Monday, October 29, 2018

Law Students Attend Annual Meetings for LeadingAge and NaCCRA

Law students from Penn State's Dickinson Law attended sessions hosted by LeadingAge and National Continuing Care Residents Association (NaCCRA) on October 28 in Philadelphia.  It was my pleasure to share this experience with students.  I see these opportunities as a great way to think about the wider world of business and law opportunities, and to consider how law and aging can intersect.  

In the morning, we heard from A.V. Powell about best practices for actuarial evaluations  to  Dickinson Law Student Mark Lingousky and Parker Life CEO Roberto Muniz promote greater understanding of financial issues for continuing care and life plan communities across the country.  At lunch we met Parker Life's CEO Roberto Muñiz, shown here on the right with Dickinson Law student Mark Lingousky, and discussed Roberto's ongoing projects such as working to established coordinated care options not just in Parker's center of operations in New Jersey, but also in Roberto's family home in Puerto Rico.  

After lunch we attended a LeadingAge educational program on "Legal Perspectives on Provider Operational Issues," presented by four attorneys from around the country.  Afterwards the students commented that they were surprised by how many of the topics had come up in one of Dickinson Law's unique 1L courses, on Problem Solving and Lawyering Skills.  It is great to see such correspondence between real life and law school life.  Of particular interest was hearing how residential communities are coping with issues connected to legalization of marijuana, including medical marijuana and so-called recreational marijuana, both from the context of resident use and potential use by employees.  

On the drive home from Philadelphia, I had the chance to debrief with the students about what most interested them at the conferences.  They quickly said they appreciated the opportunity to talk with engaged seniors about what matters concerned them.  Indeed, after the attorneys leading the afternoon program took a quick poll at the outset to ask how many of the members of the audience were attorneys (outside or inside counsel), operational staff, or board members, one student leaned into me and said, "They forgot to ask how many people in the audience were residents or consumers of their services!"  

Music to our ears, right Jack Cumming?  

October 29, 2018 in Consumer Information, Current Affairs, Ethical Issues, Health Care/Long Term Care, Housing, International, Legal Practice/Practice Management, Programs/CLEs, Property Management | Permalink | Comments (0)

Friday, October 26, 2018

Filial Friday: "Elternunterhalt" -- An Update on Germany's Approach to Filial Support Law

GermanyMy first close look at filial support law in Germany arose in 2015, when I met a German-born, naturalized U.S. citizen living in Pennsylvania who had received a series of demand letters from Germany authorities asking her to submit detailed financial information for the authorities to analyze in order to determine how much she would be compelled to pay towards care for her biological father in German.  Her father had become seriously ill and did not have inadequate financial resources of his own.  As I've come to learn, the name for Germany's applicable legal theory is elternunterhalt, which translates into English as "parental maintenance."   

Since 2015, I've heard from other adult children living in the U.S.,  but also in Canada and England, about additional cross-border claims originating in Germany.  They write in hopes of getting objective information and to share their own stories, which I appreciate. In some instances, such as the first case I saw in Pennsylvania, a statutory defense becomes relevant because of past "serious misconduct" on the part of  the indigent parent towards the child.  The misconduct has to be more than mere alienation or gaps in communication. Sometimes misconduct such as abuse or neglect is the very reason the child left Germany, searching for a safer place.  

Most of the adult children who reach out to me report they had never heard of elternunterhalt.  Their years of estrangement are often not just from the parent but from the country of their birth.  Even those who still have a relationship with the parent in Germany often learn of the potential support obligation only after their parent is admitted to a nursing home or other form of care.  They face unexpected demands for foreign payments, while they are often still looking to fund college for children or their own retirement needs.  

National German authorities began to mandate enforcement of elternunterhalt in 2010 in response to increasing public welfare costs for their "boomer" generation of aging citizens.  Enforcement seems to have been phased in slowly among the 16 states in the country.  I've read news stories from Germany about confusion and anger in entirely domestic cases.

A claim typically begins with letters from a social welfare agency in the area where the needy parent is living.  The first letters usually do not state the amount of any requested maintenance payment, but enclose forms that seek detailed, documented information about the "obligated child's" income and certain personal expenses or obligations (such as care for minor children). The authorities also seeks information about any marital property and for income for any spouse of "life partner." 

Whether or not the information is supplied, at some point in a wholly domestic German case the social welfare office may initiate a request for a specific amount of  back pay as well as current "maintenance." Such a request cannot be enforced unless the child either agrees to pay or a court of law decrees that payment must be made.  The latter requires a formal suit to be initiated by the agency and litigated in the family divisions of the German courts.  The amount of any compelled payment is determined by a host of factors, including the amount of the parent's pension, savings, and any long-term care insurance, and the child's own financial circumstances.

Cross border cases have been pursued within the EU with some reported results.  As for parental maintenance claims presented to U.S. children, enforceability is less clear.  According to some of the letters sent by German authorities, Germany takes the position that a German court ruling in a cross border elternunterhalt claim can be enforced in the United States under "international law."  The letters do not explain what legal authorities are the basis for such enforcement. 

The Hague Convention on International Recovery of Child Support and Other Forms of Family Maintenance was approved by the European Union, thereby affecting Germany, in 2014.  The treaty is mostly directed to the mechanics of international child support claims and is built on past international agreements on child support; however the treaty also provides that the Convention shall apply to any contracting state that has declared that it will extend the application "in whole or in part" to "any maintenance obligation arising from a family relationship, parentage, marriage or affinity, including in particular obligations in respect of vulnerable persons."  See Article 2(3). 

Continue reading

October 26, 2018 in Consumer Information, Current Affairs, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, International, Legal Practice/Practice Management, Property Management, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (1)

Monday, October 1, 2018

Podcast: The Long-Distance (Elder) Con

The New Yorker has a podcast that offers another take on a topic that we often explore on this Blog: Why do older persons sometimes "fall" for an obvious con job, such as as offshore lotteries or stranded grandchild scams?  The wilder the facts, the greater the "obvious" risk, but that doesn't deter some "investors."  One daughter is determined to get to the bottom of her deceased father's tragic loss. of his entire life savings.  I recently heard the first of a two-part podcast called "The Long-Distance Con" (it aired for the first time 3 days ago) and found it pretty darn interesting.  Here's a summary of the first part:

On the day that Maggie Robinson Katz learned that her father had only a few days to live, she also found out that her wealthy family couldn’t pay his hospital bills: his fortune had disappeared. Katz didn’t learn how until several years later, when she began listening to a box of cassette tapes given to her by her stepmother.

 

The tapes record her father, Terry Robinson, speaking on the phone with a man named Jim Stuckey, a West Virginian based in Manila, about a kind of business proposition. Hidden in jungles and caves in the Philippines, Stuckey said, were huge caches of gold bullion, uncut U.S. currency, and Treasury bonds; if Robinson put up the money to pay the right people, Stuckey could get the treasures out.

 

It seemed absurd to people around Robinson, and the Treasury Department warns of scams that sound just like this.

 

But Robinson, a successful retired executive, fell for it hook, line, and sinker. His daughter Maggie struggles to understand why and how, talking with TheNew Yorker’s Maria Konnikova and others.

This is part one of a two-part series.  Here is the link to the first, 27 minute podcast.  

October 1, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, International | Permalink | Comments (0)

Friday, September 28, 2018

Aging, Law and Society CRN Call for Papers in Advance of 2019 Annual Meeting in D.C.

The Aging, Law and Society Collaborative Research Network (CRN) invites scholars to participate in a multi-event workshop as part of the Law and Society Association Annual Meeting scheduled for Washington D.C. from May 30 through June 2, 2019.

For this workshop, proposals for presentations should be submitted by October 22, 2018. 

This year’s workshop will feature themed panels, roundtable discussions, and rapid fire presentations in which participants can share new ideas and research projects.

The CRN encourages paper proposals on a broad range of issues related to law and aging.  For this event, organizers especially encourage proposals on the following topics:

  • The concept of dignity as it relates to aging
  • Interdisciplinary research on aging
  • Old age policy, and historical perspectives on old age policy
  • Sexual Intimacy in old age and the challenge of “consent” requirements
  • Compulsion in care provision
  • Disability perspectives on aging, and aging perspectives on disability
  • Feminist perspectives on aging
  • Approaches to elder law education

In addition to paper proposals, CRN also welcomes:

  • Volunteers to serve as panel discussants and as commentators on works-in-progress.
  • Ideas and proposals for themed panels, round-tables, or a session around a new book.

If you would like to present a paper as part of a the CRN’s programming, send a 100-250 word abstract, with your name, full contact information, and a paper title to Professor Nina Kohn at Syracuse Law, who, appropriately enough also now holds the title of "Associate Dean of Online Education!"  

September 28, 2018 in Current Affairs, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, Housing, International, Programs/CLEs, Property Management, Retirement, Science, Social Security, State Cases, State Statutes/Regulations, Statistics, Web/Tech, Webinars | Permalink | Comments (0)

Friday, August 31, 2018

How Should Non-Wage Compensation of Live-In Caregivers Be Analyzed for Fairness?

Professors Adam Hofri-Winogradow (Hebrew University of Jerusalem) and Richard Kaplan (University of Illinois) have an interesting new article, addressing how different countries analyze property transfers to caregivers.   They recognize that, broadly speaking, reviewing authorities tend to treat family members differently than they treat professional caregivers when it comes to questions about undue influence or other theories that may invalidate a transfer as unfair. Further, they recognize that policies may differ for live-in caregivers versus hourly helpers.   Also, on a comparative basis, countries may differ on how a governmental unit provides employment-based public benefits for home carers, thus perhaps influencing how family members view pre- and post-death gifts to caregivers.

From the abstract:   

In this Article, we examine how the United States, Israel, and the United Kingdom approach property transfers to caregivers. The United States authorizes the payment of public benefits to family caregivers only in very restricted situations. The U.K. provides modest public benefits to many family caregivers. Israel incentivizes the employment of non-family caregivers but will pay family caregivers indirectly when assistance from non-relatives is unavailable. All three jurisdictions rely on family caregivers working for free or being compensated by the care recipients. We examine the advantages and disadvantages of several approaches to compensating family caregivers, including bequests from the care recipient, public benefits, tax incentives, private salaries paid by the care recipient, and claims against the recipient's estate. We conclude that while the provision of public benefits to family caregivers clearly needs to be increased, at least in the United States, a model funded exclusively by public money is probably impossible.

For more, read Property Transfers to Caregivers: A Comparative Analysis, published in June by the Iowa Law Review.  

August 31, 2018 in Current Affairs, Estates and Trusts, Ethical Issues, Federal Cases, Health Care/Long Term Care, International, Property Management, State Cases | Permalink | Comments (0)

Sunday, August 26, 2018

A Different Approach to Dementia in the Netherlands

The New York Times reported recently on some innovations in The Netherlands, in  Take a Look at These Unusual Strategies for Fighting Dementia. It opens describing a virtual bus ride "simulation that plays out several times a day on three video screens" and moves into explaining that this virtual bus trip "is part of an unorthodox approach to dementia treatment that doctors and caregivers across the Netherlands have been pioneering: harnessing the power of relaxation, childhood memories, sensory aids, soothing music, family structure and other tools to heal, calm and nurture the residents, rather than relying on the old prescription of bed rest, medication and, in some cases, physical restraints." Another recreates a trip to the beach, both of which can spur conversations about previous trips.

The Netherlands has a preference for paying for care in the home rather than in facilities.  I've previously blogged about one facility in The Netherlands (De Hogeweyk). In The Netherlands, "facilities, which are privately run but publicly funded, are generally reserved for people in an advanced state of the disease."  One component of the Dutch approach is the physical surroundings designed to create a certain era or location. Another is creating small households of residents.

The article is accompanied by a number of great photos of involved residents. I plan to ask my students to discuss whether the Dutch model would work here in the U.S. What do you think?

August 26, 2018 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Housing, International | Permalink | Comments (0)

Monday, July 16, 2018

The Future For The Aging Demographic?

The National Academies Press has released Future Directions for the Demography of Aging.This volume contains the proceedings of a workshop and the overview explains

Almost 25 years have passed since the Demography of Aging (1994) was published by the National Research Council. Future Directions for the Demography of Aging is, in many ways, the successor to that original volume. The Division of Behavioral and Social Research at the National Institute on Aging (NIA) asked the National Academies of Sciences, Engineering, and Medicine to produce an authoritative guide to new directions in demography of aging. The papers published in this report were originally presented and discussed at a public workshop held in Washington, D.C., August 17-18, 2017.

The workshop discussion made evident that major new advances had been made in the last two decades, but also that new trends and research directions have emerged that call for innovative conceptual, design, and measurement approaches. The report reviews these recent trends and also discusses future directions for research on a range of topics that are central to current research in the demography of aging. Looking back over the past two decades of demography of aging research shows remarkable advances in our understanding of the health and well-being of the older population. Equally exciting is that this report sets the stage for the next two decades of innovative research–a period of rapid growth in the older American population.

Part 1 looks at trends in health and health disparities, Part 2 examines the implications of social and environmental factors, Part 3 covers families and intergenerational issues, Part 4 covers employment and retirement, Part 5 discusses cognitive issues and disability, Part 6 reviews global aging and Part 7 offers new approaches. You can purchase the softcover book here, download a free pdf of the book by clicking here or read the book online.

 

July 16, 2018 in Books, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, International, Retirement, Science, Statistics | Permalink | Comments (0)

Tuesday, June 26, 2018

Filial Claims - Does Germany Look to In-Laws for Maintenance Claims?

Recently a U.S. reader of some of our "Filial Friday" posts in the the Elder Law Prof Blog inquired about Germany's reinvigorated use of filial support laws.  He asked:

"Is an inlaw responsible for adult support in Germany? For example, if an [American] person is married to a German [living in the U.S.], the German doesn't work [in the U.S.] and has no income, will the American spouse's income be garnished to pay for the adult care of the mother in law?"

In reading an English translation of Title 3 provisions of the German Civil Code on "Obligation to Maintain," I find that only a spouse of an indigent or "lineal" relatives are identified as having an obligation to maintain "each other."  See Sections 1601 and 1608. 

However, when adult children in the U.S. receive requests from Germany authorities, they are often asked to provide detailed financial information, including identification of all marital property in the U.S.  Recent German correspondence I reviewed asked the American daughter, "Do you or your spouse/partner in a registered civil partnership hold assets?" The married daughter was then asked to identify the "type of assets, including cash, savings, capital, land or property, and the value."   This type of request for financial information seems to arise under Section 1605 of the Civil Code, which provides:

"Where the person with an obligation to maintain lives under the matrimonial property regime of community of property, his obligation to maintain towards relatives is determined as if the marital property belonged to him."

Further, Section 117 of Germany's Social Security Law provides that where the government is providing social welfare benefits, liable family members must "inform the social welfare body of their income and asset situation."   

So far, I haven't seen an American child of an indigent German parent "compelled" to pay maintenance, despite German government inquiries and letters suggesting this is possible if family members fail to cooperate voluntarily.  I suspect there are instances where the demands for financial information are frightening enough that some Americans agree to provide "some" voluntary support.  I'm always interested when Americans receive requests from foreign authorities under this new wave of filial law obligations. The cross-border fact patterns are perfect for my Conflict of Laws course.  One of these days, we'll probably see some formal test cases. 

Americans aren't the only ones surprised by the vigor with which German authorities are seeking reimbursement for state care costs from relatives.   Here's one man's dilemma from 2014, captured in a German newspaper Süddeutsche Zeitung, as translated into English for the Financial Times.  

June 26, 2018 in Current Affairs, Ethical Issues, Health Care/Long Term Care, Housing, International | Permalink | Comments (0)

Thursday, June 14, 2018

The Evolution of Email Scammers: Moving from Granny, to Granny's Lawyers and Financial Companies as Their Targets

In my Elder Protection Clinic days, I met with family members of older adults victimized by off-shore scammers.  In one notable case, the older mother,  normally a savvy woman about her personal finances, had succumbed to the flattery of someone posing as a  financial advisor, who offered her various new "investments."  He knew just how to work her, appealing to her "business acumen," using internet maps to learn about her neighborhood and thus to make it seem his office was in a building near her bank in a suburb of Pittsburgh.   Even after her daughter, with the help of a legitimate financial advisor who caught the unusual activity on the mother's accounts, shut down any easy means of access to her mom, the mother continued to believe the perpetrator was just bad at financial advice, and not totally corrupt.   

The elderly mother's  judgment on who to trust was impaired, but the impairment was specific and hard to recognize because she otherwise functioned fairly well.  The combination of the perpetrator's flattery, his appeal to her once-strong financial skills, and the fact that she was lonely, trapped in her house as her physical strength was waning, all contributed to the success of the scam.  It all began with a single email.

A recent announcement by the FBI of a coordinated law enforcement effort to disrupt international scammers reveals how the scamming industry has evolved. The FBI explains:

Operation WireWire—which also included the Department of Homeland Security, the Department of the Treasury, and the U.S. Postal Inspection Service—involved a six-month sweep that culminated in over two weeks of intensified law enforcement activity resulting in 74 arrests in the U.S. and overseas, including 42 in the U.S., 29 in Nigeria, and three in Canada, Mauritius, and Poland. The operation also resulted in the seizure of nearly $2.4 million and the disruption and recovery of approximately $14 million in fraudulent wire transfers.

 

A number of cases charged in this operation involved international criminal organizations that defrauded small- to large-sized businesses, while others involved individual victims who transferred high-dollar amounts or sensitive records in the course of business. The devastating impacts these cases have on victims and victim companies affect not only the individual business but also the global economy. Since the Internet Crime Complaint Center (IC3) began formally keeping track of BEC [business e-mail compromise] and its variant, e-mail account compromise (EAC), there has been a loss of over $3.7 billion reported to the IC3.

 

BEC, also known as cyber-enabled financial fraud, is a sophisticated scam that often targets employees with access to company finances and trick them—using a variety of methods like social engineering and computer intrusions—into making wire transfers to bank accounts thought to belong to trusted partners but instead belong to accounts controlled by the criminals themselves. And these same criminal organizations that perpetrate BEC schemes also exploit individual victims—often real estate purchasers, the elderly, and others—by convincing them to make wire transfers to bank accounts controlled by the criminals.

 

Foreign citizens perpetrate many of these schemes, which originated in Nigeria but have spread throughout the world.

Law firms were among the most frequent targets of the scammers, who posed as clients to access funds held in the law firms' trust accounts.  For more on the industry, read "It's Time to Stop Laughing at Nigerian Scammers -- Because They're Stealing Billions of Dollars,"  from the Washington Post.    

June 14, 2018 in Cognitive Impairment, Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Cases, Federal Statutes/Regulations, International, Property Management | Permalink | Comments (0)

Friday, June 8, 2018

Filial Friday: Using Cultural Norms to Explore Public Policy on Elder Care

Duke University Law graduate and 2018-19 Bristow Fellow H. Hunter Bruton uses filial support laws in China and contrasting government policies in Japan to explore public policy choices affecting the relative responsibilities of family and government to provide care for aging adults. The author's 2018 article for the University of Minnesota Law Review begins:

This Essay aims to fill that gap by formulating policy recommendations from the lessons of China and Japan--two countries that have taken divergent approaches to facilitating familial and communal eldercare. Conventional wisdom paints cultural portraits with a broad brush: inescapable forces fight against familial and communal eldercare in the West, while Eastern cultures revere the elderly. But cultural ideals and characterizations do not always accord with reality. Similar to the United States, cultural and societal trends in both China and Japan have resisted government efforts to place the eldercare burden on families and communities. This Essay explores how each government’s response has altered eldercare practices and elucidates general principles applicable to the American-eldercare context.

 

Part I begins by defining eldercare and explaining the benefits of familial and communal eldercare. It concludes with a brief survey and analysis of familial and communal eldercare’s past, present, and future in America. With the goal of increasing familial and communal eldercare in mind, this Essay turns towards two differing international examples. Part II scrutinizes China’s solution--mandating familial and communal eldercare to alleviate government costs. Part III analyzes Japan’s approach--institutionalizing encouragement of familial and communal eldercare. Each Part also evaluates American analogs, and possible reform opportunities in the United States. An all-inclusive assessment and comparison would require empirical studies and elaboration beyond this Essay’s scope. Instead of purporting to meet these demands, this Essay intends to chronicle the successes and shortcomings of China and Japan and give American policymakers a better understanding of pertinent considerations in formulating eldercare policy.

For more, read Improving Familial and Communal Eldercare in the United States: Lessons from China and Japan.

June 8, 2018 in Current Affairs, Ethical Issues, Health Care/Long Term Care, International | Permalink | Comments (0)

Thursday, June 7, 2018

BBB: Sweepstakes & Lottery Scams

The Better Business Bureau recently released a new report, Sweepstakes, Lottery and Prize Scams. So why, you ask, am I writing about this report?Because of this:

BBB found these frauds concentrate disproportionately on older people, who suffer the largest losses by far. A vast worldwide industry of sweepstakes mailings specifically targets older victims. Major law enforcement efforts are focused on the millions of deceptive mailings that have flooded the mailboxes of seniors across the country. In addition to money loss, victims often are emotionally devastated when they realize they have been defrauded. Some have even resorted to committing suicide.

In particular, the report offers data for the past 3 years by age group and shows the number of complaints by age and the amount of losses (and the total is staggering). The report ponders why elders are targets, offering

While some studies suggest older consumers are somewhat less likely to be fraud victims than the general population, perhaps because they have more life experience to guide them, there is evidence suggesting they are more likely to become victims of sweepstakes fraud. Complaint data shows more than half of victims are over 60, and those over 70 years old account for more than two thirds of the losses related to this scheme.

Why is this? It is speculated that the fraudsters hope to find victims with mild cognitive impairment, dementia or Alzheimer’s disease. These people often continue sending hundreds of thousands and even millions of dollars to fraudsters. A retired college president sent tens of thousands of dollars to scammers. CNN reported that an older man suffering from Alzheimer’s sent all of his funds to scammers and then committed suicide when the prize money never came. A San Diego TV station explains how one senior victim was defrauded.

In addition, seniors may simply have more money and may have been at the same address, with the same phone number, for a longer time and therefore may be easier to locate.

The 16 page report offers insight onto scams from Jamaica, Costa Rica and social media, provides profile stories of some victims and perpetrators, and offers suggestions and recommendations with contact info for agencies that handle cases of scams and frauds.

There is a lot of information packed into this 16 page report. Check it out!

June 7, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, International, Other, Statistics | Permalink | Comments (0)

Wednesday, June 6, 2018

Dax, France -- a Prototype Village for Residents with Dementia?

From Ben Mulford, a law graduate working at the Iowa Department on Aging, comes an interesting description of a French village designed to give residents who have Alzheimer's Disease as much freedom and normalcy of life as possible, in a safe setting. Map Dax France

Work has begun on France's first "Alzheimer's village” where patients will be given free rein without medication in a purpose-built medieval-style citadel designed to increase their freedom and reduce anxiety. 

 

Residents of the village in Dax, southwestern France, will be able to shop in a small supermarket, go to the hairdressers, local brasserie, library, gym and even a little farm.  They will live in small shared houses designed to reflect their personal tastes and in four districts reminiscent of the southwestern French region between forests and the seashore.

 

While it may sound similar to a typical residential complex, the inhabitants are all men and women suffering from Alzheimer's,  the commonest cause of dementia. . . . 

 

The village is the brainchild of the late Henri Emmanuelli, a former Socialist minister and local MP who launched the project after reading about a Dutch gated model village in Weesp, Netherlands, seen as a pioneering care facility for elderly people with dementia.

 

Residents are confined to the village for their own safety but are allowed to move around freely inside and are watched over by plain-clothed medical staff. The staff don't treat patients, they care for residents, they say.
 
Interesting details include the plans for researchers "cohabiting" with residents, and using a high ratio of live-in carers and volunteers to stage activities.   The article makes the amusing (worrying?) comparison to the plot of The Truman Show, a movie where a key resident, played by Jim Carrey, was living in a fake town.    
 
Will this be cost effective?   The projection is described as "largely funded by the region," and the prediction is it will "only cost patients €66 per day, roughly the same as the rate for a traditional nursing home in France."  
 
I'm a bit skeptical about the "medieval" citadel design as being comforting.  I doubt if residents would be that old.  But, perhaps it would enhance a vacation feel to the location.  I know a resident of a dementia care community, one that follows a village concept on a smaller scale, and when the misting system is operating to cool the exterior porches for all the cottages, she thinks she's at a hotel on the coast of California.  That is a nice alternative to reality -- Arizona in the summertime.  Plus, ambiance of the location is important to attracting and keeping workers, and to make family members and friends feel relaxed and welcome, too.
 
Thank you, Ben, for sharing this interesting piece.  For more, read France Starts Work on Revolutionary 'Alzheimer's Village' Where Patients Roam Almost Free, from The Telegraph

June 6, 2018 in Cognitive Impairment, Consumer Information, Dementia/Alzheimer’s, Health Care/Long Term Care, Housing, International | Permalink | Comments (0)

Friday, June 1, 2018

2018 World Elder Abuse Awareness Day Webinar

Happy June 1. Celebrate by registering now for a free webinar for World Elder Abuse Awareness Day! From the DOJ Elder Justice Initiative, this 4 p.m. webinar will include:

A presenter from the Social Security Administration will share the latest on representative payees; an EJI representative will talk about the Elder Abuse Prevention and Prosecution Act and new resources being developed to better respond to elder abuse; an expert from the Administration for Community Living will describe their guardianship grant programs and the importance of data collection for policy and programmatic enhancement; and the Deputy Director of the National Center on Elder Abuse will present on some of the latest trends and resources that will help you to better respond to elder abuse.

Expert presenters include:
Lydia Chevere, Public Affairs Specialist, Social Security Administration
Aiesha Gurley, Aging Specialist, Office of Elder Justice and Adult Protective Services, U.S. Department of Health and Human Services
Susan C. Lynch, Senior Counsel for Elder Justice, U.S. Department of Justice
Julie Schoen, Deputy Director, National Center on Elder Abuse

To register for this webinar, click here

June 1, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, International, Programs/CLEs, Webinars | Permalink | Comments (0)

Monday, May 21, 2018

Asia Begins to Focus on New Senior Housing Models -- and Foreign Investors

From Singapore, comes a recent article in The Independent titled "Asia's Ageing Crisis Calls for Innovative Senior Housing Models and Foreign Investment."  The article begins:

Asia is facing an ageing crisis with rising life expectancies and record low birth rates in some countries, as a result there is an increasing need for senior housing to cater to Asia’s ageing population. In a new report released today, Colliers International identified key trends in Asia’s demographic shift as well as innovative senior housing models around the globe which may be applicable to this region. . . .

 

Mr. Govinda Singh, Executive Director, Valuation and Advisory Services at Colliers International, said, "Singapore's greying population presents many opportunities for both policymakers and private developers to further invest in senior housing solutions. Demand for such accommodation will be also spurred by the rising awareness of  healthcare and wellness benefits, and retirees having the financial capacity to take advantage of senior living services and facilities." . . . 

 

On May 12, 2018, Singapore Prime Minister Lee Hsien Loong officially opened the country’s first retirement community Kampung Admiralty in Woodlands – an integrated residential development with a range of healthcare, elder and childcare facilities, together with commercial space to serve residents of the area. The concept was conceived by the Housing and Development Board more than four years ago.

The article noted population trends in the region, including the prediction that Asia's population of people over age 65 will "nearly triple by 2050 to 945 million, while the percentage of people over age 75 will often be "staggering," especially in Japan (36.4%), South Korea (35.3%), Hong Kong (33.9%), and Thailand (29%) by 2050.

May 21, 2018 in Consumer Information, Current Affairs, Housing, International, Retirement, Statistics | Permalink | Comments (0)

Monday, May 14, 2018

Japan Mandates Cognitive Screening For Drivers Over Age 75

As reported by the New York Times, Japan is using mandated screening tools to remove older drivers who are identified as displaying signs of cognitive impairment:

Since 2009, all drivers 75 and older must submit to a test of their cognitive functioning when they renew their licenses, typically once every three years. Under a new traffic law that took effect in March 2017, those who score poorly are sent to a doctor for examination, and if they are found to have dementia, the police can revoke their licenses.

 

More than 33,000 drivers who took the cognitive test last year showed what the police deemed to be signs of cognitive impairment and were ordered to see a doctor. The police revoked just over 1,350 licenses after doctors diagnosed dementia.

For more, including photos of some of the screening tools, plus interesting demographic data about rural Japan, read Japan Moves to Ease Aging Drivers Out of Cars.  

 

 

May 14, 2018 in Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Ethical Issues, International | Permalink | Comments (0)

Thursday, May 10, 2018

David Goodall Has Ended His Life

Earlier in the week we'd blogged about Australian David Goodall who, at 104, had decided he'd lived more than long enough and traveled to Switzerland to end his life.  The New York Times, among other news outlets, reported that he has done so. A Song Before Dying: David Goodall, 104, Australian Scientist, Ends His Life in Switzerland reports that "[o]n Thursday, Mr. Goodall died about 12.30 p.m. local time, according to Exit International, a right-to-die organization of which he had been a longtime member."  His decision has caught a lot of media attention, and the article relates that he held a final press conference the day before his death.

He was crystal clear about why he had chosen “the Swiss option.” Euthanasia and assisted dying are banned in Australia, though Victoria State has passed a law on assisted dying that goes into effect next year; it will apply only to terminally ill patients who have a life expectancy of no more than six months... He said he hoped his life story would “increase the pressure” on Australia to change its laws. “One wants to be free to choose his death when death is at the appropriate time,” Mr. Goodall said.

Mr. Goodall wanted no events marking his death. The article concludes that when he was asked "[h]ow would he like to be remembered? “As an instrument of freeing the elderly from the need to pursue their life irrespective,” he said at the news conference on Wednesday. .. At one point, he was asked what tune he would choose for his last song, and he said the final movement of Beethoven’s Ninth Symphony. Then he began to sing, with verve and vigor... According to Mr. Nitschke, Mr. Goodall did end up choosing Beethoven, and he died the moment “Ode to Joy” concluded."

 

*updated to correct location

May 10, 2018 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Health Care/Long Term Care, International, Other | Permalink | Comments (0)

Wednesday, March 21, 2018

World Elder Abuse Awareness Day is June 15, 2018

With World Elder Abuse Awareness Day just a few months away, it's time to think about any events your organization might offer.  According to the USC Center on Elder Mistreatment NCEA email, a microsite has been created  that offers suggestions, helpful hints, events and more. Want to take some kind of action? Check the information here for 13 ideas in a number of categories. Planning an event? List it there. It's never too early to start planning!  And let others know using #WEAAD.

March 21, 2018 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care, International, Other, Programs/CLEs | Permalink | Comments (0)

Sunday, February 25, 2018

Australia's 5th Annual National Elder Abuse Conference

I had the honor of attending and speaking at Australia's 5th Annual National Elder Abuse Conference, held recently in Sydney.  Speakers at the two day conference included many government dignitaries,  a series of concurrent sessions and a number of abstract presentations.  The conference offered a multi-disciplinary, multi-cultural focus and included a wide-range of topics over the conference.   I found the energy level and interest at this conference to be high.  I moderated a panel of law enforcement and community activists and their efforts are outstanding. One of the interesting points to me was that the problems they're facing here are so similar to those in the US.  Exchanging information about prevention and responses was very useful. Post-conference information about recordings of the  sessions will be available soon on the conference website.  This is a conference well worth attending, even though Australia is a bit of a trek from the US.  The conference rotates locations within Australia, so the website will also have information about dates and locations for the 2019 conference.

February 25, 2018 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, International, Programs/CLEs | Permalink

Thursday, January 25, 2018

Netherlands: Examining Physician's Actions in Euthanasia Death of 74-Year Old Woman with Dementia

As my blogging colleague Becky Morgan has highlighted in two of her posts this week, about a February conference at Hastings and recent proposals for "dementia advance directives," end-of-life decisions are increasingly high-profile topics for those working in law, medicine and ethics.  Add to this the case under review in the Netherlands, where a physician described as a "nursing home doctor" performed euthanasia for a 74-year old woman with "severe dementia." A Dutch law legalizing euthanasia, that came into effect in 2002 and that was recently the subject of new "guidelines for performing euthanasia on people with severe dementia," is also under review.  From Dutch News in September 2017:

The case centres on a 74-year-old woman, who was diagnosed with dementia five years ago. At the time she completed a living will, saying she did not want to go into a home and that she wished to die when she considered the time was right. After her condition deteriorated, she was placed in a nursing home where she became fearful and angry and took to wandering through the corridors at night.The nursing home doctor reviewed her case and decided that the woman was suffering unbearably, which would justify her wish to die.

 

The doctor put a drug designed to make her sleep into her coffee which is against the rules. She also pressed ahead with inserting a drip into the woman’s arm despite her protests and asked her family to hold her down, according to the official report on the death. This too contravenes the guidelines. Once the public prosecution department has finished its investigation it will decide whether or not the doctor, a specialist in geriatric medicine, should face criminal charges.

In reading articles about this matter, I'm struck by how often the articles (and my own post here) draw attention to the woman's age, comparatively "young" at 74, as well as the fact that her euthanasia directive written five years earlier also expressed her wish not to leave her home.  If an individual is younger -- with dementia -- does that reduce society's willingness to "allow" aid in dying? If individuals are older -- and what age is old enough -- is it less controversial? And is a family bound by the individual's wishes not to leave her home?  Tough questions, indeed.

This case has also drawn attention in commentary in the US, including a January 24, 2018  Washington Post piece with the provocative title, How Many Botched Cases Would It Take to End Euthanasia of the Vulnerable?   

January 25, 2018 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Ethical Issues, International | Permalink | Comments (0)

Thursday, December 28, 2017

Dementia Therapy in German Nursing Home

A German nursing home is turning back the hands of time in an effort to better treat residents with dementia. The Washington Post story, A German nursing home tries a novel form of dementia therapy: re-creating a vanished era for its patients, explains how rather than trying to help residents remember, the facility takes them back to a specific period of time when they were younger.  For example one "nursing home ...  is trying to trigger [resident] ... memories by re-creating settings from [a prior] era as a form of therapy. While other nursing homes are also trying to help their residents remember details of their lives, what is going on here could well be the only concerted effort to re-create for its residents an entire historical era." This includes providing residents with tools they used in their jobs-but this only works if they liked their jobs, according to the article. Items are placed in "a memory room" for residents to visit.  The staff had to become knowledgeable about the time period in order to appear as an authentic residents of the era. So far the facility focuses on two decades with plans to expand to encompass a third decade.

Thanks to my colleague, Professor Mark Bauer, for alerting me to the article.

December 28, 2017 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, International | Permalink