Monday, November 11, 2019
The National Center on Law & Elder Rights has announced the release of the Elder Justice Toolkit. According to the website
The Elder Justice Toolkit is a resource created by the National Center on Law & Elder Rights. It contains practical information on civil legal remedies, practice tips, and sample pleadings for attorneys seeking protection and redress for their clients who have experienced elder abuse. Multiple states’ perspectives are considered and used as examples, but the Toolkit is designed for national use.
Some of the resources contained in the Elder Justice Toolkit have come from legal assistance organizations and have been re-formatted or re-purposed by NCLER...
This resource will continue to grow and have materials added to it over time. To receive NCLER communications and updates on resources, sign up here.
To find additional resources on elder justice topics, please read our Elder Justice Compendium.
A collection of our elder abuse webcast trainings can be found here.
Each topic includes a summary, an issue brief and step-by-step guide and a video. Here's an example of an issue brief on mandatory reporting for elder abuse cases.
Check it out and bookmark the webpage!
Sunday, November 10, 2019
ProPublica ran an in-depth story about a case of mistaken identity and the removal of life support.The Wrong Goodbye covers the story of removal of life-support from a patient, after which the family learns that the patient was not in fact their relative. The must-read story offers examples of how and why mis-identification of patients may occur. After writing about the facts and both families, the story turns to the litigation.
“The defendants negligently misinformed the plaintiff that her brother ... was admitted to the hospital in an unconscious state. The defendants negligently misinformed the plaintiff that her brother had died on July 29, 2018. As a result of the defendant’s misinformation and negligent conduct the plaintiff has suffered severe emotional harm and injuries.”
[The hospital] ... did not deny the mix-up, but argued it was not liable for any damages because no member of the Williams family ... had actually been a patient at the hospital. The hospital asked a judge to dismiss the case.
[The] lawsuit was reported in a daily story inside the New York Post on Jan. 27, 2019. It did not report the identity of the person taken off life support, but the story was reproduced on a slew of news websites.
[The widow] found the article on her Facebook feed. It had been aggregated on a website called Dearly.com. She eventually realized the story involved [her husband's] death, that he was the unidentified dead man in the article. Months into her efforts to figure out the details of her husband’s death, she saw in [the attorney], who’d been quoted in the article, someone who might help. Maybe [the attorney] would represent her, too.
She met [the attorney] in his Brooklyn office. He was quite certain she had a case. He was less certain he could represent both families. He arranged for her to call [a member of the other family] to see if everyone was comfortable with the idea....
When the conversation was over, [the attorney] was representing both families.
The article ponders the oversight from the law and various state and federal agencies and the impact this has had on the families. In the epilogue to the article, we are updated
More than a year after her husband’s death [the decedent's spouse] feels deeply frustrated, and increasingly doubtful that her husband’s death will ever be fully explained or that anyone will ever be held accountable. The police have all but stopped speaking to her. [The hospital] seems to have been cleared by the Health Department.
[The widow's] remaining chance at what she wants — a full explanation and punishment if warranted — appears to rest with ... the lawyer....
This summer, a judge in the Bronx rejected [the hospital's] motion to dismiss [the] lawsuit. [The attorney] is eager to start collecting more material in discovery.
. . ..
Read this article, realizing the story has not yet ended. It provides an important teaching point for us with our students.
Thursday, November 7, 2019
The Federal Trade Commission (FTC) recently sent a report to Congress, Protecting Older Consumers 2018-2019: A Report of the Federal Trade Commission. Here is the introduction to the 40 page report:
As the nation’s primary consumer protection agency, the Federal Trade Commission (“FTC” or “Commission”) has a broad mandate to protect consumers from unfair, deceptive, or fraudulent practices in the marketplace.1 It does this by, among other things, filing law enforcement actions to stop unlawful practices and, when possible, returning money to consumers. The FTC also protects the public through education and outreach on consumer protection issues. Through research and collaboration with federal, state, international, and private sector partners, the FTC strategically targets its efforts to achieve the maximum benefits for consumers, including older adults. Protecting older consumers in the marketplace is one of the FTC’s top priorities. Unfortunately, in numerous FTC cases, older adults have been targeted or disproportionately affected by fraud. For example, the FTC has brought numerous enforcement actions in federal court to stop deceptive technical support schemes that affected older consumers.As the population of older adults grows,the FTC’s aggressive efforts to bring law enforcement action against scams that affect them, as well as provide useful consumer advice, become increasingly important.
The FTC submits this second annual report to the Committees on the Judiciary of the United States Senate and the United States House of Representatives to fulfill the reporting requirements of Section 101(c)(2) of the Elder Abuse Prevention and Prosecution Act of 2017. The law requires the FTC Chairman to file a report listing the FTC’s enforcement actions “over the preceding year in each case in which not less than one victim was an elder or that involved a financial scheme or scam that was either targeted directly toward or largely affected elders.” Given the large number of consumers affected in FTC actions, this list includes every administrative and federal district court action filed in the one-year period. Appendix A to this report lists all of the FTC’s enforcement actions over the preceding year. In addition to the list, the FTC files this report to provide detail on the agency’s efforts to protect older consumers, including its research and strategic initiatives, its law enforcement actions that noted an impact on older adults, and its targeted consumer education and outreach.
The full report is available here.
Wednesday, November 6, 2019
Student George Thurlow found this story about athletes helping elders with their utilities:
The Jacksonville Jaguars NFL team and linebacker Myles Jack recently made headlines by helping to keep utilities on for several elderly Jacksonville residents in October 2019. While this donation made a difference in helping 31 elderly customers to keep their electricity on, it also speaks to a larger societal issue—there are many older Americans (ages 65 and above) that face financial hardship.
According to a 2008 study from the Center for American Progress, 22.4% of older Americans have family incomes that would be considered poor—within 150% of the poverty line (which in 2019 is $12,490 for a single person or $16,910 for a couple). This measure also likely underestimates the elderly poverty rate as it fails to consider thing like high medical costs (which nearly would double the figure for New York state). These individuals struggle the most with paying their utility bills. While programs such as Florida’s Low-Income Home Energy Assistance Program (LIHEAP) and Emergency Home Energy Assistance for the Elderly Program (EHEAP) can help older Americans meet this need, they require substantial documentation to apply and leave out some older Americans struggling but with income above 150% of the poverty line. Also, older Americans are more likely to live in older homes with insufficient insulation and not have newer, more efficient heating and cooling systems, only increasing their costs. The end result of this is that a lot of older Americans are struggling balancing their utility bills with other necessities.
While this is a good dead by the Jaguars and Myles Jack, how do we help other older Americans facing this same struggle? Do we increase Social Security and Medicare benefits? Do we encourage more economical housing arrangements that would have lower utility bills? These are serious discussions that we will need to have and the need to have these conversations will not disappear anytime soon with rising medical costs, rising life expectancies, and a growing number of people nearing retirement age with insufficient savings.
Jenna Kyle writes about elders in one country who are committing crimes in order to be jailed for housing:
Jail as a Warehouse for the Japanese Elderly
It is commonly discussed how people in today’s North American society have a lack of respect for the elderly. Often, you hear how in other cultures, such as those in Asia, respect for the elderly still exists. However, this article illustrates that a lack of respect and resources for the elderly is a global problem.
Seniors in Japan are intentionally committing petty crimes as they have no money to afford food and shelter. They commit these crimes knowing how seriously Japanese courts treat petty theft, expecting to receive jail sentences; and therefore, food and shelter. In the past, children traditionally looked after their parents in Japan. But, recently in provinces that lack economic opportunities, younger people have moved away, leaving the elderly to look after themselves. It is interesting to consider whether a similar epidemic could occur in the United States. Personally, I don’t believe it is as likely. In Japan, the elderly are committing petty non-violent crimes, as they are known to come with high sentences. In the US, petty crimes, such as shoplifting are not typically given such high sentences. Therefore, American seniors would need to commit more extreme crimes to be sentenced to a jail term, crimes I feel elderly people are less likely to commit.
Further, Japan is improving their prisons, putting in handrails and special toilets and implementing special classes for older offenders. Historically, American prisons aren’t as elder friendly, making them a less desirable living situation for impoverished American elders.
This article also raises another important issue. A model in Japan has been costed to build an industrial complex retirement village where people would forfeit half their pension to get free food, free board and healthcare, etc. It has been determined that it would cost significantly less for the government to do this than to continue to put money into their jails to make them adequate for their elderly inmates. I believe this illustrates how the government and society tends to deal with issues involving the elderly in a reactive manner instead of a proactive manner. If the government and society were able to take more proactive measures in caring and aiding the elderly, it would not only benefit the government (less money spent) but would also greatly improve the quality of life for their elderly citizens.
Erin Morse writes a very personal story about looking for an ALF for a family member.
Finding an Assisted Living Facility For Your Loved One
Around this time last year, my family and I were looking into assisted living facilities for my grandma that had been diagnosed with dementia years prior. Thankfully we had time to look into these options, something many people don’t have on their side as many are being discharged from the hospital and can no longer go home.
We began looking into our options for assisted living facilities because it was becoming too hard on my grandpa to be her caregiver and unfortunately in-home care was not our best option because my grandpa, the devoted husband that he is, refused to give up on my grandma and thought he didn’t need the help.
Several things played a factor in what I looked at when assessing the different facilities. It was important to me that the facility allowed visitors whenever, with no advance notice. If a facility makes you give notice and/or only allow visitors in a certain time frame, it’s a huge red flag.
The quality of food was also top of my list. I didn’t want my loved one eating cafeteria slop. I wanted the food to be edible, fruits and vegetables that actually looked like fruits and vegetables, and a healthy well-rounded diet. I wanted the food to be made fresh daily and not come from a freezer.
I also factored into my decision what the residents were doing in the daytime when we visited. Were they sitting around watching tv? Were they just sitting in their wheelchairs and sleeping? Did they seem to never leave their room? Or were they active and participating in different types of activities?
There is obviously an extensive list of things to consider when choosing a facility for your loved one which can be found with a simple google search, one of those lists being located at the following link: https://www.aarp.org/caregiving/basics/info-2017/assisted-living-options.html. It is also helpful to make a list of things that would be important to you if you were about to enter into a facility.
Which brings me to present day, where my family and I are now potentially looking at facilities for my grandpa, who was just diagnosed with Alzheimer’s. Things that I have now added to my list are to thoroughly read the facilities contract - paying close attention to arbitration clauses and their ability to terminate the contract; observe the facility’s turnover – which I recommend looking at their open job positions and see how often new job postings are being posted; and even learn about who is on their payroll – how many registered nurses, do they have a visiting doctor, do they have a local pharmacy or a pharmacy that delivers, etc.
Monday, October 28, 2019
Here's where you register for the newsletter.
According to the announcement I received, this what Bold School is about:
Friday, October 18, 2019
Here's a new fact sheet from the Keck School of Medicine at USC on an important topic. What I should know about opioid pain medicine is a valuable 2 page fact sheet in an easy-to-use format. The topics include pain meds vs. opioids, items that interact badly with opioids, signs of overdoses and more.
Check it out!
Monday, October 14, 2019
MarketWatch published an article last week on the amount of money you need to have for your retirement, If you want to have enough money when you retire, you need to know this. "Calculating future savings requires numerous factors, including current age and predicted retirement age, any current assets, how the portfolio is invested and at what rate a person can realistically expect that money to grow. The latter, known as a “rate of return,” includes inflation, interest and dividend payments, and many experts disagree on what individuals can anticipate that rate to be." There are various views regarding the percentages needed for the rate of return and there are a couple of ways to reference it, the article explains.
As with most other facets of retirement planning, an assumed rate of return can be different from one person to the next, said [one advisor]... The reality is that it is almost entirely dependent upon your own personal allocation....” Many advisers also have their own way of creating projections, and will show clients a few estimates — from conservative to aggressive — when making a financial plan. “There is no one perfect number to use....”
Still, investors may want to err on the conservative side, as it’s better to save too much than end up in retirement with too little.... And investors, especially younger ones, should not be chasing returns.
Bottom line, you need to start saving (the earlier the better) for your retirement if you plan to retire
Thursday, October 3, 2019
Who among us doesn't have a smart phone or computer, or even a tablet? They are not only ubiquitous, they are integral, and perhaps essential, to our daily lives. What happens when someone, due to cognitive impairments, is no longer able to use these devices? Kaiser Health News made that the subject of a recent article. The Delicate Issue Of Taking Away A Senior’s Smartphone describes the potential problems
Increasingly, families will encounter similar concerns as older adults become reliant on computers, cellphones and tablets: With cognitive impairment, these devices become difficult to use and, in some cases, problematic.
Computer skills may deteriorate even “before [older adults] misplace keys, forget names or display other more classic signs of early dementia,” Zorowitz wrote recently on a group email list for geriatricians. (He’s based in New York City and senior medical director for Optum Inc., a health services company.)
“Deciding whether to block their access to their bank accounts, stocks and other online resources may present the same ethical dilemmas as taking away their car keys.”
Consider that some folks stay in touch with family and friends through their digital lives. But also consider how scammers can use email to perpetrate a fraud. The article notes a difficulty in using these devices---a difficulty that did not previously exist--may be an indicator of cognitive issues signaling a need for a comprehensive exam of cognition. Family can be helpful, but still realize there are issues
[B]eware of appropriating someone’s passwords and using them to check email or online bank or brokerage accounts. “Without consent, it’s a federal crime to use an individual’s password to access their accounts,” said Catherine Seal, an elder-law attorney at Kirtland & Seal in Colorado Springs, Colo. Ideally, consent should be granted in writing.
The article notes that some with dementia lose interest in their devices, but that is not true for everyone-it depends on the type of cognitive impairment. "More difficult, often, are situations faced by people with frontotemporal dementia (FTD), which affects a person’s judgment, self-awareness and ability to assess risk." The article then profiles the experiences of a noted elder law attorney and friend of mine, whose husband as an FTD diagnosis. She shared the steps she takes to keep her husband safe online.
Read the entire article, especially the last part where personal experiences and tips are shared. It's an important topic-we all need to think about this and plan for the eventuality in case we need to give up our digital word.
October 3, 2019 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care, Other | Permalink | Comments (0)
Wednesday, October 2, 2019
We are still in hurricane season down here in Florida, sporting 90 degree temperatures, while Montana had a blizzard. Natural disasters take all forms so it's important to remember that everyone needs a disaster plan. the University of Michigan National Poll on Healthy Aging published a new report, Emergency Planning among Older Adults.
Natural disasters and other emergencies can happen anywhere. When they do occur, older adults, including those with chronic health conditions and impaired mobility, may be particularly vulnerable to adverse effects. In May 2019, the University of Michigan National Poll on Healthy Aging asked a national sample of adults age 50–80 about their experiences with disasters and emergency planning as well as their preparedness for such events.
Preparing for emergencies
In the past year, more than one in five adults age 50–80 (22%) had experienced an emergency or disaster such as a power outage lasting more than a day, severe weather, evacuation from their home, or a lockdown, while 73% reported experiencing at least one such event during their lifetime. More than half of respondents (53%) thought they were likely to experience an emergency or disaster in the next year.
The question is then, are these folks prepared? Not everyone, according to the poll results:
Although more than half of older adults believe they will likely experience some type of natural disaster or emergency in the coming year and the majority generally feel confident in their ability to manage through them, many older adults have not taken key steps recommended by disaster preparedness agencies. Nearly half of respondents either did not know if their community had an emergency alert system or had not yet signed up. Having any advanced warning of a disaster or emergency, even minutes, can help people get to a safer place, so signing up for these alerts, where available, is important.
Although most older adults who require essential medications or health supplies reported having a seven-day supply available, three in four individuals who use medical equipment that requires electricity did not have an alternative power source. Roughly half of respondents reported having a week’s supply of food or water, or tools for communication in the event of a power outage such as a solar or battery cell phone charger or a battery-powered or hand crank radio. Disaster preparedness agencies recommend such resources for everyone, and these steps may be particularly important for older adults with complex health needs or mobility challenges.
The American Red Cross, FEMA, and AARP all offer guidance for preparing/responding to disasters and emergencies specifically designed for older adults. These groups and others tasked with promoting emergency preparedness should consider utilizing new strategies to reach and engage older adults who may not already be well-prepared for emergencies. Additionally, health care professionals who care for older adults should consider discussing disaster preparedness, particularly in areas that routinely face natural disasters. Preparing now can help older adults — and everyone — to be ready for emergencies.
The full report is available here.
Tuesday, October 1, 2019
We all know how important it is to keep moving! But what gives us the maximum benefit, at least from the standpoint of being the most you can be (I sound like the old Army ad "Be all you can be") when you are older. The Washington Post ran this informative article, The longevity files: A strong grip? Push-ups? What actually can help you live to a ripe old age.
Here are some tips from the article--pushups, walking speed, sitting on the floor and standing up (known as sit-rise) and grip strength matter. But those are not magic elixirs--instead they are representative of your ability, "that you are still strong and nimble enough" to do them. "What these tests have in common is they’re good shorthand of things that matter for longevity: overall health, fitness and muscle strength. A fit person walks faster than someone out of shape, and getting up off the floor is tricky for people with weak bones and muscles."
As the article notes, there is no magic pill for longevity, but exercise does help... a lot. Even short amounts of exercise make a difference. Oh and it's not just exercise; sleep matters as well as does diet. Alcohol in moderation and keeping stress under control are also important. Having friends and a purpose are also discussed in the article.
This reminds me of so much of what we were taught in health and gym classes back in high school. So now that you've read this post, read the article and then take walk.
Thanks to Professor Naomi Cahn for sending me the link to the article.
One of the questions I ask my students at the beginning of the semester is to quickly tell me characteristics of someone the students consider to be old. I typically get responses that involve wrinkles, grey hair, use of assistive mobility devices and the like. I will sometimes ask them to tell me about positive aging representations in television and movies. In the past someone would mention the Golden Girls, now I'm not so sure current generations of students are familiar with the show, so instead I expect someone to mention Grace and Frankie.
To this point, I was quite interested in the project between AARP and Getty Images, Media Image: Age Representation in Online Images. The report from AARP reveals the common use of negative images in media to portray elders.
Visual portrayals and stock photography build and reinforce stereotypes. The current landscape of online images does not accurately reflect the 50-plus population. This portrayal may exacerbate ageism in the workplace by rarely showing adults age 50-plus at work or with technology but rather as isolated or dependent on others for assistance. Images are often intended as heartwarming, showing younger people helping the 50-plus, but this portrayal has unintended consequences.This media scan suggests that visual representations need to reflect greater diversity and authenticity. Specifically, more images are needed that portray older adults as independent and actively engaged in their communities. In addition, more images are needed that show the 50-plus in work settings and using technology with confidence.
Here are some of the key findings from AARP's study
- Nearly half of all adults in the U.S. are 50 and older, but only 15 percent of the random sample of images studied showed people in this age group. That's fewer than 1 in 7 images.
- Adults 50-plus are portrayed in a positive light 72 percent of the time. That's much less than people 49 or younger, who are featured in a positive light 96 percent of the time.
- Although 1 in 3 people in the U.S. labor force are age 50-plus, only 13 percent of online media images show a middle-aged or older adult in a work setting.
To remedy this, AARP & Getty have launched an online collection of positive stock aging that can be licensed for use, AARP and Getty Images Launch Photo Collection to Fight Ageism.
To fight ageism and illustrate the active lifestyles of adults age 50-plus, AARP has joined with Getty Images in launching a collection of more than 1,400 stock photos available for a fee to media outlets, ad agencies and other firms.
The Disrupt Aging Collection features photos of older Americans as vibrant and engaged, some of whom are singing, skiing, swimming in the sea, traveling abroad, playing team sports and hoisting adult beverages with their friends at the beach.
Check out the photos here. Now, if only they were free....
Monday, September 30, 2019
I'm always interested in the special touches some elder law attorneys bring to their practices, and I've written previously (not necessarily on this blog) about them. Years ago, I remember a friend and preeminent elder law attorney, Ray Parri, decided to have office pets-he was the first I'd heard to do so (really it was a long time ago). He routinely had cats, and I know at one point he had two office cats, one named Mason and the other named Perry (if you get the reference I know your generation!). It's not only special touches but also special events that can set elder law attorneys apart from others, IMHO. Here's one upcoming that illustrates my point. Our alum, Stephanie Edwards, has an upcoming caregiver event, titled "Caregiver's Holiday Paws Pause." With several other agencies and a local church, this event offers 3 hours of staffed respite care for for folks who have caregivers, resources for caregivers, 90 minutes to interact with adoptable animals (and maybe they will get a new home for the holidays) and a presentation by a dementia coach. I'd be interested in hearing about other unique events from elder law attorneys, so let me know!
Friday, September 27, 2019
I gave my students an assignment to write a blog post on a current event that would be of interest in a class on law and aging. Here are two that I've received---I thought you might find them interesting.
This was supposed to have been a fun family weekend. My sister-in-law was headed home with a car filled with special treats and presents to celebrate my niece's sweet sixteenth birthday. The weather was clear and traffic was moving smoothly when the crash occurred.
A ninety year old drove through a stop sign and directly into traffic, causing a multi-car accident. My sister-in-law had to be cut from her SUV and taken to the trauma center. I saw her crumpled vehicle first-hand, and it is an absolute wonder she survived. It is uncertain how long her injuries will significantly impact her life. Yet, she was the incredibly lucky one.
A young couple and their infant was also struck by the elderly driver's car. Seeing this family's vehicle was horrific. I knew the infant was in critical condition at the hospital. When I saw this car, it looked as if it had been in a compactor; it didn't seem possible for anyone to survive. Unfortunately, the infant didn't.
As those involved in the accident struggle to heal and make sense of the tragedy, my heart goes out to the family of the elderly driver. I have so many questions. I wonder...did family members recognize the signs that their loved one should no longer be driving? Did they try to intervene? Was the driver aware of taking the wheel? Is he aware now? How will the driver and family cope with the legal and emotional burden of this accident? What more can be done to prevent this kind of heartbreak?
Elders in Politics: Perceptions of elders in the 2020 election
Brandy Orth Becker
While the perception and social utility of elders in the United States has always been a topic of discussion, throughout American history, there is a revamping of this discussion with the perspective of another elder ( 65+) as President of the United States of America.
Some common associations with the concept of getting older are memory loss, confusion, social dissonance, etc. All of these factors go to the sharpness of the mind and the ability to understand and process information. These factors are such that if relevant, any leader of a nation could be called into question.
Vice President Joe Biden has been the most clearly targeted in this 2020 election as far as ageism. Despite the fact that many who take the stage at a political debate have a tendency to jumble words, forget details, or misspeak, his errors are being connected automatically to senility and attributed to his age. After an inconsistent statement by Biden in the democratic presidential primary debate in Houston, co-candidate Julian Castro insinuated that Biden was unable to recall the statements that he had just made moments ago (See article). The internet in a quick response, picked up on the insinuations of Mr. Castro. As a result, any actual factual or political statements made by Biden in the debate were overshadowed by a discussion/parody of his age and capacity to lead as an elder.
At 72, Vice President Joe Biden is the oldest among the democratic candidates in the 2020 election. However, with his age comes a very impressive career in the political realm, making him one of the most politically experienced candidates among the bunch. It will be up to the American People in anticipation of, and at the polls, to weigh these facts, and to decide if age will in fact play a factor in disqualifying a presidential candidate.
Thursday, September 26, 2019
Per a story recently in CNN, Jimmy Carter jokes 'I hope there is an age limit' on presidency.
Former President Jimmy Carter said if he were 80 years old he would not be able to handle the responsibilities of being President and joked that he hopes there is an "age limit" on the office.
The comments from the 94-year-old former commander-in-chief are especially notable as the age of the three top Democratic 2020 presidential hopefuls, who are in their 70s, has been the subject of ongoing debate. The 39th president didn't mention any Democratic candidates by name at a town hall at the Carter Center in Atlanta on Tuesday night when he was asked if he might consider running for a second, non-consecutive term."I hope there is an age limit," he said as the audience laughed. "You know, if I were just 80 years old, if I were 15 years younger, I don't believe I could undertake the duties that I experienced when I was President."Carter said the presidency requires mental fortitude and one must "be able to adapt to new ideas.". . ."So the things I faced then in foreign affairs, I don't think I could undertake them when I was 80 years old. So 95 is out of the question. I had a hard time walking when I came in," said Carter, whose birthday is on October 1.
Thanks to one of my students for sending me this article!
Thursday, September 19, 2019
The American Federation on Aging Research (AFAR) released a white paper, Longevity and Health of
U.S. Presidential Candidates for the 2020 Election: White paper from the American Federation for Aging Research. Here is the abstract from the white paper:
Abstract: The oldest person ever elected president of the U.S. could take office in 2021 – but questions about the health and longevity prospects of presidential candidates are now relevant given the advanced age of many of the candidates. In the absence of medical records, assessing health, longevity, and survival prospects for candidates requires the use of data from national vital statistics. Here we estimate the lifespan, healthspan, disabled lifespan, and four-year survival probabilities for U.S. citizens that match the attributes of all of the candidates and the sitting president for the next two election cycles. Results suggest that chronological age should not be a relevant factor in the forthcoming election.
There has been some discussion about the age of candidates, so it's interesting to think about the research on the topic, and it can be a useful tool for a discussion with students. Here's the conclusion to the report:
Dr. David Scheiner stated that it is not acceptable to take the word of candidates or sitting presidents that they are healthy, and therefore candidates should make their medical records public so voters can make decisions based on a full disclosure of any medical conditions. At one level this makes sense because harboring a lethal condition that could lead to death while in office, might influence how people vote -- or at the least, lead voters to pay more attention to the choice for vice president. Yet, if a candidate is healthy today, it is unclear whether future health status should ever be a criterion used to judge a presidential candidate. The voting public and legal scholars need to weigh in on whether or not medical records should be required to be disclosed by candidates or a sitting president.
With regard to the relevance of age in deciding whom to vote for, estimates of healthspanr ealistically suggest that some of the presidential candidates are at a higher risk of experiencing some level of frailty and disability during a first or second term in office because they are older.
Health and longevity challenges are closer for candidates now in their 70s relative to those younger because age is an established risk factor for fatal and disabling conditions; but despite this, many survive to their 80s and 90s with their mental and physical capacities largely intact. Without an ability to know in advance who among the candidates might fall into this category, chronological age itself should not be used as a sole disqualifier to run for or become president.
If the lower limit of age 35 was chosen by America’s founding fathers because they envisioned the presidency requiring the experience, maturity, and wisdom that comes with age; or that time allows the voting public to make judgments based on a candidate’s established track record; then one could make the case that the most qualified among the available candidates are older. Given the favorable health and longevity trajectories of almost all of the presidential candidates relative to the average member of the same age and gender group in the U.S., and the apparent current good health of all of the candidates, there is reason to question whether age should be used at all in making judgments about prospective presidential candidates.
Wednesday, September 18, 2019
Do you have your estate planning documents done? Made funeral arrangements? Think you have everything covered? Well, did you make a "when I die file?" According to an article in Time magazine, Why You Need to Make a 'When I Die' File—Before It's Too Late this file is likely
the single most important thing you do before you depart. It may sound morbid, but creating a findable file, binder, cloud-based drive, or even shoebox where you store estate documents and meaningful personal effects will save your loved ones incalculable time, money, and suffering. Plus, there’s a lot of imagination you can bring to bear that will give your When I Die file a deeper purpose than a list of account numbers. One woman told us she wants to leave her eulogy for husband in the file, so she can pay homage to him even if she goes first.
Without such a file, the process of compiling the information can be time-consuming and emotionally draining for the family. Here are some of the tips from the article
First, call the companies behind your cable, internet, cell phone, club memberships, and anything else that bills for services on an ongoing basis and add your partner or kids to the account as a joint owner. If billing accounts are not in both your and a loved one’s name, your survivors will end up spending hours on the phone and in offices begging bureaucrats to shut them down or convert the accounts to their name so they can manage them. Think of every frustrating call you’ve had with your cell provider, and then multiply it by 10.
Here are a few of the things you’ll put into your “When I Die” file:
□ An advance directive that’s signed (and notarized if necessary)
□ A will and living trust (with certificate of trust)
□ Marriage or divorce certificate(s)
□ Passwords for phone, computer, email, and social media accounts
(We recommend using an online password manager to collect them all, sharing the master password with someone you trust, and then designating emergency contacts within the program who are allowed to gain access.)
□ Instructions for your funeral and final disposition
□ An ethical will
□ Letters to loved ones
There is more information about the file in the book on which this article is based, Beginner’s Guide to the End.
Sunday, September 15, 2019
A story in Kaiser Health News, In Search Of Age-Friendly Health Care, Finding Room For Improvement highlights needed design improvements within health care facilities.
For older adults, especially those who are frail, who have impaired cognition, or who have trouble seeing, hearing and moving around, health care facilities can be difficult to navigate and, occasionally, perilous.
Grab bars may not be placed where they’re needed. Doors may be too heavy to open easily. Chairs in waiting rooms may lack arms that someone can use to help them stand up.
Toilets may be too low to rise from easily. Examination tables may be too high to get onto. Lettering on signs may be too small to read. And there may not be a place to sit down while walking down a hallway if a break is needed.
Examining the changes from the "ground-up" so to speak, the article starts with the issues from poorly thought-out parking: inconvenient location of the lot to insufficient spaces for those with disabilities. Don't forget signage---is there enough? Is it logically located? Is it hard-to read? (think poor contrast, glare or hard-to read fonts). Then there are steep ramps, a lack of available walkers and wheelchairs to borrow at the facility's entrance and a lack of automatic doors. Ever been asked by the receptionist to take a clipboard of forms to fill out at your seat? Of course-no big deal--unless you use a walker or two canes--talk about having your hands full! Oh and let's get started about seats--too low, too soft, no arms or all with arms!
The article is an interesting read and hopefully those who design health care facilities will think about these things--because humans don't all come in one size or all have the same abilities or needs.
Thursday, September 12, 2019
The New York Times ran an article about, At Colleges, What's Old is New: Retirees Living on Campus.
This story focuses on "a growing number of colleges sponsoring retirement communities on campus or thinking about it." The schools promote the educational impact of this, but of course there can be a monetary benefit to the college.
The schools say their motive is more educational and social — encouraging intergenerational mixing — than financial. But the communities promise a new revenue stream for institutions that are coping with reduced state operating support and declining college enrollment in many parts of the country. They are bringing a new generation (or old generation) to c ampus to fill classes, eat in dining halls, attend student performances and become mentors.
Not everyone supports the concept, with concerns about older people complaining about noise from parties, and the recognition that their presence in the classroom can change the dynamics, without the same stakes, since only the younger people take the classes for grades. But that's not guaranteed to happen and in fact, the opposite may occur. One couple quoted for the article "say the whole reason they are moving to ... College and not to Miami is that they like to stay up late and party. [They] believe that the other residents will be the same — not your parents’ grandparents. “They’re forward thinkers, not the ones to go down to Florida and order the early bird special...."
The article features several colleges that are implementing the concept. The cost may be too steep for some. There are different approaches being adopted. It all is very interesting.
Check it out!
Tuesday, September 10, 2019
Kaiser Health News addressed the topic of hunger amongst elders in Starving Seniors: How America Fails To Feed Its Aging.
This is incredibly sobering
[M]illions of seniors across the country quietly go hungry as the safety net designed to catch them frays. Nearly 8% of Americans 60 and older were “food insecure” in 2017, according to a recent study released by the anti-hunger group Feeding America. That’s 5.5 million seniors who don’t have consistent access to enough food for a healthy life, a number that has more than doubled since 2001 and is only expected to grow as America grays.
While the plight of hungry children elicits support and can be tackled in schools, the plight of hungry older Americans is shrouded by isolation and a generation’s pride. The problem is most acute in parts of the South and Southwest. Louisiana has the highest rate among states, with 12% of seniors facing food insecurity. Memphis fares worst among major metropolitan areas, with 17% of seniors like [one mentioned in the article] unsure of their next meal.
You're thinking to yourself, surely there are options. What about those federally funded meals programs? Something else? Uh....not likely.
[G]overnment relief falls short. One of the main federal programs helping seniors is starved for money. The Older Americans Act — passed more than half a century ago as part of President Lyndon Johnson’s Great Society reforms — was amended in 1972 to provide for home-delivered and group meals, along with other services, for anyone 60 and older. But its funding has lagged far behind senior population growth, as well as economic inflation.
The biggest chunk of the act’s budget, nutrition services, dropped by 8% over the past 18 years when adjusted for inflation, an AARP report found in February. Home-delivered and group meals have decreased by nearly 21 million since 2005. Only a fraction of those facing food insecurity get any meal services under the act; a U.S. Government Accountability Office report examining 2013 data found 83% got none.
Oh and by the way-the act expires at the end of this month-it's now up to COngress to reauthorize and determine its budget. Food stamps may be an option, but "only 45% of eligible adults 60 and older have signed up for ... SNAP, the food stamp program for America’s poorest. Those who don’t are typically either unaware they could qualify, believe their benefits would be tiny or can no longer get to a grocery store to use them."
Government programs have long wait lists but there are those who get help, "2.4 million people a year benefit from the Older Americans Act’s group or home-delivered meals, allowing them to stay independent and healthy." Poor diet, hunger, and starvation have significant consequences, in some instances resulting in major health issues or even death.
Where you one of those kids growing up whose parent said something along the lines of "eat your vegetables (or clean your plate), there are children starving in (insert country)? Nowadays it may be "eat your vegetables, grandma is starving...."
Keep an eye on Congress' actions on reauthorization-it's important!
Monday, September 9, 2019
Dorian was a bad, bad storm. For those of you who don't live in hurricane country, it may be hard to grasp the magnitude of needed preparations. Every area of the country has natural disasters, some (like hurricanes) coming with more notice than others. How far in advance should authorities order an evacuation, knowing the course can change (see, e.g. Dorian). There needs to be enough time to move those who are medically , cognitively or physically comprised. The New York Times examines preparations in
Remember Hurricane Irma? The Florida authorities certainly do.
The last major Atlantic storm to hit the state was foremost in officials’ minds. When Hurricane Irma came ashore two years ago, a dozen patients died after a nursing home in Hollywood, Fla., lost its air-conditioning. The tragedy prompted new regulations and an acknowledgment that evacuation orders were not enough to protect the state’s large older population. When it comes to older people, no state has more retirees than Florida, where they make up one-fifth of the population, according to the AARP.
A new state law requires backup generators and enough fuel to maintain comfortable temperatures at nursing homes and assisted living centers, a mandate first tested last year when Hurricane Michael struck the Florida Panhandle. Last week, four nursing home workers were charged in the Hurricane Irma deaths, which were ruled homicides.
Remember the article from a few days ago about the elevator being out of repair? Look at this: "Jacksonville, Fla., officials advised residents with just a few hours’ notice that it would disable its elevator on Monday afternoon." That leaves residents with two choices: go now, or not be able to go at all, without someone physically getting the resident down the stairs.
Lots of folks live in Florida nursing homes, especially in S. Florida, according to the article. After Irma, Florida now requires SNFs and ALFs to have emergency generators. The week before the threat of Dorian, "[t]he Miami Herald reported ... that nearly 60 percent of the state’s 687 nursing homes did not yet have enough power backup."
The article offers examples of some facilities in Florida that implemented their emergency evacuation plans. In some parts of Florida, we were very lucky. Those in Dorian's path, from the Bahamas on, were not. In case you missed it, hurricane season goes til the end of November