Thursday, September 19, 2019

Should Chronological Age Be A Factor In Deciding Someone Is Too Old To Be President?

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:

Conclusion

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.

September 19, 2019 in Consumer Information, Current Affairs, Other | Permalink | Comments (0)

Wednesday, September 18, 2019

Do You Have A When I Die File?

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

September 18, 2019 in Advance Directives/End-of-Life, Books, Consumer Information, Current Affairs, Health Care/Long Term Care, Other | Permalink | Comments (0)

Sunday, September 15, 2019

How to Make Health Care Age-Friendly

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.

September 15, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, Other | Permalink | Comments (0)

Thursday, September 12, 2019

Living On Campus-Not Just College Students But Retired Individuals

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!

September 12, 2019 in Consumer Information, Current Affairs, Housing, Other | Permalink | Comments (0)

Tuesday, September 10, 2019

Hunger Amongst America's Elders

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!

 

September 10, 2019 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Food and Drink, Health Care/Long Term Care, Other | Permalink | Comments (0)

Monday, September 9, 2019

When It's Time to Evacuate-It Takes More TIme

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 

Hurricane Dorian Tests Florida’s Ability to Move Older Adults Out of Harm’s Way.

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 

September 9, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, Other | Permalink | Comments (0)

Sunday, September 8, 2019

Happy Places to Retire

With Dorian finally moving on, I thought it would be good for all of us to post something that was happy. So Kiplinger ran an article, 10 of the Happiest Places to Retire in the U.S.  According to the article, these "10 retirement destinations rank the highest in terms of the overall well-being of residents."  These are Charlottesville, VA; Ann Arbor, MI: Portland, ME;Carlsbad, CA; Durham-Chapel Hill, NC; Cape Coral, FL; Richland, WA;; Provo, UT; Charleston, S.C.; and Burlington, VT. Not having lived in these, I can't comment on if they are happy places to live.

To come up with the rankings, Kiplinger relied on the "Well-Being index" which the article explains " is based specifically on residents' feelings about five elements of well-being: "purpose" (liking what you do and being motivated to achieve goals), "social" (having supportive relationships and love), "financial" (managing your budget to feel secure), "community" (liking where you live) and "physical" (being in good health). "  Using this index, then Kiplinger "factored in the "community" and "physical" components of the Well-Being Index, where available, as well as living costs, safety, median incomes and poverty rates for retirement-age residents and the availability of recreational and health care facilities."

The article is available here.

September 8, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Other, Retirement, Statistics | Permalink | Comments (0)

Friday, September 6, 2019

Mediation & Arbitration in Florida Probate Rules?

Proposed amendments to the Florida Probate Rules are out for comment. These amendments allow for  the use of mediation and arbitration. "The amendments provide that the court may refer all or any part of a contested probate or guardianship matter to mediation or arbitration, thereby empowering courts and parties with the option of using non-adversarial dispute resolution processes to resolve these disputes."

Here's some info about the proposed rules:

Rule 5.181 Rules Common to Mediation and Arbitration(a)Referral by Presiding Judge or by Stipulation. Except as hereinafter provided or as otherwise prohibited by law, the presiding judge may enter an order referring all or any part of a contested probate or guardianship matter to mediation or arbitration. The parties to any contested probate or guardianship matter may file a written stipulation to mediate or arbitrate any issue between them at any time. Such stipulation shall be incorporated into the order of referral. (1)Conference or Hearing Date. Unless otherwise ordered by the court, the first mediation conference or arbitration hearing shall be held within 60 days of the order of referral. (2)Notice. Within 15 days after the designation of the mediator or arbitrator, the court or its designee, who may be the mediator or the arbitrator, shall notify the parties in writing of the date, time, and place of the conference or hearing, unless the order of referral specifies the date, time, and place. (b)Motion to Dispense with Mediation and Arbitration. A party may move, within 15 days after the order of referral, to dispense with mediation or arbitration, if: (1)the issue to be considered has been previously mediated or arbitrated between the same parties pursuant to Florida law; (2)the issue presents a question of law only; (3)the order violates rule 1.710(b) or rule 1.800; or(4)other good cause is shown.

(c)Motion to Defer Mediation or Arbitration. Within 15 days of the order of referral, any party may file a motion with the court to defer the proceeding. The movant shall set the motion to defer for hearing prior to the scheduled date for mediation or arbitration. Notice of the hearing shall be provided to all interested parties, including any mediator or arbitrator who has been appointed. The motion shall set forth, in detail, the facts and circumstances supporting the motion. Mediation or arbitration shall be tolled until disposition of the motion.

(d)Disqualification of a Mediator or Arbitrator. Any party may move to enter an order disqualifying a mediator or arbitrator for good cause. If the court rules that a mediator or arbitrator is disqualified from hearing a case, an order shall be entered setting forth the name of a qualified replacement. Nothing in this provision shall preclude mediators or arbitrators from disqualifying themselves or refusing any assignment. The time for mediation or arbitration shall be tolled during any periods in which a motion to disqualify is pending.

Proposed Rule 5.182, "Mediation Rules", provides the parties can agree to mediation or the court can order it on the court's own motion.  However, section 5.182(b) precludes from mediation matters concerning bond, contempt and other matters as determined in an administrative order. Likewise, Proposed Rule 5.185 covers matters excluded from arbitration. Proposed Rule 5.183 covers procedures for mediation and proposed rule 5.184, completing mediation.

The proposed rules are available here.

September 6, 2019 in Consumer Information, Current Affairs, Other, State Statutes/Regulations | Permalink | Comments (0)

Mediation & Arbitration in Florida Probate Rules?

Proposed amendments to the Florida Probate Rules are out for comment. These amendments allow for  the use of mediation and arbitration. "The amendments provide that the court may refer all or any part of a contested probate or guardianship matter to mediation or arbitration, thereby empowering courts and parties with the option of using non-adversarial dispute resolution processes to resolve these disputes."

Here's some info about the proposed rules:

Rule 5.181 Rules Common to Mediation and Arbitration(a)Referral by Presiding Judge or by Stipulation. Except as hereinafter provided or as otherwise prohibited by law, the presiding judge may enter an order referring all or any part of a contested probate or guardianship matter to mediation or arbitration. The parties to any contested probate or guardianship matter may file a written stipulation to mediate or arbitrate any issue between them at any time. Such stipulation shall be incorporated into the order of referral. (1)Conference or Hearing Date. Unless otherwise ordered by the court, the first mediation conference or arbitration hearing shall be held within 60 days of the order of referral. (2)Notice. Within 15 days after the designation of the mediator or arbitrator, the court or its designee, who may be the mediator or the arbitrator, shall notify the parties in writing of the date, time, and place of the conference or hearing, unless the order of referral specifies the date, time, and place. (b)Motion to Dispense with Mediation and Arbitration. A party may move, within 15 days after the order of referral, to dispense with mediation or arbitration, if: (1)the issue to be considered has been previously mediated or arbitrated between the same parties pursuant to Florida law; (2)the issue presents a question of law only; (3)the order violates rule 1.710(b) or rule 1.800; or(4)other good cause is shown.

(c)Motion to Defer Mediation or Arbitration. Within 15 days of the order of referral, any party may file a motion with the court to defer the proceeding. The movant shall set the motion to defer for hearing prior to the scheduled date for mediation or arbitration. Notice of the hearing shall be provided to all interested parties, including any mediator or arbitrator who has been appointed. The motion shall set forth, in detail, the facts and circumstances supporting the motion. Mediation or arbitration shall be tolled until disposition of the motion.

(d)Disqualification of a Mediator or Arbitrator. Any party may move to enter an order disqualifying a mediator or arbitrator for good cause. If the court rules that a mediator or arbitrator is disqualified from hearing a case, an order shall be entered setting forth the name of a qualified replacement. Nothing in this provision shall preclude mediators or arbitrators from disqualifying themselves or refusing any assignment. The time for mediation or arbitration shall be tolled during any periods in which a motion to disqualify is pending.

Proposed Rule 5.182, "Mediation Rules", provides the parties can agree to mediation or the court can order it on the court's own motion.  However, section 5.182(b) precludes from mediation matters concerning bond, contempt and other matters as determined in an administrative order. Likewise, Proposed Rule 5.185 covers matters excluded from arbitration. Proposed Rule 5.183 covers procedures for mediation and proposed rule 5.184, completing mediation.

The proposed rules are available here.

September 6, 2019 in Consumer Information, Current Affairs, Other, State Statutes/Regulations | Permalink | Comments (0)

Wednesday, September 4, 2019

Assisted Living-Is It the Right Option for Assistance in Living?

My colleague and dear friend Professor Bauer, sent me the link to a recent op-ed in the New York Times,  How Not to Grow Old in America.The assisted living industry is booming, by tapping into the fantasy that we can all be self-sufficient until we die.

Assisted living seems like the solution to everyone’s worries about old age. It’s built on the dream that we can grow old while being self-reliant and live that way until we die. That all you need is a tiny bit of help. That you would never want to be warehoused in a nursing home with round-the-clock caregivers. This is a powerful concept in a country built on independence and self-reliance.

The problem is that for most of us, it’s a lie. And we are all complicit in keeping this dream alive.

The author notes that the ALF industry has a financial incentive to market their product and it's appealing to the kids of those who reside in ALFs.  The author writes, "[t]he irony of assisted living is, it’s great if you don’t need too much assistance. If you don’t, the social life, the spalike facilities, the myriad activities and the extensive menus might make assisted living the right choice. But if you have trouble walking or using the bathroom, or have dementia and sometimes wander off, assisting living facilities aren’t the answer, no matter how desperately we wish they were." Further, the author offers data that most of these residents need more care than that provided and argues in favor of regulation, using several actual cases as illustrations to support the call for regulation.

We need to let go of the ideal of being self-sufficient until death. Just as we don’t demand that our toddlers be self-reliant, Americans need to allow the reality of ourselves as dependent in our old age to percolate into our psyches and our nation’s social policies. Unless we face up to the reality of the needs of our aging population, the longevity we as a society have gained is going to be lived out miserably.

September 4, 2019 in Consumer Information, Current Affairs, Dementia/Alzheimer’s, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Other, Retirement, State Statutes/Regulations | Permalink | Comments (1)

Friday, August 30, 2019

Accessibility of Elder Housing-What Happens When the Elevator is Out of Order?

A local news station recently ran an article about the impact of a broken elevator on the residents who live on top floors in  8 On Your Side gets results for seniors in building with broken elevator.   Knowing my colleague and dear friend, Professor Bauer, had written an article on 55+ housing that included a discussion of accessibility issues, I asked him if he'd write a guest post for us on this topic. Here it is:

Would You Please Just Fix It?

By
Mark D. Bauer
Professor Law
Stetson University College of Law

 

A recent news story in Tampa Bay reported that the single elevator in a mid-rise apartment building stopped working in late May and would not be repaired until October.  That alone is surprising and seems wrong.  But what makes this story particularly shocking is it occurred in an age 62 and older HUD subsidized building.  Even more shocking:  there are no federal laws regulating elevator repairs in federally managed or sponsored elder housing.

The story was made for television.  A local news station interviewed numerous tenants with disabilities incapable of walking down staircases.  One elder tenant interviewed said she had not been able to leave her home in two months and she found it very depressing.  I have little doubt that most anyone would feel the same way.

The good news is that by airing this story and providing publicity to the tenants, the company managing the apartment complex arranged for free hotel rooms for any resident desiring one.  The elevator still will not be repaired until October because a part needs to be manufactured abroad.  But at least the elder tenants now have an alternative to remaining prisoners in their own homes.

The bad news is that while this particular situation may be extreme, elder residents of multi-story apartment buildings are often trapped in their homes with little warning and no real alternative.  The fact that most elevator repairs take less than six months is little comfort.

Department of Housing and Urban Development regulations require only the most basic life safety features in elder housing, such as smoke detectors.  Most state and local laws covering elevators require that they be inspected and remain in good repair.  It is always hard to search for the absence of a law or a case, but I have found nothing in the United States that regulates how long a repair may take.  Unfortunately, I suspect the answer is “as long as needed.”

I did find one relevant case in Indiana where residents of elder housing suffered without elevators for over a month and then sued.  On procedural grounds, the federal court held that the residents might have a viable argument under the Americans with Disabilities Act but could not sue under traditional landlord-tenant law (here the residents claimed that the broken elevator “constructively evicted” them).  And as you might imagine, once the judge opened the door just a crack for possible litigation, the owners of the elder housing complex immediately fixed the elevator and settled with the residents.

It is ironic that the government sponsors or subsidizes elder housing without ensuring the physical safety of the residents, particularly when private entities often profit through participation in these programs.  In researching this issue, a simple Google search produced literally hundreds of news stories about elders all over the country being trapped in multi-story buildings during lengthy elevator repairs.  Like the situation here in Tampa Bay, the elevators were often repaired quickly after a local news story.

Even elevators in good repair cannot function without electricity.  After many elders were killed or injured in Florida after a major hurricane in 2005 made their apartments inaccessible, a state law was passed requiring all 55 and older housing to add emergency generators for elevators.  The real estate lobby was particularly effective here and got the state legislature to repeal the law a short time later.

Subsidized or government-owned congregate housing for elders is aging; few units have been added since the 1980s, and certainly not enough to replace housing demolished or converted to other uses.  Five elevator companies remain after industry consolidation, and only one is located in the United States.  It is no surprise then that elevators installed in the last century are difficult to repair.  Cities and counties with large elder populations often spend extraordinary amounts of money responding to emergency calls requiring firefighters to carry elders down staircases.

It is easy to ignore a problem like stranded elders in high-rises because any single building has these problems infrequently, and with no publicity.  But nationally we are putting lives in danger and wasting precious public funds by ignoring the problem.  Currently it is very unlikely that HUD will take any corrective action.  But in the long-run, it would be much cheaper to plan for broken elevators by requiring elder communities to provide for temporary accessible housing, or coordinate services necessary for daily living, or require emergency generators in mid- or high-rise buildings with only one elevator.

Professor Bauer's law review article on 55+ housing is available here.  Thanks Professor Bauer!

August 30, 2019 in Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Other, State Statutes/Regulations, Television | Permalink | Comments (1)

Wednesday, August 28, 2019

Veterans Victims of Consumer Scam

The New York Times recently reported indictments against five perpetrators of an identity theft scam that targeted vets.

5 Indicted in Identity Theft Scheme That Bilked Millions From Veterans explains how the scam worked:

First, they secretly photographed the Social Security and bank account numbers of thousands of veterans and senior military members on a computer screen at a United States Army base in South Korea.

Then, they used the personal information to withdraw or reroute millions of dollars in disability benefits and other payments made to veterans. The stolen funds were later wired to the bank accounts of so-called money mules and laundered so that they could not be traced.

The perpetrators were charged with aggravated identity theft, wire fraud and conspiracy according to the article.  Described as the largest ever perpetrated against military personnel, "the personal information of more than 3,000 veterans and military personnel had been compromised over a period from 2014 to 2019. Many of the victims were disabled and older, and were unlikely to access their account information online." DOJ is still looking to identify victims.  "The Justice Department and Veterans Affairs are in the process of notifying victims and trying to help them recover lost funds."

August 28, 2019 in Consumer Information, Crimes, Current Affairs, Federal Cases, Federal Statutes/Regulations, Other, Veterans | Permalink | Comments (0)

Tuesday, August 27, 2019

Napping More Than Usual? Read This Article.

We have all had that after lunch afternoon slump where we just want a nap. Do you find yourself napping more than usual? There is a new study on changes to sleep-wake cycles and Alzheimer's. For the non-scientist like me, here's the USA Today story:  Napping more? That could be an early symptom of Alzheimer's, new study says.

So wait, don't panic if you are a normal napper.  Here's a segment from the article that explains: "People who develop Alzheimer's tend to sleep more during the day, taking naps or feeling drowsy and dosing off. Sometimes, they wake up during the night; that's called fragmented sleep .... If napping is a part of your routine on a regular basis though, you don't need to worry about taking an afternoon snooze, or mid-morning for that matter."  So it's all about the change in sleep patterns. Whew.

Here's the abstract for the article about the study.

Introduction

Sleep-wake disturbances are a common and early feature in Alzheimer's disease (AD). The impact of early tau pathology in wake-promoting neurons (WPNs) remains unclear.

Methods

We performed stereology in postmortem brains from AD individuals and healthy controls to identify quantitative differences in morphological metrics in WPNs. Progressive supranuclear palsy (PSP) and corticobasal degeneration were included as disease-specific controls.

Results

The three nuclei studied accumulate considerable amounts of tau inclusions and showed a decrease in neurotransmitter-synthetizing neurons in AD, PSP, and corticobasal degeneration. However, substantial neuronal loss was exclusively found in AD.

Discussion

WPNs are extremely vulnerable to AD but not to 4 repeat tauopathies. Considering that WPNs are involved early in AD, such degeneration should be included in the models explaining sleep-wake disturbances in AD and considered when designing a clinical intervention. Sparing of WPNs in PSP, a condition featuring hyperinsomnia, suggest that interventions to suppress the arousal system may benefit patients with PSP.

The full study is available here.

August 27, 2019 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Other, Science, Statistics | Permalink | Comments (0)

Friday, August 23, 2019

UBER and LYFT as the Answer to Elder Transportation Needs?

The New York Times was considering that question in a recent article,Older People Need Rides. Why Aren’t They Using Uber and Lyft?

More than half of adults over 65 own smartphones, the Pew Research Center has reported. Yet among adults 50 and older, only about a quarter used ride-hailing services in 2018 (a leap, however, from 7 percent in 2015). By comparison, half of those aged 18 to 29 had used them.

In a survey by AARP last year, only 29 percent of those over 50 had used ride-hailing apps. Two-thirds said they weren’t likely to do so in the coming year, citing in part concerns about safety and privacy. (Given data breaches at Uber, that’s no baseless fear.)

So wouldn't these options help people remain more independent, especially while we wait for self-driving cars to become widely available for all of us? One expert quoted in the article said absolutely! "One reason for such optimism: evidence that with personalized instruction, older adults can master the mobile apps and take “networked transportation” to medical appointments, entertainment and leisure activities, social visits and fitness classes."

A recent study from U.S.C. covered in the article noted when the researchers "offered three free months of unlimited Lyft rides to 150 older people in and around Los Angeles (average age: 72) who had chronic diseases and reported transportation problems... [w]ith training, nearly all used Lyft, most through the mobile app (a few used a call-in service), for an average of 69 trips. On follow-up questionnaires, almost all riders reported improved quality of life."

That's great news but the companies are seeing an opportunity here. 

Lyft and Uber and others are contracting with third parties, bypassing the need for older riders to use apps or to have smartphones at all.

They’re joining forces with health care systems, for instance. In the past 18 months, more than 1,000 — including MedStar, in the Washington area, and the Boston Medical Center — have signed on with Uber Health for “nonemergency medical transportation,” the company said.

Case managers and social workers can use Uber or Lyft to ferry patients to or from clinics and offices, reducing missed appointments.

In addition, they are working with various senior communities and exploring other programs for those who have mobility issues, including the ability to order accessible transportation and training drivers of how to assist riders with mobility issues!  There are other smaller companies carving out a part of the market, whether portal-to-portal service or the ability to call for a ride by phone. The article also explores the potential costs in using ride-hailing services.

In the U.S.C. study, the typical trip cost $22; the cost per month, had users actually paid it, averaged $500. After the study, about a fifth of riders said they wouldn’t continue using ride-hailing, mostly because of cost.

Some Medicare Advantage programs now cover rides to medical appointments and pharmacies; Lyft expects to partner with most Advantage plans by next year....But most older Americans still use traditional Medicare, which doesn’t cover such transportation.

 

August 23, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, Medicare, Other, Travel | Permalink | Comments (0)

Tuesday, August 20, 2019

Register Now: Webinar on Access to Justice in Older Age

The Global Alliance for the Rights of Older Persons has announced an upcoming webinar on August 22, 2019 from 7-8 a.m. edt (yes that's correct 7-8 AM).   Here's info about the webinar:

Access to Justice is one of the new areas of older people’s human rights that will be discussed at the 11th session of the Open-Ended Working Group on Ageing in New York from 6-9th April 2020. The UN will soon call for written submissions on this topic, which will play an important role in shaping the debates that will happen at the 11th session.  A strong civil society response to this consultation is vital. This webinar will explore some of the key issues and barriers around access to justice in older age. It will also offer tips and support on how you can prepare high quality substantive inputs to the upcoming UN consultation.  

  • Moderator: Susan Somers (INPEA and GAROP Steering Group member)
  • Panelist: Bill Mitchell (Townsville Community Legal Service, Australia)

To register for this important webinar, click here.

August 20, 2019 in Consumer Information, Current Affairs, International, Other, Programs/CLEs, Webinars | Permalink | Comments (0)

Sunday, August 18, 2019

Observation status trial

Last week, the class action suit against CMS on observation status finally went to trial.  According to the story from the Medicare Rights Center, Lawsuit Seeks to Improve Medicare Beneficiary Access to Nursing Facilities explains the importance of the case, as the trial started last week:

Because an observation stay is not officially considered an inpatient stay, it does not count as a qualifying hospital stay for purposes of Medicare SNF coverage—which means Medicare will not pay for any subsequent SNF care. This leaves patients on the hook for the entire cost of a needed SNF stay—potentially thousands of dollars.  Beneficiaries unable to afford this care may self-discharge against medical advice and return home before they are physically or mentally ready, and potentially suffer further devastating and expensive acute health effects.

Currently, people with Medicare cannot appeal the decision to classify a hospital stay as an outpatient stay, but a court case—Alexander v. Azar—may change that. In 2011, seven plaintiffs filed a class action lawsuit to try to gain the right to appeal the decision to classify them as outpatients in observation stay instead of as inpatients who would potentially be eligible for SNF coverage. After many twists and turns, the case has finally made it to trial.

More information about the trial that got underway last week was provided in a Kaiser Health News article, Class-Action Lawsuit Seeks To Let Medicare Patients Appeal Gap in Nursing Home Coverage which contains lots of interesting info about the issue and the litigation.  For example, "'HHS’ Office of Inspector General urged CMS to count observation care days toward the three-day minimum needed for nursing home coverage. It’s No. 1 on a list issued last month of the 25 most important inspector general’s recommendations the agency has failed to implement." The importance of this case can't be emphasized enough.  I'll update you when I know more.

August 18, 2019 in Consumer Information, Current Affairs, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Medicare, Other | Permalink | Comments (0)

Friday, August 16, 2019

Medical Aid in Dying in NJ on Hold

The AP has reported that a judge has temporarily enjoined the NJ Medical Aid in Dying law that went into effect a few weeks ago.  The hearing is scheduled for October according to the story, New Jersey’s medically assisted suicide law put on hold. 

"The order means that New Jersey’s recently enacted measure cannot be enforced by the state attorney general and comes in response to a lawsuit brought by a doctor practicing in the state... [who argues in the lawsuit] that immediate and irreparable damage will probably result in view of the fact that if its enforcement is not immediately enjoined, New Jersey citizens can actually begin dying.”  The plaintiff, a doctor, contends "that the law is an affront to religious doctors [and] the law violates constitutional rights as well as common law barring suicide."

Stay tuned.

August 16, 2019 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Health Care/Long Term Care, Other, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Friday, August 9, 2019

The Borchard Foundation Center on Law & Aging RFP for 2020 Academic Research Grants

The Borchard Foundation Center on Law & Aging has released its RFP for 2020 Academic Research Grants.  Here are some details:

Legal, health sciences, social sciences, and gerontology scholars and professionals are invited to submit research proposals to The Borchard Foundation Center on Law & Aging. The objective of the Academic Research Grants is to further research and scholarship about new or improved public policies, laws, and/or programs that will enhance the quality of life for older adults, including those who are poor or otherwise isolated by language, culture, disability, lack of education, or other barriers.

Up to four grants of a maximum of $20,000 each will be awarded. The Center expects grantees to meet the objectives of the grant program through individual or collaborative research projects that either:

  • analyze and recommend changes to one or more important existing public policies, laws, and/or programs relating to older adults, or
  • anticipate the need for and recommend new public policies, laws, and/or programs necessitated by changes in the number and demographics of the country’s and the world’s elder populations, by advances in science and technology, by changes in the health care system, or by other developments.

It is expected that the research product will be publishable in a first-rate academic journal. Applicants are encouraged to disseminate research findings through additional channels such as conferences, stakeholder meetings, and white papers.

Larger budgets using outside matching funds are encouraged but not required. Favorable weight is given to proposals that indicate, where appropriate, that active attempts will be made to solicit required additional funds for the project (including a list of sources to be approached). Grant funds must be used for the approved budget purposes, which may include reasonable compensation for investigator(s), consultant(s), and research assistant(s), print and computer-based research materials, and other necessary expenses. Faculty salary support will not be approved other than for (1) summer when the applicant is not eligible for summer support from their university or (2) buying out a course. Grant funds may not be used for thesis or dissertation research, student tuition or fees, or university overhead or administrative charges.

Proposals must be submitted by one or more individual researchers who will be responsible for carrying out the project. Collaborating researchers may be affiliated with the same or different institutions. Grant funds must be administered by an academic, government, or other non-profit organization. Evidence of federal tax-exempt status is required before funds will be released.

The on-line application form on the Center’s website, www.borchardcla.org, will be available after September 15, 2019. Applications should be submitted no later than October 15, 2019. Selections will be made on or about December 15, 2019.

Proposals should include a narrative description of the research project (5 pages maximum), including proposed research activities, how the research meets the objective of the Center’s grant program, why the project is otherwise important, a description of the intended written research product(s), the journal(s) to which the work product(s) will be submitted for publication, and a statement regarding IRB approval. Required attachments are a project timeline, detailed budget (including matching support, if any), curriculum vitae of the investigator(s), and federal tax exemption letter evidencing the administrating organization is a 501(c)(3) organization not classified as a private foundation.

Within three months of project completion, grantees must submit by email a final written report that includes a description and chronology of the research and results and an accounting of grant funds. In addition, a short progress and status report must be submitted eight months following project commencement. Upon publication of any research products, either print or electronic copies should be submitted to the Foundation.

For further description of the Academic Research Grant Program, the Request for Proposals, and the application form, please see the Center’s Web site at www.borchardcla.org. For more information, contact Catheryn Koss, ck@borchardcenter.org.

The online application is available here.

August 9, 2019 in Consumer Information, Current Affairs, Grant Deadlines/Awards, Other | Permalink | Comments (0)

Thursday, August 8, 2019

Early Diagnosis of Alzheimer's Through Testing

So we don't be on the cusp of a cure for Alzheimer's but recent stories indicate the medical folks might be getting closer to diagnosing it. First, the New York Times reported that we may soon have a blood test that can diagnose it.

A Blood Test for Alzheimer’s?  It’s Coming, Scientists Report

For decades, researchers have sought a blood test for beta amyloid, the protein that is a hallmark of Alzheimer’s disease. Several groups and companies have made progress, and [last]
Thursday, scientists at Washington University in St. Louis reported that they had devised the most sensitive blood test yet.

The test will not be available for clinical use for years, and in any event, amyloid is not a perfect predictor of Alzheimer’s disease: Most symptomless older people with amyloid deposits in their brains will not develop dementia.

But the protein is a significant risk factor, and the new blood test identified patients with amyloid deposits before brain scans did. That will be important to scientists conducting trials of drugs top revent Alzheimer’s. They need to find participants in the earliest stages of the disease.

Since we can't cure it, why do we want to diagnose it?

There is no treatment for Alzheimer’s, and very early diagnosis of any disease can be problematic, since it may not progress. So the first use for this blood test will probably be to screen people for clinical trials of drugs to prevent Alzheimer’s disease, said Dr. Michael Weiner, a neurologist at the University of California, San Francisco.

Ok, a blood test. Pretty easy, not too invasive.  Here's another test on the horizon, according to another article, again in the New York Times: A Brain Scan May Predict Alzheimer’s. Should You Get One? There is "criteria developed by the Alzheimer’s Association and nuclear medicine experts, which call for PET scans only in cases of unexplained or unusual symptoms and unclear diagnoses.... But as evidence mounts that brain damage from Alzheimer’s begins years before people develop symptoms, worried patients and their families may start turning to PET scans to learn if they have this biomarker."  These tests are expensive and "[a]myloid plaques occur commonly in older people’s brains, but not everyone with amyloid will develop dementia, which probably involves multiple factors. Nor does a negative PET scan mean someone won’t develop dementia."

There's a lot of research being done and we all owe a big thank you to the researchers fighting this and all the other diseases out there that threaten us as we age.

August 8, 2019 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Other, Science | Permalink | Comments (0)

Sunday, August 4, 2019

"Intensive Grandparenting": The Glue for Working Parents & Kids

The New York Times ran a story about "intensive grandparenting," a term that makes sense to me, but one I hadn't seen used before this. When Grandparents Help Hold It All Together explains that the phrase, developed by sociologists, which "refer[s] to a commitment to providing regular child care, often accompanied by housekeeping or other tasks."  The story shares experiences of some grandparents who have committed to their families in helping out while the parents are working.  As the article explains, this type of grandparenting goes beyond the stereotypical view of grandkids visiting grandparents for short visits or fun trips.

How many hours are intensive grandparents putting in?  How many are doing so?  Who knows for sure, "but a recent study reports that about half of young children, a third of those in elementary school and even 20 percent of teenagers spend at least some time with grandparents in a typical week... [and one] sociologist ... and author of “Grandmothers at Work,” analyzed federal data for grandparents aged 51 to 70 who had jobs, most working full-time. About 45 percent had provided care for grandchildren during the previous two years, a proportion she expects to increase."

Intensive grandparenting--why now?  The article offers reasons: changing views of parenting and "an indictment of a country that pays lip service to families while providing little real support."

Today’s parents work at demanding, often insecure jobs. Many employers still don’t provide adequate (or any) parental leave, sick days or health insurance. Quality day care often costs a small fortune; schools operate on calendars that don’t accommodate parents’ work schedules.

It's so wonderful grandparents are available to step in and the article mentions the value to grandparents in doing so, but also the costs to grandparents, including fatigue, the sense of obligation, and worry about their kids. It's important for these intensive grandparents to make informed decisions before changing their lives to step into the role: "[E]xperts worry ... about people who cut back on work hours, retire too early or otherwise imperil their own financial security to provide intensive grandparenting.... Grandparents [may end up] shelving their own projects and interests to care for grandkids. They may lose social connections, an important factor in older adults’ psychological and physical well-being."

Oh and by the way, parents--be sure to thank your parents, these "intensive grandparents" for all they are doing. As the article notes-it is darn important to do so.

 

 

August 4, 2019 in Consumer Information, Current Affairs, Other | Permalink | Comments (0)