Monday, May 14, 2018
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.
Thursday, May 10, 2018
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
Wednesday, March 21, 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.
Sunday, February 25, 2018
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.
Thursday, January 25, 2018
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?
Thursday, December 28, 2017
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.
Thursday, December 21, 2017
Filial Friday: Can Americans be Compelled by Germany to Contribute to Costs for a Parent's Care in Germany?
It has been awhile since I've written a "Filial Friday" post. Perhaps any question about legal obligations for family members to pay for care of another is an unfair topic during the holiday season. A bit too downbeat, yes? But, in fairness it is a topic that has reemerged in my "inbox," as I've recently received two communications from American adult children of biological parents in Germany. In each instance, the reason is that Germany authorities are writing to American citizens to notify them that an aging German parent is or may be in need of "social welfare benefits" in Germany. As one demand letter puts it:
"The above person is your mother. According to [the Germany Civil Code] you have a basic obligation to pay maintenance for your mother. According to Section 94 of the [Social Security Code] the maintenance obligations of a person eligible for benefits are passed on to [the Germany regional authorities] up to the amount of the expenses we incur in so far as this is not excluded for legal reasons."
In other words, it appears the German social service agency is saying that if it is called upon to incur expenses for welfare of a Germany citizen, it has the legal authority to seek contribution or reimbursement from the family members identified in German statutory law as having a maintenance obligation, including any children living in other countries.
As readers of this Blog know, I have a long-standing interest in such filial support claims, in large part because I live and work in Pennsylvania, the U.S. state that most frequently enforces a colonial-era law, permitting third-party providers of care in certain instances to compel adult children to pay reimbursement for costs of care, usually nursing home care. The 2012 Pennsylvania Superior Court decision in Health Care & Retirement Corporation of America v. Pittas, where an adult son was found to be liable for more than $90,000 for his mother's nursing home care, is one of the most dramatic modern example of domestic enforcement in the U.S.
The letters from Germany undoubtedly surprise, and perhaps frighten, the American children who have probably never heard of such a claim coming from public authorities. (In the U.S., in the modern era the occasional claim usually comes from a nursing home that isn't being paid for long-term care by private or public means, and the claims are not coming from public agencies.)
Friday, December 8, 2017
A haunting story and visual images of growing old alone in Japan, from the New York Times, including this excerpt:
To many residents in Mrs. Ito’s complex, the deaths were the natural and frightening conclusion of Japan’s journey since the 1960s. A single-minded focus on economic growth, followed by painful economic stagnation over the past generation, had frayed families and communities, leaving them trapped in a demographic crucible of increasing age and declining births. The extreme isolation of elderly Japanese is so common that an entire industry has emerged around it, specializing in cleaning out apartments where decomposing remains are found.
For more, see A Lonely Death, by Norimitsu Onishi, published November 30, 2017.
Sunday, November 26, 2017
The Canadian Centre for Elder Law (CCEL) released a new report, Report On Vulnerable Investors: Elder Abuse, Financial Exploitation, Undue Influence And Diminished Mental Capacity, which can be downloaded as a pdf here. The report was a joint project between CCEL and FAIR (Canadian Foundation for Advancement of Investor Rights). Here is the executive summary of the report
Canadian investment firms and their financial services representatives1 (hereinafter referred to as "financial services representatives" or simply "representatives") serve millions of vulnerable investors, many of whom are older Canadians. Vulnerable investors may be persons living in isolated, abusive or neglectful situations which can make them more likely to be subject to undue influence. They also may be persons with diminished mental capacity due to health issues, developmental disability, brain injury or other cognitive impairment. Such social vulnerabilities may be episodic, or long-term.2
Who is a Vulnerable Investor?
Older investors, persons with fluctuating or diminished mental capacity, and adults who are subject to undue influence or financial exploitation are collectively referred to in this report as vulnerable investors. This concept of vulnerability is often a contentious one. This report uses the term "vulnerable" to refer to social vulnerability, and does not ascribe vulnerability to older persons as an inherent personal characteristic.3 Rather, the term reflects an understanding that differing social conditions may make a person more or less vulnerable. Individual older investors may personally not be socially vulnerable. But as a group, older individuals may be subject to external conditions—such as ageism—that negatively affect them. This report specifically notes that ageism can make older people broadly vulnerable as a class, even while individual older adults may not be, or identify, as particularly vulnerable themselves.
This report adopts the core aspects of the Quebec definition of vulnerable investor. A vulnerable investor is a person who is in a vulnerable situation, who is of the age of majority, and lacks an ability to request or obtain assistance, either temporarily or permanently, due to one or more factors such as a physical, cognitive or psychological limitation, illness, injury or handicap.
It is important, and a goal of this report, to highlight the increased social vulnerability risks associated with aging and to raise awareness that aging life-course benchmarks may trigger a representative to start ensuring that increased appropriate protections or standards are in place. In this way, the issue of older investors will be drawn to the fore, without supporting the myth that all old people are vulnerable and in need of protection.
Monday, November 13, 2017
Here's the info from my dear friend, Sue Field, co-editor.
Elder Law Review The Elder Law Review is an independent refereed e-journal produced by Elder Law at Western Sydney University. It is the only Australian Journal concerned with Elder Law. The Review publishes articles about legal issues relating to seniors in all areas of law, including wills, powers of attorney, substitute decision-making, guardianship, discrimination, accommodation, contracts, financial management, retirement income, taxation and property. The Review is multi-disciplinary, bringing together professionals working, researching and writing in the aged care area. It is designed to be of interest to academics, practitioners and those involved in the provision of aged care.
The Elder Law Review can be accessed at
Call for submissions for Volume 11 (due for publication early 2018).
Notes to contributors The theme of the forthcoming issue will be “Legal and Financial Issues surrounding Retirement Villages” Original, unpublished contributions are invited for any of the following sections of the Review:
- the Refereed section containing scholarly articles about the legal/social/economic/policy issues associated with “International Perspectives on Elder Law”. While we will consider articles of any length, we prefer them to be between 3000 and 8000 words.
- the Comments section, which consists of contributions from government, lawyers and aged care representatives, commenting on issues which the contributor perceives to be of contemporary significance within elder law.
- News and Current Issues – including legislative changes and case notes.
- Elder Law in Practice which profiles legal practices, community projects, social justice initiatives and pro-bono schemes from all over the world that specifically target the legal needs of older people.
Papers must conform to the Australian Guide to Legal Citation which can be accessed at
In particular, contributors should note the conventions regarding footnotes and bibliographies. Submissions must be received by January 15th, 2018 and should be addressed to Sue Field S.Field@westernsydney.edu.au
For further information please contact Sue Field co-editor S.Field@westernsydney.edu.au Contributors are reminded that papers should be written in clear language accessible to specialists and non-specialists alike and that submission of articles is no guarantee of publication, as the Elder Law Review is a peer reviewed journal and ERA ranked.
Thursday, October 12, 2017
The next meeting of the Aging, Law & Society Collaborative Research Network is set for June 7-10, 2018 in Toronto as part of the Law & Society Annual meeting. Here's the info from the announcement:
The Aging, Law, and Society Collaborative Research Network (CRN) invites scholars to participate in a multi-event workshop sponsored by the CRN as part of the Law and Society Association’s 2018 Annual Meeting. The Aging, Law & Society CRN brings together scholars from across disciplines to share research and ideas about the relationship between law and aging, including how the law responds the needs of persons as they age and how law shapes the aging experience. 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. However, we especially encourage proposals on the following topics:
• Creative, inter-disciplinary and empirical methodologies for studying law and aging;
• Intergenerational relationships, ageism, and intergenerational justice;
• Theoretical frameworks for understanding the law as it relates to older adults;
• Legal responses to dementia;
• Long-term care;
• Elder abuse and neglect;
• Human rights of older adults; and
• Identity and intersectionality in older age.
In addition to paper proposals, we also welcome:
• 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.
Proposals are due October 16 (get busy writing). The form for submission is available here http://www.lawandsociety.org/Toronto2018/2018-guidelines.html). and should be sent by email to Professor Nina Kohn firstname.lastname@example.org & Dr. Issi Doron, email@example.com along with a 1000 word abstract and your contact info.
Tuesday, June 27, 2017
A recent story in the Toronto Star covers a ruling from a trial court judge about Canada's Medical Aid-in-Dying law. Advocates hail judge’s decision in woman’s assisted death appeal explains the judge's decision: "[a] 77-year-old woman seeking medical assistance in dying has a “reasonably foreseeable” natural death, a judge declared Monday in an attempt to clear up uncertainty that left her doctor unwilling to perform the end-of-life procedure for fear of a murder charge." The concern in the case was the meaning of "reasonably foreseeable" and the judge held "[t]o be reasonably foreseeable, the person’s natural death doesn’t have be imminent or within a specific time frame or be the result of a terminal condition...."
The judge went on to explain
“The legislation is intended to apply to a person who is “on a trajectory toward death because he or she a) has a serious and incurable illness, disease or disability; b) is in an advanced state of irreversible decline in capability; and c) is enduring physical or psychological suffering that is intolerable and that cannot be relieved under conditions that they consider acceptable,” ....
Wednesday, May 17, 2017
If you scoffed at this title, thinking "of course I am" then you are not alone. But, if you scoffed at this title, thinking "nope, I'm not" then you are not alone either. The Pew Research Center Fact Tank released another News in Numbers, this time on social media use. Not everyone in advanced economies is using social media found higher usage in certain countries than others. Sweden, US, the Netherlands and Australia are top in social media use (about 70%) by country. But what about use by age? "The age gap on social media use between 18- to 34-year-olds and those ages 50 and older is significant in every country surveyed. For example, 88% of Polish millennials report using social networking sites, compared with only 17% of Poles ages 50 and older, a 71-percentage-point gap." With a 71% age gap in Poland taking the #1 place in the Pew brief, the U.S. was ranked last with only a 34% age gap in social media use.
Friday, May 12, 2017
On May 10, 2017, my research colleagues Gavin Davidson (Queens University Belfast) and Subhajit Basu (University of Leeds) participated in a policy briefing at Stormont, the Northern Ireland Assembly in Belfast. They appeared in support of recommendations by the Commissioner of Older People (COPNI) Eddie Lynch on a major plan for modernization of social care programs for vulnerable adults (of any age).
Professors Davidson and Basu focused on three key recommendations:
- Northern Ireland should have a single legislative framework for adult social care with accompanying guidance for implementation. This could either be new or consolidated legislation, based on human rights principles, bringing existing social care law together into one coherent framework.
- All older people in Northern Ireland, once they reach the age of 75 years, should be offered a Support Visit by an appropriately trained professional. This will be based on principles of choice and self-determination and is aimed at helping older people to be aware of the support and preventative services that are available to them.
- Increasing demands for health and social care reinforce the importance of considering how these services should be funded. All future funding arrangements must be equitable and not discriminate against any group who may have higher levels of need.
The audience, which included researchers, social service program administrators and elected officials (not only from Northern Ireland, but elsewhere, including the Isle of Man), reportedly responded strongly to the recommendations, especially to the concept of specially-trained "support visitors," offered to persons age 75 or older. The intent is to provide individuals with planning support and, where needed, medical assessment. Guidance and information is often needed for pre-crisis planning, thus moving in the direction of prevention of crises and reduction of need for last-minute response. The support visitor concept has been used successfully in Denmark and other locations in Europe. The next step for Northern Ireland would likely be a pilot or test project.
As a co-author of the research reports that led to the COPNI recommendations, working with Professors Gavin Davidson and Subhajit Basu as part of a team headed by Dr. Joe Duffy of Queens University Belfast, I found it an interesting coincidence that at almost the same time as the Northern Ireland government session, I was addressing similar interests in "preventative" planning while speaking on elder abuse in a "Day on the Hill" program at the Capitol in Pennsylvania, hosted by the Alzheimer's Association. It is clear that on both sides of the Atlantic, we are interested in cost-effective, proactive measures to help people stay in their homes safely.
Monday, April 17, 2017
Register now for Justice in Aging's latest webinar, Older Adults & Immigration. The webinar is set for Friday April 21, 2017 from 2 p.m. to 3 p.m. edt. Oh, and did I mention, it is free! Here's a description of the webinar
Are your immigrant senior clients coming to you with immigration-related questions? Recent events may leave your immigrant senior clients understandably confused. Need clarification on an immigrant older adult’s eligibility for safety net programs like Medicaid or SSI? Join Justice in Aging as we host a special immigration law webinar with our partners from the National Immigration Law Center. Intended for an audience who work with low income seniors but who are not familiar with immigration law, this webinar will cover basic topics, like:
• Different types of immigrants in our communities;
• Rights and protections for immigrant seniors;
• Immigrant senior eligibility for SSI, Social Security, Medicare, and Medicaid; and
• Resources for individual assistance
This free webinar will also highlight some of the recent events affecting immigrant seniors and how they may be affected by changes in government policies.
To register, click here.
Wednesday, February 15, 2017
Our good friend, a true expert on international perspectives on elder law, Professor Kate Mewhinney, is offering her course on Comparative Law and Aging in London this summer. Here are the details for the 3 credit course, part of a summer program that begins May 29, 2017:
This course examines how countries address what has been called the “silver tsunami” – the rapidly aging demographic. Through a comparative and international analysis students will learn how different legal systems address similar challenges brought on by increased longevity and fewer births. The course allows us to compare legal approaches to such issues as retirement ages, pensions and Social Security, appointment of financial surrogates, employment discrimination, filial responsibility and health care policies on long-term care and end-of-life options. The focus will be on the U.S., U.K. and major European countries, as well as Japan, the European Union, and China. There are no prerequisites. Students will be graded on class participation, a quiz on fundamentals, and a short research paper to be turned in within a month of the course end.
Wednesday, January 25, 2017
The Denver Post ran an AP story a few weeks ago about Americans retiring abroad. Growing number of Americans are retiring outside the U.S. highlights the increase in the number of Americans who decide to retire and live abroad. "The number grew 17 percent between 2010 and 2015 and is expected to increase over the next 10 years as more baby boomers retire... Just under 400,000 American retirees are now living abroad, according to the Social Security Administration. The countries they have chosen most often: Canada, Japan, Mexico, Germany and the United Kingdom." The article references a lower cost of living or cheaper health care as a reason some Americans choose to retire to other countries. Climate may also be a factor. It would be an interesting exercise for students to list the issues and considerations when clients decide to retire to another country. Anyone want to assign this as a project?
Thursday, November 3, 2016
The Guardian ran a story last month about proposed legislation in the Netherlands for elders who aren't terminally ill, but instead believe they have lived long enough. Netherlands may extend assisted dying to those who feel 'life is complete' explains that "[t]he Dutch government intends to draft a law that would legalise assisted suicide for people who feel they have “completed life” but are not necessarily terminally ill." Cabinet ministers have provided the Dutch Parliament with a letter about the plan, explaining "people who 'have a well-considered opinion that their life is complete, must, under strict and careful criteria, be allowed to finish that life in a manner dignified for them'." The intent is to limit the law's application to elders "'because the wish for a self-chosen end of life primarily occurs in the elderly, the new system will be limited to' them." The article indicates that there would be safeguards in the law. The target for completing the draft legislation is the end of 2017.
Thanks to Ron Hammerle for alerting me to the proposed legislation.
Friday, October 21, 2016
LeadingAge, the trade association that represents nonprofit providers of senior services, begins its annual meeting at the end of October. This year's theme is "Be the Difference," a call for changing the conversation about aging. I won't be able to attend this year and I'm sorry that is true, as I am always impressed with the line-up of topics and the window the conference provides for academics into industry perspectives on common concerns. For example, this year's line up of workshops and topics includes:
- General sessions featuring Pulitzer Prize winning journalist Charles Duhigg on the "The Science of Productivity," 2013 MacArthur Fellow and psychologist Angela Duckworth on the the importance of grit and perservance for successful leadership, and famed neurosurgeon and speaker Sanjay Gupta on "Medicine and the Media."
- Hundreds of sessions, organized by "interest groups":
October 21, 2016 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Discrimination, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, International, Legal Practice/Practice Management, Medicaid, Medicare, Programs/CLEs, Property Management, Retirement, Science, Social Security, State Cases, State Statutes/Regulations, Veterans | Permalink | Comments (2)
Wednesday, October 12, 2016
A new stage has been added to the human life cycle due to increasing numbers of the very old. In particular, adults over eighty constitute a new focus for developmental research. These older adults seem to have reached a stage beyond Erikson’s eight stages, first proposed sixty-four years ago. As Joan Erikson suggested, eight stages no longer capture the end of life concerns of this older group. In this paper, I review the research focusing on the self-reports of individuals who are still thriving in their eighties and nineties. I suggest that this research supports a ninth Eriksonian life stage. This ninth stage might be called “Appreciation versus Resignation with the associated strength, Enthusiasm.” A defining aspect of the elders described in the studies cited below is that they express a keen appreciation for their extended years and a determination not to squander them. I discuss implications for practice and for further research.
Who are these 9th stagers and why study them? According to the introduction,
“Ninth stagers” are individuals in their eighties and nineties. I suggest that the emerging picture of this stage is considerably brighter than the one Joan Erikson painted. In the spirit of Erik Erikson’s (1950) proposed eight stages, I suggest that the ninth stage is characterized by a dialectical tension between two qualities, appreciation and resignation, with the associated strength, enthusiasm. I consider research focused on ninth stagers’ self-reports as well as research on the essential conditions for sustaining vitality and enthusiasm. Following Gawande (2015), I suggest that our diminished picture of the capacity for vitality in ninth stagers is, in part, an artifact of the medicalized assisted living environment in which many of our seniors live and the deleterious effect of this environment on their autonomy, competence, and relatedness.
The 9 page article looks at vitality, longevity and psychological variables to name a few. The author concludes "this ninth life stage might be called “Appreciation versus Resignation with the associated strength, Enthusiasm.” A defining aspect of many of the elders in the studies cited was that they expressed keen appreciation for their extended years and a determination not to squander them. Enthusiasm does not seem too strong a word to characterize their strength. Toquote Henry David Thoreau: 'None are so old as those who have outlived enthusiasm.'"
A pdf of the article is available for download from here.