reduce the time and money spent on construction.

...

These 400-square-foot houses are the nation’s first 3D-printed residences, according to Icon. Its process — which incorporates an 11-foot-tall printer that weighs 3,800 pounds — relies on robotics. Beads of a pliable concrete material dubbed Lavacrete ooze from the behemoth printer in ripples that stack and harden into a wall with curved corners.

The idea is to cut the time and as much as half the cost associated with traditional construction, limit the environmental footprint and trim the number of workers on crews, said Jason Ballard, Icon’s co-founder and CEO.

The article talks about supporters and detractors of the concept and gives more info about the project. Check it out!

March 10, 2020 in Consumer Information, Current Affairs, Housing, Other | Permalink | Comments (0)

Thursday, March 5, 2020

Do You Know Enough About the Legal Issues Surrounding Subsidized Housing?

If you answer to that question was no, then register now for this free webinar from the National Center on Law and Elder Rights, Legal Basics of Subsidized Housing Rents: Income, Formula-Based, and Tax Credit Properties Here's information about the webinar:

A variety of rules govern the setting and adjustment of rents in different federally assisted rental housing programs. For most tenants in these programs, a tenant’s share of the rent is based on the tenant’s income, usually at 30% of adjusted household income. For some tenants, however, the rent may be unrelated to tenant income. This is true for: 1) tenants in privately owned, federally supported housing, without deep rental subsidies or with formula rents; 2) for certain public housing tenants who pay a “flat rent” based on reasonable market value or who are subject to minimum rents set by statute; and 3) tenants in Low Income Housing Tax Credit (LIHTC) properties where rents are set based on a percentage of the local area median income. This webinar will provide an overview of the rules governing tenant rent contributions in the major federal programs, including public housing, project-based rental assistance programs, the Housing Choice Voucher program, and LIHTC. The webinar will also review how a tenant’s rent contribution is established and adjusted in different programs, with a particular focus on the rules governing income determinations.

To register, click here.

March 5, 2020 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Housing, Programs/CLEs, Webinars | Permalink | Comments (0)

Wednesday, March 4, 2020

Where Do You Plan to Live When You are "Old"?

It's never too early to start making plans about where you will live once you are "old".  According to the Washington Post, Even in midlife, it’s smart to start thinking about where you’ll live when you’re old.

According to AARP, people turning 65 these days will probably live another 20 years — and 70 percent will need some level of long-term care. I needed a plan — actually a revised plan, because until then [the author] expected[the] husband to be part of [the] plan. But ... [divorce happened and the need] to think about an aging plan ... [With]contemporaries .... now approaching (or passing) Medicare age, [the author] asked for their thoughts on senior living. [A]  former work colleague [responded]  “Denial, Steven. Sheer denial.” A high school friend, ... hit the nail on the proverbial head: “Call me Peter Pan. My plan is to never grow up and need senior living.” ....

Like 90 percent of older Americans, [the author]  hoped to “age in place” — until [seeing] how difficult it was for [the author's] parents (and worrisome for their kids). And expensive: premiums for long-term care policies ... now average $2,700 a year, according to the industry research firm LifePlans, which AARP reports “puts the coverage out of reach for many Americans.”

The author, undertaking due diligence, visited examples of some housing options, ultimately sending in money to be placed on a waiting list. 

"I understand better now why my parents couldn’t make a plan: It’s scary to contemplate one’s own old age. I love my current house (with a ground-floor master, making it feasible for aging in place), but I’m glad to have a Plan B with that deposit check as my safety net. Without a spouse (at least for now), I’m guessing my three 20-something nieces will be pleased, too."

March 4, 2020 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Other | Permalink | Comments (0)

Wednesday, February 19, 2020

Prospective Residents Need More Info About ALFs

Friend and colleague, Professor  Naomi Cahn sent us this story. In the article,  Incomplete and inadequate: Information lacking for seniors looking for assisted living, early on the authors explain the reasons for their research:

We and our colleagues track the ever-changing circumstances of long-term care in the U.S. As we study policies and practices, we have observed that the expansion of assisted living is clearly a game-changer, creating new challenges in the industry. Many states have increased assisted living regulation in recent years. Some consumer advocates have called for nursing-home style federal rules, though others oppose this, saying assisted living should remain flexible enough to serve residents with a range of needs, from personal care only to end-of-life comfort.

Now we know why they did the research, here's what they did: "Using criteria formulated from prior research, along with information provided by some states, we examined 39 key elements of each website. Those elements included the size of the facility, cost, license status, the insurance it accepts, and any special services offered, such as memory care. We also looked at each website’s usability – the ease in finding critical information."

The article reports they found gaps in provided info, websites that they thought were difficult to navigate although they found some websites that had better info and were easier to use. "True, the state websites are better than they were 15 years ago. But they are less than what they should be. Many of the elderly, the disabled, and the families who love them require more to make appropriate choices. When navigating the internet, the principle of “buyer beware” should not be the driver."

February 19, 2020 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Other, State Statutes/Regulations, Web/Tech | Permalink | Comments (0)

Tuesday, February 4, 2020

What Type of Multi-Generational Housing is Right For You?

Threr are a lot of choices.... The New York Times covered this in  this article: In They Wanted a Multigenerational Home in Brooklyn. Which Apartment Did They Choose?  the goal for the recently married couple with a baby on the way was to have a home where her parents could live with them. The article is interactive, after summarizing the 3 properties reviewed by the couple, the readers can select which property they would choose, and guess at the property actually chosen by the couple.  (I guessed wrong).  Check it out-and see if your reasoning is the same as the couple featured in the article.

February 4, 2020 in Consumer Information, Current Affairs, Housing, Other | Permalink | Comments (0)

Thursday, January 30, 2020

Too Young for Senior Living?

My colleague and dear friend, Mark Bauer sent me this article, An orphaned teen is being forced out of his grandparents' senior community because he's too young.   Here's what happened. The kid's parents both died and he moved in with his grandparents in Prescott, Az, where they live in a 55+ community.  "[T]he homeowner's association said it could face legal issues if he stayed."  He has about 5 months to move out. Although younger folks can live there, the minimum age noted in the article is 19.  Both sides have representation and no solution was noted in the article.  My sense from the article is  the positions boil down to these: have some compassion from the one side, and from the other-there are rules and those who live there have an interest in the purpose of the rules.  The young man is 15 years old.  I do understand both sides of the argument-there are those who chose to live there because they wanted to live in a community with age restrictions. But on the other hand, both of his parents died.....  This is a great fact pattern for our students, and I'm planning to assign them to represent each of the sides and make their arguments.

Stay tuned.

 

January 30, 2020 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Housing, Other, State Statutes/Regulations | Permalink | Comments (0)

Monday, January 27, 2020

Boomer Myths??

It may just be me, but it seems there are a lot of stories about Boomers recently. I guess it makes sense, given the ages of boomers. Some of the stories may be a bit more tongue-in-cheek, or cultural illustrations rather than substantive, (see, e.g. Chief Justice Roberts: Is 'OK, Boomer' Evidence Of Age Discrimination?  and Saturday Night Live-Undercover Boss: Where are they now).  A recent article in the New York Times reviewed a myth about boomers living in urban environments.  The Myth of the Urban Boomer  Baby boomers are actually less drawn to urban living than previous generations.

Baby boomers are such a large group that you can find them practically everywhere in great numbers, including in urban areas. Today in cities, for example, you’re more likely to run into a 54-to-72-year-old with your bike or scooter (please be careful!) than you would have in the past.

Maybe that’s the reason many news media accounts have promoted the idea that boomers are returning to cities at a rapid rate.

It seems to make sense. Many downtowns are safer and livelier than they were 30 years ago. At a certain point, downsizing and moving back to the city has appeal — it’s closer to work and all those interesting things to do, and the children might have finally left the nest.

There’s one problem. The story line is wrong: Boomers today are actually less urban than previous generations of older people.

The article has some interesting data regarding housing preferences and trends for boomers. The article's closing paragraph gives a good snapshot for those who don't have time to read the entire article: "[f]or developers and public officials in cities, the rising number of older city dwellers is real, and it matters. There is growing demand for the housing features and public services that many older adults prefer. More of the urban housing stock will need to be homes that work for seniors. But that’s not because boomers love cities or are more drawn to urban living than previous generations — just the opposite. It’s simply that there are more of them, almost everywhere." (As an aside, the article at one point refers to some boomers as "the urban oldster.")

January 27, 2020 in Consumer Information, Current Affairs, Housing, Other | Permalink | Comments (1)

Friday, December 20, 2019

More Student Views on Current Events

Frequent readers of this blog know that this semester I had my students write posts about their observations on recent events.  The semester has ended and I have a final post from a student to share with you.

Jeidy Beltran writes about aging in place.

THE COST OF AGING IN PLACE

 Kaiser Health News recently published the article “For Boomers Reframing Aging, Age-Proofing A Home Won’t Come Cheap,” discussing the high investments older persons are incurring when retrofitting their homes to be able to “age in place.” According to the article, “by 2050, almost one-quarter of Americans will be 65 or older,” and what living arrangements and services will be available to them is the million-dollar question. Most of the common options are moving in with relatives or moving to a care facility. The article states that baby boomers are not attracted to either of those options and it is quite understandable why – they want to preserve their autonomy and independence. Nevertheless, many are left without an option given that aging in place and preserving the highest amount of independence can be considered a luxury and available to those who are most affluent.

According to Kaiser, “in a recent survey of 1,000 people age 65 and older, 80% of respondents were concerned about their ability to age in place due to financial reasons. About 60% said that they have less than $10,000 in savings (including investments and retirement plans).” Given that in this day in age, neither communities or homes are suited for “aging in place,” accomplishing it can present quite a hurdle. Most communities are not people focused, meaning that they do not have the necessities within walking distance. Also, most homes are either not single-story or they do not have the necessary modifications to allow one to age in place (narrow doors and hallways, low toilet seats, bathtubs rather than walk in showers with grab bars…etc.). Given that everyone has a different view of what aging in place signifies, retrofitting a home and when it is done can vary. Some may start looking into their forever home from the time they purchase their first home or by the time they start planning for retirement and possible disability, while others undertake the task when presented with a disability that requires such modifications. Home modifications can also vary in degree. They can be as little and inexpensive as “adding grab bars or lever doorknobs” to highly expensive changes such as “widening doorways or lowering light switches.” The article commented on a couple in Texas who undertook the task of completely modifying their home and including all that might be necessary in case they might need it in the future, which could easily cost them $300,000 just for renovations.

My initial concern with aging in place was that people would deplete their funds in achieving their “dream” and aging in place appropriate home, but would fail to account for the future need of services. After reading the article and seeing that some people build their home with the expectation that a caregiver might live in the home makes me think that some people are thinking of the possibility that they might need services after all. The choice between wanting to preserve as much independence as possible, requiring services, and the financial burdens of each is a hefty one, but I believe that if properly planned, aging does not have to be so complicated. Have you thought about this? If so, have you analyzed your situation and weighed the pros and cons of each of the housing options?

December 20, 2019 in Consumer Information, Current Affairs, Housing, Other | Permalink | Comments (0)

Thursday, December 19, 2019

Recent Survey on Needs of Older Adults in Tampa Bay Area, Florida

The Area Agency on Aging for Pinellas-Pasco (Florida) along with the Pinellas Community Foundation  did a Community Assessment Survey of Older Adults  (CASOA):

The Community Assessment Survey of Older Adults, or CASOA, is a printed survey that was sent to 10,000 randomly selected households across every Pinellas and Pasco zip code in which at least one resident was known to be aged 60 and over. The Pinellas Community Foundation and the Area Agency on Aging of Pasco-Pinellas joined forces to conduct this comprehensive needs assessment of the area’s aging community.

The survey, which is available here offers key findings in 9 categories:

Overall Community explores how older residents view the community overall, how connected they feel to the community and overall feelings of safety, as well as how likely residents areto recommend and remain in the community.

. . .

Health and Wellness Of all the attributes of aging, health poses the greatest risk and the biggest opportunity for communities to ensure the independence and contributions of their aging populations. Health and wellness, for the purposes of this study, included not only physical and mental health, but issues of independent living and health care.

. . .

Housing  The movement in America towards designing more “livable” communities those with mixed-use neighborhoods, higher-density development, increased connections, shared community spaces and more human-scale design will become a necessity for communities to age successfully.

 . . .

    Outdoor Spaces and Building Generally, communities that have planned for older adults tend to emphasize access --access to parks, green spaces, buildings, and places where the public wants to gather. Accessibility of public places in a community has a major effect on older residents’ quality of life, allowing them to remain mobile, access services, participate in productive activities and engage socially.

. . .

Transportation and Streets Mobility access increases the likelihood that seniors will be engaged with the community and the economy. Because the US is currently highly reliant on automobiles, older drivers may become concerned with their dependency on others for transportation because they can become isolated without their motorized mobility. Those that reside in livable communities where they can reach their destinations easily and comfortably on foot or in public transportation are more likely to remain engaged in their communities and to demonstrate signs of successful aging.

. . .

Social Participation, Inclusion and Education Opportunities. A “community” is often greater than the sum of its parts, and having a sense of community entails not only a sense of membership and belonging, but also feelings of emotional and physical safety, trust in the other members of the community and a shared history.

. . .

Volunteer and Civic Engagement Productivity is the touchstone of a thriving old age. This section of the report examines the extent of older adults’ engagement in the Pasco-Pinellascommunity as determined by their time spent attending or viewing civic meetings, volunteering or providing help to others.

. . .

Job Opportunities People in the U.S. are working longer and retiring at an older age than they did 20 years ago. Of all developed countries, the U.S. has the highest labor force participationof adults age 65 and older. Older adults are postponing retirement for a variety of reasons: improved health, to benefit from delayed pension plans, to accumulate additional wealth, and because the knowledge worker economy is less physically demanding than jobs in the economy of 20 years ago. Some experts believe that older workers will become an untapped resource for economic stability when Baby Boomers begin retiring.

. . .

Community Information Sometimes residents of any age fail to take advantage of services offered by a community just because they are not aware of the opportunities. The educationof a large community of older adults is not simple, but when more residents are made aware of attractive, useful and well-designed programs, increasing numbers of residents will benefit from becoming participants.

. . .

The summary of the results are available here.

 

December 19, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Other, Statistics | Permalink | Comments (0)

Tuesday, December 10, 2019

Updates from Missouri

I was in Missouri last week for a couple of days and had a chance to visit with some great people. First, I had the privilege to meet Dr. Erin Robinson and Dr. Clark Peters from the School of Social Work at Mizzou.   The work they are doing in gerontological social work is quite interesting. At some point our conversation segued into the role of technology in caregiving for older adults, and Dr. Robinson shared with me the research and activities of the Mizzou Center for Eldercare & Rehabilitation Technology, whose "mission is to create technology for proactive healthcare that helps older adults and people of all ages and needs to lead healthier, more independent lives."   We also talked about the University's foray into housing for elders, known as TigerPlace. which is a partnership between Americare and the Mizzou Sinclair School of Nursing.

On Friday, I attended day two of the winter symposium of the Missouri Chapter of NAELA (MoNAELA), The two day program had a robust agenda of general sessions and two tracks, advanced and basics. These folks are a great bunch of people who are quite knowledgeable and caring.

 

 

December 10, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Programs/CLEs, Science, Web/Tech | Permalink

Wednesday, December 4, 2019

Who is Going to Buy Boomers' Homes?

Here's an interesting question: The Silver Tsunami: Which Areas will be Flooded with Homes once Boomers Start Leaving Them?   It's a good question; an important one.   Here are some highlights from the article:

  • Over the next 20 years, more than a quarter (27.4 percent) of the nation’s currently owner-occupied homes are likely to hit the market as their current owners pass away or otherwise vacate their homes.
  • Places likely to be most impacted by this upcoming Silver Tsunami include both retirement hubs (Miami, Orlando, Tampa and Tucson) and regions where young residents have left (Cleveland, Dayton, Knoxville and Pittsburgh). The impact of the Silver Tsunami is also likely to vary greatly across different areas within metros.
  • The places likely to be least impacted include those with vibrant economies featuring fast growth and affordable housing that act as magnets for younger residents (Atlanta, Austin, Dallas and Houston).
  • Housing released by the Silver Tsunami will provide a substantial and sustained boost to housing supply, comparable in magnitude to the fluctuations that new home construction experienced in the 2000s boom-bust cycle.
  • It seems likely that, in the coming two decades, the construction industry will need to place a greater focus on updating existing properties, in addition to simply building new homes.

The article suggests we look for this tsunami to "hit" between 2020-2030.  Where will it hit the hardest?

The Silver Tsunami will strike nationwide, impacting between one-fifth and one-third of the current owner-occupied housing stock in every metro analyzed.

Well-known retirement destinations, including Miami, Orlando, Tampa and Tucson, will experience the most housing turnover in the wake of the Silver Tsunami. If the number of future retirees choosing to make these places home during their golden years fails to match generations past and local housing demand fades, these areas may end up with excess housing.

The article contains important statistics ranking areas most and least likely to be affected.  The article also discusses a ray of sunshine within this tsunami-the housing turnover is likely to serve as a substitute for new construction.

Get your tsunami preparedness kit together---you've been warned :-)

Thanks to Professor Mark Bauer for sending me the article.

 

December 4, 2019 in Consumer Information, Current Affairs, Estates and Trusts, Housing | Permalink | Comments (0)

Tuesday, October 22, 2019

Pennsylvania's Unique Role for Older Adult Advocacy in State Government

On Monday, I participated in a panel discussion of aging services in Pennsylvania, at the invitation of Professor Patricia Aguilera-Hermida, who is on the faculty of Human Services and Family Studies at Penn State Harrisburg.  Even though I knew most of the panelists -- all experienced professionals from Pennsylvania's Department of Aging -- the occasion gave me new insight and respect for the role of advocacy on behalf of older adults.  The students were attentive and asked great questions, and I suspect some of them saved their best questions for the one-on-one time with the speakers.

Penn State Harrisburg  Panel on Aging Services 10.22.19

Robert Torres, the Secretary of Aging in Pennsylvania reminded us that our state has a uniquely strong, dedicated funding system to advocate for older adults through the Pennsylvania Lottery.  About 80% of the department's operations and outreach budget is funded by this source.  As anyone who has worked in state or federal government would know, the "fight" for adequate funding for operations can be intense, and in many states older adults would not have a strong position in the queue for necessary dollars.

The breadth of programming outlined by the panelists is impressive. For example,  Christine Miccio, Director of the Bureau of Aging Services described in detail the OPTIONS program that provides direct support for more than 55,000 older adults who are still in their homes. Pennsylvania also has more than 500 publicly supported Senior Centers -- a way to reach additional people with meals, health care information, activities and social programs.  Margaret Barajas, a dynamo who is the Statewide Long-Term Care Ombudsman, explained how a system of volunteer and paid advocates investigate and coordinate responses to concerns about senior living-based needs, including concerns about quality of services in nursing homes and assisted living facilities.  Denise Getgen, as director of the Older Adult Protective Services Office, described the ever growing need for investigation of complaints about elder abuse, neglect and exploitation.  In recent years, the number of complaints received and investigated by the state has grown to over 40,000 allegations per year, with the majority of concerns focusing on self-neglect for persons in isolated circumstances.  I've worked with several of these units directly over the years, especially when I was head of my Law School's Elder Protection Clinic.  Pennsylvania's Area Agencies on Aging continue to fund and coordinate certain free legal services for seniors in need in each county throughout the state.

One student asked about whether services from the Department are limited to "citizens" of the United States -- and it was impressive to hear the long list of services that are NOT restricted by citizenship.  Another student tossed a "softball" question -- "what is your favorite program?" -- and Christine Miccio hit it out of the park by describing the success of a new pilot program in rural Pennsylvania that matches up older adults who need housing or assistance -- with those who can provide housing or assistance.   She joked that she is now the eHarmony of housing matches, especially as the original pilot program is extending to several additional counties.  

My thanks to Professor Aguilera-Hermida for hosting this noon-time chat with so many students who are considering a wide range of aging services as part of their career goals.  One enterprising student explained to me that her interest in the field of gerontology at medical school was sparked when she found affordable housing as a student in a well-known, nearby nursing home that had "extra" space.  

October 22, 2019 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care, Housing, State Statutes/Regulations | Permalink | Comments (0)

Tuesday, October 15, 2019

Loosening the Regs of Florida ALFs?

The Tampa Bay Times ran an article a few days ago that raises some important issues. Florida’s assisted living facilities write rules on reporting deaths, injuries . explains the current reporting requirements when a resident is injured and the proposed change to the requirement.

When a resident in one of Florida’s assisted living facilities falls, dies or is seriously injured, that facility is required to tell the state within one business day that something has gone wrong. But a bill before lawmakers would give operators weeks to report such critical incidents — potentially leaving residents in harm’s way, elder advocates warn.

Industry groups for assisted living facilities, which crafted much of the bill’s language and handed it to lawmakers, say the one-day reports are not needed, and eliminating them will reduce onerous paperwork and unnecessary administrative fines.

Hang on for a second and think about this.  There must be a reason for the current requirement... and advocates say it's because they "are necessary to inform state regulators quickly of potential incidents, and that the change is part of a decades-long deregulation of the industry that could put residents at greater risk."

The section on adverse incidents involves one of the key methods for alerting regulators when something goes wrong. Currently, an initial report must be filed if a resident dies, sustains serious injuries, goes missing or is transferred to a hospital or other facility for more intensive care — and facility administrators think they may be responsible.

Assisted living facilities are required by statute to submit up to two reports: one within one business day after an incident, and another full report within 15 days if the facility determines it is responsible. When a report is filed, the Agency for Health Care Administration can then use it to initiate an investigation if it raises concerns about resident safety.

The proposal requires just 1 report that is filed by 15 days, when the facility makes the decision that " the incident happened in the scope of its care, though it would direct the facility to begin investigating the incident within 24 hours" the article reports. The article indicates that the bill was brought by the Florida Senior Living Association, and is supported by AHCA. Advocates for residents take the opposing few-that is more regulation rather than less.  The bill's sponsor in the Florida Senate is quoted as saying "the legislation [is] a “modernization” bill that would primarily update language in the statute, and allow residents to use devices to move around more easily or prevent falls.... [and that] the language to reduce the number of adverse incident reports was meant to bring assisted living facilities in line with a recent change made to reduce those reports for nursing homes, and “to make sure the language would be as similar as possible." Although the Senator has spoken primary with the industry folks, she plans to talk to resident groups too, the article reports.

Read the bill and follow it. If you live in Florida, let your elected representative know your position on this. If you live in another state, pay attention anyway. The revisions could be proposed in other states as well.

October 15, 2019 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care, Housing, State Statutes/Regulations | Permalink | Comments (0)

Monday, October 7, 2019

Hospitals in the Housing Business?

Kaiser Health News ran this story, Why Hospitals Are Getting Into The Housing Business.

The article opening with anecdotes involving patients at a Denver hospital,

In the first half of this year alone, the hospital treated more than 100 long-term patients. All had a medical issue that led to their initial hospitalization. But none of the patients had a medical reason for remaining in the hospital for most of their stay.

Legally and morally, hospitals cannot discharge patients if they have no safe place to go. So patients who are homeless, frail or live alone, or have unstable housing, can occupy hospital beds for weeks or months — long after their acute medical problem is resolved. For hospitals, it means losing money because a patient lingering in a bed without medical problems doesn’t generate much, if any, income. Meanwhile, acutely ill patients may wait days in the ER to be moved to a floor because a hospital’s beds are full.

What's a hospital to do? In some cases, provide or pay for housing for  those patients. According to the article, a number of hospitals are "exploring ways to help patients find a home. With recent federal policy changes that encourage hospitals to allocate charity dollars for housing, many hospitals realize it’s cheaper to provide a month of housing than to keep patients for a single night."  Think about that statement again.... one month of housing may be cheaper than one night's hospital stay.

So the Denver hospital featured in the story is taking this a step farther, "partnering with the Denver Housing Authority to repurpose a mothballed building on the hospital campus into affordable senior housing, including about 15 apartments designated to help homeless patients transition out of the hospital."

Examine these numbers: One night in the hospital featured in the story "costs ... "$2,700 a night [and] ..... [p]atients who are prime candidates for the transitional units stay on average 73 days, for a total cost to the hospital of nearly $200,000. The hospital estimates it would cost a fraction of that, about $10,000, to house a patient for a year instead."

The KHN article references a recent report from the Urban Institute on the correlation between health and housing.  Fascinating info!

October 7, 2019 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Medicaid, Medicare | Permalink | Comments (0)

Thursday, September 12, 2019

Living On Campus-Not Just College Students But Retired Individuals

The New York Times ran an article about, At Colleges, What's Old is New: Retirees Living on Campus.

This story focuses on "a growing number of colleges sponsoring retirement communities on campus or thinking about it." The schools promote the educational impact of this, but of course there can be a monetary benefit to the college.

The schools say their motive is more educational and social — encouraging intergenerational mixing — than financial. But the communities promise a new revenue stream for institutions that are coping with reduced state operating support and declining college enrollment in many parts of the country. They are bringing a new generation (or old generation) to c ampus to fill classes, eat in dining halls, attend student performances and become mentors.

Not everyone supports the concept, with concerns about older people complaining about noise from parties, and the recognition that their presence in the classroom can change the dynamics, without the same stakes, since only the younger people take the classes for grades. But that's not guaranteed to happen and in fact, the opposite may occur. One couple quoted for the article "say the whole reason they are moving to ...  College and not to Miami is that they like to stay up late and party. [They] believe[] that the other residents will be the same — not your parents’ grandparents. “They’re forward thinkers, not the ones to go down to Florida and order the early bird special...."

The article features several colleges that are implementing the concept.  The cost may be too steep for some.  There are different approaches being adopted. It all is very interesting.

Check it out!

September 12, 2019 in Consumer Information, Current Affairs, Housing, Other | Permalink | Comments (0)

Sunday, September 8, 2019

Happy Places to Retire

With Dorian finally moving on, I thought it would be good for all of us to post something that was happy. So Kiplinger ran an article, 10 of the Happiest Places to Retire in the U.S.  According to the article, these "10 retirement destinations rank the highest in terms of the overall well-being of residents."  These are Charlottesville, VA; Ann Arbor, MI: Portland, ME;Carlsbad, CA; Durham-Chapel Hill, NC; Cape Coral, FL; Richland, WA;; Provo, UT; Charleston, S.C.; and Burlington, VT. Not having lived in these, I can't comment on if they are happy places to live.

To come up with the rankings, Kiplinger relied on the "Well-Being index" which the article explains " is based specifically on residents' feelings about five elements of well-being: "purpose" (liking what you do and being motivated to achieve goals), "social" (having supportive relationships and love), "financial" (managing your budget to feel secure), "community" (liking where you live) and "physical" (being in good health). "  Using this index, then Kiplinger "factored in the "community" and "physical" components of the Well-Being Index, where available, as well as living costs, safety, median incomes and poverty rates for retirement-age residents and the availability of recreational and health care facilities."

The article is available here.

September 8, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Other, Retirement, Statistics | Permalink | Comments (0)

Wednesday, September 4, 2019

Assisted Living-Is It the Right Option for Assistance in Living?

My colleague and dear friend Professor Bauer, sent me the link to a recent op-ed in the New York Times,  How Not to Grow Old in America.The assisted living industry is booming, by tapping into the fantasy that we can all be self-sufficient until we die.

Assisted living seems like the solution to everyone’s worries about old age. It’s built on the dream that we can grow old while being self-reliant and live that way until we die. That all you need is a tiny bit of help. That you would never want to be warehoused in a nursing home with round-the-clock caregivers. This is a powerful concept in a country built on independence and self-reliance.

The problem is that for most of us, it’s a lie. And we are all complicit in keeping this dream alive.

The author notes that the ALF industry has a financial incentive to market their product and it's appealing to the kids of those who reside in ALFs.  The author writes, "[t]he irony of assisted living is, it’s great if you don’t need too much assistance. If you don’t, the social life, the spalike facilities, the myriad activities and the extensive menus might make assisted living the right choice. But if you have trouble walking or using the bathroom, or have dementia and sometimes wander off, assisting living facilities aren’t the answer, no matter how desperately we wish they were." Further, the author offers data that most of these residents need more care than that provided and argues in favor of regulation, using several actual cases as illustrations to support the call for regulation.

We need to let go of the ideal of being self-sufficient until death. Just as we don’t demand that our toddlers be self-reliant, Americans need to allow the reality of ourselves as dependent in our old age to percolate into our psyches and our nation’s social policies. Unless we face up to the reality of the needs of our aging population, the longevity we as a society have gained is going to be lived out miserably.

September 4, 2019 in Consumer Information, Current Affairs, Dementia/Alzheimer’s, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Other, Retirement, State Statutes/Regulations | Permalink | Comments (1)

Friday, August 30, 2019

Accessibility of Elder Housing-What Happens When the Elevator is Out of Order?

A local news station recently ran an article about the impact of a broken elevator on the residents who live on top floors in  8 On Your Side gets results for seniors in building with broken elevator.   Knowing my colleague and dear friend, Professor Bauer, had written an article on 55+ housing that included a discussion of accessibility issues, I asked him if he'd write a guest post for us on this topic. Here it is:

Would You Please Just Fix It?

By
Mark D. Bauer
Professor Law
Stetson University College of Law

 

A recent news story in Tampa Bay reported that the single elevator in a mid-rise apartment building stopped working in late May and would not be repaired until October.  That alone is surprising and seems wrong.  But what makes this story particularly shocking is it occurred in an age 62 and older HUD subsidized building.  Even more shocking:  there are no federal laws regulating elevator repairs in federally managed or sponsored elder housing.

The story was made for television.  A local news station interviewed numerous tenants with disabilities incapable of walking down staircases.  One elder tenant interviewed said she had not been able to leave her home in two months and she found it very depressing.  I have little doubt that most anyone would feel the same way.

The good news is that by airing this story and providing publicity to the tenants, the company managing the apartment complex arranged for free hotel rooms for any resident desiring one.  The elevator still will not be repaired until October because a part needs to be manufactured abroad.  But at least the elder tenants now have an alternative to remaining prisoners in their own homes.

The bad news is that while this particular situation may be extreme, elder residents of multi-story apartment buildings are often trapped in their homes with little warning and no real alternative.  The fact that most elevator repairs take less than six months is little comfort.

Department of Housing and Urban Development regulations require only the most basic life safety features in elder housing, such as smoke detectors.  Most state and local laws covering elevators require that they be inspected and remain in good repair.  It is always hard to search for the absence of a law or a case, but I have found nothing in the United States that regulates how long a repair may take.  Unfortunately, I suspect the answer is “as long as needed.”

I did find one relevant case in Indiana where residents of elder housing suffered without elevators for over a month and then sued.  On procedural grounds, the federal court held that the residents might have a viable argument under the Americans with Disabilities Act but could not sue under traditional landlord-tenant law (here the residents claimed that the broken elevator “constructively evicted” them).  And as you might imagine, once the judge opened the door just a crack for possible litigation, the owners of the elder housing complex immediately fixed the elevator and settled with the residents.

It is ironic that the government sponsors or subsidizes elder housing without ensuring the physical safety of the residents, particularly when private entities often profit through participation in these programs.  In researching this issue, a simple Google search produced literally hundreds of news stories about elders all over the country being trapped in multi-story buildings during lengthy elevator repairs.  Like the situation here in Tampa Bay, the elevators were often repaired quickly after a local news story.

Even elevators in good repair cannot function without electricity.  After many elders were killed or injured in Florida after a major hurricane in 2005 made their apartments inaccessible, a state law was passed requiring all 55 and older housing to add emergency generators for elevators.  The real estate lobby was particularly effective here and got the state legislature to repeal the law a short time later.

Subsidized or government-owned congregate housing for elders is aging; few units have been added since the 1980s, and certainly not enough to replace housing demolished or converted to other uses.  Five elevator companies remain after industry consolidation, and only one is located in the United States.  It is no surprise then that elevators installed in the last century are difficult to repair.  Cities and counties with large elder populations often spend extraordinary amounts of money responding to emergency calls requiring firefighters to carry elders down staircases.

It is easy to ignore a problem like stranded elders in high-rises because any single building has these problems infrequently, and with no publicity.  But nationally we are putting lives in danger and wasting precious public funds by ignoring the problem.  Currently it is very unlikely that HUD will take any corrective action.  But in the long-run, it would be much cheaper to plan for broken elevators by requiring elder communities to provide for temporary accessible housing, or coordinate services necessary for daily living, or require emergency generators in mid- or high-rise buildings with only one elevator.

Professor Bauer's law review article on 55+ housing is available here.  Thanks Professor Bauer!

August 30, 2019 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Other, State Statutes/Regulations, Television | Permalink | Comments (1)