Monday, December 16, 2024
Bruyère Health and uOttawa: Imaging a Future Without Disability or Dementia?
On November 28, 2024, I was giving "thanks." Less because it was Thanksgiving Day in the United States, but more because I was witnessing a fascinating day of health-related research reports by individuals and teams connected to Bruyère Health Research Institute in Ottawa, Canada. Dr. Kumanan Wilson, CEO at Bruyère, made my attendance possible, and it was an inspiring day, hosted at the Canadian Museum of Nature. Presenters were asked to frame remarks in the context of "Imagining the Future...." And the most interesting questions asked us to "imagine the future without disabilities or Alzheimer's Disease."
Some of the highlights of the packed program:
- Keynote speaker Dr. Claire Kendall, Associate Dean, Social Accountability, uOttawa, who describes herself as a practicing family physician as well as researcher, and who was imaging a future where local data transforms the health care of both patients and communities. She explained the research underway to track avoidable deaths, as well as information showing inequities within and between neighborhoods in terms of access to housing, food banks, COVID-19 care, and in-person primary health care. I was especially intrigued by the Ottawa Neighbourhood Study Project.
- "Snapshot" Speaker Sessions, often with graduate students making the presentations. For example, several studies are looking at what patients say about why they use hospital Emergency Rooms rather than primary health care doctors for "routine" care needs. These interviews are helping to create "collaboration" among different community venues, including libraries and food stores, to make health care access easier, including "pop-up" health clinics.
- Poster programs that provided me with my first introduction to "social prescribing pathways," especially for older people.
- Learning more about technology advances, including the "Kira" project that uses virtual reality to create conversation opportunities for people with dementia.
- Keynote speaker Dr. Andrew Frank, a neurologist and investigator with the Bruyère Memory Program and a professor at uOttawa. Dr. Frank asked us to consider how it is that Alzheimer's disease continues to devastate individuals without us taking action. He said, "Alzheimer's Disease 'deserves' a response." Dr. Frank outlined the latest work on biomarkers and the possibility of simple blood tests. He explained the "gut microbiome project," enhancements for "Smart Homes," and safety adaptations for driving. He talked about the challenges of promising drug trials for treatment (not cures) for Alzheimer's -- and he was frank about the ways in which Canada can and should play important roles in future research.
I have the feeling I might have been the only law professor in the room. But, I also suspect I'll be inviting many of these researchers to future conferences "for" lawyers and law professors!
December 16, 2024 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Discrimination, Ethical Issues, Health Care/Long Term Care, Housing, International, Science | Permalink | Comments (0)
Wednesday, December 4, 2024
Presenting to uOttawa on "The Challenges of Advancing Effective Justice for Older People"
I'm laughing as I type this post today, because it is snowing in Ottawa. The photo here was taken while crossing my favorite bridge over the Rideau Canal on the way to the University of Ottawa, just as the snow is getting started today.
This is the first time it has snowed while I've been in residence as a Fulbright Research Scholar at the University of Ottawa. So. of course, it is snowing as I'm scheduled to make a live presentation today on behalf of the LIFE Research Institute and the Centre for Health Law, Policy and Ethics on campus at uOttawa. Fortunately, there is a live-streaming option for attendees.
To say this entire semester has been a wonderful gift to me from my hosts at Fulbright and uOttawa is an understatement. I have many people to thank! But, first, in case you want to see the slides I will use to keep myself on track while speaking today, here is a link.
I'm looking forward to using what I'm learning at uOttawa in my future research and publications. So, stay tuned!
December 4, 2024 in Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, International | Permalink | Comments (0)
Friday, November 22, 2024
uOttawa Report: Dynamic Programming on "Governing Reproduction" at Centre for Health Law, Policy and Ethics
One of the perks of a Fulbright Fellowship is the opportunity to attend conferences that introduce you to new topics, outside of your traditional research areas, and which stimulate new thinking even in your traditional areas. That happened to me this week while attending a conference with the title Governing Reproduction, sponsored by the University of Ottawa's Centre for Health Law, Policy and Ethics, which is also the host for my Fellowship. The two-day program has included a wide array of cutting edge issues such as access to abortion and contraceptives, health care for indigenous women during and following giving birth, health care funding, legislative initiatives and more.
I was very interested to hear an especially persuasive presentation on the topic of abortion law by Joanna Erdman, Professor of Health Law and Policy at Dalhousie University. Professor Erdman approached the topic of regulation from the perspective of health care as a public right, and the need for public spaces to access such care. She connects the need for a functioning means of abortion care in a public space to the need for security, privacy and dignity. Intriguing. It made me think about an issue I've been watching from Ottawa play out on the evening news in nearby Buffalo, New York, where the community is facing the closure of a long-standing and respected local nursing home, triggering public outcry as this will affect 100+residents and more than 300 jobs. The closure is triggered by inadequate public and private funds to keep operating. Public nursing homes are at risk of "failing" all over the United States.
On the second day of the conference, the panel on surrogacy captured my attention.
In Canada, federal law makes it illegal to "pay" surrogates or to pay certain intermediaries, sometimes called surrogacy agencies or brokers, for "matching" potential parents with potential surrogates. But despite that federal law, more than a dozen surrogacy agencies are operating in Canada, sometimes appearing to avoid federal attention by taking the position they are not charging for "matching" but rather for "other" services needed by the parties to the contract during the gestational period.
The speakers on potential regulatory issues for surrogacy arrangements included Vanessa Gruben, Professor of Law at uOttawa and also the Director of the Centre for Health Law, Policy and Ethics, Stephanie Carsley, Professor of Law, uOttawa, and Alicia Czarnwoski, a PhD candidate at uOttawa who spoke about her survey of the operators of commercial ventures involved in facilitation of surrogacy. Isabel Côté, Canada Research Chair in Third-Party Reproduction and Family Ties from the University of Quebec, also spoke about her research into reactions of family members to the roles of surrogates.
Of course, all of that got me thinking, especially when I heard that some 40% of surrogacy contracts in Canada may involve intended parents from outside of Canada. I'm teaching Conflict of Laws when I return to Penn State Dickinson Law in January. Heads up to my students! You can expect a cross-border and federalism fact pattern between U.S and Canada in the realm of surrogacy! What jurisdiction's law controls if a contract issue arises? If tort issues arise? If "fraud" exists?
November 22, 2024 in Crimes, Current Affairs, Discrimination, Ethical Issues, Federal Cases, Health Care/Long Term Care, International, State Cases | Permalink | Comments (0)
Wednesday, October 30, 2024
Canadian Province Begins Permitting "Advance Requests" for Medical Assistance in Dying
In a first for Canada, the province of Quebec last year enacted a law permitting "Advance Requests" for Medical Assistance in Dying (MAID). Quebec delayed implementation of the law to permit the federal government to amend the Canadian criminal which restricts MAID to instances where the person making the request still has "capacity" immediately before the action is to be taken. But effective on October 30, 2024, Quebec announced that despite no action at the federal level, it would begin the approval process for Advanced Requests immediately, deemed to be supportive of the wishes of people with degenerative cognitive conditions, including Alzheimer's.
Following the announcement, the federal Minister of Health says Ottawa will not be contesting advance MAID requests in Quebec despite the conflict with federal criminal law. CBC News reports the federal government says it "will launch a countrywide consultation on the issue next month, with a report set to be published in March 2025."
As a U.S. outsider watching this play out, the Quebec decision also appears to me to reflect growing political tensions, including those who are pressuring Prime Minister Justin Trudeau to grant their various demands, such as demands for increases in federal funds flowing to provincial projects, as the price to pay for any ongoing support for his national leadership position.
October 30, 2024 in Cognitive Impairment, Consumer Information, Crimes, Current Affairs, Dementia/Alzheimer’s, Ethical Issues, Federal Cases, Health Care/Long Term Care, International | Permalink | Comments (0)
Sunday, October 6, 2024
Visiting in Canada as a 2024-25 Fulbright Fellow at University of Ottawa
I'm catching up on my blogging life after an especially busy summer, which included a horseback riding adventure with a dear friend from New Mexico, Deborah Walker, along the Ring of Kerry in County Killarney, Ireland. We enjoyed every moment!
Now I'm in Canada as a visiting 2024-25 Research Chair in Health Law, Policy and Ethics at the University of Ottawa's Center for Health Law. This is my second career opportunity to "visit away" under the auspices of a Fulbright Fellowship program and it is wonderful to experience new places, new ideas, and new people.
My start on the Fulbright was a little delayed -- because of a late summer horseback riding accident (although, thankfully that accident did NOT take place in Ireland), as I managed to break my arm and bruise a few ribs when my horse fell unexpectedly, sending us both to the ground from a canter.
I must admit -- after a lifetime of riding both horses and bicycles for long distances in new places with a few tumbles along the way -- you would think I "knew" better than to jump at the chance to ride one more "new" horse who had arrived in the barn just a few days before my original planned departure for Canada. Whoops! The ER, a cast, a bit of surgery and lots of physical therapy and I'm back on a good path. This is my first time blogging with both hands on the keys since the tumble.
I've been fascinated by the University of Ottawa programming I'm witnessing. I chose Canada -- and specifically Ottawa -- because I wanted to take time to experience the nation's capital, and take a close look at Canada's health care program and approaches to aging issues. So far, I've already sat in on presentations on a range of health-related subjects, including a book launch on September 25 of Pandemics, Public Health, and the Regulation of Borders.
The multi-author approach provided important contrasts on the question of what does it mean to keep vulnerable populations safe in the face of a global health care crisis, while still being "good national citizens" of the world. Colleen Flood, recent Director of UOttawa's Center for Health Law and now the Dean of Queen's University Faculty of Law and a co-editor of the Routledge Press (open access) book, led off the discussion that centered on COVID-19, by comparing New Zealand's locked border approach with the attempts of both Canada and the United States to limit travel (and thereby reduce transmission of disease) while still permitting open borders to facilitate economic transactions, including movement of needed supplies. I was especially interested in the presentation of Kumanan Wilson, a physician and scientific leader with the Bruyère Research Institute, who provided a brief history of the science of "vaccine passports," including the need for stable, reliable sites for digital information. (Did you lose track of your paper vaccine card(s))?
Stay tuned! More reports to come!
October 6, 2024 in Books, Consumer Information, Current Affairs, Ethical Issues, International, Science | Permalink | Comments (0)
Friday, June 14, 2024
Report on 2024 Annual Sonya L. Patterson Memorial Elder Abuse Symposium in Oklahoma
Recently, I participated in a well-organized CLE event, offered annually as a memorial to a great attorney who passed away too soon. The Annual Sonya Patterson Memorial Elder Abuse Symposium is hosted by Legal Aid Services in Oklahoma. By all accounts, Sonya Patterson, who died in an accident while just a few years into her already notable career as an attorney, is a proper subject of this tribute, as she was deeply concerned with advocacy for individuals who may be victims of abuse, exploitation or neglect.
Cutting edge topics were a big part of the summer 2024 program. For example, one new concern is about "dirty deeds," where fraudsters record deed transfers, often targeting properties without any mortgages, and thus often targeting the equity earned by older owners. We heard from hard-working staff members in the Oklahoma County Clerk's office in Oklahoma City, where the county has created a registry/notification system for owners as a way to receive an "alert" about potential fraud. In one instance, the fraudster was arrested while in the act, at the County Clerk's office! We also heard about the very real need for pro bono legal assistance on this topic, as many older owners may not have ready savings or cash to pay private attorneys to catch and cure the fraud.
Here was the full lineup for 2024 Symposium::
- Introduction to Elder Abuse Law: Cassandra Bobbitt & Richard Goralewicz
- Ageism: Richard Goralewicz
- Step by Step, Slowly it Can Happen: Examining Dynamics of Conflicts of Interest for Lawyers in Representation of Older Persons and Families
- Oklahoma Legislative Responses to Elder Abuse: Oklahoma Representative Nicole Miller
- Cleaning Up "Dirty Deeds," by representatives of a County's Deed Recording Office and Attorney Christopher Jones
- Recognizing and Responding to Elder Abuse in Indian Country: Peggy Jo Archer, Judith Kozlowski, Margaret Carson
- Undue Influence and Its Ethical Implications: David M. Postic, Adjunct Professor at University of Oklahoma College of Law
At the invitation of Rick Goralewicz, senior law project attorney with Legal Aid Services in Oklahoma, I used the visually interesting tale of a real-life Irish Pub to discuss very real consequences of failing to recognize conflicts of interest for attorneys attempting to represent both the older adult and other family members on planning transactions. My special thanks to Rick and Attorney Ana Reynolds for inviting me again this year!
June 14, 2024 in Advance Directives/End-of-Life, Consumer Information, Crimes, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, Housing, International, Property Management, State Cases, State Statutes/Regulations | Permalink | Comments (0)
Sunday, April 14, 2024
Combining Education and Community Service for Pennsylvania Law Students: "Wills for Heroes"
On a recent Saturday in April, I had the privilege of spending the day -- almost 9 hours, in fact -- with first responders and veterans, and sometimes their children, plus attorneys, notaries, and law students at an event in Central Pennsylvania. The students, lawyers and notaries were all volunteering their time to prepare wills and other key estate planning documents for community area residents at the Cumberland County Good Hope Fire Station, in Mechanicsburg, Pennsylvania. The Wills for Heroes event had a full slate of 50 spots for clients, and the seats seemed full all day. In fact the last two sets of documents were witnessed about 4:30 in the afternoon. Shown here are two Penn State Dickinson Law students, Alaina Kuzmitsky (R) and Devon Lacy (L), working under the direction of a notary and local attorney.
The Wills for Heroes program is organized in Pennsylvania under the auspices of the Pennsylvania Bar Association's Young Lawyers Division, with the support from individual county bar groups. Paul D. Edgar, Esq., who is the incoming President of the Cumberland County Bar Association, and who currently spends his weekdays in the state Attorney General's office, provided a great training session and set everyone up in the large community room of the very busy Good Hope Fire Station. There were 10 well-spaced tables devoted to interactions between teams of lawyers and law students, for discussion about wills, powers of attorneys and advance health care directives. Separate tables offered witnesses and notaries for final documents. Law students from both Penn State Dickinson School of Law and Widener Law Commonwealth were fully engaged in the drafting and review process, a great opportunity for combining their hands-on education with public service.
In addition to Devon and Alaina, the Dickinson Law contingent included several students who were completing an "experiential component" of a Spring semester Elder Law class (Jonathan Biedler, Caitlin Godsey, Talmage Pearce, Devon Lacy, and Joe O'Donnell), three first-year law students (Aidan Levinson, Kristen Ramillano, and Maedot M. Teweldemedhin), two additional upper division law students (Hannah Pasco and Payton Pittman), plus LLM student Naby Bangoura. Also, one of the practicing attorneys, Fred Gibson, is a recent graduate of Penn State Dickinson Law, who identified his professional interest as potentially including estate planning and elder law while still in school -- and is now helping other law students do the same.
LLM Student Naby Bangoura wrote to me after the event to express his thoughts on what he described as "key" components to the event, including the use of software that permits customization of the documents. It was an opportunity for him to recognize how in the United States, the Rules of Professional Conduct governing attorneys apply "even" during free legal services. He offered a comparative, international perspective, observing:
"It is truly extraordinary that the Pennsylvania Bar has brought together different professionals, including attorneys, notaries, and students, to assist individuals in drafting their wills at no cost. I have rarely seen this type of synergy and collaboration between professionals from different backgrounds in jurisdictions such as France or West Africa. Although I have attended some pro bono services in France during Covid, which concerned the impact of force majeure on business operations and some remedial measures they could explore, this kind of in-person collaboration and experimental learning is extremely valuable. I wish such initiatives could be experimented with in other parts of the world."
Finally, the firefighters and emergency personnel working at the Station welcomed everyone to their Station with generous offerings of food and coffee throughout the day, and an opportunity to take photos with the fire trucks at the end of the day. We appreciate your service to the community and it was a pleasure to talk with so many of you.
April 14, 2024 in Advance Directives/End-of-Life, Current Affairs, Estates and Trusts, Ethical Issues, Health Care/Long Term Care, International, Legal Practice/Practice Management, Programs/CLEs, Veterans, Web/Tech | Permalink | Comments (0)
Tuesday, September 20, 2022
Canada Medically-Assisted Death
The New York Times recently ran this article, Is Choosing Death Too Easy in Canada? "Last year, Canada changed its assisted death law, permitting people with chronic, “grievous and irremediable” conditions and physical disabilities to commit suicide, even if they are not terminally ill." As far as how Canada compares to other countries, "Canada is among 12 countries and several American states where assisted death is permitted in certain circumstances. Since last year, it has been one of at least three — including Belgium and the Netherlands — that allow an assisted death if the person is suffering from a chronic painful condition, even if that condition is not terminal." Part of what is causing debate, according to the article, is a change that takes effect in March of 2023, when "the law will expand again, to apply to people with some mental disorders. A Parliamentary committee of lawmakers is studying what standards should govern those cases; its report is expected in the fall." The article discusses views of opponents and proponents and includes some stories of Canadians. Read the article. It will be great for a basis for class discussion!
September 20, 2022 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Health Care/Long Term Care, International | Permalink | Comments (0)
Tuesday, July 26, 2022
7th World Congress on Adult Capacity 2022
I have heard that the 7th World Congress on Adult Capacity 2022 was quite successful. I was excited to see that the conference organizers have published a link to download the various presentations. The link is available here and then choose the presentations you wish to download.
July 26, 2022 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, International | Permalink | Comments (0)
Tuesday, June 14, 2022
World Elder Abuse Awareness Day 2022
Tomorrow is the day-World Elder Abuse Awareness Day 2022. Lots of activities are happening in observation of the day. Here are just a couple. Register for the 8th Global Summit here. Or check out the Connecticut program, "On World Elder Abuse Awareness Day, June 15, Danbury Age Well Community Council presents a panel of experts to identify, prevent, and address financial exploitation of older adults in our community." To register for this Connecticut zoom program, click here. (Thanks to Judge Yamin (one of the speakers) for alerting me to the Connecticut program). What are you doing to observe the day?
June 14, 2022 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, International | Permalink | Comments (0)
Saturday, June 11, 2022
Two Hundred Years of Guns.... What if you knew the outcome when you were writing the Second Amendment?
Alexander Merezhko, a good friend since he was a visiting Fulbright Scholar at Dickinson Law from his home country of Ukraine, is now a member of Ukraine's parliament and a senior legal advisor to President Zelenskyy. We email regularly about events in our respective countries; of course, there is a lot for us to discuss. Recently, Alexander mentioned that discussions were underway about legalizing individual gun ownership in his country. Suffice it to say, Professor Merezhko is worried about what happens after the war. It seems likely the assault by Russian forces motivates those debates in Ukraine, but what about the future? A similar struggle, America's own then-recent war for independence, was part of the context for the language of the Second Amendment to the U.S. Constitution, beginning with the words, "A well regulated Militia, being necessary to the security of a free State...."
Could America's Founding Fathers have dreamed that the contextual phrase would be dismissed as significant and the remaining words of the Second Amendment would be treated as a mandate that permits unrestricted sales of weapons to individuals who are not part of any well-regulated system? There is a very interesting article with historical details I've never considered in The New Yorker, titled How Did Guns Get So Powerful?From the article by Phil Klay:
We wonder how we got here. How did guns grow so powerful—both technically and culturally? Like automobiles, firearms have grown increasingly advanced while becoming more than machines; they are both devices and symbols, possessing a cultural magnetism that makes them, for many people, the cornerstone of a way of life. They’re tools that kill efficiently while also promising power, respect, and equality—liberation from tyranny, from crime, from weakness. They’re a heritage from an imagined past, and a fantasy about protecting our future. It’s taken nearly two hundred years for guns to become the problem they are today. The story of how they acquired their power explains why, now, they are so hard to stop.
Why am I writing about guns (again) in the Elder Law Prof Blog? The need for better support for mental health for youth and elders is part of what needs to be addressed. Sadly, guns are part of a larger story not just for 18 year-olds in New York or Texas, but also for older Americans, as "firearm suicides are one of the leading causes of death for older Americans." See Firearm Suicides in the Elderly: A Narrative Review and Call for Action, published in 2021 in the Journal of Community Health.
June 11, 2022 in Cognitive Impairment, Crimes, Current Affairs, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, International, State Statutes/Regulations, Statistics | Permalink | Comments (0)
Wednesday, March 30, 2022
Victoria Law Foundation Hosts International Access to Justice and Legal Services Forum in Australia March 30 through April 1
I had the unique privilege of joining an interdisciplinary team of professionals discussing timely concerns about access to justice for older persons, not only in the host country of Australia but around the world. Our session, entitled Legal Need, Empowerment and Older People, began with Susannah Sage Jacobson and Eileen Webb, academics from the University of South Australia, who addressed ageism and specific examples of abuse, followed by Frances Batchelor, Acting Director of the Australian National Ageing Research Institute, discussing new consumer-based research on quality of residential care. The International Access to Justice Online Forum is hosted by the Victoria Law Foundation and the UCI Law Civil Justice Research Initiative, with panelists across the three days of programming from Australia, the U.S, Canada, New Zealand and the U.K. There is still time -- depending on which side of the international date line you reside -- to catch more presentations as the event runs through April 1, 2022.
In addition, research papers and reports and video captures of the program are being posted online. Take a good look!
March 30, 2022 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Crimes, Current Affairs, Dementia/Alzheimer’s, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, International | Permalink | Comments (0)
Wednesday, February 23, 2022
Australian Discussion About UN Convention on the Rights of Older Persons
The Older Persons Advocacy Network has announced an upcoming roundtable, Age with Rights: Advocating for a UN Convention for the Rights of Older Persons. "The Older Persons Advocacy Network (OPAN) is participating in the #Agewithrights global rally by holding a roundtable conversation about rights, ageism, and the need for supporting a UN Convention on the Rights of Older Persons. You'll hear directly from Caroline Carroll, Robin Vote, Natalie Clements, and Kathy Mansfield members of our National Older Persons Reference Group, who each have their own stories and views to share." Click here to register, but note that this is being held in Australia, so mind the time zone differences!
February 23, 2022 in Consumer Information, Current Affairs, Discrimination, International, Other, Programs/CLEs, Webinars | Permalink | Comments (0)
Friday, January 14, 2022
Roundup of Articles Part 2
Here are the rest of the news items I mentioned in yesterday's post.
Nursing Homes Bleed Staff as Amazon Lures Low-Wage Workers With Prime Packages
National Guard Empties Bedpans and Clips Toenails at Nursing Homes
Why Older Women Face Greater Financial Hardship Than Older Men
From my friend Morris Klein, Increasing Medicaid’s Stagnant Asset Test For People Eligible For Medicare And Medicaid Will Help Vulnerable Seniors
Nursing Hone Visitation FAQ ( CMS updated January 6, 2022).
A Catch-22 Trips Up Some in Legal Guardianship Who Try to Regain Independence
Man becomes first person in Colombia with non-terminal illness to die by legal euthanasia
Colombian woman dies by euthanasia after historic legal fight
and finally from my friend Professor Richard Kaplan, Richard L. Kaplan (Illinois; Google Scholar), When the Stepped-Up Basis of Inherited Property Is No More, 47 ACTEC L.J. 77 (2021) (see Tax Law Prof Blog for synopsis)
Now we are all caught up. More next week!
January 14, 2022 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, International, Medicaid | Permalink
Monday, October 4, 2021
Breakthrough in Alzheimer's Research?
My dear friend and colleague, Professor Feeley, sent me a link to this recent article, Likely cause of Alzheimer’s identified in new study.
Here's a brief bit of info about the study
[S]cientists in Australia have recently discovered an additional factor that may be responsible for the development of this neurodegenerative condition.
Lead study author Dr. John Mamo, Ph.D. — distinguished professor and director of the Curtin Health Innovation Research Institute at Curtin University in Perth, Australia — explained to Medical News Today the conclusion from the new research...
“This study,” he added, “shows that exaggerated abundance in blood of potentially toxic fat-protein complexes can damage microscopic brain blood vessels called capillaries and, thereafter, leak into the brain, causing inflammation and brain cell death.”
The findings were published here. This is the abstract from the article
Several lines of study suggest that peripheral metabolism of amyloid beta (Aß) is associated with risk for Alzheimer disease (AD). In blood, greater than 90% of Aß is complexed as an apolipoprotein, raising the possibility of a lipoprotein-mediated axis for AD risk. In this study, we report that genetic modification of C57BL/6J mice engineered to synthesise human Aß only in liver (hepatocyte-specific human amyloid (HSHA) strain) has marked neurodegeneration concomitant with capillary dysfunction, parenchymal extravasation of lipoprotein-Aß, and neurovascular inflammation. Moreover, the HSHA mice showed impaired performance in the passive avoidance test, suggesting impairment in hippocampal-dependent learning. Transmission electron microscopy shows marked neurovascular disruption in HSHA mice. This study provides causal evidence of a lipoprotein-Aß /capillary axis for onset and progression of a neurodegenerative process.
October 4, 2021 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, International, Other, Science | Permalink
Tuesday, September 14, 2021
Highlights from Touro Conference on Aging, Health, Equity, and the Law (9.13.21)
Touro College's Jacob Fuschberg Law Center hosted a fabulous half-day, interdisciplinary program on Aging, Health, Equity and the Law. Among the highlights:
- A perfect kickoff with opening remarks on the theme of the conference from Syracuse Law Professor Nina Kohn, who outlined the civil rights of older persons, reminding us of existing laws and the potential for legal reforms;
- A unique "property law" perspective on the importance of careful planning about ownership or rights of use, in order to maximize the safety and goals of the older person, provided by Professor Lior Strahilevitz from University of Chicago Law School;
- Several sessions formed the heart of the conference by taking on enormously difficult topics arising in the context of Covid-19 about access to health care, including what I found to be a fascinating perspective from Professor Barbara Pfeffer Billauer from her recent work in Israel. She started with an interesting introduction of three specific pandemic responses she's identified in her research. She then focused on how "Policy Pariah-itizing" has had a negative effect on health care for older adults, with examples from Israel, Italy, and China. I was also deeply impressed by the candid presentations of several direct care providers, including nursing care professionals Esperanza Sanchez and Nelda Godfrey, about the ethical issues and practical pressures they are experiencing;
- Illinois Law Professor Dick Kaplan offered timely perspectives on incorporating cultural sensitivity in Elder Law Courses. His slides had great context, drawing in part from an article he published about ten years ago at 40 Stetson Law Review 15;
- Real world examples about tough end-of-life decisions involving family members and/or formally appointed surrogates, with Deirdre Lock and Tristan Sullivan-Wilson from the Weinberg Center for Elder Justice leading breakout groups for discussions.
I know I'm failing to mention other great sessions (there were simultaneous tracks and I was playing a bit of leap-frog). But the good news is we can keep our eyes out for the Touro Law Review compilation of the articles from this conference, scheduled for Spring 2022 publication. I know it was a big lift to pull off the conference in the middle of the fall semester. Thank you!
September 14, 2021 in Advance Directives/End-of-Life, Books, Cognitive Impairment, Consumer Information, Crimes, Current Affairs, Dementia/Alzheimer’s, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, Housing, International, Property Management, Science | Permalink
Friday, September 10, 2021
Bringing Voices of the Public into Classrooms: Lessons from Ireland and 9/11
A number of years ago, I had an especially wonderful sabbatical experience with the help of the U.S. Fulbright Program that provided opportunities to conduct research in both Northern Ireland and the Republic of Ireland. Queen's University Belfast was my host institution, and there I met Professor Joe Duffy (on the left), who was working in social work, aging services and law. We have become forever friends, as well as co-workers on several projects.
One of the key educational concepts I learned from Joe's work was the importance of involving service users in the classroom, as well as in research. I experienced this as a "student" in Northern Ireland as I listened to speakers with Loyalist (Unionist) and Republican (Nationalist) perspectives on the historic "Troubles" in Ireland. I'd been working for years with U.S. law school clinics, which are inherently involved with "user" (client) voices, but when I returned from my time in Belfast I began to more actively include older adults in my doctrinal classes, usually as guest speakers about a particular case or experience. I confess, however, that I've drifted away a bit from that, but today I have a fresh reminder of why it is important to bring clients into the classroom.
Joe Duffy did his own Fulbright-sabbatical in the U.S. recently, and as part of that experience he worked at NYU with social work students and survivors of 9/11. This week, Queen's University offers Joe's detailed written account of how the NYU team planned carefully for including survivors as speakers in the classroom, and how the experiences were valuable for everyone. We can -- and I believe should -- remember to make time for similar outreach and listening exercises with students in law school. Here's a brief taste from Joe's experience with bringing 9/11 survivors into the classroom:
I knew from the beginning that trust building was at the heart of this process. I was indeed mindful of this throughout, where would I start in terms of asking people to share such difficult and personal experiences? The answer was to start with the people themselves and to create a safe environment where people felt valued and respected. In planning, we met as a group over a number of weeks and decided how the programme would evolve. Every aspect was therefore co-produced and together we agreed the following questions as the basis for the Conversation:
- Can you share with these students a summary of your experiences from 9/11?
- To what extent does the aftermath of such a traumatic event still impact on your life today and others close to you?
- How has this experience affected your identity?
- What sort of help did you receive to support you after these experiences?
- What are the skills that these students need to focus on when helping an individual cope with trauma related issues and also what are the behaviours they should avoid?
- What are the students take away messages from today.
The 90-minute classes ran for three consecutive weeks with two/three group participants joining me each week with the students. The students listened attentively and respectfully to the dialogue and there was total silence in the classroom, such was the emotional magnitude of the atmosphere. After each class we gathered for a coffee at a nearby café which helped the group support each other and reflect on what we had learned from the process.
I encourage you to read Joe's full article, Changed Lives: Voices from 9/11 in the Classroom. The voices of both survivors and students are captured succinctly here -- and provide wonderful reminders of the importance of a simple (or, perhaps not-so-simple) skill that all lawyers need to cultivate, the ability to listen. That seems especially relevant as a reminder during the 20th anniversary of 9/11.
September 10, 2021 in Consumer Information, Current Affairs, International, Legal Practice/Practice Management | Permalink | Comments (0)
Monday, August 23, 2021
Nurse Robots?
There have been stories of late about shortages of nurses, for various reasons. For example, NPR reported, Hospitals Face A Shortage Of Nurses As COVID Cases Soar. So, then a dear friend and colleague of mine today sent me a link to this story: Meet Grace, the ultra-lifelike nurse robot. Grace, developed by a robotic company in Hong Kong, is "a humanoid robot it hopes will revolutionize healthcare.... Designed as an assistant for doctors, Grace is equipped with sensors, including a thermal camera to detect a patient's temperature and pulse, to help doctors diagnose illness and deliver treatments....The android is a companion for patients, too. Specializing in senior care, Grace speaks three languages -- English, Mandarin, and Cantonese -- and can socialize and conduct talk therapy." The company expects to start large scale production of this robot and another robot by year's end. The article notes that this robot is attended to assist, not supplant, health care providers. There's an accompanying video, which includes a brief clip of the robot showing Tai Chi moves to the reporter. The robot at one point responds that her specialization is in "senior care." I don't know what the cost will be of such a robot and what patient load it can handle. Plus, I'm not sure about the lack of human connections in caregiving. We'll have to wait to see whether the robot is at least a partial solution to the caregiving and nursing shortages.
August 23, 2021 in Consumer Information, Current Affairs, Health Care/Long Term Care, International, Science | Permalink | Comments (0)
Thursday, July 1, 2021
As Covid-19 Eases, Is Germany Again Seeking "Filial Support" (Elternunterhalt) Payments from Children?
It has been a while since I've written a "Filial Friday" post. After more than a year of no calls or requests for information about "Elternunterhalt" payments in Germany, in the last 45 days I've heard from three sets of American citizens who recently received requests for financial contributions to the care of an aging parent in Germany. In each of the instances, the adult children had never heard of Germany's parental maintenance laws before receiving the demand.
Since last writing about elternunterhalt on this Elder Law Prof Blog (see here and here), I've learned about some changes to the German laws.
First, Germany adopted a threshold annual income for a potentially obligated child of at least 100,000 Euros, effective for claims after January 1, 2020.
Second, it appears that Germany has also clarified that only the adult child's income is considered in determining the amount of the potential support obligation. In the past, the German authorities would routinely ask for "all" income and asset information for the child and any spouse or partner.
For more on this, see this article and another article, from Germany, describing these changes as "reforms." Germany's renewed use of filial support laws began with a ruling by the Federal Court on June 23, 2002. "The legal basis is mainly Section 1601 and 1602 Paragraph 1 BGB," according to a third article.
While I've often seen "claim letters" submitted to adult children living in the U.S., I've never seen a formal administrative proceeding or court proceeding to enforce such a claim if not paid voluntarily. In some instances, I've seen German authorities agree to drop the claim, usually because there is strong evidence that the now needy-parent neglected or mistreated the child while the child was a minor. I have also sometimes seen a voluntary settlement between the U.S. child and the German authorities. But, have any of our readers seen a litigated outcome in a cross-border claim? Do we have any attorneys reading this blog with experience with cross-border claims between the U.S. and Germany?
July 1, 2021 in Consumer Information, Current Affairs, Estates and Trusts, Ethical Issues, Health Care/Long Term Care, International, Statistics | Permalink | Comments (2)
Thursday, May 27, 2021
Elders in China Have to Delay Retirement?
A few weeks ago the New York Times ran an article regarding the need for delayed retirement on the part of many Chinese elders. A Graying China May Have to Put Off Retirement. Workers Aren’t Happy, notes that the "Chinese government said it would raise the mandatory retirement age, which is currently 60 for men." Why, you ask, did China announce this unpopular plan? Because, according to the article, this phased-in "delay [of] the legal retirement age” over the next five years, [is] an attempt to address one of the country’s most pressing issues. Its rapidly aging population means a shrinking labor force. State pension funds are at risk of running out. And China has some of the lowest retirement ages in the world: 50 for blue-collar female workers, 55 for white-collar female workers, and 60 for most men." The article notes other countries that have taken a similar approach and the bumpy road in doing so. It also notes that this was a problem decades in the making. There are ramifications of this approach (beyond unhappy workers), including "[the risk of] undermining another major government priority: encouraging couples to have more children, to slow the aging of the population."
Stay tuned.
May 27, 2021 in Consumer Information, Current Affairs, International, Other, Retirement | Permalink | Comments (0)