Friday, January 18, 2019
Mark your calendars for this upcoming webinar on student loan debts and elders, scheduled for January 29 at 2 est. Here's a description of this free webinar:
A growing number of older adults are carrying more student loan debt than ever before. Many took loans for their own studies while some also borrowed or cosigned loans for a child or another person. Student loan repayment—or debt collection consequences following non-payment—can impede saving for retirement or making ends meet on a fixed income. Unfortunately, even Social Security benefits can be taken to repay defaulted student loans.
This webcast will present the basics of student loan law and a framework for issue-spotting and solving common student loan problems. Topics covered during the webcast will include: identifying a loan type/status, making loan payments affordable, evaluating loan cancellation options, stopping involuntary debt collection activity, and curing default.
To register, click here
Thursday, January 17, 2019
My dear friend and executive director of the ABA Commission on Law and Aging sent me a notice about a part-time employment opportunity for two students. The Coalition to Transform Advanced Care (C-TAC) ("an alliance of 140 organizations whose sole purpose is to ensure that all Americans with advanced illness, especially the sickest and most vulnerable, receive comprehensive, high-quality, person- and family-centered care that is consistent with their goals and values and honors their dignity") has announced two student fellowship opportunities for a project, "two part-time, temporary positions as C-TAC Changemaker Fellows. Fellows will primarily undertake research for programs that align with their interests (policy, family caregiving, health disparities, data/metrics) and will be assigned a C-TAC mentor. Supporting program staff will also be an important opportunity for the Fellows to learn and support projects." Students need to be at least seeking a bachelor's or master's degree and have relevant interests in advocacy, public policy and the political realm. More information-contact Allan Malievsky (AMalievsky@thectac.org) with “C-TAC Changemaker” in the subject line.
Thursday, January 10, 2019
This article is a couple of months old, but I don't think the subject is at all dated. Stat ran an opinion piece, U.S. hospitals ignore improving elder care. That’s a mistake explaining that hospitals aren't designed to be elder-friendly
In the 21st century, health care is to elderhood as education is to childhood. But we don’t see bond measures for the “construction, expansion, renovation, and equipping” of hospitals to optimize care of old people, an investment that would surely benefit Americans of all ages.
People age 65 and older make up just 16 percent of the U.S. population but nearly 40 percent of hospitalized adults. In 2014, Americans over age 74 had the highest rate of hospital stays, followed by those in their late 60s and early 70s.
Remarkably, hospitals aren’t designed with elders in mind. Walk through one and you’ll almost invariably find cheerful decor for children, services and facilities aimed at adults, and a gauntlet of obstacles and insults to elders.
Thinking about the design of the hospitals, consider these notes from the article' "[o]ld people end up in old buildings. That usually means long walks down halls without railings or chairs with arms for rest stops. It means signs that are hard to read until you are right under them. It means a one-size-fits-all approach to both facilities and care that doesn’t acknowledge that the needs, preferences, and realities of a 75- or 95-year-old with a medical condition might differ from those of a 35- or 55-year-old with the same thing."
Noticing the volume of business from this demographic, the article highlights some efforts
A collaboration of industry leaders, including the American Hospital Association, the John A. Hartford Foundation, and the Institute for Healthcare Improvement, has launched an age-friendly health system initiative. While its purview is limited to a few geriatric conditions, it’s a step in the right direction. (And the field of geriatrics is finally beginning to model itself after pediatrics, taking a more whole health, life stage approach to elderhood.)
Some of the best ideas for hospital design come from outside health care. Innovations developed for aging-in-place homes or continuing care communities offer prototypes of “silver architecture.” Businesses like Microsoft are investing in structural and people-flow design that meets needs across the lifespan. They are adopting the position that if you design for the mythical “average human” you create barriers, whereas if you design for those with disabilities you create systems that benefit everyone.
Wednesday, January 9, 2019
There's no cure for Alzheimer's but according to a recent article in the New York Times, Dementia May Never Improve, but Many Patients Still Can Learn individuals with dementia can be taught certain forgotten skills. Known as "cognitive rehabilitation", "[t]he practice brings occupational and other therapists into the homes of dementia patients to learn which everyday activities they’re struggling with and which abilities they want to preserve or improve upon." It's important to realize that this training won't reverse the decline from the disease, but instead "the therapists devise individual strategies that can help, at least in the early and moderate stages of the disease. The therapists show patients how to compensate for memory problems and to practice new techniques." But, and this is important, the therapy can make a huge difference for folks with dementia---the "researchers have demonstrated that people with dementia can significantly improve their ability to do the tasks they’ve opted to tackle, their chosen priorities. Those improvements persist over months, perhaps up to a year, even as participants’ cognition declines in other ways."
Another approach being used in the U.S., the "T.A.P. program includes more patients with serious cognitive loss than cognitive rehab does. And it takes a somewhat different tack: T.A.P. aims to reduce the troubling behaviors that can accompany dementia: repeated questions, wandering, rejecting assistance, verbal or physical aggression" with the study showing "the frequency of such behaviors decreased compared to a control group, allowing family members to spend fewer daily hours caring for patients."
This is important research-read this article!
Monday, January 7, 2019
According to AARP, employee benefits most valued by Boomers are Health Insurance, Retirement Benefits Most Attractive to Boomer Workers
Boomer workers tend to place great importance on health insurance benefits and 401(k) matching contributions from their employers, according to a newly released Harris poll of 2,026 U.S. adults.
Gen Xers and younger adults also value these benefits but are somewhat more inclined than boomers to put a priority on paid time off and flexible work schedules, according to the poll, conducted for the American Institute of Certified Public Accountants (AICPA).
The statistics in the article are interesting. For example, as far as what employee benefits are important: for the Boomers, 71% said health insurance and 67% said 401(k), 54% pensions while the millennials and Xers placed less importance on pensions, 16% and 34% respectively. Millennials placed more importance on workplace flexibility compared to Boomers. How long do the Boomers surveyed intend to continue working? According to the article, 22% may retire within a year, 22% are considering cutting back on the amount they work and 13% are looking at a job change with only 14% likely to work more.
Sunday, December 9, 2018
Well, I guess it was only a matter of time. I've blogged on numerous occasions about "elder tech" and now it seems Apple, at least its watch, is moving into that market. Kaiser Health News reported In Grandma’s Stocking: An Apple Watch To Monitor Falls, Track Heart Rhythms.
[W]hen Apple unveiled its latest model in September — the Series 4, which starts at $399 — it was clear it was expanding its target audience. This Apple Watch includes new features designed to detect falls and heart problems. With descriptions like “part guardian, part guru” and “designed to improve your health … and powerful enough to protect it,” the tech giant signaled its move toward preventive health and a much wider demographic.
One expert quoted in the article noted that the older generation is used to wearing watches and thus this would be a much easier wearable for them. Here's how the fall monitoring feature works. "The fall-monitoring app uses sensors in the watchband, which are automatically enabled for people 65 and older after they input their age. These sensors track and record the user’s movements, and note if the wearer’s gait becomes unsteady. ... If a fall is detected, the watch sends its wearer a notification. If the wearer doesn’t respond within a minute by tapping a button on the watch to deactivate this signal, emergency services will be alerted that the wearer needs help." We all know how falls can lead to devastating complications for older persons.
The heart monitor feature again using wristband sensors is used "to monitor a patient’s heartbeat and send alerts if it gets too fast or too slow. Specifically, the app is meant to detect atrial fibrillation, which is a type of arrhythmia, also described as a problem with the speed or rhythm of the heartbeat." The article notes some doctors have concerns that this feature will send folks needlessly to the ER.
The article notes that the FDA has "cleared" but not approved the feature, which means "that means they haven’t faced as much rigorous testing as something that has gained the agency’s formal OK."
More to come.
Monday, December 3, 2018
U.S. life expectancy has declined. What's up with that? According to an article in the Washington Post, this is not good news for us. U.S. life expectancy declines again, a dismal trend not seen since World War I emphasizes the impact of the opioid and suicide crises.
The data continued the longest sustained decline in expected life span at birth in a century, an appalling performance not seen in the United States since 1915 through 1918. That four-year period included World War I and a flu pandemic that killed 675,000 people in the United States and perhaps 50 million worldwide.
The U.S. trend seems to be opposite of what is happening in other countries, and although the decline may not seem very large, it is still part of an overall concerning trend. The numbers re: opioid deaths cited in the article are shocking. Read the article to absorb the data and look at the geographical info detailing where opioid deaths are highest and lowest. It's just not drug deaths attributing to the decline. "Other factors in the life expectancy decline include a spike in deaths from flu last winter and increases in deaths from chronic lower respiratory diseases, Alzheimer’s disease, strokes and suicide. Deaths from heart disease, the No. 1 killer of Americans, which had been declining until 2011, continued to level off. Deaths from cancer continued their long, steady, downward trend."
December 3, 2018 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Federal Statutes/Regulations, Health Care/Long Term Care, Other, State Cases, Statistics | Permalink
Tuesday, November 27, 2018
The Senate Special Committee on Aging is holding its next hearing tomorrow, November 28, on guardianships. “Ensuring Trust: Strengthening State Efforts to Overhaul the Guardianship Process and Protect Older Americans.” is scheduled for 2:30 p.m. and will feature 4 witnesses. Testimony and remarks will be posted to the website after the hearing.
Thursday, November 1, 2018
The National Consumer Law Center sent out an email listing resources for attorneys and others helping elders recover from natural disasters. The email described the situation:
Older adults living in communities hit by natural disasters disproportionately suffer emotional trauma and financial hardship after the event. Age-related changes, including decreases in mobility and cognitive abilities make it harder for older adults to navigate the recovery process and access resources to repair or rebuild their homes. Once the immediate danger has passed, older adults will need assistance from insurance, government, and nonprofit organizations or other aid agencies to rebuild their home and community support system. In the days and weeks after the disaster older adults are forced to deal with a wide variety of issues, including home repair, reconnecting utilities, and making payments, including mortgage, credit cards, and student loans. Unlike many others affected by disasters, older adults may have fewer private assets to aid in recovery making the process to rebuild financially more difficult. Here are some resources the National Consumer Law Center (NCLC) has compiled to help guide advocates in advising older adults.
Issue Brief: Assisting Homeowners with Reverse Mortgages after a Natural Disaster: A Guide for Advocates, October 2018
Webinar: Assisting Older Homeowners after a Natural Disaster (National Center on Law and Elder Rights), June 20, 2018:
Free Webcast: Assisting Older Homeowners After a Natural Disaster, June 2018
Issue Brief: Helping Older Homeowners Recover from Natural Disasters, June 2018
Wednesday, October 31, 2018
Periodically as elder law profs, we have shared ideas for videos that we might use in our classes. It seems to me that it's been a while since we have done that, so I thought I'd share that I used the movie UP by Pixar recently in discussing property concepts regarding people who are older. I thought the first 15-20 minutes were good illustrations of aging in place, new urbanism, ageism, ADLs, crimes, stereotyping and even land use principles. Particularly the sequence that shows the husband and wife aging together is very compelling as the entire segment has no dialogue, yet the students completely know what was going on.
Any of you elder law profs have movies you use in your classes?
Tuesday, October 23, 2018
Consider enrolling in Medicare Part A, to cover hospitalization expenses....
Double up on checkups....Starting at age 65, [doctor] visits should last longer than the standard 20 minutes — so older patients have time to discuss what’s on their minds. Older patients who do this regularly tend to require “minor tweaks” instead of major repairs ....
Schedule annual visits to the dermatologist, ophthalmologist — and visits every five years to the gastroenterologist.
Take the leap and sign up for long-term health insurance....
Stick to a vaccine regimen. Vaccines are important again....
Evaluate your diet....
Bone up on Social Security....
Challenge your financial plan.....
Serve your community [by volunteering]....
Look to the future....
Get your paperwork in order....
Wednesday, October 17, 2018
EAGLE is the new guide on elder abuse for law enforcement is a joint effort from the U.S. Department of Justice along with USC's Keck School of Medicine (host of the National Center on Elder Abuse (NCEA)) as well as the USC Keck School of Medicine Department of Family Medicine & Geriatrics, the USC-Irvine Center of Excellence on Elder Abuse & Neglect & USC-Davis School of Gerontology. EAGLE includes a first responder checklists, a checklist for gathering evidence, information about state statutes, a section on interviewing victims and photography tips, to highlight a few. This is a significant tool and you need to take a look at it. Make sure your local law enforcement folks know about this website.
Thursday, October 11, 2018
Previously we have blogged about the need for caregivers and how that role typically falls to family members. What about those "elder orphans" or "solo agers" who don't have kids or family to fill that role? Kaiser Health News addressed that issue in the article, Without Safety Net Of Kids Or Spouse, ‘Elder Orphans’ Need Fearless Fallback Plan. “[E]lder orphans” (older people without a spouse or children on whom they can depend) and “solo agers” (older adults without children, living alone), [are expected] to move through later life without the safety net of a spouse, a son or a daughter who will step up to provide practical, physical and emotional support over time [and almost]22 percent of older adults in the U.S. fall into this category or are at risk of doing so in the future, according to a 2016 study." Not only are there a fair amount of folks in this category according to the survey, "70 percent of survey respondents said they hadn’t identified a caregiver who would help if they became ill or disabled, while 35 percent said they didn’t have “friends or family to help them cope with life’s challenges.” This means these folks are not prepared for aging, according to one expert quoted in the article. The article discusses the survey results and provides so suggestions for experts on how these elder orphans or solo agers can prepare.
But the key here is to be proactive-there is no magic wand here folks.
Tuesday, October 9, 2018
As Hurricane Michael is bearing down on the Florida panhandle, it bears mentioning that we are still in hurricane season down here in the Gulf coast and that natural disasters can occur anywhere at any time. So this article in the Tampa Bay Times giving an update about the SNFs in Florida complying with the generator law was timely. As hurricane nears, most long-term care facilities haven’t finished backup power plans notes that even as Hurricane Michael has the Florida panhandle in its path, "[m[ore than half of the 412 assisted-living facilities and nursing homes have yet to implement their emergency power plans, after receiving extensions from the state to comply."
A review of data maintained by the Agency for Health Care Administration shows that, in 33 counties encompassing the western half of the state south to Hernando County and east to Putnam County, more than half of the 412 assisted-living facilities and nursing homes have yet to implement their emergency power plans. Nearly all of those facilities have been granted extensions, many through the end of the year, citing regulatory delays and equipment and contractor shortages.
What are these non-compliant facilities likely to do, especially with landfall imminent? The article notes that "those facilities are turning to temporary generators, portable coolers and sometimes evacuations to keep residents safe — just as they have in years past before the rules were approved." The area projected for Hurricane Michael has a number of facilities that have received exemptions or are still in the process of complying with the rule. The article discusses what the state and regulators are doing and how facilities are preparing.
We have to hope for the best at this point. I think everyone is well served by asking long term care facilities about their disaster plans. The rest of us in Florida are keeping an eye on Michael's path and thinking about those in it.
Thursday, October 4, 2018
The call to action explains that "Medicare as we know it is under attack. Current efforts and proposals will privatize Medicare and increase costs. Against the wishes of most Americans, some lawmakers want to cut Medicare benefits, driving up costs to you, and making health care and prescription drugs even less affordable." (emphasis in the original). The website covers "why now", stories, facts, "take action" and has a link to donate. The "take action" page includes questions to ask Congressional candidates and an action kit, among other tools. Test your Medicare IQ on the facts page. And if you want to feel the urgency, look at the countdown clock to the midterm elections on the home page.
Tuesday, October 2, 2018
Sunday's Washington Post ran this article with an eye-catching title: Self-proclaimed ‘Old Coots’ offer life advice at farmers market. Their slogan: ‘It’s Probably Bad Advice, But It’s Free.’ Here's how this all came about:
The group of retired friends who meet every Saturday morning at a Salt Lake City deli were growing tired of the same conversation each week.
Sure, they were solving the world’s problems. But they wanted more excitement in their Saturday morning. They wanted to share their wisdom beyond their friend group of seven. As a lark, they set up a card table at the nearby Salt Lake City’s farmers market and told people they were dispensing free advice.
And guess what happened? "[T]o their surprise, people started showing up and sharing their problems. A lot of them." They realized they were filling an important need and they took this duty seriously. How popular are they? According to the article, "[e]ach Saturday since the summer, the “Old Coots” have taken on the issues of about 30 to 40 people who come by seeking their advice. It’s a way for a person to get an outside opinion from somebody who has nothing to gain...." Among the most common questions? Meeting someone and keeping romance in a relationship. They do get some unique questions, such as what to do about ghosts in the house of one person who stopped by for advice. What's out of bounds for topics? Politics and religion but they do have forms for folks who want to register to vote.
They don't give advice to each other-- they only give advice to strangers, because, as one of them quipped about giving advice to each other, “Who would listen?”
The end of the farmer's market season also marks the end of their advice giving at the market. They "will fold up their banner and card table when the farmers market ends for the season later this fall, but they hope to return next year, coffee cups in hand, advice at the ready. As one of them so insight fully noted, “To be truthful, I’m not sure that any of us can claim to have much wisdom, said [one of the old coots], but it sure has been a lot of fun. Maybe all of us coots really do have more to offer than we thought.”
Thursday, September 20, 2018
Florence has moved on, the California wildfires are under containment, and there is still that volcano in Hawaii... so it's only a matter of time until the next natural disaster. So the National Center on Law & Elder Rights recent issue brief from Fay Gordon at Justice in Aging, Legal Services and Disaster Assistance, is so timely. As the issue brief notes, "Legal aid organizations are quickly mobilizing to help older adults impacted by recent hurricanes,
wildfires, and volcanoes. Older adults are at increased risk of disease and death during disasters due to a higher prevalence of chronic conditions, physical disability, cognitive impairment, and other functional limitations.1 Potential limitations in mobility, access to transportation or limitations can further exacerbate the challenges older adults face during emergencies." (citations omitted) The brief offers resources from several agencies, offers a quick summary of the toolkit for state Medicaid agencies and consumer protection advice. This is all very useful information for us, regardless of where we live. Bookmark this issue brief!
Monday, September 10, 2018
The Washington Post recently published an interesting article considering the implications of retirement of business owners on employees. What a ‘silver tsunami’ of retiring Baby Boomer business owners could mean for their workers focuses on the implication of "the wave of retiring Boomers who own closely held private businesses. They will need to sell their companies, transition them to a new generation of owners -- or risk shutting them down, cutting jobs in the process."
The article looks at "a little noticed measure in the recently signed defense spending bill aims to address the widening wealth divide between workers and the owners or top executives who manage them. The measure, co-sponsored by Sen. Kirsten Gillibrand (D-N.Y.), is intended to expand financing options and raise awareness for programs that can help employees become partial owners of the companies where they work" which "make[s] it possible for firms to use Small Business Administration loans to finance what’s known as employee stock ownership plans, or ESOPs, an arrangement that can help transfer ownership of the company to employees rather than have to find a suitable buyer or rely on family members who may be ill-suited or unprepared to keep the lights on."
According to one expert, this change is a big deal, although the "immediate impact is probably limited to small companies: The SBA loans that can be used are capped at $5 million, though they can be combined with other financing."
Wednesday, September 5, 2018
When a resident of a long term care facility dies, should that person's passing be marked in some way? According to a recent article in Kaiser Health News, Creating Rituals To Honor The Dead At Long-Term-Care Facilities one expert says the answer to that question is yes. This expert
Wednesday, August 29, 2018
Women still tend to work fewer years and earn less than men, which leads to less income in retirement. One reason is that women are often still the main family caregiver. Traditionally, Social Security has recognized this role by providing spousal and widow benefits for married women. Today, however, many women are not eligible for these benefits because they never married or they divorced prior to the 10-year threshold needed to qualify. Even those who are married are less likely to receive a spousal benefit, as their worker benefit is larger. Thus, many mothers receive little to no support to offset lost earnings due to childrearing.
The 10 page brief looks at how the topic is handled in other countries and discusses two avenues for resolution in the U.S.: (1) "[i]ncrease the number of work years that are excluded from benefit calculations ... [and] (2) [p]rovide earnings credits to parents with a child under age six for up to five years." The article concludes in part
It is easy to understand the appeal of crediting Social Security records to reflect lost earnings due to caring for a child. In the past, this activity was usually compensated for by the spousal benefit, but changes in women’s work and marriage patterns have left fewer eligible for it. A credit is also more appealing than a spousal benefit if the goal is to compensate for the
costs of childrearing, independent of marital status.