Thursday, January 16, 2020

Forgetfulness is Not Just for the Old

I always talk with my students about memory loss and what it might signal--but always when we talk about memory loss, or for them, forgetfulness, every one of them has experienced an episode of forgetfulness, whether misplacing their phones or losing their keys.   I was pleased to read a recent editorial in the New York Times by neuroscientist, Everyone Is Wrong.

Short-term memory contains the contents of your thoughts right now, including what you intend to do in the next few seconds. It’s doing some mental arithmetic, thinking about what you’ll say next in a conversation or walking to the hall closet with the intention of getting a pair of gloves.

Short-term memory is easily disturbed or disrupted. It depends on your actively paying attention to the items that are in the “next thing to do” file in your mind. You do this by thinking about them, perhaps repeating them over and over again (“I’m going to the closet to get gloves”). But any distraction — a new thought, someone asking you a question, the telephone ringing — can disrupt short-term memory. Our ability to automatically restore the contents of the short-term memory declines slightly with every decade after 30.

Given that everyone has forgetfulness, the author's next point is important:

The relevant difference is not age but rather how we describe these events, the stories we tell ourselves about them. Twenty-year-olds don’t think, “Oh dear, this must be early-onset Alzheimer’s.” They think, “I’ve got a lot on my plate right now” or “I really need to get more than four hours of sleep.” The 70-year-old observes these same events and worries about her brain health. This is not to say that Alzheimer’s- and dementia-related memory impairments are fiction — they are very real — but every lapse of short-term memory doesn’t necessarily indicate a biological disorder.

So, why might we focus on this with elders?  The author suggests elders have more memories to get through-it's going to take more time to remember a specific and generally it may take older folks a bit longer to remember things. 

This is a very interesting article that I plan to reference when I'm discussing issues regarding memory loss and dementia with my students.

January 16, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Other | Permalink | Comments (0)

Wednesday, January 15, 2020

International Federation on Aeging Webinar on 1th Session of the UN Open-Ended Working Group on Ageing

The UN Open-Ended Working Group on Ageing has its 11th Session coming up.  Prior to that meeting, the International Federation on Aeging, along with  the Global Alliance For the Rights of Older People (GAROP) are offering an upcoming webinar on National Advocacy ahead of the 11th Session of the United Nations Open-Ended Working Group on Ageing.is holding a webinar on National Advocacy Ahead of the 11th Session of the UN Open-Ended Working Group on Ageing on January 22, 2020 at 7 a.m. est. This webinar will

  • Provide information for all NGOs engaging in the UN Open-ended Working Group on Ageing (OEWG) process at the national level.
  • Focus particularly on what national advocacy NGOs can do to influence their governments ahead of the 11thOEWG session in April.
  • Include updates and insights from a UN perspective and concrete examples of national advocacy from GAROP members. 

Click here to register for this program.

Summaries of the prior meetings of the U.N. Working Group can be accessed here.

January 15, 2020 in Consumer Information, Current Affairs, International, Other, Retirement | Permalink | Comments (0)

Monday, January 13, 2020

DOJ Elder Justice Initiative Resources for Law Enforcement

The Department of Justice Elder Justice Initiative has some great resources for all of us. The EJI recently released a number of resources for law enforcement, located here.

The resources include information about an online training from the National White Collar Crime Center (NW3C),  downloadable fliers, data, the Elder Abuse Guide for Law Enforcement (EAGLE), roll call videos and more.

Although the resources are targeted for law enforcement, they are still very helpful to others. In particular, I thought this chart showing how the different departments within law enforcement might encounter victims of elder abuse. I think this will help my students more fully understand the numerous ways these cases come to light. Check it out!

 

January 13, 2020 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Other | Permalink

Friday, January 10, 2020

PACE Program and Adult Day Care

Kaiser Health News (KHN) recently published a story about a PACE program, Government-Funded Day Care Helps Keep Seniors Out Of Nursing Homes And Hospitals.

The services provided by PACE, a national program primarily funded by Medicaid and Medicare, are intended to keep people 55 and older who need nursing home levels of care at home as long as possible and out of the hospital.

The program is more important than ever as baby boomers age, its proponents say.

“The rapidly growing senior population in California and across the country will put enormous strain on our current fragmented, and often inefficient, health care delivery system,” said Tim Lash, president of Gary and Mary West PACE. California officials consider PACE an integral part of the state’s strategy to upgrade care for aging residents.

Consider the cost-savings to states with PACE programs, as well as the number of folks, typically dual eligibles, who participate. According to the story,

The National PACE Association said data it collected for 2019 shows seniors enrolled in PACE cost states 13% less on average than the cost of caring for them through other Medicaid-funded services, including nursing homes.

. . .

PACE participants who do not receive government medical benefits can pay out of their own pockets. At Gary and Mary West, the tab ranges from $7,000 to $10,000 a month, depending on the level of care.

Nationally, 50,000 enrollees participate in PACE programs at over 260 centers in 31 states. In California, PACE serves nearly 9,000 vulnerable seniors at 47 locations.

PACE provides the same services as under Medicare and Medicaid, and use of team from various disciplines to provide care. Patients often have chronic conditions and  almost 2/3 of them have some level of cognitive difficulty.

Check it out.

 PACE enrollees commonly have conditions such as vascular disease, diabetes, congestive heart failure, depression and bipolar disorder.

January 10, 2020 in Cognitive Impairment, Consumer Information, Current Affairs, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Medicare, Other | Permalink | Comments (0)

Tuesday, January 7, 2020

Catching Up on Some News

Two articles, updating us on two topics important to all of us.

First, statistics. We know women statistically live longer than men,and a recent data report from Pew updates us that this still is true and in many instances women are younger than their husbands.  That it means that late in life, many women will be alone. Globally, women are younger than their male partners, more likely to age alone tells us that "[t]he pattern of spousal age gaps – and the fact that women tend to live at least a few years longer than men – helps explain another universal theme: Across the world, women are about twice as likely as men to age alone. One-in-five women ages 60 and older live in a solo household (20%), compared with one-in-ten men (11%)."  The report looks at religion and geography to measure the extent of this trend. "Rates of living alone over the age of 60 are tied to many factors, including cultural norms, economic development, levels of education and life expectancy. In countries where governments offer fewer retirement benefits or other support systems for older adults, families may face a greater responsibility to provide care."

The next article is from Sunday's New York Times, on the continuing shortage of geriatricians.Older People Need Geriatricians. Where Will They Come From?  notes the long-term shortage of geriatricians and explains their importance, using one real-life example to "spotlight the rising need for geriatricians. These doctors not only monitor and coordinate treatment for the many ailments, disabilities and medications their patients contend with, but also help them determine what’s most important for their well-being and quality of life." There's very little progress on closing this gap, according to the article. "An analysis published in 2018 showed that over 16 years, through academic year 2017-18, the number of graduate fellowship programs that train geriatricians, underwritten by Medicare, increased to 210 from 182. That represents virtually no growth when adjusted for the rising United States population."

The article explains why there aren't more doctors going into the field, including the economics realities.  One measure to address the shortage is cross-training.

Medical associations representing cardiologists and oncologists have begun focusing on older patients...

Health systems are adopting age-friendly approaches, like specialized emergency rooms. The American College of Surgeons’ new verification program sets standards hospitals should meet to improve results for older patients.

Last month the Senate Committee on Health, Education, Labor and Pensions voted to reauthorize a $41 million program that educates health professionals in geriatrics; it awaits a floor vote. A companion bill has already passed the House of Representatives.

Health professionals increasingly recognize that if they’re not in pediatrics, they will be seeing lots of seniors, whatever their specialty. A 2016 American Medical Association survey, for example, found that close to 40 percent of patients treated by internists and general surgeons were Medicare beneficiaries.

Pay attention to these issues. They will affect all of us either directly or through a family member.

 

January 7, 2020 in Consumer Information, Current Affairs, Health Care/Long Term Care, International, Other, Statistics | Permalink | Comments (0)

Monday, January 6, 2020

Guest Blog on The Greying of HIV of America

I had blogged previously about meeting with two professors from the School of Social Work at the U. of Missouri.  One, Dr. Erin Robinson, was kind enough to write the following blog on this important topic.

The Greying of HIV in America

By: Dr. Erin L. Robinson, MSW, MPH

Assistant Professor, University of Missouri School of Social Work

Email: robinsonel@missouri.edu

My name is Dr. Erin Robinson and much of my research focused on older adults, sexual health, and the prevention of HIV. I get a lot of questions about my research, including the need for such research, therefore I am going to share some information with you about the ‘greying of HIV’ in the United States. Over the past decade, older adults have been one of the fastest growing population groups affected by HIV/AIDS in the United States. Currently, 17% of all new HIV infections in the U.S. occur among people ages 50 years and older. This age group also accounts for nearly half of all people currently living with HIV. While the routes of HIV transmission in older adults is similar to that of their younger counterparts, there are some unique factors that contribute to the ‘greying of HIV’ in the U.S. Below are some interesting facts:

Facts about HIV and Aging:

  • Older men are disproportionately impacted by HIV, however rates of older heterosexual women becoming newly infected are rapidly growing. This has led to specialized prevention interventions for older, heterosexual women.
  • Older African American and Hispanic men and women are disproportionately impacted by HIV.
  • 60% of all older adults living with HIV are virally suppressed, which means they have no risk of sexually transmitting the disease to others.
  • Older adults are more likely to be diagnosed when HIV is further along in the disease progression (i.e. late-stage HIV). This means treatment options may not be as effective and mortality rates increase. Many of the symptoms for HIV can be similar for other illnesses, therefore if an older person does not test for HIV then they (and their healthcare provider) may attribute the symptoms to other causes.
  • HIV can cause dementia-like symptoms, this is called HIV-associated neurocognitive disorders (HAND), AIDS dementia complex, or HIV-associated dementia. However, those symptoms can be reversed with proper HIV medications.
  • Over the past few years, new HIV infections have decreased among the aging population. This is due, in part, to tailored prevention interventions among public health officials. However, we still have progress to make in order to curb the disparities.

Why are we seeing this ‘greying of HIV’ in the U.S.?

  • Historically, older adults today have higher divorce rates than previous generations. This means older adults are engaging in new romantic relationships at higher rates as well.
  • Our older generation today has lived through major historic events that have helped shape their outlook on themselves, their relationships, and their sexuality. This includes the industrial revolution, the 2nd wave of the women’s rights era, the Civil rights movement, the sexual revolution, the gay rights movement, and others.
  • Older adults are healthier now than ever before, allowing them to experience sexually satisfying relationships later in life. Over the past 20 years, erectile dysfunction medications have also enabled men to engage in sexual relationships well into their later years.
  • After women have reached menopause and can no longer get pregnant, we see lower levels of condom use. This is true for both committed relationships and new sexual encounters with a casual partner.
  • Older adults do not perceive themselves to be at risk for STIs and HIV, therefore are less cautious in avoiding transmission.
  • A lot of stigma exists around older adults and their sexuality. Many people like to believe that older adults do not engage in sex. Therefore, this creates an environment where older adults feel like they have to hide or deny their sexuality, which exacerbates STI and HIV infection and diagnosis rates.
  • Healthcare providers have a difficult time talking to their older patients about their sexual health and HIV. In fact, when there is an age differential and a gender differential between the provider and the older patient, providers report being uncomfortable prompting such conversations. Providers also report that time is a big barrier in initiating such conversations, especially when their older patient has other health concerns.

Source: https://www.cdc.gov/hiv/group/age/olderamericans/index.html

 

January 6, 2020 in Consumer Information, Current Affairs, Health Care/Long Term Care, Other, Statistics | Permalink | Comments (0)

Friday, January 3, 2020

New Personal Safety Toolkit for APS Staff

Adult Protective Services Technical Assistance Resource Center released a new personal safety toolkit.

APS casework can create personal safety risk for staff conducting investigations, assessments, and home visits. The safety of personnel can have a noticeable impact on the ability of APS programs to provide services to the adults who need them most. Commitment to worker safety includes maintaining a safe work environment with a focus on prevention, mental health training, and emergency preparedness planning.

The purpose of this toolkit is to provide a resource to administrators and front-line staff to increase the safety of APS staff. It includes helpful information such as a presentation slide template for basic training, smart technology tips, and policies and procedures. APS programs are encouraged to add program logos, emergency contact numbers, etc., to customize the templates to fit their needs. The APS TARC requests that any adapted materials be credited to us.

Resources that make up the toolkit include a webinar, slides. sample procedures and policies, smart phone apps, and more, accessible here.

 

January 3, 2020 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Other | Permalink | Comments (0)

Thursday, January 2, 2020

Acting Classes in Senior Center

I wanted to start the New Year with happy news, so I wanted to share this article from the New York Times, Lights. Camera. Senior Center? The story focuses on actor, Mr. Hoffman, who holds acting classes at a local senior center

Mr. Hoffman,  ... has become a celebrity, if not quite the kind he had envisioned. A few years ago he started to volunteer at the senior center as a type of acting coach. He helps people in their 70s, 80s and 90s perform scenes from films like “Casablanca,” “Brokeback Mountain” and “The Wizard of Oz,” even providing wigs and costumes for special videotaped performances, which they toast with champagne flutes filled with vanilla Ensure.

He now faces a popularity dilemma-the folks in the senior center love him and his classes, but his acting career is heating up and time is limited.  In addition to the acting classes and his career, he also raise money for the senior centers, most recently for Meals on Wheels.  Even though is time is limited, he has no plans to stop the acting classes. "I will somehow make it work. I am not leaving them.”

 

A nice story to start the New Year!

January 2, 2020 in Consumer Information, Current Affairs, Other | Permalink | Comments (0)

Friday, December 20, 2019

More Student Views on Current Events

Frequent readers of this blog know that this semester I had my students write posts about their observations on recent events.  The semester has ended and I have a final post from a student to share with you.

Jeidy Beltran writes about aging in place.

THE COST OF AGING IN PLACE

 Kaiser Health News recently published the article “For Boomers Reframing Aging, Age-Proofing A Home Won’t Come Cheap,” discussing the high investments older persons are incurring when retrofitting their homes to be able to “age in place.” According to the article, “by 2050, almost one-quarter of Americans will be 65 or older,” and what living arrangements and services will be available to them is the million-dollar question. Most of the common options are moving in with relatives or moving to a care facility. The article states that baby boomers are not attracted to either of those options and it is quite understandable why – they want to preserve their autonomy and independence. Nevertheless, many are left without an option given that aging in place and preserving the highest amount of independence can be considered a luxury and available to those who are most affluent.

According to Kaiser, “in a recent survey of 1,000 people age 65 and older, 80% of respondents were concerned about their ability to age in place due to financial reasons. About 60% said that they have less than $10,000 in savings (including investments and retirement plans).” Given that in this day in age, neither communities or homes are suited for “aging in place,” accomplishing it can present quite a hurdle. Most communities are not people focused, meaning that they do not have the necessities within walking distance. Also, most homes are either not single-story or they do not have the necessary modifications to allow one to age in place (narrow doors and hallways, low toilet seats, bathtubs rather than walk in showers with grab bars…etc.). Given that everyone has a different view of what aging in place signifies, retrofitting a home and when it is done can vary. Some may start looking into their forever home from the time they purchase their first home or by the time they start planning for retirement and possible disability, while others undertake the task when presented with a disability that requires such modifications. Home modifications can also vary in degree. They can be as little and inexpensive as “adding grab bars or lever doorknobs” to highly expensive changes such as “widening doorways or lowering light switches.” The article commented on a couple in Texas who undertook the task of completely modifying their home and including all that might be necessary in case they might need it in the future, which could easily cost them $300,000 just for renovations.

My initial concern with aging in place was that people would deplete their funds in achieving their “dream” and aging in place appropriate home, but would fail to account for the future need of services. After reading the article and seeing that some people build their home with the expectation that a caregiver might live in the home makes me think that some people are thinking of the possibility that they might need services after all. The choice between wanting to preserve as much independence as possible, requiring services, and the financial burdens of each is a hefty one, but I believe that if properly planned, aging does not have to be so complicated. Have you thought about this? If so, have you analyzed your situation and weighed the pros and cons of each of the housing options?

December 20, 2019 in Consumer Information, Current Affairs, Housing, Other | Permalink | Comments (0)

Thursday, December 19, 2019

Recent Survey on Needs of Older Adults in Tampa Bay Area, Florida

The Area Agency on Aging for Pinellas-Pasco (Florida) along with the Pinellas Community Foundation  did a Community Assessment Survey of Older Adults  (CASOA):

The Community Assessment Survey of Older Adults, or CASOA, is a printed survey that was sent to 10,000 randomly selected households across every Pinellas and Pasco zip code in which at least one resident was known to be aged 60 and over. The Pinellas Community Foundation and the Area Agency on Aging of Pasco-Pinellas joined forces to conduct this comprehensive needs assessment of the area’s aging community.

The survey, which is available here offers key findings in 9 categories:

Overall Community explores how older residents view the community overall, how connected they feel to the community and overall feelings of safety, as well as how likely residents areto recommend and remain in the community.

. . .

Health and Wellness Of all the attributes of aging, health poses the greatest risk and the biggest opportunity for communities to ensure the independence and contributions of their aging populations. Health and wellness, for the purposes of this study, included not only physical and mental health, but issues of independent living and health care.

. . .

Housing  The movement in America towards designing more “livable” communities those with mixed-use neighborhoods, higher-density development, increased connections, shared community spaces and more human-scale design will become a necessity for communities to age successfully.

 . . .

    Outdoor Spaces and Building Generally, communities that have planned for older adults tend to emphasize access --access to parks, green spaces, buildings, and places where the public wants to gather. Accessibility of public places in a community has a major effect on older residents’ quality of life, allowing them to remain mobile, access services, participate in productive activities and engage socially.

. . .

Transportation and Streets Mobility access increases the likelihood that seniors will be engaged with the community and the economy. Because the US is currently highly reliant on automobiles, older drivers may become concerned with their dependency on others for transportation because they can become isolated without their motorized mobility. Those that reside in livable communities where they can reach their destinations easily and comfortably on foot or in public transportation are more likely to remain engaged in their communities and to demonstrate signs of successful aging.

. . .

Social Participation, Inclusion and Education Opportunities. A “community” is often greater than the sum of its parts, and having a sense of community entails not only a sense of membership and belonging, but also feelings of emotional and physical safety, trust in the other members of the community and a shared history.

. . .

Volunteer and Civic Engagement Productivity is the touchstone of a thriving old age. This section of the report examines the extent of older adults’ engagement in the Pasco-Pinellascommunity as determined by their time spent attending or viewing civic meetings, volunteering or providing help to others.

. . .

Job Opportunities People in the U.S. are working longer and retiring at an older age than they did 20 years ago. Of all developed countries, the U.S. has the highest labor force participationof adults age 65 and older. Older adults are postponing retirement for a variety of reasons: improved health, to benefit from delayed pension plans, to accumulate additional wealth, and because the knowledge worker economy is less physically demanding than jobs in the economy of 20 years ago. Some experts believe that older workers will become an untapped resource for economic stability when Baby Boomers begin retiring.

. . .

Community Information Sometimes residents of any age fail to take advantage of services offered by a community just because they are not aware of the opportunities. The educationof a large community of older adults is not simple, but when more residents are made aware of attractive, useful and well-designed programs, increasing numbers of residents will benefit from becoming participants.

. . .

The summary of the results are available here.

 

December 19, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, Housing, Other, Statistics | Permalink | Comments (0)

Wednesday, December 18, 2019

American Society on Aging 2020 Annual Conference

Registration is open for the American Society on Aging 2020 annual conference in Atlanta, Aging 2020: Examining the Needs of Today's Diverse Older Adults set for March 24-27, 2020. Take a look at the extensive agenda to identify sessions that are can't miss.  It promises to be a great conference! #AiA20 #Aging2020

(PS-I'm on the board and reviewed some of the proposals, so I know it will be great!)

December 18, 2019 in Consumer Information, Current Affairs, Other, Programs/CLEs | Permalink | Comments (0)

Tuesday, December 17, 2019

Save the Date: Reframing Elder Abuse on Social Media Webinar

Here's a save the date announcement about an important upcoming webinar on Friday January 24, 2020 at 8 a.m. est, 11 pst. 

National Adult Protective Services Association (NAPSA) and National Center on Elder Abuse (NCEA) presents:

How to Reframe Elder Abuse on Social MediaWebinar

Over the past few years, the NCEA’s Reframing Elder Abuse project, an initiative to change the way we talk about elder abuse with the public has built momentum. The project aims to demonstrate how we can restructure our communities to put elder abuse on the public agenda, generate a sense of collective efficacy on the issue, and boost support for systemic solutions to prevent and address it. Social media can be the first, and in some ways, the easiest place to begin to reframe how the public thinks about elder abuse. During this webinar, participants will review best practices in public communications on elder abuse based on an evidence-based strategy and receive tips and resources in social media application.

Mark your calendars to register for the webinar, once registration is open.

December 17, 2019 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Other, Programs/CLEs, State Statutes/Regulations, Webinars | Permalink | Comments (0)

Thursday, November 21, 2019

New Replication Guide on Guardianship WINGS Projects

WINGS (the Working Interdisciplinary Network of Guardianship Stakeholders) 2019 Replication Guide has been released by the American Bar Association Commission on Law & Aging. The replication manual makes a case for reform, gives an update and then provides info on the 10 core principles of WINGS. It then provides a step-by-step guide for launching a WINGS project in a state, and concludes with this thought

WINGS can breathe fresh air into the drive by courts and community stakeholders to advance adult guardianship reform and promote less restrictive options. WINGS have sparked numerable interactions that can have ripple effects in the lives of vulnerable people. WINGS is collective impact at work!

The full replication manual is available here.

November 21, 2019 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Other, State Statutes/Regulations | Permalink | Comments (0)

Wednesday, November 20, 2019

June 2020 Conference on Law Teaching & Learning

I received an email last week announcing the below summer conference on Law Teaching & Learning

Institute for Law Teaching and Learning—Summer 2020 Conference

Effective Instruction in Online and Hybrid Legal Education

June 11—13, 2020

University of Arkansas at Little Rock William H. Bowen School of Law

Little Rock, Arkansas

 Conference Theme:  The future of legal education has arrived, with more and more law schools moving toward teaching part or all of their J.D. program online.  During this conference, we will explore how law professors can design and implement methods for teaching effectively in online environments, including both synchronous and asynchronous formats.  After an opening plenary examining data regarding the effectiveness of online education, the subsequent plenaries and concurrent workshops will address the following topics in the context of online and hybrid courses and programs:  course and program design, assessment of student learning, active learning and student engagement, teaching methods, providing feedback, and collaborative learning.

 

Conference Structure:  The conference will consist of three plenary sessions and a series of concurrent workshops that will take place on Thursday, June 11; Friday, June 12; and the morning of Saturday, June 13.  The conference will open with an informal reception on the evening of Wednesday, June 10.  Details about the conference will be available on the website of the Institute for Law Teaching and Learning, www.lawteaching.org

 

Registration Information:  The conference fee for participants is $285, which includes materials, meals during the conference (three breakfasts and three lunches), and the welcome reception on Wednesday, June 10.  The conference fee for presenters is $185.  Details regarding the registration process will be provided in future announcements.

 

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

Monday, November 18, 2019

Do You Think Your Parents are Stubborn?

This is a serious question, although your reaction may be to think it's a tongue in cheek question. It's actually the subject of a New York Times article from a few months back. Think Your Aging Parents Are Stubborn? Blame ‘Mismatched Goals’ reports on a study of middle-aged adult kids about their views of their parents. Even the parents may refer to themselves as stubborn. But isn't this really just normal behavior when parents and their adult kids reach an impasse about something regarding the parent? "The more polite social science term for such skirmishes: mismatched goals. “If the goal is not shared — the older adult wants to walk to the grocery store himself and the child says, ‘I don’t think it’s a good idea’ — that’s when conflict can arise,” Dr. Heid explained. Such clashes, and related reports of stubbornness, increase when the parent and child live together, she found."  Are the kids trying to be too controlling, too helpful?  Are the parents not being sensible about their decisions? "These familiar, probably universal, safety-versus-autonomy debates have led some critics to object that adult children overemphasize the former, when what matters more to their parents is maintaining independence and pursuing what they find meaningful." Stubbornness has it's pros and cons, according to the article.  The researcher offers some thoughts on defusing a battle of the wills: "[s]he suggests trying to equalize power in the relationship, allowing the parent to also provide support, even by just listening empathetically to a child’s account of her tough week. “It could be beneficial for the relationship to not have it all be one-sided... She’s also a fan of incremental progress, a negotiation that leads to a more reciprocal exchange."  It's a very interesting article regarding a tough subject.

 

November 18, 2019 in Consumer Information, Current Affairs, Health Care/Long Term Care, Other | Permalink | Comments (0)

Friday, November 15, 2019

Two Recent Articles About Dementia

Two articles in the news are worth mentioning, in case you missed them. First, the New York Times ran an article, Why Didn't She Get Alzheimer's? The Answer Could Hold a Key to Fighting the Disease. "Researchers have found a woman with a rare genetic mutation that has protected her from dementia even though her brain has developed major neurological features of the disease."  The article highlights a recently published study "in the journal Nature Medicine, [in which] researchers say the woman, whose name they withheld to protect her privacy, has another mutation that has protected her from dementia even though her brain has developed a major neurological feature of Alzheimer’s disease."  The article reminds us to not expect instant therapies-this is going to take time, but even so, it's still very positive news. "[T]his case comes at a time when the Alzheimer’s field is craving new approaches after billions of dollars have been spent on developing and testing treatments and some 200 drug trials have failed. It has been more than 15 years since the last treatment for dementia was approved, and the few drugs available do not work very well for very long."

Thanks to Professor Naomi Cahn for alerting me to this article.

The second article I wanted to mention also appeared recently in the New York Times. The Loneliness of Frontotemporal Dementiaoffers this description of the disease:

Frontotemporal dementia attacks people in their fifth or sixth decade, just as retirement comes within reach. Doctors believe the disease affects 60,000 people in the United States alone. Neurons in the front and side of the brain wilt, and along with them, images of peacefully growing old fade. Judgment and complex planning yields to chaotic disorganization. Inhibitions give way to impulsivity and hypersexuality, so that longtime faithful partners look to affairs and excessive pornography. Empathy turns to apathy. Obsessions and compulsions erupt. Language can become laborious; the meaning of words and objects can be lost, and fluent speech can dissolve into fragments of sentences with nonsensical grammar. Jarringly, memory remains largely untouched. Since brain areas that dictate personality are often the first to suffer, most people end up on a therapist’s couch long before finding their way to a neurologist.

The article examines the importance of support groups and how some individuals present with the disease.  There are some trials underway; "'[b]ecause frontotemporal dementia is often familial, we can get people into a trial before they have symptoms,' [according to one expert] 'By sequencing genes from a blood sample, we know which family members are probably going to get the disease. If we can slow down progression in those people, it’s virtually a cure.'”

 

November 15, 2019 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Other, Science | Permalink | Comments (0)

Wednesday, November 13, 2019

Older Americans Act Reauthorization Passes House

HR 4334, Dignity in Aging, which provides appropriations for the Older Americans Act through 2024, passed the House of Representatives on October 28, 2019. The text of the bill is available here.  According to a press release from the Elder Justice Coalition which brought this good news to my email box,

EJC National Coordinator Bob Blancato said, “The bill retains the all-important Title VII of the Older Americans Act, especially maintaining funding for the work of the long-term care ombudsman program. We support a new provision in the bill which updates elder justice activities to include community outreach and education and ensures innovative projects capture programs and materials for developing partnerships in communities.”

Blancato continued, “Further, we are hopeful that the 35 percent increase in authorization provided for the five-year life of the bill will be followed by adequate appropriations to allow this new initiative to go forward without reducing any existing funding related to elder abuse prevention.”

The EJC also appreciates the continued authority contained in the bill for the National Center on Elder Abuse and the National Long-Term Care Ombudsman Resource Center, as well as the new codification of the National Resource Center on Women and Retirement.

Other new provisions in the bill include first-time social isolation screening, further coordination of services to address this issue, and creation of an advisory council on social isolation. Since social isolation is a leading risk factor for elder abuse, neglect, and exploitation, these interventions are critical to preventing abuse and neglect.

You can sign up to track the bill and get updates here.

Blancato also had special praise for the Education and Labor Committee’s Civil Rights and Human Services Subcommittee Chair Suzanne Bonamici for her leadership on this bill and noted that she is also the co-chair of the House Elder Justice Caucus.

November 13, 2019 in Consumer Information, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Health Care/Long Term Care, Other | Permalink | Comments (0)

Tuesday, November 12, 2019

More Student Views on Recent Events

As the semester winds down, I have a few more posts from my students giving us updates on current events.  Here's a happy and inspiring story from Shelby Reinwald:

“Love a Senior Day”

On Saturday, October 26, Jacksonville, Florida hosted its first-ever “Love a Senior Day.” This “not-so-typical” senior expo event’s primary purpose was to bring together people of all ages to recognize and celebrate older Americans and their care providers. Guest speakers at the event, including Bill Thomas, a renowned geriatrician and co-founder of the Eden Alternative and Green House Project, hoped to inform attendees of three major issues faced by the senior population: health, wealth, and dignity.

Thomas sought to pose questions to attendees with the goal of getting them to think about ways to communicate with loved ones while aging and to consider various financial management strategies to help with long-term care planning. Further, Thomas hoped to destigmatize the concept of aging as a “decline,” and to instead get more people to realize aging is just another phase of growth.

Attendees were also provided valuable information on local politics, health care and Medicare.

What made this event especially unique, though, was that music, yoga, and games were offered alongside the informative presentations in an effort to get people to “live [their] lives and forget age.”

I believe events like this will help pave the way in combating ageism and to foster relationships between people of all ages. “Love a Senior Day” is a fantastic way to gather people and educate them on ways to better care for themselves and loved ones while aging – which is something we all do – in one united space.

Aging should be celebrated, so keep an eye out for future “Love a Senior” events that you could attend at http://loveasenior.com/love-a-senior-day-events/.

Links:

The Jacksonville Times-Union article on “Love a Senior Day”:  https://www.jacksonville.com/news/20191023/jacksonvilles-first-love-senior-day-is-not-your-typical-senior-expo

For information on the Eden Alternative, visit: https://www.edenalt.org/

For information on the Green House Project, visit: https://www.thegreenhouseproject.org/about/visionmission

Maddison Cacciatore writes about the important of exercise in cases of cognitive decline:

The New York Times recently published Steps to Prevent Dementia May Mean Taking Actual Steps, which discusses the preventative and mitigating  effects exercise can have on cognitive decline diseases for people of a more advanced age. The article also rebuts the common presumption that brain-training apps are a reliable way to prevent or slow the development of cognitive decline. I think this a topic SNF’s need to be aware of in order to provide better care for their residents. I realize that in this risk averse society, brain training apps may be more appealing to SNF’s, as they have a far lower ability to cause physical harm to residents, however, does this it really a lower risk of harm in the long run. Reducing or avoiding necessary exercise and replacing this with a lacking alternative the SNFs are setting their residents up for a faster decline in health.

The above-referenced article outlines a few of the reasons why exercise is beneficial in regard to cognitive deterioration, one of which is common sense but not often mentioned in this discussion. Exercise brings people together in a social environment, which in turn provides them with social interaction and a need to use their brain. This is so important. SNF’s need to realize the importance of incorporating exercise and social interaction into residents’ care plans, when applicable. Any movement is better than nothing.

The New York Times included some very persuasive information regarding the prevalence of dementia in the US:

“A recent study in Health Services Research found that the additional cost of dementia to Medicare is nearly $16,000 per person over five years. About 14 percent of people in the United States over the age of 71 have some form of dementia. Alzheimer’s disease is the leading cause, afflicting 5.7 million people.”

As someone who has personally seen the toll these diseases cause on a family, as well as the positive effects of exercise on the slowing of its progression, this topic is of great importance to me and think it should be on every SNF’s radar in the future.  One of my grandfathers is 92 and has very advanced Alzheimer’s. Our family opted to have a family member live with/provide him care. Pat, the caretaker, forces my Grandpa to walk around the yard a few times throughout the day. Grandpa is always more coherent after he walks, and it is especially noticeable what days he does not get some sort of exercise. We all know and agree that if he were in a SNF, not being forced to exercise on a daily basis, he would not be here today. Additionally, my other grandfather, in my opinion, has prevented (or at least put off) his development of this disease. All three of his younger siblings developed and passed away from Alzheimer’s. Because my grandfather is terrified of the disease, he is constantly exercising and playing the brain development apps. He is 77 and exercises for at least an hour every day. I am not an expert by any means, but it is my opinion that he has not been diagnosed due to this constant exercise.

The prevalence of cognitive decline is a very important problem, needing more attention. They are a great emotional and financial burden on a community, and if there is a way to prevent and/or mitigate their progression, SNFs and families need to take note. It may be more work, and not the most financially appealing option, but the end result is much more important.

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

Monday, November 11, 2019

Elder Justice Toolkit Released

The National Center on Law & Elder Rights   has announced the release of the Elder Justice Toolkit.  According to the website

The Elder Justice Toolkit is a resource created by the National Center on Law & Elder Rights. It contains practical information on civil legal remedies, practice tips, and sample pleadings for attorneys seeking protection and redress for their clients who have experienced elder abuse. Multiple states’ perspectives are considered and used as examples, but the Toolkit is designed for national use.

Some of the resources contained in the Elder Justice Toolkit have come from legal assistance organizations and have been re-formatted or re-purposed by NCLER...

This resource will continue to grow and have materials added to it over time. To receive NCLER communications and updates on resources, sign up here.

To find additional resources on elder justice topics, please read our Elder Justice Compendium.

A collection of our elder abuse webcast trainings can be found here.

Each topic includes a summary, an issue brief and step-by-step guide and a video.  Here's an example of an issue brief on mandatory reporting for elder abuse cases.

Check it out and bookmark the webpage!

November 11, 2019 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Other, State Statutes/Regulations | Permalink | Comments (0)

Sunday, November 10, 2019

The Wrong Goodbye

ProPublica ran an in-depth story about a case of mistaken identity and the removal of life support.The Wrong Goodbye covers the story of removal of life-support from a patient, after which the family learns that the patient was not in fact their relative.  The must-read story offers examples of how and why mis-identification of patients may occur.  After writing about the facts and both families, the story turns to the litigation.

“The defendants negligently misinformed the plaintiff that her brother ... was admitted to the hospital in an unconscious state. The defendants negligently misinformed the plaintiff that her brother had died on July 29, 2018. As a result of the defendant’s misinformation and negligent conduct the plaintiff has suffered severe emotional harm and injuries.”

[The hospital] ... did not deny the mix-up, but argued it was not liable for any damages because no member of the Williams family ...  had actually been a patient at the hospital. The hospital asked a judge to dismiss the case.

[The] lawsuit was reported in a daily story inside the New York Post on Jan. 27, 2019. It did not report the identity of the person taken off life support, but the story was reproduced on a slew of news websites.

[The widow] found the article on her Facebook feed. It had been aggregated on a website called Dearly.com. She eventually realized the story involved [her husband's] death, that he was the unidentified dead man in the article. Months into her efforts to figure out the details of her husband’s death, she saw in [the attorney], who’d been quoted in the article, someone who might help. Maybe [the attorney] would represent her, too.

She met [the attorney] in his Brooklyn office. He was quite certain she had a case. He was less certain he could represent both families. He arranged for her to call [a member of the other family] to see if everyone was comfortable with the idea....

When the conversation was over, [the attorney] was representing both families.

The article ponders the oversight from the law and various state and federal agencies and the impact this has had on the families. In the epilogue to the article, we are updated

More than a year after her husband’s death [the decedent's spouse]  feels deeply frustrated, and increasingly doubtful that her husband’s death will ever be fully explained or that anyone will ever be held accountable. The police have all but stopped speaking to her. [The hospital] seems to have been cleared by the Health Department.

...

[The widow's] remaining chance at what she wants — a full explanation and punishment if warranted — appears to rest with ... the lawyer....

This summer, a judge in the Bronx rejected [the hospital's] motion to dismiss [the] lawsuit. [The attorney] is eager to start collecting more material in discovery.

. . ..

Read this article, realizing the story has not yet ended. It provides an important teaching point for us with our students. 

November 10, 2019 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Other, State Cases | Permalink | Comments (0)