Wednesday, February 19, 2020
Friend and colleague, Professor Naomi Cahn sent us this story. In the article, Incomplete and inadequate: Information lacking for seniors looking for assisted living, early on the authors explain the reasons for their research:
We and our colleagues track the ever-changing circumstances of long-term care in the U.S. As we study policies and practices, we have observed that the expansion of assisted living is clearly a game-changer, creating new challenges in the industry. Many states have increased assisted living regulation in recent years. Some consumer advocates have called for nursing-home style federal rules, though others oppose this, saying assisted living should remain flexible enough to serve residents with a range of needs, from personal care only to end-of-life comfort.
Now we know why they did the research, here's what they did: "Using criteria formulated from prior research, along with information provided by some states, we examined 39 key elements of each website. Those elements included the size of the facility, cost, license status, the insurance it accepts, and any special services offered, such as memory care. We also looked at each website’s usability – the ease in finding critical information."
The article reports they found gaps in provided info, websites that they thought were difficult to navigate although they found some websites that had better info and were easier to use. "True, the state websites are better than they were 15 years ago. But they are less than what they should be. Many of the elderly, the disabled, and the families who love them require more to make appropriate choices. When navigating the internet, the principle of “buyer beware” should not be the driver."
Tuesday, February 18, 2020
One of my students sent me the recent article about sneaker insoles with built-in GPS. I always talk to my students about the various technologies, including tracking devises, and ask them to think about autonomy, privacy, consent, and product reliability. Shoe with GPS insole lets you track loved ones with Alzheimer's or dementia explains how the device works, the info provided and the real-time data provided (in this case, the article notes the product updates the data every 5-10 minutes). One customer was quoted along the lines that the use of the product allows her mom to wander, but that the daughter can catch up to mom, before harm befalls mom. I was thinking about this.... it still allows mom to be mobile but I still would like to think more about privacy, data security, consent and more. This, of course, is not the only type of tracking device available to families who have elders who may wander. I've not had any experience with them, but on its face sounds like it may allow the elder to stay at home or have some freedom. (but what can happen before the location is updated or the family even checks for an updated location). Anyone have experiences with any tracking devices for elders who wander?
Thursday, December 12, 2019
I read last week about a technology problem with a diabetes monitor, A glitch in diabetes monitors serves as a cautionary tale for health tech. Although primarily about this particular device, the article observes that the reliability on this kind of health tech means it's too important for it to malfunction. Some of the things my students and I always discuss in the context of using technology for aging in place is the reliability of the technology, informed consent to its use, privacy of data collected and the cyber security of those companies that store the data. As this article illustrates, when we rely on technology to keep people safe, we need the technology to be reliable. It's early days yet as far as the use of technology to age in place and how well it will function over the long haul.
The Task Force on Research & Development for Technology to Support Aging Adults Committee on Technology of the National Science & Technology Council issued a report, Emerging Technologies to Support an Aging Population. Section VIII of the report, Cross-Cutting Themes. addresses these issues and others, including system dependability, privacy and security, times when the systems are unavailable, vulnerabilities, and more.
These are issues that lead to a robust class discussion, and even a few good topics for students' scholarly papers.
Tuesday, December 10, 2019
I was in Missouri last week for a couple of days and had a chance to visit with some great people. First, I had the privilege to meet Dr. Erin Robinson and Dr. Clark Peters from the School of Social Work at Mizzou. The work they are doing in gerontological social work is quite interesting. At some point our conversation segued into the role of technology in caregiving for older adults, and Dr. Robinson shared with me the research and activities of the Mizzou Center for Eldercare & Rehabilitation Technology, whose "mission is to create technology for proactive healthcare that helps older adults and people of all ages and needs to lead healthier, more independent lives." We also talked about the University's foray into housing for elders, known as TigerPlace. which is a partnership between Americare and the Mizzou Sinclair School of Nursing.
On Friday, I attended day two of the winter symposium of the Missouri Chapter of NAELA (MoNAELA), The two day program had a robust agenda of general sessions and two tracks, advanced and basics. These folks are a great bunch of people who are quite knowledgeable and caring.
Monday, December 9, 2019
Last week Kaiser Health News reported on mistakes on the Medicare website, which may have causes probelms for beneficiaries chosing their plans during open enrollment. Website Errors Raise Calls For Medicare To Be Flexible With Seniors’ Enrollment explains the extent of the problem.
The overhauled Plan Finder debuted at the end of August, and 2020 plan information was added in October. Over the past three months, Plan Finder problems reported to CMS by the National Association of Insurance Commissioners, the National Association of Health Underwriters, and state and national consumer advocates included inaccurate details about prices, covered drugs and dosages, and difficulty sorting and saving search results, among other things.
CMS made almost daily corrections and fixes to the website, which is the only tool that can compare dozens of private drug and medical plans ― each with different pharmacy networks, covered drugs and drug prices. The website provides information for more than 60 million people with Medicare and their families, as well as state Medicare counselors and the representatives who answer the 800-MEDICARE help line.
Unsurprisingly, the article notes that some folks signed up before corrections were made, which may not become apparent to them until they use the plan in 2020. Which leads me to my next point.
Sen. Bob Casey of Pennsylvania, the senior Democrat on [the Senate Special Committee on Aging], also said Medicare needs to reach out so people know they can request a “special enrollment period” if they discover next year they made a wrong choice due to inaccurate Plan Finder information.
“People with Medicare must be aware that this reprieve exists and should not have to jump through hoops to qualify,” he said. The administration should “use all means necessary” to let beneficiaries know about their options for a special enrollment period.
Fifteen Senate Democrats, led by Casey, sent a letter Thursday to Medicare Administrator Seema Verma asking the agency to “widely publicize the existing SEP for people who were misled by information” in the Medicare Plan Finder and to make switching plans easy.
The Associated Press reported on that at the end of last week. Senators urge Medicare to allow seniors a drug plan do-over:
In its statement Friday, Medicare said it wants to ensure that seniors “are confident in their decisions and happy in the coverage they choose.”
Medicare said it’s always had the ability to grant do-overs, “but this year we’re doubling down on ensuring that choosing their Medicare coverage is a simple and painless experience for beneficiaries.”
Medicare officials told AP that if seniors had problems with the plan finder and were unhappy with the outcome, they could call 1-800-MEDICARE and request to make a switch.
Agency officials said beneficiaries don’t need to use any technical language, only explain what their issue is to the call center representative. No documentation or screen shots will be required.
Stay tuned. This may not be over.
Tuesday, July 30, 2019
Have you ever used the Medicare Plan Finder? The GAO released a report a few days ago about it. Medicare Plan Finder: Usability Problems and Incomplete Information Create Challenges for Beneficiaries Comparing Coverage Options explains that the website isn't too user-friendly, with a redesign coming soon.
Medicare beneficiaries have many decisions to make when selecting their health and prescription drug coverage. Their choices affect their out-of-pocket costs and which providers they can see. The Medicare Plan Finder website is a primary source for comparing options.
Many officials who assist beneficiaries in selecting coverage—about three-quarters of those we surveyed—told us beneficiaries struggle with the website. They and others said it is difficult to navigate, contains complex terms, and lacks information needed to compare coverage options.
Medicare’s administrator plans to launch a redesigned website in August.
Here are the highlights from the GAO report:
The Medicare Plan Finder (MPF) website—a primary resource for comparing Medicare coverage options—is difficult for beneficiaries to use and provides incomplete information, according to stakeholders and research studies. These sources and directors of State Health Insurance Assistance Programs (SHIP) GAO surveyed—who assist beneficiaries with their Medicare coverage choices—reported that beneficiaries struggle with using MPF because it can be difficult to find information on the website and the information can be hard to understand. For example, MPF
requires navigation through multiple pages before displaying plan details,
lacks prominent instructions to help beneficiaries find information, and
contains complex terms that make it difficult for beneficiaries to understand information.
In response to GAO's survey, 73 percent of SHIP directors reported that beneficiaries experience difficulty finding information in MPF, while 18 percent reported that SHIP counselors experience difficulty.
Further, the results include "incomplete estimates of costs under original Medicare, making it difficult to compare original Medicare and Medicare Advantage (MA), the program's private heath plan alternative." Further, Medigap plan info isn't included in the results, with 75% "of the SHIP directors surveyed [reporting] that the lack of Medigap information in MPF limits the ability of beneficiaries to compare original Medicare to MA."
This is worrisome, given the emphasis on using the Medicare website for beneficiaries. So it will be important to examine the redesigned website to make sure it is more user-friendly, and contains complete and accurate info.
The full report is available here. Stay tuned.
Tuesday, April 30, 2019
Apparently researchers and gamers are collaborating -- on a "game" that could be used to "identify individuals who might have early and mild symptoms of dementia that medical test aren't able to detect." The game, developed in Germany, and called Sea Hero Quest, reportedly uses virtual reality technology to have a "player" manipulate a virtual boat on a game board. Players are "given a map and shown checkpoints, then the map is taken away and players must navigate to these checkpoints in the game world without the map."
Some of the data reported strike me as, hmmm, surprising. I suspect this game might have greater validity if the players have established, previous skills in using the gaming tools, as well as interest or patience with the technology. There might also be some serious ethical questions for how the "game" is employed as a diagnostic tool. For more details, read "A Video Game Developed to Detect Alzheimer's Disease Seems to Be Working."
Wednesday, February 6, 2019
AARP's research has an update on tech use among older adults. Older Americans’ Technology Usage Keeps Climbing shows adoption of technology by a fair number of older adults. "Today, 91 percent of those age 50+ report using a computer and 94 percent say technology helps them keep in touch with friends and family. And notably, the assumption that older individuals rely less on technology than others may be increasingly inaccurate. More than 80 percent of Americans age 50 to 64 have smartphones, which is about the same as the population at large. Grandparents are also spending a considerable amount on gifts — many likely tech-focused — for their grandkids." Perhaps, unsurprisingly, is the interest in technology's impact on cars and driving with almost 25% keen on "advanced driver assistance technology." As well, about 25% of those surveyed were atrracted to online learning.
One important note from the survey: lack of confidence in security. and privacy online. "Privacy and security issues remain a concern for many in the older age bracket, with Americans over 50 not placing much trust in institutions to keep their personal data safe. AARP finds fewer than 1 in 4 trust online retailers, the federal government, and telecom service providers, among others. A related finding, meanwhile, highlights an opportunity to provide more education to older adults specifically on safe tech practices: Nearly 1 in 5 indicates they have low confidence in their safety online."
Sunday, December 9, 2018
Well, I guess it was only a matter of time. I've blogged on numerous occasions about "elder tech" and now it seems Apple, at least its watch, is moving into that market. Kaiser Health News reported In Grandma’s Stocking: An Apple Watch To Monitor Falls, Track Heart Rhythms.
[W]hen Apple unveiled its latest model in September — the Series 4, which starts at $399 — it was clear it was expanding its target audience. This Apple Watch includes new features designed to detect falls and heart problems. With descriptions like “part guardian, part guru” and “designed to improve your health … and powerful enough to protect it,” the tech giant signaled its move toward preventive health and a much wider demographic.
One expert quoted in the article noted that the older generation is used to wearing watches and thus this would be a much easier wearable for them. Here's how the fall monitoring feature works. "The fall-monitoring app uses sensors in the watchband, which are automatically enabled for people 65 and older after they input their age. These sensors track and record the user’s movements, and note if the wearer’s gait becomes unsteady. ... If a fall is detected, the watch sends its wearer a notification. If the wearer doesn’t respond within a minute by tapping a button on the watch to deactivate this signal, emergency services will be alerted that the wearer needs help." We all know how falls can lead to devastating complications for older persons.
The heart monitor feature again using wristband sensors is used "to monitor a patient’s heartbeat and send alerts if it gets too fast or too slow. Specifically, the app is meant to detect atrial fibrillation, which is a type of arrhythmia, also described as a problem with the speed or rhythm of the heartbeat." The article notes some doctors have concerns that this feature will send folks needlessly to the ER.
The article notes that the FDA has "cleared" but not approved the feature, which means "that means they haven’t faced as much rigorous testing as something that has gained the agency’s formal OK."
More to come.
Friday, September 28, 2018
The Aging, Law and Society Collaborative Research Network (CRN) invites scholars to participate in a multi-event workshop as part of the Law and Society Association Annual Meeting scheduled for Washington D.C. from May 30 through June 2, 2019.
For this workshop, proposals for presentations should be submitted by October 22, 2018.
This year’s workshop will feature themed panels, roundtable discussions, and rapid fire presentations in which participants can share new ideas and research projects.
The CRN encourages paper proposals on a broad range of issues related to law and aging. For this event, organizers especially encourage proposals on the following topics:
- The concept of dignity as it relates to aging
- Interdisciplinary research on aging
- Old age policy, and historical perspectives on old age policy
- Sexual Intimacy in old age and the challenge of “consent” requirements
- Compulsion in care provision
- Disability perspectives on aging, and aging perspectives on disability
- Feminist perspectives on aging
- Approaches to elder law education
In addition to paper proposals, CRN also welcomes:
- Volunteers to serve as panel discussants and as commentators on works-in-progress.
- Ideas and proposals for themed panels, round-tables, or a session around a new book.
If you would like to present a paper as part of a the CRN’s programming, send a 100-250 word abstract, with your name, full contact information, and a paper title to Professor Nina Kohn at Syracuse Law, who, appropriately enough also now holds the title of "Associate Dean of Online Education!"
September 28, 2018 in Current Affairs, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, Housing, International, Programs/CLEs, Property Management, Retirement, Science, Social Security, State Cases, State Statutes/Regulations, Statistics, Web/Tech, Webinars | Permalink | Comments (0)
Wednesday, August 29, 2018
Giving Caregivers (and Law Students!) an Opportunity to See Life through the Eyes of A Person with Dementia
Relias Learning developed an educational tool to promote empathy for individuals with dementia, in the form of a a video shot from the perspective of "Henry," a care facility resident.
Originally intended to help in training professionals, in June 2018 Relias released a version to the general public free of any charges. A second Virtual Reality version, is available for a modest price of $10. There are lots of good points for class discussion in the free on-line version of a Day in the Life of Henry, available here.
Monday, August 27, 2018
The title is somewhat tongue in cheek (I use the phrase in my class to be provocative) but it was only a matter of time until the potential of a micro-chip for elders was becoming a reality. This firm already microchips employees. Could your ailing relative be next? in the Washington Post, explains that a firm that already microchips employees is looking to develop "a more sophisticated microchip that is powered by human body heat and includes GPS tracking capabilities and voice activation [and]... [they] acknowledge that the chips will offer a convenient way to track people — especially those suffering from Alzheimer’s and dementia." The chip the company has in mind will do more than just track whereabouts, according to the article. It will have a medical component that will track the wearer's vitals and notify the wearer's doctor if something is amiss. These "medical microchips" have proponents as well as detractors as the article explains.
The article offers that only about half of the company's employees opted for the microchip, and there are other companies using the technology with humans. One expert thinks using microchips with humans is going to be a done-deal, but not for a few decades. I'm all for the use of tech, but worry about privacy, informed consent and cyber security issues. Although it requires a chip to be inserted into the body, is it any less invasive than cameras or technology monitoring devices such as those used in a medical cottage or a gps tracker in a cane or shoes? I still hold out hope for privacy....even though it may be eroding.
Monday, July 9, 2018
Recently I was chatting with my always interesting California friend, Jack Cumming. We were commenting how lately we've been swamped with interesting new topics in aging. Jack had the best report of all.
It seems that a senior living community is working with a new company to serve as a testing ground for wearable exoskeltons. What's that? Remember how Bruce Wayne always had his Bat Suit ready to go in his Bat Cave?
How might this work? Watch the video at the "Discover" tab for a company called Seismic, that is developing what it rightly calls (and has trademarked) "powered clothing."
I suspect my health law colleague Matt Lawrence will like this too! We can call this a Sci Fi Monday post!
Friday, May 25, 2018
Of course, I'm supposed to be finishing my exam grading. Instead, while stopping by my office, I find a copy of a short story from one of my colleagues. The accompanying note says,"Not even my sci-fi 'escape' is untouched by elder care issues. Thought you'd get a kick out of this."
And indeed, I do. I definitely recommend "Today I Am Paul," by Martin L. Shoemaker. The author draws upon his personal experiences in visiting his mother-in-law in a nursing home to craft a true tale ... with a difference ... as the narrating caregiver is an android.
While my printed-page-loving self recommends reading the short story, I also found a great podcast of the story being read aloud by Kate Baker and I'm linking it here, from Clarkesworld Magazine.
I now plan to use this story to introduce my Elder Law course in the autumn. So much to talk about, including the roles of family, caregivers, technology, fear..... I suspect my co-blogger Becky Morgan, with her often expressed enthusiasm for tech including driverless cars, will appreciate this story too. Happy reading or listening for Memorial Day weekend!
Many thanks to Dickinson Law Professor Matthew Lawrence for this unique, caring experience.
Thursday, May 24, 2018
Believe it or not, there are those in the US who are not on the Internet. Although the numbers are growing, some still haven't gotten onto the information highway. We are seeing an increase in the use of the Internet by those we consider elders, but there are still others who don't use it.
Pew Research periodically releases a report on internet use. The last one, a Fact Tank from a couple of months ago, showed a gradual increase. 11% of Americans don’t use the internet. Who are they?explains that "[t]he size of this group has changed little over the past three years, despite ongoing government and social service programs to encourage internet adoption in underserved areas. But that 11% figure is substantially lower than in 2000, when the Center first began to study the social impact of technology. That year, nearly half (48%) of American adults did not use the internet."
The report looks at all age groups, but since this is the elderlawprof blog, I'm interested in the internet usage by elders. The report gives us that: "[s]eniors are the age group most likely to say they never go online. Although the share of non-internet users ages 65 and older decreased by 7 percentage points since 2016, about a third today do not use the internet, compared with only 2% of 18- to 29-year-olds."
So basically one-third of elders still are off the information highway. As more and more Boomers move past age 65, it will be interesting to see if that number drops or holds steady. Our students need to understand that figure, too, since so many of them are online non-stop.
Tuesday, March 13, 2018
There are amazing technologies out there, and I'm sure more are being invented as I write this. Kaiser Health News ran a story about technology designed to allow elders to age in place and to satay connected. New Technologies Help Seniors Age In Place — And Not Feel Alone opens by relating a story of one elder who agreed to the use of a long-distance monitoring system so her son across the country could keep track of her well-being. "For many, the technology offers not just the tools they need to continue to live at home, but newfound confidence and connectedness with faraway family and friends." One expert quoted in the article has named this trend as "'monitored independence,' and it is changing how older generations age in America. 'People want to be autonomous, irrespective of age,'" said this expert. The article notes that voice-assisted technologies are goign to play a large role in helping elders age in place as these devices can do a lot more than just play music. Pair those with apps designed to help elders and will become proactive in interactions rather than reactive. The article offers a forthcoming app as an example where it will ask the elder if the elder has remembered to take her medication. There are currently apps that remind the user to take medication and allows the user to designate a second party to get an alert if the user misses a dose of medication.
More fall detection devices are coming our way as well, some very soon and others before too long.
It's interesting to see tech moving into this market and hopefully more will be done to help us live independently longer. Is anyone thinking about the privacy aspects of using all this tech?
Wednesday, December 27, 2017
DOJ's office on Violence vs. Women (OVW) is offering a 5-part webinar series on Abuse in Later Life. The webinar series is free. The series will be presented jointly by the National Clearinghouse on Abuse in Later Life (NCALL) and The ABA Commission on Domestic and Sexual Violence. The 5 parts will cover
- January 25, 2018 Abuse in Later Life Overview
- February 8, 2018 Forming the Relationship with your Client
- February 22, 2018 Client Goal-setting and Non-litigation Responses
- March 8, 2018 Legal Resolutions and Remedies
- March 22, 2018 Bringing the Case-Trial Skills
All the webinars are offered at 1:30 est. To register click here
Tuesday, December 26, 2017
The DOJ Elder Justice Initiative is holding a free webinar on January 12, 2018 at 2 est on What Hotline Workers Need To Know About Elder Abuse. To register, click here. Here's the info about the webinar
Julie Childs, J.D., Consultant to the U.S. Department of Justice Elder Justice Initiative, hosts a discussion with Maria Shumar, Victim Specialist Consultant to the U.S. Department of Justice Elder Justice Initiative, and Keeley Frank, Senior Service Specialist from the National Center for Victims of Crime, on assessing and responding appropriately to calls from older adults who may have experienced elder abuse. We’ll discuss case examples to provide hotline workers tips on how to assist these callers and direct them to relevant resources and services.
Friday, December 15, 2017
Are you familiar with the National Center on Law and Elder Rights? If you are an academic teaching courses about any aspect of elder law, disability law, Medicare or Medicaid, you will want to know more about this resource. If you are working in a legal services organization that represents older clients or disabled adult clients, you will want to now about this resource. If you are a young lawyer and just handling your first case involving home-based or facility-based care for older persons who are can't afford private pay options, you will definitely want to know about this resource. In fact, if you are a long-time lawyer representing families who are struggling to find their way through an "elder care" scenario, you too might benefit from an educational "tune up" on available benefits. And the very good news? This is a free resource.
The National Center on Law and Elder Rights (NCLER) was established in 2016 by the federal Administration for Community Living. The new entity is, in essence, a partnership project, with the goal of providing a "one-stop resource for law and aging network professionals" who serve older adults who need economic and social care assistance. Justice in Aging (formerly the National Senior Citizens Law Center) which has primary offices on the east and west coast is a key partner, working with the American Bar Association's Commission on Law and Aging, the National Consumer Law Center (NCLC), and the Center for Social Gerontology (TCSG). Attorneys at these four NCLER partners provide substantive expertise, including preparation of materials available in a variety of formats, such as free webinars on a host of hot topics. The Directing Attorney is Jennifer Goldberg from Justice in Aging and the Project Manager is attorney Fay Gordon.
It strikes me that a very unique way in which NCLER will be a valuable resource is through what the offer as "case consultations" for attorneys and other professionals. Think about that -- you may have long-experience with one branch of "elder law" such as Medicaid applications, but you have never before handled an elder abuse case with a bankruptcy problem. Here is the way to potentially get experienced guidance!
The web platform for NCLER offers a deep menu of resources, including recordings of very recent webinars and information on future events. I recently signed up for a January 2018 webinar program on elder financial exploitation and even though it is a "basics" session I can tell I'll hear about a new tools and possible remedies, as the presenters are Charlie Sabatino and David Godfrey. I just watched a recording of another recent webinar and it was very clear and packed with useful information. There is a regular schedule for training sessions -- with "basics" on the second Tuesday of every month and more advanced training sessions on the third Wednesday every month.
I confess that somehow NCLER wasn't on my radar screen until recently (probably because my sabbatical last year put me about a year behind on emails -- seriously!) but I'm excited to know about it now.
December 15, 2017 in Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Cases, Health Care/Long Term Care, Legal Practice/Practice Management, Medicaid, Medicare, Programs/CLEs, Social Security, Web/Tech, Webinars | Permalink | Comments (0)
Tuesday, December 5, 2017
Our friend and colleague, Professor Naomi Cahn at GW Law, sent us a link to a story published in Slate. The Digital Afterlife Is a Mess recounts the tangle created by the number of accounts a person may have, knotted up by company policies and wrapped around various laws.
Today’s world is different. Many of us have chosen to go paperless, so all of our financial statements are delivered electronically; we even file digital tax returns. Our love letters may no longer be written in ink on paper, our reading and listening and viewing interests no longer documented by hardcover books and magazines, record albums, and VCR tapes, and our photos no longer stored in boxes under out beds.
So once the digital asset owner dies, how does the executor gain access to these digital assets and further, determine their value, if any? The article explains the hurdles, including the potential for committing a crime unwittingly by using the decedent's account and password to access digital files. The article turns to the Uniform Act designed to address this growing problem: the Uniform Fiduciary Access to Digital Assets Act, Revised, which has been adopted by almost 2/3 of the states. The Act "allows a fiduciary to manage much of a decedent’s digital property, giving access to many things other than the content of electronic communications (unless this access has been limited by the user or by a court order) and even permitting access to content in certain limited situations." The article explains the 4-tiered system the Act uses for prioritizing and offers practical suggestions such as starting with inventorying your own digital assets, subscribing to an online account management program, and include coverage of digital assets in estate planning documents.