Tuesday, October 20, 2020

The Future of Long Term Care Facilities Globally, Post-COVID

The Washington Post recently published an article examining the future of long term care facilities around the world, As covid-19 cases surge, global study paints grim picture for elder-care homes.

There are few easy lessons. In many countries, the trend is hard to escape: The larger the coronavirus outbreak in an area, the more deaths elder-care facilities there can expect to see, according to the results of an ongoing transnational research project, which published new data this week.

Across 26 countries, elder-care home residents have accounted for an average of 47 percent of recorded coronavirus deaths, according to data collected by the International Long-Term Care Policy Network, a global collaboration between academics and policymakers.

With the cases rising again, will the death toll in facilities rise as well? We know that residents of SNFs are more frail, but what causes such a high death rate is the subject of ongoing research according to the article. Because of the lack of or variations in data with various countries, "[t]he only true metric for understanding the impact of covid-19 on elder-care homes is to look at the total number of deaths among residents and compare the change over previous years, but that data is rarely published...."

Countries tried various approaches, some with success, some without.  But what works? "[I]t can be hard to isolate tactics that work. In some facilities in Spain and Britain, having staff live on site and submit to frequent testing appears to have helped keep the virus out. In the United States, rapid response teams that isolate patients and take them to hospitals have been helpful in limiting the virus’s spread."  Tactics don't come without tradeoffs, however. For example, restricting visitation may protect residents but the isolation has a negative impact.

Will there be significant and long-lasting changes to the way we provide long-term care?  "Elder-care facilities may see significant changes — and not just in the short term. The International Long-Term Care Policy Network predicts higher costs and lower demand for elder-care services may not be a blip but could last for 'many years to come.'"

October 20, 2020 in Consumer Information, Current Affairs, Health Care/Long Term Care, International | Permalink | Comments (0)

Thursday, October 1, 2020

New Fact Sheet from National Center on Elder Abuse

The National Center on Elder Abuse has released a new fact sheet,  Communicating with
People with Limited English Proficiency. Here are a few of their tips:

We encourage the use of these best practice tips to aid your communication efforts:
• When anticipating a need to hire a new role on your team, screen for bilingual or multilingual candidates.
• Identify members among your team who speak other languages who you know can assist with outreach when connecting with people who speak different languages.
• Establish a list of translated basic phrases, such as “Do you speak English?”.
• If someone is contacting you by phone and has reception issues (Are they trying to reach you from somewhere remote or out of the country?), try to obtain as much information as possible to contact the person back, in the hopes of establishing a clearer second communication attempt.
• For people requesting information with language barriers or who may be hard-of-hearing, slow down your speaking pace, pronounce words clearly, and repeat phrases when necessary.

The full list of tips is available here.

October 1, 2020 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care, International | Permalink | Comments (0)

Monday, September 21, 2020

The Swedish Housing Experiment

A recent article in The Guardian highlighted a housing experiment in Sweden that combats loneliness,  'It's like family': the Swedish housing experiment designed to cure loneliness. (If you don't have an account with The Guardian, you need to register, but there is no fee).

The project, known as Sällbo,  is 

[A] radical experiment in multigenerational living in Helsingborg, a small port city in southern Sweden. Its name is a portmanteau of the Swedish words for companionship (sällskap) and living (bo), and neatly encapsulates the project’s goals – to combat loneliness and promote social cohesion by giving residents incentives, and the spaces, for productive interaction.

Sällbo, which opened last November, consists of 51 apartments spread over four floors of a refurbished retirement home. More than half of the 72 residents are over 70s, like Ahlsten and Bacharach; the rest are aged 18-25. All were selected after an extensive interview process to ensure a mix of personalities, backgrounds, religions, and values, and all had to sign a contract promising to spend at least two hours a week socialising with their neighbours.

Not only was this project designed to combat isolation amongst Sweden's elders, it also was designed to respond to "the 2015 refugee crisis [which] meant organisations like Helsingsborgshem were under pressure to house growing numbers of people who were struggling to integrate with – and win acceptance from – Swedish society. So a plan was hatched to mix the two, with younger Swedish people acting “as a bridge."  So far the reports of the project's success have been positive despite the hurdles of starting a new endeavor in these times (think COVID). Information about the services, costs, etc. are available here.

Thanks to my colleague and dear friend, Professor Bauer, for bringing this article to me.

September 21, 2020 in Consumer Information, Current Affairs, Housing, International | Permalink | Comments (0)

Friday, September 11, 2020

Legal Issues in Using AI for Caregiving

Computer Weekly recently addressed the legal issues that may occur when using technology for caregiving AI may be a solution to the social care crisis, but what are the legal concerns?,  looks at the caregiving situation in the U.K.  Building on the story from yesterday about the robot "Pepper" who can carry on conversations, the article highlights some legal issues, such as an individual's privacy. 

Consider this-the robot could report concerns about abuse, for example, "the technology might provide a report, supported by video evidence, to family members or those with the legal responsibility of care, such as attorneys or deputies, who can then review such material. It can easily become part of a care home contract to consent to such filming, although it is vital that this is handled in a sensitive manner and regularly deleted to ensure that a resident’s privacy is protected." The article notes concerns about "sensitive personal data." Would residents provide consent? Who would consent if a resident lacks capacity. As the article concludes, "[W]e must never forget who is at the heart of these considerations, and the legal framework needs to catch up with the technology to protect them and for it to have a viable chance of success."

Thanks to Professor Feeley for sending me this article.

September 11, 2020 in Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, International, Other, Science | Permalink | Comments (0)

Thursday, September 10, 2020

Lonely? Robot Companions May Help

The Guardian recently published an article about the use of robots in long term care facilities to combat loneliness of residents. Robots to be used in UK care homes to help reduce loneliness describes the roll these robots can play in interacting with residents.  These are not your "normal" robots, but then I don't know what one would consider a "normal" robot. These robots, on wheels, "called “Pepper”, move independently and gesture with robotic arms and hands and are designed to be “culturally competent”, which means that after some initial programming they learn about the interests and backgrounds of care home residents. This allows them to initiate rudimentary conversations, play residents’ favourite music, teach them languages, and offer practical help including medicine reminders."  The researchers not that these robots do not replace human caregivers but instead supplement them.  The robots were tested in the U.K. and Japan and researchers found that those residents who spent time with the robots for "18 hours across two weeks had a significant improvement in their mental health. There was a small but positive impact on loneliness severity among users and the system did not increase feelings of loneliness...." 

Robots, whether "Pepper" or others, do have limitations--for example, they aren't human.  The article reports some of the limitations mentioned, such as their chats with residents were lacking some depth, were impersonal and lacked cultural awareness. Their movements were, shall we say, robotic. But imagine, a robot that can hold a conversation with you.  This can be a great tool, to supplement human caregivers!

Thanks to Professor Feeley for sending me the article.

September 10, 2020 in Consumer Information, Current Affairs, Health Care/Long Term Care, International, Other, Science | Permalink

Thursday, July 9, 2020

Are Older Adults Now the Proverbial Canaries in the Global Mines?

During an AALS-sponsored online "hang-out" session this week, the featured host, Syracuse Law Professor Nina Kohn, helped faculty think about better ways to conduct online courses, including Elder Law.  We also talked about our research projects for the summer.  Nina commented that she has never before had "so much to write about and so little time to do so," which I suspect has something to do with her wonderfully active children!  But, I also think that most of us in the AALS Section on Law and Aging are feeling the same way.  It is as if our client base -- older persons -- are at the epicenter of so much tragedy.  Sadly, the COVID-19 illness has hugely impacted older persons, as documented frequently on this Blog.  

And now the news that in Japan, seasonal rains that have become steadily worse over the years for reasons associated with climate change, have triggered extraordinary flooding, resulting in the drowning deaths of many elders in their nursing homes or while trying to shelter at home.  From the New York Times article, Japan's Deadly Combination: Climate Change and an Aging Society:yAlthough the Japanese gird every June and July for the rainy season — known as tsuyu — this year the rainfall has set records in Kyushu, with more rain expected to blanket central Japan by the end of this week.

 

Older residents accustomed to year after year of summer rains may believe they know how to ride out the downpours at home. Yet they may not understand the growing severity of the rains or the increased dangers of flooding.

 

“Under the emerging impact of global warming, there is an increasing risk or potential that rainfall amounts could be at a level that we haven’t experienced in the past,” Professor Nakamura said. “So I think that citizens must realize that their previous experience may no longer work. We have to act even earlier or faster than what we have experienced in the past.”

 

Evacuation itself can pose a risk to the elderly. Conditions in evacuation centers inevitably fall short of those in nursing homes designed for old-age care. For the frailest patients, the moves can cause injury or destabilize long-term care plans....

 

In the case of the Senjuen nursing home, Aki Goto, its director, told The Kumamoto Nichinichi Shimbun, a local newspaper, that she had been more concerned about mudslides than flooding. When the waters came, she added, the caregivers could not move quickly enough to move all the residents upstairs.

 

Six of the workers were on call the night of the floods last weekend, the newspaper reported. That still left each caregiver in charge of more than 10 aging residents, some of whom were unable to walk without help. Even with the aid of local volunteers, they could not bring everyone to safety upstairs as the floodwaters rapidly rose and deluged the ground floor.

Whether it is hurricanes in the Carribean and US, wildfires in western US states, extraordinary storms or unique diseases around the world, our elderly are often seeming to take the heaviest blows.  Isolated and with inadequate protective equipment or assistance, the pattern of "unexpected" deaths continue.  Unexpected?  

 

July 9, 2020 in Current Affairs, Ethical Issues, Health Care/Long Term Care, Housing, International | Permalink | Comments (0)

Thursday, July 2, 2020

Topics and Speakers Announced for AALS January 2021 Program on Intersectionality, Aging and the Law

Hard to believe we are scheduling for January 2021, isn't it!  Here's the scheduled speakers and topics for the co-hosted program during the AALS Annual Meeting in San Francisco on "Intersectionality, Aging and the Law:"

July 2, 2020 in Advance Directives/End-of-Life, Cognitive Impairment, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, International, Programs/CLEs, Statistics | Permalink | Comments (0)

Thursday, June 18, 2020

Upcoming Webinar: Extreme Home Takeovers - Dealing with "Concerned" Relatives

On Monday, June 22, 2020, I'm joining the 3rd Annual Memorial Elder Abuse Sympsium hosted by Legal Aid Services of Oklahoma and being delivered as a webinar over the course of several sessions.  On Monday, the first set of speakers includes deeply experienced professionals in banking and securities, both potential avenues for elder fraud, as well as Judge Scott Roland of the Oklahoma Court of Criminal Appeals.  I follow them with the topic "Extreme Home Takeovers - Dealing with Concerned Relatives" -- the clever title supplied by our hosts!  

I'll be offering comparative statutory and common law approaches for recovering a house. including my own experiences while supervising Dickinson Law's Elder Protection Clinic.  The need is usually triggered by a transaction often tied to the worries of the older person, hoping or believeing that a family member, friend or new "befriender" would be more likely to save them from the dreaded nursing home if they give the hoped-for-caregiver "the house."  I'll be using cases from Ireland, Pennsylvania, Oklahoma (of course) and beyond for strategies, and discussing everything from filial support laws, to improvident tranaction laws, to the common law concept of failure of consideration in "support deeds." 

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June 18, 2020 in Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, Housing, International, State Cases, State Statutes/Regulations | Permalink | Comments (0)

More Reasons for a Serious Bi-Partisan Commitment to Citizenship for DACA Health & Long-Term Care Workers

Shared by my colleague, Professor Medha Makhlouf, who heads Dickinson Law's Medical-Legal Partnership Clinic, this thoughtful article explaining the importance of DACA-recipient health care workers in the United States, especially now:    

The Covid-19 pandemic is stretching our public health system to its limits and challenging our ability to meet the urgent and critical medical needs of the country as never before. As executives responsible for the legal affairs of major hospitals and lawyers working in Covid-19 hot spots, we know how crucial it is to have every available front-line medical worker fighting this pandemic. . . . 

 

New data from the Center for American Progress reveals that the DACA-recipient health care work force includes more than 6,000 diagnosing and treating practitioners, including respiratory therapists, physicians assistants and nurses; some 8,000 health aides, including nursing assistants and orderlies; more than 7,000 other health care support workers; and some 5,500 health technologists and technicians.

 

The Association of American Medical Colleges told the Supreme Court that nearly 200 physicians, medical students and residents depend on DACA for their ability to practice medicine and serve their communities. Those 200 trainees and physicians alone would care for hundreds of thousands of patients per year in normal times — the association estimates as many as 4,600 patients per year, per person. Under the demands of the Covid-19 pandemic, those numbers will be much higher.

 

The Center for Migration Studies found that 43,500 DACA recipients work in the health care and social-assistance industries, including more than 10,000 in hospitals....

The decision on the DACA case is expected this week.  "If the Supreme Court upholds the decision to terminate DACA, nearly 700,000 people — including those health care workers — will lose their ability to work and live in the United States."  For more, ready the full NYT article, There's Only One Thing Stopping Trump From Deporting Health Care Workers.  

For once, the members of Congress from both sides of the aisle should be ready with emergency legislation for citizenship (or at a minimum, permanent residency status) for these essential workers.  It is the least we can do for people who are doing the most. And it is vital for the best interests of public health across the nation.  A win-win, if we can just focus on what's important.  

WOW!  Moments after I posted the above, I see the news flash that Supreme Court Rules Against Trump Administration Attempt to End DACA, A Win for Undocumented Immigrants Brought to U.S. As Children.  

After reading the opinion(s), it is clear that while DACA recipients have a temporary reprieve, the real need is serious consideration of true relief from fear of deportation.  Must they really wait until after the election?  

June 18, 2020 in Consumer Information, Current Affairs, Discrimination, Ethical Issues, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, International | Permalink | Comments (0)

Wednesday, June 17, 2020

This "Should" Be Easy: Support DACA Workers in Health Care and Long-Term Care

The Supreme Court 's ruling on the fate of DACA-residents and workers in the U.S. could be issued this week.  Regardless of the outcome on the case itself, everyone who cares about quality of health care, including long-term care, should also care about the United States' need to be honest about how much health care depends on the hard work and commitment to care provided by temporary-status and undocumented-status  workers in health and personal care jobs.  I've seen DACA workers in action in elder care, and I've seen their families ripped apart by harsh immigration rulings.

NPR's Morning Edition had a short and yet deeply important segment today on Health Care Workers Who Are Awaiting Supreme Court DACA Decision.   Do listen to the podcast replay --  it is just 4 minutes -- and think about whether this is a key opportunity for a true, bipartisan solution for DACA-children (families) who so often are working in some of the most challenging (and dangerous) U.S. jobs during the COVID-19 pandemic.  Let's do the right thing.  

June 17, 2020 in Consumer Information, Current Affairs, Ethical Issues, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, International, Medicaid, Medicare | Permalink | Comments (0)

Sunday, June 7, 2020

Using Technology to Enhance Family Caregiving (and grieving)

The increasing use and sophistication of various  new technical products and remote platforms for monitoring patients and family members is profiled in this article from the New York Times I can remember when my very rudimentary way of checking daily on my Mom  was watching her yahoo email account to see whether there was a green oval to indicate she was typing!  Somewhere along the way, the ethical implications of monitoring other's online activity eliminated that option, and that makes sense. 

And speaking of technology, tomorrow is my first participation in an online memorial.  A Zoom send-off.  A another step in the brave new world of finding new ways to be together alone.  

 

 

 

June 7, 2020 in Consumer Information, Current Affairs, Dementia/Alzheimer’s, Ethical Issues, Health Care/Long Term Care, International, Web/Tech | Permalink | Comments (0)

Tuesday, May 26, 2020

Barbara Pfeffer Billauer: An International Perspective on Ageism in the Time of Corona

George Washington Law Professor Naomi Cahn recently shared a piece by Israel-based law and policy author Barbara Pfeffer Billauer on  "Al Tashlichaynu L'Et Zichna: Ageism in the Time of Corona."  This thoughtful piece begins with a theme I've been discussing with others, how close to dystopian science-fiction the last 10 weeks have seemed.  She makes the opening comparison of current policy-based decisions to the science-fiction movie Logan's Run, where the "acceptable" price paid for a civil society was a mandatory limit on life spans -- to just 30 years. Logans_run_movie_poster  Professor Pffeffer Billauer observes "In this world of COVID, the age of devitalization is a bit older. But us oldsters are subject to truncation just the same."

She continues:

It’s time to expose the flawed basis on which morbidly dystopic and discriminatory responses toward the aged have been become public health policy– both as a warning that initial and instinctive public health responses must be constantly re-evaluated and updated – and as an alert that discriminatory responses can be couched as public health concerns, even as their main purpose is to further political goals.

 

At first glance, “protection of the vulnerable” seems laudatory and compassionate. Nevertheless, this approach should trigger concerns of discrimination. In the case of age-related discrimination, the dangers are, perhaps, exacerbated, as those affected are more likely to just accept it. Others accept these pronouncements without delving into the “scientific” or epidemiological underpinnings of the pronouncements. Even worse, is that rationale that might, in actuality, be political can be camouflaged as nobly “helping the needy.” 

Professor Pfeffer Baillauer warns that even as governments begin to ease virus-related restrictions, in many instances "the 'vulnerable' (aka the elderly)" are still locked down, and that the "differential relaxation of lockdowns is problematic, both from legal and public health perspectives."

Based purely on early (and stagnant) reports, we bought into this protectivist age-related response: The elderly were — and are — to have their liberty disproportionately restricted –because they are considered “vulnerable”. It’s time to question this approach and unmask the rank discrimination behind it, or at the very least, reveal the dangers of blind acquiescence without serious inquiry into the scientific basis.

She questions the statistical basis for some governments' decisions to impose mandatory isolation:

The Italian debacle, notably lots of deaths, was attributed to their older population. But these pronouncements were based on gross, oversimplified statistical calculations. Germany, with a similar age distribution, suffered far fewer deaths. So did Japan, with a population even older than Italy’s . Compare the case-fatality in Italy of 14% (as of March 19) with that of Germany (at 4.5%), or the even older Japanese demographic with a similar case-fatality (4.7%). Basic tools of epidemiological assessment, such as standardized age-adjusted rates, appear not to have been performed to sustain the extrapolation of the Italian experience to other countries. Basic epidemiological constraints, such as the ecological fallacy, were never even considered.

 

But there is more to the misleading assertion that the elderly are at greater risk than just flawed statistics. The approach obscures the key question: greater risk of what? Of disease susceptibility, of spreading it to others – or of dying?

She is provocative.  She notes that if there is legitimacy to mandating isolation of the elderly based on nursing home statistics on infection and death, perhaps the same rule should be assigned to the "financially flush," such as those who make up the majority of cruise ship passenger rosters, whether or not they are embarked on an actual cruise.

For more, read the full blog post linked above.  For MUCH more, keep an eye on Barbara's SSRN account for her next piece. Thanks, Naomi, for another great share!

 

May 26, 2020 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Discrimination, Ethical Issues, Health Care/Long Term Care, Housing, International, Statistics | Permalink | Comments (0)

Sunday, May 17, 2020

A Positive Headline about Age for a Troubled Time...

Visiting London's Horses 2019
At just about this time last year, I was in Europe and took a walking side trip to the Royal Mews, the stables for Buckingham Palace.  So, I smiled today when I happened to notice this Vanity Fair headline:  "The Queen is Riding Horses Every Day and Ready to Work Harder Than Ever" -- at age 94.  

May 17, 2020 in Current Affairs, International | Permalink | Comments (0)

Monday, May 4, 2020

Tuesday is #GivingTuesdayNow

Tuesday May 5 (tomorrow) is the annual #GivingTuesdayNow.  We all know how much others need assistance.  The American Bar Association Fund for Justice and Education highlights the work that the ABA Commission on Law & Aging is doing 

 

Nursing homes and other senior living facilities are not the only places where COVID-19 is creating a health care crisis for nearly 2 million frail older adults and their care providers. Private homes are the other setting at risk for roughly 12 million older adults who receive both personal and post-acute care.

The ABA Commission on Law and Aging (COLA), a long-time authority on legal services for the elderly, offers comprehensive resources for caregivers at home and in nursing care facilities, like Ten Legal Tips for Caregivers and:
Important Guidance for Keeping Elderly Safe from Abuse During COVID-19
With older adults remaining in place as the coronavirus spreads into communities, the potential for isolation, self-isolation, quarantine and lock downs may increase risk factors for abuse, neglect and exploitation. For those who respond to such abuse, COLA’s summary of important health and safety guidelines will be invaluable.

On Tuesday, May 5th – #GivingTuesdayNow – the eldercare community will have the unique opportunity to support the Commission’s work, especially now with coronavirus posing an intensive threat to our seniors’ lives. #GivingTuesdayNow is a global day of generosity and unity, a day to come together and give back in response to the unprecedented need caused by COVID-19, no matter who or where we are.

The link to make a donation is here.

Wondering how you can help others? This is how. Do it now.  Whether for the Commission, a food bank, a senior center, the Red Cross,  or another organization, do  it now!

May 4, 2020 in Consumer Information, Current Affairs, Health Care/Long Term Care, International | Permalink | Comments (0)

Thursday, April 30, 2020

AALS Call for Papers/Presenters on Intersectionality, Aging and the Law

The AALS Section on Law and Aging is joining forces with the Sections on Civil Rights, Disability Law, Family and Juvenile Law, Minority Groups. Poverty, Sexual Orientation, Gender-Identity Issues, Trusts & Estates and Women in Legal Education to host a program for the 2021 Annual Meeting, scheduled to take place in San Francisco in January.  The theme for the program is appropriately broad -- "Intersectionality, Aging and the Law."  

I like this definition of "intersectionality": 

The interconnected nature of social categorizations such as race, class, and gender as they apply to a given individual or group, regarded as creating overlapping and interdependent systems of discrimination or disadvantage.  Example:  "Through an awareness of intersectionality, we can better acknowledge and ground the differences among us."

We need great presenters!  

From Naomi Cahn at George Washington Law:

We are interested in participants who will address this subject from numerous perspectives. Potential topics include gray divorce, incarceration, elder abuse (physical or financial), disparities in wealth, health, housing, and planning based on race or gender or gender identity, age and disability discrimination, and other topics.  The conception of the program is broad, and we are exploring publication options.

If you are interested in participating, please send a 400-600 word description of what you'd like to discuss.  Submissions should be sent to Professor Naomi Cahn, ncahn@law.gwu.edu, by June 2, 2020, and the author[s] of the selected paper(s) will be notified by July 1, 2020.  

AALS is planning on hosting the annual meeting from January 5-9 and I personally feel the overall theme for the conference is apt in these fraught times:  The Power of Words

 

April 30, 2020 in Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Discrimination, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Grant Deadlines/Awards, Health Care/Long Term Care, Housing, International, Legal Practice/Practice Management, Programs/CLEs, Property Management, Science, Statistics, Webinars, Weblogs | Permalink | Comments (0)

Wednesday, April 8, 2020

End-of-Life Decisions and Technology, Especially Ventilators

At Dickinson Law, in the last third of the Spring 2020 Semester, my Elder Law students are doing a module on End-of-Life Decisions.  I had planned this module more than a year in advance; certainly the timing has proven to be uniquely relevant.  Originally, my plan was for an in-depth discussion about choices related to assisted death, sometimes known as the Death with Dignity or Physician-Assisted Death.  And we are considering comparative studies and positions on legislation intended to support this choice, starting with a review of Oregon's more than 20 years of experience in providing this option.  

The COVID-19 pandemic, however, is triggering new focal points on end-of-life decisions.  Consider for example the statement by an emergency room chief in a San Francisco hospital, as quoted recently in the Los Angeles Times, "You have an 80-year-old and a 20-year-old and both need a vent and you only have one.  What do you do?"  Individuals may have thoughtfully made advance decisions about whether they want mechanical assistance in breathing during life-or-death circumstances.  They may have appointed an agent to speak for them or created written directions via living wills, DNR orders, or POLST documents.  But it is one thing to make you own decision; it is another to have the "decision" made because of lack of what is arguably baseline equipment.  

I've been particularly interested in the history behind ventilator shortages as reported by The New York Times.  

Thirteen years ago, a group of U.S. public health officials came up with a plan to address what they regarded as one of the medical system’s crucial vulnerabilities: a shortage of ventilators. The breathing-assistance machines tended to be bulky, expensive and limited in number. The plan was to build a large fleet of inexpensive portable devices to deploy in a flu pandemic or another crisis.

 

Money was budgeted. A federal contract was signed. Work got underway.

 

And then things suddenly veered off course. A multibillion-dollar maker of medical devices bought the small California company that had been hired to design the new machines. The project ultimately produced zero ventilators.

The rest of the story reads like a detective tale.  The small California-based company was proposing a new generation of easy-to-use, more cost effective, mobile ventilators.  By 2012, the partners were on schedule to file for market approval in September 2013, paving the path for production.  However, in May 2012, a much large medical device manufacturer bought the California-based company for just over $100 million.  Good news? That larger company might have especially strong resources for speedy production, right?

The new owner, Covidien, already made ventilators -- at a higher cost -- and in 2014, reportedly told federal officials they wanted to get out of the new ventilator contract.  The federal government agreed to cancel the contract. Covidien was sold to an even larger international company in 2015.

Why?  For more, read "The U.S. Tried to Build a New Fleet of Ventilators.  The Mission Failed," by Nicholas Kulish, Sarah Kliff and Jessica Silver-Greenberg, published in the NY Times on March 29 2020 and updated on March 31, 2020.  Or catch a NY Times podcast that looks further into shortages of hospital rooms, COVID-19 testing supplies and ventilator availability.  All interesting -- especially if you are talking about "end-of- life decisions."  

April 8, 2020 in Advance Directives/End-of-Life, Current Affairs, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, International, Statistics | Permalink | Comments (2)

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)

Thursday, February 13, 2020

Don't Miss This Webinar: Public Charge and Elder Immigrants

Do you know about the Public Charge and Elder Immigrants issue? Justice is Aging has a webinar scheduled on this for March 9, 2020 at 2-2:30 eastern time..  Here's the info from the announcement.

Public Charge and Immigrant Seniors

In January, the U.S. Supreme Court removed the nationwide temporary injunction that had prevented the Department of Homeland Security (DHS) public charge immigration rule from taking effect. This means that the public charge rule that DHS finalized last August can go into effect nationwide, except in Illinois, where it is blocked by a statewide injunction. DHS announced that it will begin implementing the final rule on February 24th.

The Supreme Court’s decision endangers the health and well-being of older immigrants and their families and cruelly impedes the path to citizenship and family unification. However, it is not a final decision and we must continue to fight to stop this harmful policy from becoming permanent. The multiple cases challenging the underlying legality of the final public charge rule will continue in the courts. DHS has appealed all the district court decisions that issued preliminary injunctions to the Second, Fourth, Seventh, and Ninth Circuits. DHS has also asked the U.S. Supreme Court to hear the case.

Justice in Aging and our partners have filed amicus briefs in the Second and Ninth Circuits to ask the court to affirm the district courts’ nationwide injunctions and to highlight the ways in which this rule unfairly targets older immigrants, their families, and caregivers. This webinar, Updates on Public Charge & Older Immigrants, will begin with an overview of the public charge test and how it applies to older adults, discuss the current state of litigation, and provide information on what advocates need to know about the rule’s implementation.

Who should participate:
Aging and legal advocates, advocates serving immigrant communities, community-based providers, and others wanting to learn more about how changes to the public charge test and implementation of the new regulations impact older immigrants.

To register for the webinar, click here. More info about this issue is available from Justice in Aging here.

 

February 13, 2020 in Consumer Information, Current Affairs, Federal Cases, Federal Statutes/Regulations, International, Medicaid, Programs/CLEs, Webinars | Permalink | Comments (0)

Wednesday, January 15, 2020

International Federation on Aeging Webinar on 1th Session of the UN Open-Ended Working Group on Ageing

The UN Open-Ended Working Group on Ageing has its 11th Session coming up.  Prior to that meeting, the International Federation on Aeging, along with  the Global Alliance For the Rights of Older People (GAROP) are offering an upcoming webinar on National Advocacy ahead of the 11th Session of the United Nations Open-Ended Working Group on Ageing.is holding a webinar on National Advocacy Ahead of the 11th Session of the UN Open-Ended Working Group on Ageing on January 22, 2020 at 7 a.m. est. This webinar will

  • Provide information for all NGOs engaging in the UN Open-ended Working Group on Ageing (OEWG) process at the national level.
  • Focus particularly on what national advocacy NGOs can do to influence their governments ahead of the 11thOEWG session in April.
  • Include updates and insights from a UN perspective and concrete examples of national advocacy from GAROP members. 

Click here to register for this program.

Summaries of the prior meetings of the U.N. Working Group can be accessed here.

January 15, 2020 in Consumer Information, Current Affairs, International, Other, Retirement | Permalink | Comments (0)

Wednesday, January 8, 2020

Report from 2020 AALS Annual Meeting Section on Aging and the Law

For the last few years, I've found myself with conflicts during semester breaks that interfered with attending the AALS Annual Meeting.  So I was especially happy this year to attend and catch up with long-time and new friends, especially those who work in fields relevant to elder law.  

The annual meeting kicked off for me with a Joint Session hosted by the Sections on Aging and the the Law, Civil Rights, Family & Juvenile Law, Employee Benefits & Executive Compensation, and Immigration Law.  The collaborative event offered lots of interesting "Emerging Issues in Elder Law," with speakers including:

Mark Bauer, Stetson Law, who spoke about recent enforcement efforts to combat elder exploitation, and pointed to a lingering weakness associated with banks that make SARS reports that never go beyond the regulatory body, and therefore never reach first responders, such as local police.  He talked about support for a state-wide effort in Florida to improve police reports to make it easier to identify abusers who target older persons.  He also called for better record-keeping for sales of gift cards, as these have become the number 1 method that telephone scammers get older adults to send them money.  

Wendy Parmet, Northeastern University School of Law, who focused on the impact of immigration laws and policies on the health of older adults, including attempts by the current administration to change the definition of "public charge" to include anyone who could receive any public benefits whatsoever,  thereby expanding the the pool of inadmissible immigrants and further restricting eligibility for legal permanent residency.  She traced the impacts of such policies on older adults once eligible for family reunification, on older citizens overall, and on a nation that once took pride in providing help to immigrants who were "tired and poor."

Jalila Jefferson-Bullock, Duquesne Law, who talked about how some states are not applying sentencing reforms to elderly offenders, even though such inmates statistically are at the least risk of reoffending and, at 19% of the total prison population, are often generating care costs that are unsustainable.  I learned, sadly, that my own state of Pennsylvania is one of the states that is not yet making significant progress on sentencing reforms for older adults.

Rachel Lopez, Drexel University Law, who is director of Drexel's Stern Community Lawyering Clinic, carried forward the theme of needed prison reforms for older inmates, reporting the latest events that follow the Graterford Think Tank Prison Project in Pennsylvania, and making the sobering observation that the most effective argument may not be one that sounds in human rights or human dignity, but the demonstration that return to the community for aging and ill residents saves the state money.  

Naomi Cahn, George Washington Law, who is also the incoming chair for the AALS Section on Law and Aging, presented facts and figures on "gray divorce," especially with respect to financial impacts on women.  She urged a de-coupling of Social Security benefits from marriage (or perhaps marriage longevity requirements), arguing that Social Security credits should be available for time spent as caregivers.  

Browne Lewis, Cleveland-Marshall College of Law, pointed to the emerging issue of "reproductive rights" for older individuals, identifying jurisdictions that restrict women's access to assisted reproductive technologies (ART) including placing age or time restrictions on use of banked or stored eggs.

For faculty members who would like to be part of next year's Law and Aging program at the 2021 AALS Annual meeting in San Francisco, contact Naomi Cahn with your topics and interest.  

January 8, 2020 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, International, Retirement, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (0)