Patti's Blog - Advocate for Elders, People with Disabilities and Their Families

Insomnia predicts nursing home admission, study finds

Excerpt from: McKnight's (click for full article)

 

Seniors who have insomnia are more likely to be admitted to a nursing home than those who experience quality sleep, according to a recently published study.

Researchers at the Johns Hopkins Bloomberg School of Public Health utilized the Health and Retirement Study, which is a biennial survey of more than 26,000 Americans who are 50 and older.

Respondents who had symptoms of insomnia in 2006 were more likely than other survey participants to be hospitalized, admitted to a nursing home or need home healthcare by 2008, the researchers found.

“A relationship was even found between insomnia symptoms and hospitalization as well as use of any of the three health services after accounting for common medical conditions and elevated depressive symptoms,” said lead author Christopher Kaufmann, MHS, a doctoral student with the Bloomberg School's Department of Mental Health.

$7.9 Billion in Improper Social Security Payments in FY 2012

Excerpt from: CNS News (click for full article)

 

The Social Security Administration (SSA) needs to focus on "program integrity," a polite term for reducing fraud and payment errors, the agency's inspector general told Congress last week.

Reducing improper payments is one of the challenges facing the next SSA commissioner, Patrick O'Carroll, Jr., the agency's inspector general, told the House Ways and Means Subcommittee on Social Security on April 26.

In fiscal year 2012, the Social Security Administration reported $4.7 billion in improper payments in the Supplemental Security Income (SSI) program, a 9.2 percent improper payment rate. (SSI is funded by general tax revenues, not payroll taxes. It helps elderly, blind, and/or disabled people who are poor.)

The cost of care

Excerpt from: Life Health Pro (click for full article)

 

This year marks the tenth anniversary of Genworth Financial's Cost of Care survey and it's a great time to discuss long-term care in all its forms with your clients. By minimizing their risk, you can help them prepare to meet the challenges of tomorrow before the task becomes too monumental to achieve.

Here's how.

Get to know what your clients value.

Helping Seniors Learn New Technology

Excerpt from: New York Times (click for full article)

 

In an era when everything, from personal health records to nursing home quality ratings, is moving online, when the best way to stay in touch with grandchildren may involve texting, this amounts to slow progress. The tech analyst Laurie Orlov of the Aging in Place Technology Watch blog has called for a national campaign to bring 100 percent of seniors online.

Teaching skills only addresses part of the problem, of course; the costs of devices and of Internet service also keep older people offline, and so do physical limitations or cognitive impairment.

Still, learning the technology is key. As Mr. Phillips pointed out, “the Internet was a whole new world for me.” Everyone exploring a new world needs a guide.

Though lots of communities offer computer classes for older adults, the response has been mostly local and small-scale. But since my previous post brought lots of comments from frustrated adult children, I thought I’d pass along some time-tested national and about-to-be-national programs. Researchers have learned a fair amount about the ways seniors learn and have documented that computer and Internet training works well when it incorporates those findings.

Medicaid Spend Down

Excerpt from: caring.com (click for full article)

 

The cost of nursing home care is extraordinarily expensive, and Medicaid won't help pay if you have more than $2,500 in "countable" assets. Sometimes people decide to "spend down" their excess assets to qualify for Medicaid benefits. But this can be risky. If the Medicaid agency thinks you're bending the rules, you risk losing eligibility for five years. And current crackdowns by Medicaid are much more common than in years past.

Retiring with Debt? Join the Club.

Excerpt from: AARP (click for full article)

 

Paying off the mortgage before you head into the land of fixed-income living, otherwise known as retirement, is becoming an unattainable goal for a growing number of people.

A survey by the Securian Financial Group found that about half of 526 retirees polled in March carried mortgage debt into retirement. And it appears that even greater numbers of boomers will follow suit.

[Read: Fixing One Family's Finances]

The poll asked 495 pre-retirees ages 50 and older if they expected to carry mortgage debt into retirement; 67 percent said yes. In similar surveys by Securian in 2007 and 2009, just 30 percent of near retirees said the same.

Michelle Hall, a market research manager at Securian, called the latest findings troubling.

Capacity for Lifetime and Estate Planning

Excerpt from: Penn State Law Review (click for full article)

 

Clients consulting with elder and estate planning attorneys for estate planning documents will likely receive a “package” of five documents: a will, a trust (revocable or irrevocable), a health care power, a durable power of attorney, and a living will. Although capacity standards have varied for each of the items in the “package,” an informal survey of American College of Trust and Estate Counsel (ACTEC) members reveals that practitioners do not pay attention to these distinctions when they create the “package.” Practitioners are either unwilling to accept the engagement for lack of competence or willing to overlook the capacity distinctions when accepting the engagement. This article thus advocates for a uniform test for capacity when an attorney considers preparing the “package” for a client.

Unresolved Emotional Conflicts Drive Post-Death Disputes

Excerpt from: JDSupra (click for full article)

 

No family is perfect.  And while all litigation is emotional, our experience is that almost all trust and estate litigation is driven by underlying emotional disputes among family members.  And death, like divorce, can open the floodgates of those disputes.  Long simmering sibling rivalries come to a boil.  Suppressed anger towards step-parents or step-children bursts forth.  Children who felt minimized by their parents assert themselves.

If these disputes are recognized during lifetime, they can be addressed in the estate plan.  Decisions such as who to name as fiduciary or how to structure a gift to a particular family member can minimize the opportunities for those disputes to arise.

But sometimes those disputes only come to light after death, causing the estate administration to spin out of control and result in litigation.  And some beneficiaries use that litigation as their grieving process.  Ironically, those emotions also act as a roadblock to reaching a rational resolution of the legal disputes.

Slow Lawyering: Representing Seniors in Light of Cognitive Changes Accompanying Aging

Excerpt from: Penn State Law Review (click for full article)

 

As an increasing number of lawyers represent clients who are elderly, it is imperative that lawyers become more knowledgeable about the aging process and how it impacts our clients. Although it is difficult to generalize, many seniors experience numerous and diverse cognitive changes that accompany the aging process. Existing literature offers various frameworks for addressing capacity issues and techniques for assessing diminished capacity. However, current legal scholarship provides little guidance for lawyers on how to accommodate these changes when they do not rise to the level of diminished capacity or dementia, and when the changes may, in fact, result in increased wisdom and “developmental intelligence.” This article seeks to fill that void. It summarizes selected cognitive developments that impact memory, outlining various types of memory and how they evolve during the aging process. This article also discusses current literature on decision-making capacity and different decision-making models and strategies that seniors may rely upon. The article concludes with recommendations on methods for enhancing communications with aging clients, while simultaneously acknowledging and accommodating cognitive changes and enabling seniors to play a prominent role in the representational process.
* Professor of Law and Director, Elder Law Clinic, Syracuse University College of Law.

Health Care for 1972?

Excerpt from: Health Policy Forum (click for full article)

 

The fact is that roughly 70 percent of Americans over the age of 65 will need some form of long-term care, on average for three years. Yet most people, when asked, think they will never need this kind of care. To make matters even worse, many individuals mistakenly believe that Medicare will pay for long-term services and supports even (it does not). The result is a public that is woefully underprepared and ill-equipped to prepare for what are probably inevitable health needs.

This gap in knowledge and awareness has contributed to our current “non-system” of financing long-term care, in which people are left to fend for themselves to pay for services or spend down to near poverty levels to qualify for Medicaid; for only then is public help available. This is neither a sustainable nor a dignified policy. We need to develop a better model that will ensure that all Americans can age with dignity, choice, and independence. But what would that look like? As a physician, I believe we have perfected the health care delivery model for 1972. What we need today and into the future is an updated toolbox for financing long-term care that serves the needs of a 2013 population. In 1965, the average life expectancy was 69 years old. If an older person experienced a major health event—a heart attack or stroke, for example—they might have recovered, but they probably did not live much longer beyond that event. Today, with advances in medicine and technology and the increased number of intensive care units and critical care units, people are living longer than ever before, but with functional impairments and multiple chronic conditions. The delivery model we have today is not designed to meet these growing care needs, and the financial strains on individuals and families are significant.