Tuesday, July 16, 2019
The National Center for State Courts has released a new guide for monitoring conservatorships. Implementation Guide for ModernizingConservatorship Monitoring: Basic Strategies and Technology Enhancements explains that
Originally, this implementation guide was intended to encourage state courts to adop ttechnologies and analytics that would make immediate impacts. But like many intentions,the NCSC team, working with pilot states,realized that most state courts do not have the capacity to develop and implement such broad-scale changes at this time. In fact, data collection efforts showed that most state courts still have a difficult time documenting the number of active conservatorship cases.So rather than create a guide that few courts could implement, the purpose of this report is to inform readers of the efforts and advancements under way in light of problems posed by conservatorships. Regardless of the current situation within a state, the proposed strategies can be adapted to assist all courts.The project team encourages movement toward reforms that, ultimately, will improve court accountability and enhance protections for those individuals subject to a conservatorship. First laying the ground work of stakeholder support and improved data collection, then building toward technology solutions.
The document explains terminology, makes a case for reform, reviews and recommends the "Minnesota Model," reviews the experiences of pilot sites and offers 7 steps for modernizing conservatorship monitoring.
Friday, July 12, 2019
Pew Research has a new Fact Tank, "On average, older adults spend over half their waking hours alone" which explains that "Americans ages 60 and older are alone for more than half of their daily measured time – which includes all waking hours except those spent engaged in personal activities such as grooming. All told, this amounts to about seven hours a day; and among those who live by themselves, alone time rises to over 10 hours a day, according to a new Pew Research Center analysis of Bureau of Labor Statistics data."
That seems like a lot, especially when you compare the "alone-time" for other generations to this one: "people in their 40s and 50s spend about 4 hours and 45 minutes alone, and those younger than 40 spend about three and a half hours a day alone, on average. Moreover, 14% of older Americans report spending all their daily measured time alone, compared with 8% of people younger than 60."
Alone time isn't a bad thing-just ask any introvert-but even too much of a good thing can be ... too much. Alone time "can be a measure [used for] social isolation" which can have a correlation to "negative health outcomes among older adults. Medical experts suspect that lifestyle factors may explain some of this association – for instance, someone who is socially isolated may have less cognitive stimulation and more difficulty staying active or taking their medications. In some cases, social isolation may mean there is no one on hand to help in case of a medical emergency."Living arrangements also play a role in how much time a person is alone. "More than a third (37%) of older adults who live alone report spending all their measured time alone. Among those who live with someone other than a spouse, the average amount of alone time a day is seven and a half hours."
Thursday, July 11, 2019
I've blogged a number of times on the variety of issues regarding caregivers and caregiving. A recent article in the New York Times presents an interesting perspective. At 75, Taking Care of Mom, 99: We Did Not Think She Would LiveThis Long discusses what the article describes as
“a growing phenomenon: Children in their 60s and 70s who are spending their retirement years caring for parents who are in their 90s and beyond.”
The article quotes one expert who describes this as “aging together” and this parental longevity has forced the caregiver child to redefine his or her retirement plans. The article recommends ways for caregivers to take care of themselves and manage stress and discusses the importance of doing a cost-analysis “[t]o figure out what’s financially doable, it may help to seek professional advice. An accountant will calculate tax breaks for home care and other services. Local senior programs could offer guidance on free and reduced-cost programs, including counseling for burned-out caregivers.”
Thanks to my colleague and dear friend, Professor Mark Bauer, for sending me the link to this article.
Wednesday, July 10, 2019
Ugh, this article in the Washington Post covers a serious and worrisome topic. Hospices go unpunished for reported maggots and uncontrolled pain, watchdog finds reports on a recently released HHS Office of Inspector General report, 2019: Vulnerabilities in Hospice Care.
The OIG report is actually two reports "which found that from 2012 through 2016, the majority of U.S. hospices that participated in Medicare had one or more deficiencies in the quality of care they provided to their patients. Some Medicare beneficiaries were seriously harmed when hospices provided poor care or failed to take action in cases of abuse. OIG made several recommendations in both reports to strengthen safeguards to protect Medicare hospice beneficiaries from harm and to ensure hospices are held accountable for deficiencies in their programs."
The first report, Hospice Deficiencies Pose Risks to Medicare Beneficiaries, 07-03-2019 | Report (OEI-02-17-00020), found that
[t]he most common types of deficiencies involve poor care planning, mismanagement of aide services, and inadequate assessments of beneficiaries. In addition to these, hospices had other deficiencies that also posed risks to beneficiaries. These failings-such as improperly vetting staff and inadequate quality control-can jeopardize beneficiaries' safety and lead to poor care. In addition, one-third of all hospices that provided care to Medicare beneficiaries had complaints filed against them. Over 300 hospices had at least one serious deficiency or at least one substantiated severe complaint in 2016, which we considered to be poor performers. These hospices represent 18 percent of all hospices surveyed nation-wide in 2016. Most poor performers had other deficiencies or substantiated complaints in the 5-year period. Some poor performers had a history of serious deficiencies.
The full report is available here.
[s]ome instances of harm resulted from hospices providing poor care to beneficiaries and some resulted from abuse by caregivers or others and the hospice failing to take action. These cases reveal vulnerabilities in CMS's efforts to prevent and address harm. These vulnerabilities include insufficient reporting requirements for hospices, limited reporting requirements for surveyors, and barriers that beneficiaries and caregivers face in making complaints. Also, these hospices did not face serious consequences for the harm described in this report. Specifically, surveyors did not always cite immediate jeopardy in cases of significant beneficiary harm and hospices' plans of correction are not designed to address underlying issues. In addition, CMS cannot impose penalties, other than termination, to hold hospices accountable for harming beneficiaries.
The second full report is available here. In addition there is a slide show available on YouTube, a one page flyer available here, a one-page graphic of the top issues available here, a flyer on beneficiary rights available here and more.
Tuesday, July 9, 2019
Do you plan to retire? If you answer is no, you aren't alone. According to a recent poll in the Associated Press, almost 25% of folks plan to keep work. Poll: 1 in 4 don’t plan to retire despite realities of aging found a possible "disconnection between individuals’ retirement plans and the realities of aging in the workforce." The realities of life ... and aging... "often force older workers to leave their jobs sooner than they’d like." The article notes things like caregiving and health as reasons that cause folks to leave employment. In addition to this nearly 25% who plan to keep working, which "[includes] nearly 2 in 10 of those over 50.... [r]oughly another quarter of Americans say they will continue working beyond their 65th birthday."
The article contains data regarding the impetus to keep working (including financial needs) and the perceptions among those in the workforce regarding the continued employment of older workers:
39% think people staying in the workforce longer is mostly a good thing for American workers, while 29% think it’s more a bad thing and 30% say it makes no difference.
A somewhat higher share, 45%, thinks it has a positive effect on the U.S. economy.
Working Americans who are 50 and older think the trend is more positive than negative for their own careers — 42% to 15%. Those younger than 50 are about as likely to say it’s good for their careers as to say it’s bad.
However, desire and reality aren't always a match. The article also discusses reasons why folks who want to keep working have to leave the workforce.
Thanks to Professor Naomi Cahn for sending me the link to the story.
Thursday, July 4, 2019
Sounds yummy, doesn't it. My dear friend, colleague and frequent blog reader ran across a story about Jelly Drops which are described on the company's website as "Hydrating treats for people with dementia." The article sent by my friend explains that "they’re hydrating treats shaped like raindrops that come in a treat box with a see-through lid. The drops are meant to be appealing to people with dementia, as well as easy to grasp and swallow, and they contain water and electrolytes to help keep elderly patients hydrated." Both the story and the website explain the inventor's motivation for creating the product. The photo on the website shows colorful and yummy looking pieces. Hopefully the product will be available before long. Anyone who has had a relative with hydration issues will understand the value of a product such as this.
Wednesday, July 3, 2019
The chair of faculty recruitment for Detroit Mercy COL sent me this announcement regarding an opening for Property Law with the additional possibility of teaching T&E. The information is below.
Announcement: Property Law Position
University of Detroit Mercy School of Law seeks a proven or aspiring scholar and teacher with an interest in teaching first-year Property Law for a tenured or tenure-track position beginning 2020-2021. Applicants must have a law degree and strong academic background and must demonstrate either a record of or potential for both teaching excellence and high scholarly achievement in any area of law. The balance of the teaching package will be determined in conversation with the successful candidate.
Applicants should send a cover letter, which should include a brief description of their ideal teaching package and a general indication of their areas of scholarly interest. Please direct the cover letter, a current CV, additional supporting materials (if any), and any questions you may have to:
Professor Julia Belian, Chair of Faculty Recruitment
University of Detroit Mercy School of Law
651 East Jefferson
Detroit, Michigan 48226
Materials will be accepted via email or regular mail. Review of applicants will begin in July 2019 and will continue until the position is filled.
About Our Program of Legal Education
Detroit Mercy Law offers a unique curriculum that complements traditional theory- and doctrine-based course work with intensive practical learning. Students must complete at least one clinic, one upper-level writing course, one global perspectives course, and one course within our Law Firm Program, an innovative simulated law-firm practicum. Detroit Mercy Law also offers a Dual J.D. program with the University of Windsor in Canada, in which students earn both an American and a Canadian law degree in three years while gaining a comprehensive understanding of two distinct legal systems. Interested Dual J.D. students are fully integrated into upper-level U.S. courses. The program’s first-year U.S. Property Law module could form a component of the teaching package if desired.
Detroit Mercy Law is located one block from the riverfront in Downtown Detroit, within walking distance of federal, state, and municipal courts, the region’s largest law firms, and major corporations such as General Motors, Quicken Loans, and Comerica Bank. The School of Law is also uniquely situated two blocks from the Detroit-Windsor Tunnel, an international border crossing linking Detroit with Windsor and Canada.
Detroit offers a dynamic variety of culinary, cultural, entertainment, and sporting attractions. See https://www.youtube.com/watch?v=DO4J_PC1b5M and learn more at https://www.nytimes.com/2017/11/20/travel/detroit-michigan-downtown.html.
Michigan’s largest, most comprehensive private university, University of Detroit Mercy is an independent Catholic institution of higher education sponsored by the Religious Sisters of Mercy and Society of Jesus. The university seeks qualified candidates who will contribute to the University's urban mission, commitment to diversity, and tradition of scholarly excellence. University of Detroit Mercy is an Equal Opportunity Affirmative Action Employer with a diverse faculty and student body and welcomes persons of all backgrounds.
Tuesday, July 2, 2019
Last week Bloomberg Law ran a story about a new scam. Scammers Target Seniors With DNA Tests, Health Agency Says explains that the "free DNA test" is being sent to elders. "Companies offering the tests use the information gathered to steal identities or bill Medicare for unnecessary tests, the U.S. Department of Health and Human Services Office of Inspector General said in an agency fraud alert. The fraudsters are targeting victims through telemarketing, booths at public events and door-to-door visits." The fraud alert from HHS'Inspector General, Fraud Alert: Genetic Testing Scam offers these suggestions for elders:
If a genetic testing kit is mailed to you, don't accept it unless it was ordered by your physician. Refuse the delivery or return it to the sender. Keep a record of the sender's name and the date you returned the items.
Be suspicious of anyone who offers you free genetic testing and then requests your Medicare number. If your personal information is compromised, it may be used in other fraud schemes.
A physician that you know and trust should approve any requests for genetic testing.
Medicare beneficiaries should be cautious of unsolicited requests for their Medicare numbers. If anyone other than your physician's office requests your Medicare information, do not provide it.
If you suspect Medicare fraud, contact the HHS OIG Hotline.Always remember that very little in life is free and if an offer sounds to good to be true, it isn't true.
Monday, July 1, 2019
So last week I posted how elders had an impact on climate change. Now I write about the impact climate change has on elders. In case you weren't aware, there's a heat wave in Europe. In fact, one of my dear friends is teaching in our summer abroad program in Spain and he unexpectedly texted me to tell me how hot it was. So last week's story in the Washington Post on the heatwave in France seems timely.
A heat wave killed 15,000 in France in 2003. As temperatures soar again, officials are taking no chances. explains about the various steps that French authorities are taking to offset the effect of the heatwave hitting their country, These record-breaking temperatures "scientists say are becoming more common in Europe as a result of climate change." Officials in Paris have taken a number of steps to help residents cope with the heat. "The heat particularly threatens children, pregnant women and the elderly, city authorities warn. The city has set up a special phone service for elderly and sick people, and authorities have asked hospitals and retirement homes to be on alert. Older residents left alone made up many of the victims of the 2003 heat crisis." The heat is record-breaking, according to the BBC.
Unusually hot temperatures are not limited to just Europe. The Tampa Bay area of Florida (where the College of Law is located), whose residents are used to hot and humid conditions this time of year, issued a heat advisory on June 26, 2019."[I]t’s rare for temperatures in Florida to climb beyond the low 90s in the summer ... But with a high pressure system in the Atlantic blocking most of those cooling storms... the high ... should reach at least 96 – in the shade. Heat index values, meaning the temperature it feels like outside, will be 104 in Tampa and as high as 110 in the southern Bay Area."
Friday, June 28, 2019
The Office of Inspector General for Health & Human Services issued a report this month, Incidents of Potential Abuse and Neglect at Skilled Nursing Facilities Were Not Always Reported and Investigated.
Here's a summary of their findings
We determined that an estimated one in five high-risk hospital ER Medicare claims for treatment provided in calendar year 2016werethe result of potential abuse or neglect, including injury of unknown source, of beneficiaries residing in a SNF.We determined that SNFs failed to report many of these incidents to the Survey Agencies in accordance with applicable Federal requirements. We also determined that several Survey Agencies failed to report some findings of substantiated abuse to local law enforcement. Lastly, we determined that CMS does not require all incidents of potential abuse or neglect and related referrals made to law enforcement and other agencies to be recorded and tracked in the Automated Survey Processing Environment Complaints/Incidents Tracking System. Preventing, detecting, and combating elder abuse requires CMS, Survey Agencies, and SNFs to meet their responsibilities.
OIG's recommendations include
- work with the Survey Agencies to improve training for staff of SNFs on how to identify and report incidents of potential abuse or neglect of Medicare beneficiaries,
- clarify guidance to clearly define and provide examples of incidents of potential abuse or neglect,
- require the Survey Agencies to record and track all incidents of potential abuse or neglect in SNFs and referrals made to local law enforcement and other agencies, and
- monitor the Survey Agencies’ reporting of findings of substantiated abuse to local law enforcement.
The OIG full report is available here.
June 28, 2019 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Other | Permalink | Comments (0)
Wednesday, June 26, 2019
A colleague and dear friend of mine is doing amazing work to combat climate change. I have on several occasions told him he should look at the impact of climate change on elders but never have I thought about the role of elders in contributing to climate change.... until now. Last month the New York Times ran an article, Older People Are Contributing to Climate Change, and Suffering From It.
Not only have elders seen climate change happening, according to the article, "Older Americans ... are significant contributors to climate change. A just-published study has found that residential energy consumption rises as a resident’s age increases." The article examines the why of this and although "[t]he study could not provide explanations, but“there might be more need for air-conditioning,” ... [o]r older people may not be able to maintain their homes as well to conserve energy....." Living in one of those southern states where air conditioning is a must and on extremely hot days we get warnings about certain folks needing to stay in air conditioning, I can say the researcher was right on that reason.
The article notes that there is a vicious cycle occurring-"There will be more warm days in most areas because of climate change... [and] more energy use by the older group... [with] the population aging, there will be more people in that age group.'"
The article goes on to discuss how older people are disproportionately affected by climate extremes and disasters. Fighting climate change should be one of our top priorities because we are all affected by it-but clearly our older folks are affected more than most.
Thank you Roy for all of your work.
Tuesday, June 25, 2019
That's the age-old (pun intended) question, isn't it? I know my students perceive me as old, but I know in my mind I'm not as old as my chronological age would denote. So the Washington Post tackled the "how old is old?" question in a recent story, An ageless question: When is someone ‘old’?
Typically, people decide who is “old” based on how many years someone has already lived, not how many more years they can expect to live, or even how physically or cognitively healthy they are. I will soon turn 62. What does that actually tell you? Not very much, which is why, like many of my sexagenarian friends, I’m apt to claim, “Yes, age is just a number.”
So what does “old” really mean these days?
All of us who teach elder law know that asking how old is old is valid and important. It impacts eligibility for programs and benefits, for example. It's also important for the purpose of policymakers who have to make plans for aging populations, the article explains. In the U.S. we still see the use of 60 or 65 as a threshold to "old."
The United Nations historically has defined older persons as people 60 years or over (sometimes 65). It didn’t matter whether you lived in the United States, China or Senegal, even though life expectancy is drastically different in each of those countries. Nor did it depend on an individual’s functional or cognitive abilities, which can also be widely divergent. Everyone became old at 60. It was as though you walked through a door at midnight on the last day of 59, emerging a completely different person the next morning: an old person.
Two experts quoted in the article, demographers, discuss the different between chronological age and prospective age, that is "'chronological age 'tells us how long we’ve lived so far. In contrast, prospective age is concerned about the future. Everyone with the same prospective age has the same expected remaining years of life.'” One of them is quoted as saying you are old when you have a "specific life expectancy is 15 years or less. That .. is when most people will start to exhibit the signs of aging, which is to say when quality of life takes a turn for the worse." By this measure I'm not old yet but by golly I'm close.
The expert when on to elaborate
[For] ... folks in the United States... When are we considered old? For women, the old age threshold is about 73; for men, 70.... [The expert] layers his concept of prospective age with another quality, which he calls “characteristic aging.”... “It depends upon the characteristics of people, in which sense they are old,” he says. “Are they cognitively old? Are they physically old? Are they old in terms of their disabilities? It depends.”
Old is not a one-size fits all and not only are there variations within the U.S. there are by country. The article is really fascinating-read it and figure out how long before you are "old."
Thanks to Professor Naomi Cahn for sending the article.
Monday, June 24, 2019
- Maintain separate financial accounts...
- Keep detailed records»Save receipts for everything you can, and write every expenditure or decision down....
- Only use the persons’ money and property for their benefit....
- File timely reports...
- Regularly talk with the person....
- Spend time together....
- Provide social contact....
- Remember the dignity in choice....
- Safeguard the person’s rights....
- Reassess the Need to Continue the Guardianship....
The explanations for the tips and additional resources are available here.
Friday, June 21, 2019
Kaiser Health News ran an interesting story that doctors aren't always the best at breaking bad news. Never Say ‘Die’: Why So Many Doctors Won’t Break Bad News relates the experiences of one doctor who as a patient, found his doctor unable to give him his terminal diagnosis. With the time he has left, he is teaching med students on how to have the conversation.
Robust research shows that doctors are notoriously bad at delivering life-altering news, said Dr. Anthony Back, an oncologist and palliative care expert at the University of Washington in Seattle....
Up to three-quarters of all patients with serious illness receive news in what researchers call a “suboptimal way,” Back estimated.... “’Suboptimal’ is the term that is least offensive to practicing doctors,” he added.
This lack of information seems puzzling given that patients need info in order to make an informed decision. Why is this happening? For one, "many doctors, especially those who treat cancer and other challenging diseases,'“death is viewed as a failure,'” said one expert quoted in the article. The article covers the needed skills, how they might be taught, and what is being done to help with this issue.
Thursday, June 20, 2019
USA Today, ran this story, Seniors were sold a risk-free retirement with reverse mortgages. Now they face foreclosure. This is not a happy story.
Alarming reports from federal investigators five years ago led the Department of Housing and Urban Development to initiate a series of changes to protect seniors. USA TODAY’s review of government foreclosure data found a generation of families fell through the cracks and continue to suffer from reverse mortgage loans written a decade ago.
These elderly homeowners were wooed into borrowing money through the special program by attractive sales pitches or a dire need for cash – or both. When they missed a paperwork deadline or fell behind on taxes or insurance, lenders moved swiftly to foreclose on the home. Those foreclosures wiped out hard-earned generational wealth built in the decades since the Fair Housing Act of 1968 1
. . .
Borrowers living near the poverty line in pockets of Chicago, Baltimore, Miami, Detroit, Philadelphia and Jacksonville, Florida, are among the hardest hit, according to a first-of-its-kind analysis of more than 1.3 million loan records. USA TODAY worked in partnership with with Grand Valley State University, with support from the McGraw Center for Business Journalism.
The article looks at some examples of individuals who are in trouble and examines the situation that led us to this point.
Federal regulators and industry leaders cautioned that numbers alone tell only part of the story, since many foreclosures result from the natural end of reverse mortgages: the homeowner’s death. The average term of a reverse mortgage is about seven years, and if a family member is not willing or able to repay the loan, lenders push the property through foreclosure.
Regulators said actual evictions of seniors are rare. There’s no way to verify that, though, since HUD, the top government regulator of Home Equity Conversion Mortgage 4 loans, does not sign off on evictions – or even count them.
The article is lengthy but full of important information. Read it yourself, and then assign it to your students.
Thanks to my colleague and dear friend, Professor Bauer, for sending me the article.
Wednesday, June 19, 2019
DOJ announced the creation of a multi-agency strike force to fight elder fraud. Justice Department Announces New Transnational Elder Fraud Strike Force. Law Enforcement Effort Will Coordinate Action Against Foreign Fraud Schemes that Target American Seniors announces
the establishment of the Transnational Elder Fraud Strike Force, a joint law enforcement effort that brings together the resources and expertise of the Department of Justice’s Consumer Protection Branch, the U.S. Attorneys’ Offices for six federal districts, the FBI, the U.S. Postal Inspection Service, and other organizations. The Strike Force will focus on investigating and prosecuting individuals and entities associated with foreign-based fraud schemes that disproportionately affect American seniors. These include telemarketing, mass-mailing, and tech-support fraud schemes.
The Transnational Elder Fraud Strike Force will be comprised of prosecutors and data analysts from the Consumer Protection Branch, prosecutors with six U.S. Attorneys’ Offices (Central District of California, Middle and Southern Districts of Florida, Northern District of Georgia, Eastern District of New York, Southern District of Texas), FBI special agents, Postal Inspectors, and numerous other law enforcement personnel. The Strike Force will also collaborate with the Federal Trade Commission and industry partners, who have pledged to engage with the Department to help end the scourge of elder fraud. It will further benefit from the help of the Elder Justice Coordinators now assigned in every U.S. Attorney’s Office.
Monday, June 17, 2019
The Government Accounting Office released a new report on Elder Justice. Elder Justice: Goals and Outcome Measures Would Provide DOJ with Clear Direction and a Means to Assess Its Efforts explains the reason for this report
Why GAO Did This Study
Researchers estimate that as many as 1 in 10 older adults in the United States—age 60 or older—experience abuse each year. Elder abuse may involve physical, sexual, emotional, or financial abuse or neglect. It can occur by family, guardians, or caregivers as well as by strangers and international criminal enterprises, which operate schemes for monetary gain or to facilitate other criminal activities. According to media reports and congressional testimony, some older U.S. citizens who have traveled abroad have unwittingly participated in illicit activities, and in some cases, have been arrested in foreign countries.
EAPPA included a provision for GAO to review elder justice efforts in the federal criminal justice system. This report examines (1) the ways DOJ works to address crimes against older adults, and to what extent DOJ is planning for and assessing its efforts; and (2) how the Departments of State and Homeland Security address the arrest of older U.S. citizens abroad, including arrests involving international criminal enterprises. GAO reviewed agency policy documents, and interviewed agency officials, as well as a nongeneralizable sample of elder abuse stakeholders and state and local officials selected for their experience in this area.
Along with offering examples of scams and frauds targeting elders, the GAO report included a recommendation for DOJ "that DOJ develop and document elder justice goals and outcome measures to better guide its elder justice efforts."
The full report is available here.
Friday, June 14, 2019
Society gives short shrift to older age. This distinct phase of life doesn’t get the same attention that’s devoted to childhood. And the special characteristics of people in their 60s, 70s, 80s and beyond are poorly understood.
Medicine reflects this narrow-mindedness. In medical school, physicians learn that people in the prime of life are “normal” and scant time is spent studying aging. In practice, doctors too often fail to appreciate older adults’ unique needs or to tailor treatments appropriately.
The story focuses on a new book by a doctor, “Elderhood" which is "an in-depth, unusually frank exploration of biases that distort society’s view of old age and that shape dysfunctional health policies and medical practices." The rest of the article is a Q&A interview with the author focusing on her idea of "elderhood", how she sees her concepts working, and ageism. Using an anecdote, the author offers it as an example of "ageism: dismissing an older person’s concerns simply because the person is old. It happens all the time." Here is another example the author offers
Recently, a distressed geriatrician colleague told me a story about grand rounds at a major medical center where the case of a very complex older patient brought in from a nursing home was presented. [Grand rounds are meetings where doctors discuss interesting or difficult cases.]
When it was time for comments, one of the leaders of the medical service stood up and said, “I have a solution to this case. We just need to have nursing homes be 100 miles away from our hospitals.” And the crowd laughed.
The interview does have some optimistic insights, including "the age-friendly health system movement, which is unquestionably a step in the right direction. And a whole host of startups that could make various types of care more convenient and that could, if they succeed, end up benefiting older people."
Wednesday, June 12, 2019
GAO has issued a new report, Disaster Assistance: FEMA Action Needed to Better Support Individuals Who Are Older or Have Disabilities. According to the GAO findings,
A range of officials from entities that partner with the Federal Emergency Management Agency (FEMA)—including states, territories, localities, and nonprofits)—reported challenges providing assistance to individuals who are older or have disabilities following the 2017 hurricanes. For example, officials said that many of these individuals required specialized assistance obtaining food, water, medicine, and oxygen, but aid was sometimes difficult to provide.Officials in Puerto Rico and the U.S. Virgin Islands cited particular difficultiesproviding this assistance due to damaged roads and communication systems, as well as a lack of documentation of nursing home locations. Based on GAO’s analysis of FEMA data and interviews with FEMA officials and stakeholders, aspects of the process to apply for assistance from FEMA after the 2017 hurricanes were challenging for older individuals and those with disabilities. According to stakeholders and FEMA officials, disability-related questions in the registration materials are confusing and easily misinterpreted. For example, FEMA’s registration process does not include an initial question that directly asks individuals if they have a disability or if they would like to request an accommodation for completing the application process (see figure below). While FEMA has made efforts to help registrants interpret the questions, it has not yet changed the language of the questions to improve clarity. As a result, individuals with disabilities may not have requested accommodations or reported having disabilities, which may have hindered FEMA’s ability to identify and assist them.. . .
FEMA did not establish objectives before implementing its new approach to disability integration, which includes adding new disability integration staff in the regions and decreasing the number of disability integration advisors deployed to disaster sites. Without documented objectives for the new approach, regional leadership across the nation may implement changes inconsistently. In addition, the new approach shifts the responsibility for directly assisting individuals with disabilities to all FEMA staff. FEMA has taken some initial steps to provide training on the changes; however, it has not established a plan for delivering comprehensive disability-related training to all staff who will be directly interacting with individuals with disabilities. Developing a plan to train all staff would better position FEMA to achieve its intended goals and better equip deployed staff to identify and assist these survivors.
The full report is available here as a pdf.
Monday, June 3, 2019
The GAO recently released a study examining the financial implications to caregivers. Retirement Security: Some Parental and Spousal Caregivers Face Financial Risks explains
[a]bout 10% of Americans per year cared for an elderly parent or spouse from 2011 through 2017. These family caregivers may risk their long-term financial security if they have to work less or pay for caregiving expenses such as travel or medicine.
More than half of people who cared for parents or spouses said they went to work late, left early, or took time off for care
Spousal caregivers at or near retirement age had less in retirement assets or Social Security income than non-caregivers
Experts and studies identified ways to potentially improve caregivers' retirement security, such as increasing their Social Security benefits
Some caregivers experienced adverse effects on their jobs and had less in retirement assets and income.
- According to data from a 2015 caregiving-specific study, an estimated 68 percent of working parental and spousal caregivers experienced job impacts, such as going to work late, leaving early, or taking time off during the day to provide care. Spousal caregivers were more likely to experience job impacts than parental caregivers (81 percent compared to 65 percent, respectively).
- According to 2002 to 2014 data from the Health and Retirement Study, spousal caregivers ages 59 to 66 had lower levels of retirement assets and less income than married non-caregivers of the same ages. Specifically, spousal caregivers had an estimated 50 percent less in individual retirement account (IRA) assets, 39 percent less in non-IRA assets, and 11 percent less in Social Security income. However, caregiving may not be the cause of these results as there are challenges to isolating the effect of caregiving from other factors that could affect retirement assets and income.