Monday, April 12, 2021
If you haven't seen this yet, check out the new website, Alzheimers.gov. This site compiles a significant amount of great info. As the website explains
Alzheimers.gov is the federal government portal to information and resources on Alzheimer’s disease and related dementias, including Lewy body dementia, frontotemporal disorders, and vascular dementia. Alzheimers.gov is managed by the National Institute on Aging (NIA) at the National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services (HHS). HHS is the U.S. government’s principal agency for enhancing the health and well-being of all Americans.
. . .
A primary goal of Alzheimers.gov is to connect people to the many federal resources available to educate and support people whose lives are touched by these devastating diseases in their various roles. Whether you are living with dementia, a family member or friend, health care provider or other health care professional, researcher, or advocate, Alzheimers.gov is designed for you.
. . .
Sunday, April 11, 2021
Pew's recent FactTank released this, 7% of Americans don’t use the internet. Who are they? Want to take a guess who are in this 7%? "Internet non-adoption is linked to a number of demographic variables, but is strongly connected to age – with older Americans continuing to be one of the least likely groups to use the internet. Today, 25% of adults ages 65 and older report never going online, compared with much smaller shares of adults under the age of 65." There is also a correlation between education and the income of a household with being online. There has been some movement. "For example, 86% of adults ages 65 and older did not go online in 2000; today that figure has fallen to just a quarter." Think about this info and recall how important technology use became during COVID.
Friday, March 26, 2021
Published a few days ago in the New York Times, Fully Vaccinated and Time to Party: If You Are 70, notes "[o]der people, who represent the vast majority of Americans who are fully vaccinated against the coronavirus, are emerging this spring with the daffodils, tilting their faces to the sunlight outdoors. They are filling restaurants, hugging grandchildren and booking flights." The article features a number of elders who are resuming their pre-COVID lives now that they have been vaccinated. Or, as the author describes it, "[f]or now, about two-thirds of Americans over 65 have started the vaccination process and nearly 38 percent are fully vaccinated, compared with 12 percent of the overall population, giving the rest of the nation a glimpse into the after times."
The stories will make you smile.
Thursday, March 25, 2021
The World Health Organization released the Global Report on Ageism, which "outlines a framework for action to reduce ageism including specific recommendations for different actors (e.g. government, UN agencies, civil society organizations, private sector). It brings together the best available evidence on the nature and magnitude of ageism, its determinants and its impact. It outlines what strategies work to prevent and counter ageism, identifies gaps and proposes future lines of research to improve our understanding of ageism."
The executive summary is available here, discussing nature, scale, determinants, and impact of ageism, as well as strategies to reduce it and suggestions for actions. The entire 202 page report is available here.
Sunday, March 21, 2021
Kaiser Health News recently published a story, Texas Winter Storm Exposes Gaps in Senior Living Oversight. The storm
brought power failure and burst water pipes to millions of homes and businesses throughout Texas. But the impact, as is often the case in emergencies, was most profound on the state’s most vulnerable — including residents of senior living facilities.
Of the state’s 1,200 nursing facilities, about 50% lost power or had burst pipes or water issues, and 23 had to be evacuated, said [the] long-term care ombudsman for Texas. Of 2,000 assisted living facilities, about 25% had storm-related issues and 47 were evacuated. Some facilities reported building temperatures in the 50s.
The article discusses revisions to the regulations regarding emergency preparedness and the industry's responses, as well as the issues with other types of supportive housing. The article also highlights how these "disasters of a century" are actually occurring more frequently, and the focus on disaster preparedness includes a conversation about requiring facilities to have generators. "In Texas, assisted living facilities are required to have emergency plans but not generators. The legislation introduced in the wake of [the recent] winter storm ... seeks to change that. Independent living facilities ... might not be covered, though; they already have even fewer state guidelines to follow."
Friday, March 19, 2021
Educate yourself on the various scams, how they work and how to protect yourself by listening to these 7 podcasts from the New York Times. 7 Podcasts About the Art of the Scam "delve deeper into scam stories you may already know from the headlines ... and also illuminate some less familiar, like the extraordinary saga of how thousands of people were conned into blowing their life savings on a plot of worthless land in California."
Thursday, March 18, 2021
California has released its Master Plan FOR Aging. Here's the rationale for having a master plan:
Aging is changing and it’s changing California. California’s over-6o population is projected to diversify and grow faster than any other age group. By 2030, 10.8 million Californians will be an older adult, making up one-quarter of the state’s population.
The Master Plan for Aging outlines five bold goals and twenty-three strategies to build a California for All Ages by 2030. It also includes a Data Dashboard on Aging to measure our progress and a Local Playbook to drive partnerships that help us meet these goals together.
This is not a plan simply for today’s older adults. Instead, the Master Plan is a blueprint for aging across the lifespan. The Master Plan calls on all California communities to build a California for All Ages: for older Californians currently living through the many different stages of the second half of life; for younger generations who can expect to live longer lives than their elders; for communities of all ages – family, friends, neighbors, coworkers, and caregivers – surrounding older adults. As Californians, we can create communities where people of all ages and abilities are engaged, valued, and afforded equitable opportunities to thrive as we age, how and where we choose.
The five goals address health, housing, equity and inclusion, affordable aging, and caregiving. The plan is available here.
PHI issued a report regarding the direct care workers and the California Master Plan For Aging. Quality Jobs Are Essential: California’s Direct Care Workforce and the Master Plan for Aging
[P]rovides a detailed overview of the state’s direct care workforce and examines how California’s Master Plan for Aging can improve jobs for this rapidly growing workforce. It describes how the Master Plan supports this workforce, highlights where it incorporated the LTSS Subcommittee’s recommendations, and proposes where and how the Master Plan can be strengthened. This report also includes various stories from direct care workers in the state.
The report is available here for download.
Wednesday, March 17, 2021
The housing market is hot! We didn't need this New York Times article to tell us that, but it does and tells us more. In this article, Where Have All the Houses Gone? let's start with this quote: "[a] majority of homeowners in America are baby boomers or older — a group at heightened risk from the coronavirus. If many of them have been reluctant to move out and downsize over the past year, that makes it hard for other families behind them to move in and upgrade.... There are lots of steps along the “property ladder,” ... that are hard to imagine people taking mid-pandemic: Who would move into an assisted living facility or nursing home right now (freeing up a longtime family home)?"
This article is not about the Boomers and home ownership, but since this is the elderlawprof blog, I thought it was important to mention the elder-aspect of this housing boom. There are lots of reasons why the housing market is so tight, and the article explains them well.
Monday, March 15, 2021
CMS recently announced that it was expanding visitation, but with some safeguards still in place. CMS Updates Nursing Home Guidance with Revised Visitation addresses indoor visits, indoor visits during an outbreak, compassionate care visits, ombudsman visits, and vaccinations for both visitors as well as surveyors. The revised guidance is available for download here.
Prior to the CMS revised guidance, there was some effort to increase visitation, including efforts by the National Consumer Voice for Quality Long-Term Care. Consumer Voice, Other Advocates Call on CMS to Safely Open Nursing Home Doors offers this call to action: "[C]alling on CMS to restore full visitation rights as soon as possible. In the interim, and during the Public Health Emergency only, we are urging CMS to ensure that: ... [e]ach resident is allowed an essential support person (ESP) ... [and] [a]ll residents are allowed indoor and outdoor visitation in addition to visits with an ESP. " Their letter of recommendation is available here. More info about their efforts, including a virtual rally, are available here and here.
Thursday, March 11, 2021
The New York Times discussed planning and saving for your longer life in the article, If You Live to 100, You’ll Need More Than Money. As more folks reach the 100 years old marker, it's more than just having enough money to live on. The article focuses not just savings, but planning and identifying a purpose. According to one financial advisor featured in the article, "[w]hile focusing on their savings goals, [he] also helped them embrace life planning, which asks: Besides not outliving your money, how can you make your life meaningful in retirement, which could last three decades or more?"
Here's some interesting data about centenarians from the article. "The growth in the 100-plus age group is partly a result of better medical care and a combination of improved lifestyle factors. This cohort has expanded 44 percent since 2000, according to a C.D.C. study. Eighty percent of centenarians are women. And in about 40 years, the number of people 100 and older will be six times as high as it is now, according to the Census Bureau."
The article discusses factors that may lead to reaching the 100 year old mark. If you are feeling optimistic, you might check out this calculator:
In recent years, estimating longevity and planning for it have become more sophisticated. The LivingTo100 longevity calculator, developed by Dr. Perls, is a good place to start to get a rough estimate of your life span and what you can do to improve your odds of living longer, should you want to go down that path.....
Wednesday, March 10, 2021
It was only a matter of time, once the COVID vaccines became available, that we saw this question being discussed. Can Long-Term Care Employers Require Staff Members to Be Vaccinated? was the subject of a recent article in the New York Times.
It’s a question that many long-term care employers, from individual families to big national companies, are confronting as vaccines become more available, although not available enough: In a pandemic, can they require vaccination for those who care for very vulnerable older adults? Should they?
Some employers aren’t waiting. Atria Senior Living, one of the nation’s largest assisted living chains, has announced that by May 1 all staff members must be fully vaccinated.
These requirements are not without controversy. How many employers will mandate this remains to be seen. Think about this in the long term care setting, where employees are in close and frequent contact with vulnerable residents. The article offers this interesting info:
Experts say it is probably legal for employers to make vaccination a condition of employment. The federal Equal Opportunity Employment Commission has agreed, so long as mandates permit health and religious exemptions. A University of Pennsylvania analysis found last fall that nationally, about half of American adults would consider employer mandates acceptable.
One expert mentioned that these vaccines were approved under an emergency mandate, and are not yet approved by the FDA, although that is expected to be coming soon. As far as the mandate, this expert offered this view "Ethically ... it’s entirely justified. People have the right to take chances with their own health, but they absolutely do not have the right to endanger others.”
The article discusses incentives employers may offer to get more folks vaccinated and the challenges in getting direct-care workers vaccinated.
PS-for those who are members of ASA, this issue was part of a podcast offered in February for members
Tuesday, March 9, 2021
Not everyone wants to retire. Some folks continue to work because they need to while others continue to work because they want to do so. The Washington Post addressed this in a recent article, Don’t want to retire? Here’s how to maintain a fulfilling career into your 80s and beyond. "People age 75 and over, including our fresh-on-the-job president, are the fastest-growing group in the labor force, even though “age discrimination is very real,” said Susan Weinstock, vice president of financial resilience at AARP." The author of the article explores the wellness advantages of continuing to work and reviews the habits of those interviewed for the article:
- view work as pleasure
- healthy eating and exercise is a must.
- Keep stress in check.
- Mentor and nurture others, as well as yourself.
Thanks to Professor Naomi Cahn for sending me the link to this article.
Friday, March 5, 2021
Let's end the week with a happy story, shall we? The New York Times featured the return to "normal" for one nursing home. After Vaccines, Joy, Relief and Game Night
The first day back was full of ordinary moments: small talk over coffee, bidding wars at an afternoon auction, a game of dice. But after a year of loss, loneliness and disruption, the very ordinariness of it all brought joy and relief.
There's losses, sadness and joy. It's a happy way to end the week.
Wednesday, March 3, 2021
Will the administration provide support for family caregivers? This was the subject of an opinion published in the New York Times. 50 Million Americans Are Unpaid Caregivers. We Need Help. focuses on the author's personal experiences as a family caregiver. Consider this: "It’s often noted that the United States is alone among rich nations in not providing maternity leave; support for child care is likewise abysmal. Similarly — but often more invisibly — we leave millions of caregivers with little or no support in managing the financial, logistical and emotional difficulties of helping ailing parents, spouses and children." Referencing the pledge made during the campaign, the author notices the benefits:
The changes would help not just caregivers like me; what’s good for caregivers also benefits those who need assistance. Expanding home care can keep frail elderly people out of nursing homes, the drawbacks of which have been painfully exposed by the pandemic. Easing financial strains and burnout for caregivers can mean better, more compassionate treatment, which in turn can improve quality of life and outcomes for our most vulnerable citizens.
Monday, March 1, 2021
The annual Ann F. Baum Memorial Elder Law Lecture at the University of Illinois College of Law is scheduled for March 10, 2021 at noon (central) virtually. This year's lecture, "Ways of Thinking About Medical Care: Alternative Models and Structures and Their Policy Significance" will be presented by James F. Blumstein, Vanderbilt University of the University Professor of Constitutional Law and Health Law & Policy and Professor of Management, Owen Graduate School of Management, Director, Vanderbilt Health Policy Center.
Here's a description of the presentation:
Traditionally, medical care has been understood to function under a professional paradigm; medical decisions are considered purely scientific under a standard of “medical necessity.” Medicare and Medicaid were based on this model, where economics has little sway. Over time, an alternative model, an economic paradigm, has gained traction. Under the alternative model, economics plays an important role in medical decisionmaking. The professional model had a strong influence on the design and structure of Medicare and Medicaid, with significant consequences in terms of cost escalation. Medicaid, in particular, has been an uncapped entitlement program of federal/state spending. About 20 years ago, Medicaid introduced managed care, which allowed for consideration of economic factors in medical decisionmaking. And, at the same time, the Children’s Health Insurance Program (CHIP) developed a competing model for federal/state healthcare spending. The Affordable Care Act (ACA) relied on cost savings from projected Medicare spending to fund increased access to care, a clear recognition of the salient role of economics in supporting expanded access to care. Most recently, the federal government has approved a Tennessee Medicaid waiver, essentially transferring the CHIP funding model to the context of Medicaid. The interplay of economics and program design/structure in healthcare programs, culminating in the recent Medicaid waiver for Tennessee, will form the centerpiece of this year’s Baum Memorial Lecture.
Here is the info to attend
Join by Zoom Meeting
Meeting ID: 860 8008 4604
Join by Skype for Business
Thanks to Professor Kaplan for letting me know about this wonderful program!
Sunday, February 28, 2021
Still? Yes still. Seniors Seeking Vaccines Have a Problem: They Can’t Use the Internet tells us something we already know (and I have already blogged about).
The chaotic vaccine rollout has come with a maze of confusing registration pages and clunky health care websites. And the technological savvy required to navigate the text alerts, push notifications and email reminders that are second nature to the digital generation has put older adults like Ms. Carlin, who need the vaccine the most, at a disadvantage. As a result, seniors who lack tech skills are missing out on potentially lifesaving shots.
The article explains various agencies and efforts to help those without internet access but more needs to be done.
There's got to be a better way. Is it really this hard?
Monday, February 22, 2021
Despite projects to vaccinate those elders who are homebound or lack internet access, we are still lagging behind on reaching them, according to a story today in Kaiser Health News. Countless Homebound Patients Still Wait for Covid Vaccine Despite Seniors’ Priority starts with the good news-recognizing the unique outreach efforts by hospitals, health systems, and paramedics, for example. These folks are home are highly vulnerable. Described by one expert in the article as a "hidden group", they are at great risk, "[b]y virtue of their age and medical status, these seniors are at extremely high risk of becoming seriously ill and dying if they get covid-19. Yet, unlike similarly frail nursing home patients, they haven’t been recognized as a priority group for vaccines, and the Centers for Disease Control and Prevention only recently offered guidance on serving them." The article notes that those professionals whoa are regularly in contact with them are not those with access to vaccines. Medicare's reimbursement rates for time-consuming house calls doesn't allow the health care professionals to recoup their costs, notes the article. Not only that, knowing the storage requirements for the vaccines doesn't mean a health care professional can just hop into their car and drive around with the vials in a cooler.
So this brings us to this story, a new hero for all of us! Last week in the New York Times, Woman, 90, Walked Six Miles in the Snow for a Vaccine
explained how after that recent snow storm, driving was out for her, but given all her previous failed efforts to get the vaccine, she wasn't going to miss this opportunity.
Where's Rosie the Riveter when we need her?? Surely "we can do it" or at least do better?
Friday, February 19, 2021
A week or so ago, stories started to emerge that SNF employees were passing on the opportunity to get the COVID vaccine. Kaiser Health News ran this article, explaining some views Vaccine Hesitancy vs. Vaccine Refusal: Nursing Home Staffers Say There’s a Difference.
The reluctance of one staffer interviewed for the article was noted to be shared by others: "[this] hesitancy has been echoed by nursing home staff members across the state and country. But [the staffer's] reasoning — as well as that of her colleagues who also opted against the vaccine that day — goes far beyond a simple yes or no. The decision is complicated and multifaceted, they said, which means persuading them to say yes will be, too."
In reaction to the stories that SNF employees were refusing the vaccine, the article goes on to explain: "[S]ome nursing home staffers say their reluctance is being misconstrued. Most are not saying they’ll never take the vaccine, but simply that they have concerns about such a new product. They understand it went through months of clinical trials, but what about possible long-term side effects, for instance? Or how did politics play into the development process? For communities of color, their historical mistreatment by the medical system can also factor into the decision."
The article also reports on various approaches taken by SNFs to get their employees to get vaccinated.
Wednesday, February 17, 2021
The Vatican is calling for a new paradigm of care for older people after what it calls the "massacre" wrought by the coronavirus pandemic, which has disproportionately killed people living in nursing homes.
The Vatican's Pontifical Council of Life issued a position paper Tuesday that made the case for a global rethink of how to care for people in their final years, including resisting any rush to institutional care in favor of adapting home environments to the needs of people as they age.
Tuesday, February 16, 2021
Pursuant to the request from the Editor of the ACTEC Law Journal.
Call For Papers: ACTEC Law Journal
Modernizing Trusts and Estates
The American College of Trust and Estate Counsel announces a Call For Papers on the following topic:
As trusts and estates academics and practitioners look forward into the remainder of the 21st century, we acknowledge the aspects of law and practice that are changing, that should change, and that should resist change.
A special issue of the ACTEC Law Journal will be devoted to a discussion of the topic of Modernizing Trusts and Estates and will be comprised of shorter articles (2,500-5,000 words). The issue will focus on what matters are of most importance to the forward-looking trusts and estates professional. Topics may include developments in tax law, adaptations in legal technology, racial justice and diversity, new or impending statutory reform, remote or electronic estate planning documents, the funeral and death industry, and other topics that demonstrate the way in which the trusts and estates landscape is shifting.
Procedure for proposals: Authors wishing to contribute to this special volume should send a brief proposal with estimated word count to Professor Alyssa A. DiRusso, Editor, ACTEC Law Journal, at email@example.com. Please include “ACTEC Theme Volume” in the subject line of your e-mail.
Proposals are due by March 15, 2021 and authors will be notified whether their article has been selected for publication by April 1, 2021. Given the brevity of each article, articles that delve into one or two topics in detail will normally be preferred over more general articles. We encourage submissions by authors from a variety of backgrounds, including those actively involved in fiduciary administration or the practice of law.
Final articles will be due no later than August 1, 2021, and earlier submissions are welcome. Selected articles will be published in the ACTEC Law Journal, Volume 47 Issue 1, with an anticipated publication date of December 2021.