Thursday, July 25, 2019
The Global Brain Health Institute is taking applications for those who are interested in becoming an Atlantic Fellow for Equity in Brain Health at the GBHI.
The Atlantic Fellows for Equity in Brain Health program at GBHI is an opportunity to elevate ...r dedication and contributions to brain health. Applicants should demonstrate a commitment to brain health and health care policy, as well as an ability to implement effective interventions in their home community and to become a regional leader in brain health.
GBHI welcomes applications from people living anywhere in the world and working in a variety of professions. Fellows are typically early and mid-career. At least one-half of fellows will come from outside the US and Ireland, with an initial emphasis on Latin America and the Mediterranean.
Thanks to Sarah Hooper, Executive Director & Adjunct Professor of Law, UCSF/UC Hastings Consortium on Law, Science & Health Policy, Policy Director | Medical-Legal Partnership for Seniors, Senior Atlantic Fellow for Health Equity | Atlantic Institute for sending me the announcement.
Wednesday, July 24, 2019
The Washington Post ran a story with this eye-catching headline, He was deemed too old to be dangerous. Now, at 77, he’s been convicted of another murder.
When we teach elder law, oftentimes the focus is on the elder as a victim, but we do know that an elder can also be a perpetrator. In this case, the perpetrator, who
When he came before a judge in Portland, Maine, in 2010, he was in his late 60s, and had spent roughly a third of his life in prison. After doing time for killing his wife, he had assaulted another woman and gone back to jail, only to get out and attack a third woman. Flick’s violent tendencies didn’t seem likely to go away with age, both the prosecutor and his probation officer warned. But the judge chose to sentence him to just shy of four years in prison, noting that by the time he was released in 2014, he would be 72 or 73.
Here's the crux of the matter--the quote from the judge who sentenced him: "[a]t some point Mr. Flick is going to age out of his capacity to engage in this conduct... , and incarcerating him beyond the time that he ages out doesn’t seem to me to make good sense.” The article notes that statistics support the judge's perspective on this, but those statistics didn't predict the outcome here:
Eight years after that hearing, [he] struck again, fatally stabbing a woman outside a laundromat ... as her 11-year-old twin sons watched. Now 77, he was convicted of murder ... and, this time, it looks likely that he’ll spend the rest of his life in prison. The charges carry a minimum 25-year sentence, and prosecutors plan to request that he be placed behind bars for life.
So to answer the question posed in the title of this post, No, he wasn't too old to commit another murder.
Tuesday, July 23, 2019
The Uniform Electronic Wills Act permits testators to execute an electronic will and allows probate courts to give electronic wills legal effect. Most documents that were traditionally printed on paper can now be created, transferred, signed, and recorded in electronic form. Since 2000 the Uniform Electronic Transactions Act (UETA) and a similar federal law, E-SIGN have provided that a transaction is not invalid solely because the terms of the contract are in an electronic format. But UETA and E-SIGN both contain an express exception for wills, which, because the testator is deceased at the time the document must be interpreted, are subject to special execution requirements to ensure validity and must still be executed on paper in most states. Under the new Electronic Wills Act, the testator's electronic signature must be witnessed contemporaneously (or notarized contemporaneously in states that allow notarized wills) and the document must be stored in a tamper-evident file. States will have the option to include language that allows remote witnessing. The act will also address recognition of electronic wills executed under the law of another state. For a generation that is used to banking, communicating, and transacting business online, the Uniform Electronic Wills Act will allow online estate planning while maintaining safeguards to help prevent fraud and coercion.
Friday, July 19, 2019
The Washington Post recently ran an important article, ‘Well, that was a weird moment’ and other signs of dementia family members should watch for. With "[a]bout 5.8 million people in the United States are living with Alzheimer’s and dementia, said Heather Snyder, senior director for medical and scientific operations for the Alzheimer’s Association. The number is expected to rise to 14 million by 2050. Approximately 16 million people are caregivers." So it is important to help caregivers understand what might be normal aging and what might be a red flag.
So what should family members look for? What is attributable to normal aging as opposed to cognitive decline associated with dementia?
It is common to misplace keys or eyeglasses or walk into a room with a task in mind and forget what that is. Those are often attributable to multitasking or stress and are considered part of normal aging.
Here are some things to look for:
• Notes with reminders about simple tasks.
• When neighbors or friends share concern.
• Bills not paid or overpaid.
Physical appearance — someone who was always put together suddenly wears wrinkled or dirty clothing.
• Weight changes.
• Driving issues: fender benders, parking in the wrong spot.
• Any behavior that is out of the ordinary.
• Picking up an object and using it inappropriately.
• Saying things that are inappropriate — “no filter.”
• Changes in speech, personality.
One expert describes what we are looking for like this: "take notice of what she calls “well, that was a weird moment.” For instance,[the expert] was assessing a woman and did not see any deficits — until the woman asked if she could make a phone call and picked up the television remote." The article stresses the importance of planning and being proactive. Read it, so next time you forget where you left your keys, you won't worry as much.
Thursday, July 18, 2019
The Employee Benefits Research Institute (EBRI) has announced a webinar on July 24, 2019 at 2:00 p.m. edt. on Spending Patterns of Older Households and Their Financial Planning Implications.
Here's a description of the webinar:
Please join EBRI for a webinar reviewing findings from its latest research on spending behavior of older Americans. EBRI researcher Zahra Ebrahimi will examine how spending varies by retirement status, wealth, and demographic characteristics. We will then hear from Sharon Carson, Retirement Strategist, Executive Director at J.P. Morgan Asset Management, to understand the implications of these findings in assessing retirement income adequacy for financial planning purposes.
To register for the webinar, click here.
Wednesday, July 17, 2019
Previously I had blogged about the legal battle over removing life support from Frenchman, Vincent Lambert. The New York Times reported recently on his death, Vincent Lambert, Frenchman at Center of Right-to-Die Case, Dies at 42.
His family and his spouse disagreed on his wishes. "His wife, Rachel Lambert, said that he had clearly stated that he would not wish to live in a vegetative state. His parents argued that ending his life support amounted to the murder of a disabled person. Siblings and other family members took different sides in the dispute." As the article notes, "[e]uthanasia and assisted suicide are illegal in France. But the law allows patients who are terminally ill or injured with no chances of recovery to decide to stop treatments if the measures “appear useless, disproportionate” or if they seem to have no other effect than 'artificially maintaining life.'" An article about the final court decision is available here.
In a related matter, the Judge for the Florida Schiavo case has written a chapter for a book, as explained in this article:
Inside the Terri Schiavo case: Pinellas judge who decided her fate opens up. You should read it.
Tuesday, July 16, 2019
The National Center for State Courts has released a new guide for monitoring conservatorships. Implementation Guide for ModernizingConservatorship Monitoring: Basic Strategies and Technology Enhancements explains that
Originally, this implementation guide was intended to encourage state courts to adop ttechnologies and analytics that would make immediate impacts. But like many intentions,the NCSC team, working with pilot states,realized that most state courts do not have the capacity to develop and implement such broad-scale changes at this time. In fact, data collection efforts showed that most state courts still have a difficult time documenting the number of active conservatorship cases.So rather than create a guide that few courts could implement, the purpose of this report is to inform readers of the efforts and advancements under way in light of problems posed by conservatorships. Regardless of the current situation within a state, the proposed strategies can be adapted to assist all courts.The project team encourages movement toward reforms that, ultimately, will improve court accountability and enhance protections for those individuals subject to a conservatorship. First laying the ground work of stakeholder support and improved data collection, then building toward technology solutions.
The document explains terminology, makes a case for reform, reviews and recommends the "Minnesota Model," reviews the experiences of pilot sites and offers 7 steps for modernizing conservatorship monitoring.
Monday, July 15, 2019
According to a recent story published in Modern Healthcare, Nursing home staffing levels often fall below CMS expectationsfocuses on a new study that "[n]ursing home staffing levels are often lower than what facilities report, which could compromise care quality, new research shows....Self-reported direct staffing time per resident was higher than the CMS' payroll-based metrics 70% of the time, according to a new study published in Health Affairs. Staffing levels were significantly lower during the weekends, particularly for registered nurses."
We know the importance of staffing as a quality measure and ensuring quality of care, so this study is very important. "Researchers compared facility-reported staffing and resident census data and annual inspection survey dates from the Certification and Survey Provider Enhanced Reports to the CMS' long-term care facility Staffing Payroll-Based Journal from 2017 to 2018. The payroll-based data offered a more granular look, showing how staffing evolves over time rather than relying on static point-in-time estimates that were subject to reporting bias and rarely audited...."
When comparing for-profit SNFs with NFP SNFS, the researchers found the for-profits "more likely to report higher staffing numbers ... and [s]taffing levels increased before and during the times of the annual surveys and dropped off after."
The use of payroll data to determine staffing levels has only been in effect a little over a year. The story focuses specifically just on staffing levels. A log-in is required to access the study.
Friday, July 12, 2019
Pew Research has a new Fact Tank, "On average, older adults spend over half their waking hours alone" which explains that "Americans ages 60 and older are alone for more than half of their daily measured time – which includes all waking hours except those spent engaged in personal activities such as grooming. All told, this amounts to about seven hours a day; and among those who live by themselves, alone time rises to over 10 hours a day, according to a new Pew Research Center analysis of Bureau of Labor Statistics data."
That seems like a lot, especially when you compare the "alone-time" for other generations to this one: "people in their 40s and 50s spend about 4 hours and 45 minutes alone, and those younger than 40 spend about three and a half hours a day alone, on average. Moreover, 14% of older Americans report spending all their daily measured time alone, compared with 8% of people younger than 60."
Alone time isn't a bad thing-just ask any introvert-but even too much of a good thing can be ... too much. Alone time "can be a measure [used for] social isolation" which can have a correlation to "negative health outcomes among older adults. Medical experts suspect that lifestyle factors may explain some of this association – for instance, someone who is socially isolated may have less cognitive stimulation and more difficulty staying active or taking their medications. In some cases, social isolation may mean there is no one on hand to help in case of a medical emergency."Living arrangements also play a role in how much time a person is alone. "More than a third (37%) of older adults who live alone report spending all their measured time alone. Among those who live with someone other than a spouse, the average amount of alone time a day is seven and a half hours."
Thursday, July 11, 2019
I've blogged a number of times on the variety of issues regarding caregivers and caregiving. A recent article in the New York Times presents an interesting perspective. At 75, Taking Care of Mom, 99: We Did Not Think She Would LiveThis Long discusses what the article describes as
“a growing phenomenon: Children in their 60s and 70s who are spending their retirement years caring for parents who are in their 90s and beyond.”
The article quotes one expert who describes this as “aging together” and this parental longevity has forced the caregiver child to redefine his or her retirement plans. The article recommends ways for caregivers to take care of themselves and manage stress and discusses the importance of doing a cost-analysis “[t]o figure out what’s financially doable, it may help to seek professional advice. An accountant will calculate tax breaks for home care and other services. Local senior programs could offer guidance on free and reduced-cost programs, including counseling for burned-out caregivers.”
Thanks to my colleague and dear friend, Professor Mark Bauer, for sending me the link to this article.
Wednesday, July 10, 2019
Ugh, this article in the Washington Post covers a serious and worrisome topic. Hospices go unpunished for reported maggots and uncontrolled pain, watchdog finds reports on a recently released HHS Office of Inspector General report, 2019: Vulnerabilities in Hospice Care.
The OIG report is actually two reports "which found that from 2012 through 2016, the majority of U.S. hospices that participated in Medicare had one or more deficiencies in the quality of care they provided to their patients. Some Medicare beneficiaries were seriously harmed when hospices provided poor care or failed to take action in cases of abuse. OIG made several recommendations in both reports to strengthen safeguards to protect Medicare hospice beneficiaries from harm and to ensure hospices are held accountable for deficiencies in their programs."
The first report, Hospice Deficiencies Pose Risks to Medicare Beneficiaries, 07-03-2019 | Report (OEI-02-17-00020), found that
[t]he most common types of deficiencies involve poor care planning, mismanagement of aide services, and inadequate assessments of beneficiaries. In addition to these, hospices had other deficiencies that also posed risks to beneficiaries. These failings-such as improperly vetting staff and inadequate quality control-can jeopardize beneficiaries' safety and lead to poor care. In addition, one-third of all hospices that provided care to Medicare beneficiaries had complaints filed against them. Over 300 hospices had at least one serious deficiency or at least one substantiated severe complaint in 2016, which we considered to be poor performers. These hospices represent 18 percent of all hospices surveyed nation-wide in 2016. Most poor performers had other deficiencies or substantiated complaints in the 5-year period. Some poor performers had a history of serious deficiencies.
The full report is available here.
[s]ome instances of harm resulted from hospices providing poor care to beneficiaries and some resulted from abuse by caregivers or others and the hospice failing to take action. These cases reveal vulnerabilities in CMS's efforts to prevent and address harm. These vulnerabilities include insufficient reporting requirements for hospices, limited reporting requirements for surveyors, and barriers that beneficiaries and caregivers face in making complaints. Also, these hospices did not face serious consequences for the harm described in this report. Specifically, surveyors did not always cite immediate jeopardy in cases of significant beneficiary harm and hospices' plans of correction are not designed to address underlying issues. In addition, CMS cannot impose penalties, other than termination, to hold hospices accountable for harming beneficiaries.
The second full report is available here. In addition there is a slide show available on YouTube, a one page flyer available here, a one-page graphic of the top issues available here, a flyer on beneficiary rights available here and more.
Tuesday, July 9, 2019
Do you plan to retire? If you answer is no, you aren't alone. According to a recent poll in the Associated Press, almost 25% of folks plan to keep work. Poll: 1 in 4 don’t plan to retire despite realities of aging found a possible "disconnection between individuals’ retirement plans and the realities of aging in the workforce." The realities of life ... and aging... "often force older workers to leave their jobs sooner than they’d like." The article notes things like caregiving and health as reasons that cause folks to leave employment. In addition to this nearly 25% who plan to keep working, which "[includes] nearly 2 in 10 of those over 50.... [r]oughly another quarter of Americans say they will continue working beyond their 65th birthday."
The article contains data regarding the impetus to keep working (including financial needs) and the perceptions among those in the workforce regarding the continued employment of older workers:
39% think people staying in the workforce longer is mostly a good thing for American workers, while 29% think it’s more a bad thing and 30% say it makes no difference.
A somewhat higher share, 45%, thinks it has a positive effect on the U.S. economy.
Working Americans who are 50 and older think the trend is more positive than negative for their own careers — 42% to 15%. Those younger than 50 are about as likely to say it’s good for their careers as to say it’s bad.
However, desire and reality aren't always a match. The article also discusses reasons why folks who want to keep working have to leave the workforce.
Thanks to Professor Naomi Cahn for sending me the link to the story.
Monday, July 8, 2019
Professor Tara Sklar emailed me to let me know of the publication of two new articles. Her first, Preparing to Age in Place: The Role of Medicaid Waivers in Elder Abuse Prevention appears in 28 Annals of Health Law 195 (2019) and is also available on SSRN.
Here is the abstract
Over the last three decades, there has been a steady movement to increase access to aging in place as the preferred long-term care option across the country. Medicaid has largely led this effort through expansion of state waivers that provide Home and Community-Based Services (HCBS) as an alternative to nursing home care. HCBS include the provision of basic health services, personal care, and assistance with household tasks. At the time of this writing, seven states have explicitly tailored their waivers to support aging in place by offering HCBS solely for older adults, individuals aged 65 and over. However, there is growing concern about aging in place contributing to greater risk for social isolation, and with that increased exposure to elder abuse. Abuse, neglect, and unmet need are highly visible in an institutional setting and can be largely invisible in the home without preventative measures to safeguard against maltreatment. This article examines the seven states with Medicaid HCBS waivers that target older adults, over a 36-year period, starting with the first state in 1982 to 2018. We conducted qualitative analysis with each waiver to explore the presence of safeguards that address risk factors associated with elder abuse. We found three broad categories in caregiver selection, quality assurance, and the complaints process where there are notable variations. Drawing on these findings, we outline features where Medicaid HCBS waivers have the potential to mitigate risk of elder abuse to further support successful aging in place.
The second article, Elderly Gun Ownership and the Wave of State Red Flag Laws: An Unintended Consequence That Could Help Many will be published in the Elder Law Journal. It is currently available on SSRN here.
Here is the abstract
There is rising concern among health professionals and in legal circles to address gun ownership for older adults who display signs of cognitive decline, including dementia. However, elderly gun ownership remains underexamined, partly because incidents of gun violence among the elderly tend to occur in domestic settings and are much less visible than shootings in public areas. In contrast, there is widespread attention to curb mass gun violence through state legislation. Specifically, red flag laws, also known as Extreme Risk Protection Orders, have doubled in 2018 with thirteen states enacting red flag laws and over thirty states having introduced or planning to introduce this legislation. Although red flag laws were not intended to address elderly gun ownership, they uniquely apply where other gun control laws fall short, as red flag laws provide the legal process to temporarily remove access to guns for persons believed to be at an elevated risk of harming themselves or others.
This Article surveys the thirteen states that have enacted red flag laws and analyzes key legislative elements across these states. The state laws have notable variations, including authorized persons who can petition a court for a protection order, standard of proof requirements, and the length of time an order is in effect. These variations have implications for elderly gun owners and their families, particularly in how they relate to the climbing rates of cognitive decline, suicide in late life, and elder abuse. The current wave of red flag laws across the country offer an opportunity to provide greater awareness around elderly gun ownership and prevent crises from becoming tragedies.
I was particularly interested in this second piece, because we recently offered a webinar at Stetson for elder law attorneys on dementia and gun ownership. Information about the webinar and how to order an audio download are available here.
Congrats Professor Sklar and thanks for letting us know about your articles!
July 8, 2019 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Programs/CLEs, State Statutes/Regulations | Permalink | Comments (1)
Friday, July 5, 2019
That was the question posed in a recent article published in Cleveland.Com. Amid growth of assisted living, some renew calls for federal oversight opens with an examiniation of hte requirements to be employed as an aide in ALFs.
Just read this to get a sense of the issues illustrated in this article:
The number of assisted-living centers in the United States has jumped more than 150 percent in the past 20 years, fueled by an increase of residents with cognitive issues, a willingness of facilities to take more frail patients, and families who wish to avoid nursing homes.
But while the centers’ clientele has changed dramatically, there have been few efforts to systemically re-evaluate staffing or training guidelines necessary to properly serve residents. This has led some advoctates of the elderly to renew the call for federal oversight of the facilities, much like nursing homes.
For instance, nearly half of the nation’s states lack extensive training programs for the facilities’ employees, with most requiring some form of a job orientation and less than a dozen hours of instruction.
When it comes to staffing, the differences are even more stark. Thirty-eight states leave the amount of personnel needed to care for residents up to individual facility owners.
These variations fuel the position that federal oversight is needed, mainly because it would provide consistency. But there are opponents of the idea who think it will make ALF oversight more bureaucratic and expensive. With Medicaid waivers covering the cost of ALFs in some situations, the argument for federal oversight gains strength. "But because Medicaid’s role is increasing in assisted living, advocates for the elderly say the U.S. Centers for Medicaid and Medicare Services, which oversees nursing homes, should also monitor assisted-living facilities."
The article discusses efforts at the state level of ensure quality of care and offers argument both in favor of and against involvement of the feds.
What do you think?
Thursday, July 4, 2019
Sounds yummy, doesn't it. My dear friend, colleague and frequent blog reader ran across a story about Jelly Drops which are described on the company's website as "Hydrating treats for people with dementia." The article sent by my friend explains that "they’re hydrating treats shaped like raindrops that come in a treat box with a see-through lid. The drops are meant to be appealing to people with dementia, as well as easy to grasp and swallow, and they contain water and electrolytes to help keep elderly patients hydrated." Both the story and the website explain the inventor's motivation for creating the product. The photo on the website shows colorful and yummy looking pieces. Hopefully the product will be available before long. Anyone who has had a relative with hydration issues will understand the value of a product such as this.
Wednesday, July 3, 2019
The chair of faculty recruitment for Detroit Mercy COL sent me this announcement regarding an opening for Property Law with the additional possibility of teaching T&E. The information is below.
Announcement: Property Law Position
University of Detroit Mercy School of Law seeks a proven or aspiring scholar and teacher with an interest in teaching first-year Property Law for a tenured or tenure-track position beginning 2020-2021. Applicants must have a law degree and strong academic background and must demonstrate either a record of or potential for both teaching excellence and high scholarly achievement in any area of law. The balance of the teaching package will be determined in conversation with the successful candidate.
Applicants should send a cover letter, which should include a brief description of their ideal teaching package and a general indication of their areas of scholarly interest. Please direct the cover letter, a current CV, additional supporting materials (if any), and any questions you may have to:
Professor Julia Belian, Chair of Faculty Recruitment
University of Detroit Mercy School of Law
651 East Jefferson
Detroit, Michigan 48226
Materials will be accepted via email or regular mail. Review of applicants will begin in July 2019 and will continue until the position is filled.
About Our Program of Legal Education
Detroit Mercy Law offers a unique curriculum that complements traditional theory- and doctrine-based course work with intensive practical learning. Students must complete at least one clinic, one upper-level writing course, one global perspectives course, and one course within our Law Firm Program, an innovative simulated law-firm practicum. Detroit Mercy Law also offers a Dual J.D. program with the University of Windsor in Canada, in which students earn both an American and a Canadian law degree in three years while gaining a comprehensive understanding of two distinct legal systems. Interested Dual J.D. students are fully integrated into upper-level U.S. courses. The program’s first-year U.S. Property Law module could form a component of the teaching package if desired.
Detroit Mercy Law is located one block from the riverfront in Downtown Detroit, within walking distance of federal, state, and municipal courts, the region’s largest law firms, and major corporations such as General Motors, Quicken Loans, and Comerica Bank. The School of Law is also uniquely situated two blocks from the Detroit-Windsor Tunnel, an international border crossing linking Detroit with Windsor and Canada.
Detroit offers a dynamic variety of culinary, cultural, entertainment, and sporting attractions. See https://www.youtube.com/watch?v=DO4J_PC1b5M and learn more at https://www.nytimes.com/2017/11/20/travel/detroit-michigan-downtown.html.
Michigan’s largest, most comprehensive private university, University of Detroit Mercy is an independent Catholic institution of higher education sponsored by the Religious Sisters of Mercy and Society of Jesus. The university seeks qualified candidates who will contribute to the University's urban mission, commitment to diversity, and tradition of scholarly excellence. University of Detroit Mercy is an Equal Opportunity Affirmative Action Employer with a diverse faculty and student body and welcomes persons of all backgrounds.
In May, AARP ran a story about research identifying a new dementia that is not Alzheimer's. Is It Alzheimer's ... or LATE? explains about recent results into research of cases that although thought to be Alzheimer's are not. "[A] report published in the medical journal Brain reveals that in cases involving people older than 80, up to 50 percent may, in fact, be caused by a newly identified form of dementia. It's called LATE, which is short for limbic-predominant age-related TDP-43 encephalopathy....The news, published last month, is being heralded as a potential breakthrough, as identifying a new type of dementia could be critical for targeting research — for both LATE and Alzheimer's. In fact, the report included recommended research guidelines as well as diagnostic criteria for LATE." The disease can mimic some aspects of Alzheimer's, the story explains, and it can only be identified in an autopsy.
Here is the abstract from the study:
We describe a recently recognized disease entity, limbic-predominant age-related TDP-43 encephalopathy (LATE). LATE neuropathological change (LATE-NC) is defined by a stereotypical TDP-43 proteinopathy in older adults, with or without coexisting hippocampal sclerosis pathology. LATE-NC is a common TDP-43 proteinopathy, associated with an amnestic dementia syndrome that mimicked Alzheimer’s-type dementia in retrospective autopsy studies. LATE is distinguished from frontotemporal lobar degeneration with TDP-43 pathology based on its epidemiology (LATE generally affects older subjects), and relatively restricted neuroanatomical distribution of TDP-43 proteinopathy. In community-based autopsy cohorts, ∼25% of brains had sufficient burden of LATE-NC to be associated with discernible cognitive impairment. Many subjects with LATE-NC have comorbid brain pathologies, often including amyloid-β plaques and tauopathy. Given that the ‘oldest-old’ are at greatest risk for LATE-NC, and subjects of advanced age constitute a rapidly growing demographic group in many countries, LATE has an expanding but under-recognized impact on public health. For these reasons, a working group was convened to develop diagnostic criteria for LATE, aiming both to stimulate research and to promote awareness of this pathway to dementia. We report consensus-based recommendations including guidelines for diagnosis and staging of LATE-NC. For routine autopsy workup of LATE-NC, an anatomically-based preliminary staging scheme is proposed with TDP-43 immunohistochemistry on tissue from three brain areas, reflecting a hierarchical pattern of brain involvement: amygdala, hippocampus, and middle frontal gyrus. LATE-NC appears to affect the medial temporal lobe structures preferentially, but other areas also are impacted. Neuroimaging studies demonstrated that subjects with LATE-NC also had atrophy in the medial temporal lobes, frontal cortex, and other brain regions. Genetic studies have thus far indicated five genes with risk alleles for LATE-NC: GRN, TMEM106B, ABCC9, KCNMB2, and APOE. The discovery of these genetic risk variants indicate that LATE shares pathogenetic mechanisms with both frontotemporal lobar degeneration and Alzheimer’s disease, but also suggests disease-specific underlying mechanisms. Large gaps remain in our understanding of LATE. For advances in prevention, diagnosis, and treatment, there is an urgent need for research focused on LATE, including in vitro and animal models. An obstacle to clinical progress is lack of diagnostic tools, such as biofluid or neuroimaging biomarkers, for ante-mortem detection of LATE. Development of a disease biomarker would augment observational studies seeking to further define the risk factors, natural history, and clinical features of LATE, as well as eventual subject recruitment for targeted therapies in clinical trials.
The full article is available here as a pdf.
Tuesday, July 2, 2019
Last week Bloomberg Law ran a story about a new scam. Scammers Target Seniors With DNA Tests, Health Agency Says explains that the "free DNA test" is being sent to elders. "Companies offering the tests use the information gathered to steal identities or bill Medicare for unnecessary tests, the U.S. Department of Health and Human Services Office of Inspector General said in an agency fraud alert. The fraudsters are targeting victims through telemarketing, booths at public events and door-to-door visits." The fraud alert from HHS'Inspector General, Fraud Alert: Genetic Testing Scam offers these suggestions for elders:
If a genetic testing kit is mailed to you, don't accept it unless it was ordered by your physician. Refuse the delivery or return it to the sender. Keep a record of the sender's name and the date you returned the items.
Be suspicious of anyone who offers you free genetic testing and then requests your Medicare number. If your personal information is compromised, it may be used in other fraud schemes.
A physician that you know and trust should approve any requests for genetic testing.
Medicare beneficiaries should be cautious of unsolicited requests for their Medicare numbers. If anyone other than your physician's office requests your Medicare information, do not provide it.
If you suspect Medicare fraud, contact the HHS OIG Hotline.Always remember that very little in life is free and if an offer sounds to good to be true, it isn't true.
Monday, July 1, 2019
So last week I posted how elders had an impact on climate change. Now I write about the impact climate change has on elders. In case you weren't aware, there's a heat wave in Europe. In fact, one of my dear friends is teaching in our summer abroad program in Spain and he unexpectedly texted me to tell me how hot it was. So last week's story in the Washington Post on the heatwave in France seems timely.
A heat wave killed 15,000 in France in 2003. As temperatures soar again, officials are taking no chances. explains about the various steps that French authorities are taking to offset the effect of the heatwave hitting their country, These record-breaking temperatures "scientists say are becoming more common in Europe as a result of climate change." Officials in Paris have taken a number of steps to help residents cope with the heat. "The heat particularly threatens children, pregnant women and the elderly, city authorities warn. The city has set up a special phone service for elderly and sick people, and authorities have asked hospitals and retirement homes to be on alert. Older residents left alone made up many of the victims of the 2003 heat crisis." The heat is record-breaking, according to the BBC.
Unusually hot temperatures are not limited to just Europe. The Tampa Bay area of Florida (where the College of Law is located), whose residents are used to hot and humid conditions this time of year, issued a heat advisory on June 26, 2019."[I]t’s rare for temperatures in Florida to climb beyond the low 90s in the summer ... But with a high pressure system in the Atlantic blocking most of those cooling storms... the high ... should reach at least 96 – in the shade. Heat index values, meaning the temperature it feels like outside, will be 104 in Tampa and as high as 110 in the southern Bay Area."
Friday, June 28, 2019
I received several notices recently about upcoming webinars, so I thought I'd let you know about them so you can register. Both happen to be on the same day, but luckily not at the same time. Block off the time on your calendar, register and plan to eat at your desk!
1. NAPSA Research-to-Practice (R2P) Webinar on July 17, 2019 at 1:30 edt. Topic: The Role of Social Support in the Lives of Elder Abuse Victims. Register, click here.
2. National Center of Law & Elder Rights, on July 17, 2019 at n0on edt. Topic: Protecting Older Adults Against Abusive Telemarketing Scams. Register: click here.