More Young People Are Winding Up in Nursing Homes - Yahoo! News

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By MATT SEDENSKY, Associated Press

Adam Martin doesn't fit in here. No one else in this nursing home wears Air Jordans. No one else has stacks of music videos by 2Pac and Jay-Z. No one else is just 26.

It's no longer unusual to find a nursing home resident who is decades younger than his neighbor: About one in seven people now living in such facilities in the U.S. is under 65. But the growing phenomenon presents a host of challenges for nursing homes, while patients like Martin face staggering isolation.

"It's just a depressing place to live," Martin says. "I'm stuck here. You don't have no privacy at all. People die around you all the time. It starts to really get depressing because all you're seeing is negative, negative, negative."

The number of under-65 nursing home residents has risen about 22 percent in the past eight years to about 203,000, according to an analysis of statistics from the Centers for Medicare and Medicaid Services. That number has climbed as mental health facilities close and medical advances keep people alive after they've suffered traumatic injuries. Still, the overall percentage of nursing home residents 30 and younger is less than 1 percent.

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Study Compares CNA Care at Green House and Traditional Facilities | PHInational.org

from PHI blog

Certified nursing assistants (CNAs) working in skilled nursing facilities affiliated with The GREEN HOUSE® Project spend more time on direct care than their counterparts in traditional facilities, according to a new report.

The study also shows that Green House CNAs spend more time engaging with residents when they are not assisting them with activities of daily living (ADLs), as compared with CNAs in more traditional long-term care facilities.

“This study confirms what we can see and feel from the moment we enter a flourishing Green House,” said PHI Midwest Training & Organizational Development Specialist Maureen Sheahan. “The Shahbazim take pride in creating home and comfort for the elders. Their close contact with each other, along with the comprehensive way that they engage in daily life, tasks, and activities, create meaningful and satisfying relationships for both staff and elders.”
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With A New Congress, It's High Time For Some Health Overhaul Facts - Kaiser Health News

By Julie Rovner, NPR News

With the debate over health overhaul back in full force, we figured it's time to take another look at some of the claims being thrown around by Republicans and Democrats about the effect of the law and what might happen if it's repealed.
Claims & Facts

New Poll Finds Americans Split On Repeal; Divide On Capitol Hill Deepens - Kaiser Health News

from Kaiser Health News A new Gallup Poll found that public opinion is "closely divided" over whether Congress should vote to undo the health law. And on Capitol Hill, the divide is deep and entrenched, closely tracking with political loyalties. Even as GOP leaders point to the push to stop the health law as a way to "send a signal" to the American people, Senate Dems are plotting action of their own. Read More

Grandparents Rights » Grandparents custody: what is it and why?

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from CaringGrandparents.com

A grandparent may seek legal custody of their grandchildren for numerous reasons. The simplicity or complexity of this will depend on individual circumstances and whether or not both the parents and grandparents agree that the children should be in the custody of the grandparents.

Legal custody is awarded by the courts and is not merely a written agreement between two parties. If both parties are not in agreement, the grandparent or other relative must prove to the court that it is in the best interest of the child or children to be raised by someone other than the parent.

If neglect or abuse of a child is suspected, it should be reported to the Department of Social Services. It is also important to record and document any reasons why a child should be removed from the custody of his or her parents. This is not a decision that a court makes lightly and supporting evidence must be presented by a relative when seeking custody of a child.

When a person or couple becomes the custodian of a child, this does not legally sever other family relationships as in the case of adoption and may be reversed at a later time when circumstances change.
Grandparents Rights » Grandparents custody: what is it and why?

Persons with Disability Tennis Paraolympics

Wheelchair Tennis Unites Able-bodied Tennis Players | Wheelchair Accessibility Blog and Disability News

by Destiny in the Disability News

The Grand Rapids Wheelchair Sports Association has brought together Beth Redford, a tennis player in a wheelchair, and Karen Reid, an able-bodied player, in the adult doubles tournament. There’s no doubt the duo will make a great team sharing the same mentality.

“When it comes to tennis we don’t want to get beat, “says Reid.

This will be the Grand Rapids Wheelchair Sports Association’s 30th year celebration while hosting the 7th annual adult doubles charity tennis tournament. The event will be held January 7th-9th at the Ramblewood Tennis & Health Club in Grandville, Michigan. The tournament is actually an able-bodied tournament, but that won’t hold Redford back from participating with her teammate Reid who just so happens to be a tennis instructor. “Bring it on,” is how Redford felt about competing with their opponents.

“We talked about it this summer and said let’s do it, this is the first time we will play able-bodied players, and we are excited to take on the challenge,” Redford stated.

Though they will be at a slight disadvantage competing against two able-bodied teammates, they don’t seem too worried about it. There is a crew that GRWSA offers known as One Up, One Down league, made of double teams featuring one player sitting and one standing. This is aimed to bring people together and hopefully enlighten able-bodied people along with people with disabilities.

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HUD and HHS Announce Joint Effort to Assist Persons with Disabilities to Move from Institutions to Independence

U.S. Housing and Urban Development (HUD) Secretary Shaun Donovan and Health and Human Services (HHS) Secretary Kathleen Sebelius announced today a joint partnership between the two agencies to help nearly 1,000 non-elderly Americans with disabilities leave nursing homes or other healthcare facilities to live independently.  This is the first time two federal agencies are offering a combination of rental assistance, health care and other supportive services targeted to this population.
     
HUD is providing $7.5 million in rental assistance vouchers that will help nearly 1,000 individuals with disabilities rent private apartments.  Public housing authorities in 15 states will administer the rental subsidies and will work with state human service agencies to identify eligible individuals who could benefit from the program.  For a local breakdown of the funding announced today, visit HUD's Web site. 
       
Individuals receiving rental assistance through the program will also receive health and social supports that will enable them to live independently.  These supports are provided through the HHS Centers for Medicare and Medicaid's "Money Follows the Person" (MFP) grant program, which allows individuals who qualify for Medicaid-funded nursing home or other institutional care to receive supports - such as in-home nursing and personal care services - while living in the community instead.  In places where the MFP program is not available, services will be provided by a state-sponsored institutional transitional program comparable to MFP that includes dedicated supportive services.
     
As part of President Obama's Year of Community Living initiative, HUD and HHS launched a joint effort to provide housing support for non-elderly persons with disabilities who are currently receiving long-term care in institutional settings.  The interagency collaboration is intended to allow persons with disabilities to live productive independent lives in their communities rather than in institutions. 

"The Obama administration is committed to helping Americans with disabilities live independent lives. Housing is a critical piece of the equation when it comes to transitioning out of institutions," said Donovan.  "Coordinating this effort with the Department of Health and Human Services is an important step in ensuring that more Americans with disabilities will have the housing and support they need to fully participate in community life." 

"Through our collaboration with the Department of Housing and Urban Development, I know that we will be able to dramatically change peoples' lives," said Sebelius.  "Individuals with disabilities can have a life in the community that serves their needs and supports them in leading productive, meaningful lives."
     
The funding announced today is being provided through HUD's Rental Assistance for Non-Elderly Persons with Disabilities Program.  It is part of the $40 million HUD made available April 2010 to public housing authorities across the U.S. to fund approximately 5,300 rental assistance vouchers for non-elderly persons with disabilities to promote independent living for this community.  Public housing authorities applied for funding under two categories. 
     
Last October, HUD awarded $33 million to support a first round of 4,300 vouchers, making it possible for non-elderly individuals with disabilities and their families to access affordable housing in communities that meet their housing needs and so avoid potential institutionalization.  Today's announcement is for the second round funding to provide 948 vouchers targeted for non-elderly individuals with disabilities currently living in institutional settings, such as nursing homes, but who could move into a community with assistance. 

These vouchers will augment work already being done by HHS' Centers for Medicare & Medicaid Services (CMS) through its Money Follows the Person (MFP) rebalancing demonstration program.  Now in its fourth year, the MFP program has made it possible for almost 12,000 individuals to live more independent lives by providing necessary supports and services in the community.  Twenty-nine states and the District of Columbia are currently participating in the MFP program and CMS is expecting a new round of grant applications on January 7th.
     
State Medicaid agencies and local human service organizations will link eligible families to local public housing authorities that will administer voucher distribution.  To improve the connections between the housing authorities and Medicaid agencies, HUD and HHS have launched the Housing Capacity Building Initiative for Community Living Project to assist seniors and individuals with chronic conditions who are at risk of institutionalization or who currently receive care in institutional settings, in finding appropriate housing in order to live more independent lives.   
     
The Community Living Initiative is an outgrowth of the 1999 landmark Supreme Court ruling in Olmstead v. L.C.  In that case, the Court ruled that the Americans with Disabilities Act (ADA) protects a person with a disability from being unnecessarily institutionalized.  The Court said that such forced institutionalization can lead to isolation and segregation of individuals with disabilities and be a serious and pervasive form of discrimination.

RA in Men Associated With Mortality Risk

By Nancy Walsh, Staff Writer, MedPage Today

Men with rheumatoid arthritis were more than twice as likely to die over a seven-year period as their counterparts in the general population, researchers found.
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Simple Question Aids Parkinson's Diagnosis

By John Gever, Senior Editor, MedPage Today

Dutch researchers said they have found a way to distinguish atypical Parkinson's disease from the more common standard form: asking patients if they can still ride a bicycle.

When the question was put to 111 consecutive patients with Parkinson's disease, nearly all those who said it had become impossible were subsequently determined to have the atypical form, according to Bastiaan Bloem, PhD, and colleagues at Nijmegen Medical Center in the Netherlands.
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Health Spending Slows, Recession to Blame

By Emily P. Walker, Washington Correspondent, MedPage Today

Spending on healthcare grew at its slowest rate in 50 years, mostly because of recession-fueled cutbacks by businesses, governments, and households, according to a Centers for Medicare and Medicaid Services report.

The growth in healthcare spending has slowed every year since 2002, but 2009's was particularly pronounced -- growing at a rate of 4%, down from 4.7% in 2008, according to the authors of the agency's annual health spending report, published in Health Affairs.

Economic recessions do not always lead to a slowdown in healthcare spending, Anne Martin, a CMS economist and lead author told reporters at a press briefing.

Despite the slowdown in the growth rate, the U.S. still spends $2.5 trillion on healthcare, or $8,086 per person.

And if the rate of growth in spending has slowed, healthcare's share of the nation's gross domestic product (GDP) -- 17.6% -- took its largest one-year increase in the five-decade history of the CMS report.

The largest chunks of the $2.5 trillion spent on healthcare in 2009 went toward hospital care, followed by physician services, then prescription drugs.

One-sixth of the nation's financial resources went to pay for healthcare, and more than half of all taxes collected paid for healthcare, said Martin.
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Census Bureau says 15.7 percent in poverty - UPI.com

WASHINGTON, Jan. 6 (UPI) -- Using an expanded definition of poverty, the U.S. Census Bureau said it determined that 15.7 percent of Americans -- 47.8 million -- live in poverty.

Included in the new calculation are factors such as family and medical expenses, as well as government subsidies, researchers said. The definition of poverty for families generally ranges from $21,000 to $25,000 annually.

Census Bureau researcher Kathleen Short, the report's author, wrote the "new group of poor would consist of a larger population of elderly people, working families and married-couple families than are identified in the official poverty measure."

People older than 65 and younger than 15 accounted for the rate of poverty being higher, researchers said. Wednesday's report said 18 percent of children and 16.1 percent of the elderly live in poverty.

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Grandfamilies: A New Term on the Rise

by Jilly Prather

Today’s definition of “family” has been changing drastically in recent years with the advent of a new kind of family unit. Due to various reasons—such as parents having drug problems, the rise of divorce, an economy that has put millions out of work, and single moms who can no longer raise their own children—we now have a growing generation of grandparents who find themselves in the trenches of raising young grandchildren. This new phenomenon of parents depending on the grandparents to finish raising their children is also called “the skipped generation.”

As a grandparent, I once dreamed about my children leaving home to embark upon creating their own lives as independent people, having a home of their own, good jobs, and grandchildren for me to spoil and send home. Retirement was something I looked forward to, with travel plans and the freedom I felt I deserved after decades of raising my kids.

One evening a few months ago, I received a call from the police department asking if I could go pick up my 14-year-old granddaughter for an indefinite period. Of course I went quickly, as Sherry (not her real name) and I had a strong bond. I had always told her to call me if she ever needed me for any reason. I scooped her up in my arms and promised her that everything would be okay now—she was now with Grammy. I did what any other loving grandmother would do. When the grandchildren need to be saved from dangerous situations and they have no other adult to turn to, grandparents take over to provide the safety and love the child desperately lacks but needs in order to become a good adult.

In 2008, census statistics show that 6.6 million children lived with their grandparents. Of those children, 4.4 million lived in the home of a grandparent without any help or interaction from their parents (U.S. Census Bureau 2009). Those numbers are staggering and continue to increase yearly.

Older adults who once looked forward to growing a new nest of opportunities and goals now find themselves in the midst of having to start over again raising children. Many of these seniors live on a fixed income based on social security, disability or limited retirement funds that make suddenly having another child to support very difficult. In the 2008 census, the government reported that 482,000 grandparents lived below the poverty level before they became responsible for caring for grandchildren (U.S. Census Bureau 2009).
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Slow and Steady Saving Still Pays - WSJ.com

Image via WikipediaBy TOM LAURICELL

The path toward having enough money to enjoy a comfortable retirement is a long one. And as the recent decade in the U.S. stock market shows, it's one where patience pays off.

For younger retirement savers who diligently put money away, that long march of time also provides a crucial ally: the ability to recover from inevitable losses. That's especially the case for 401(k) investors who don't pass up the essentially free money that comes by taking full advantage of any matching contributions provided by their employers.

There's no reason to sugar-coat the miserable experience most stock investors have had since the collapse of the technology-stock bubble beginning in March 2000. The Standard & Poor's 500-stock index, the most commonly used market barometer, has risen an average of just 1.4% per year over the past 10 years, a 3.6% gain once dividends are included.

It was only last month that the Dow Jones Industrial Average pushed above where it stood in mid-September 2008 when giant brokerage house Lehman Brothers collapsed.

But let's look at how steady savings and the passage of time can benefit younger 401(k) investors. Consider a person making $40,000 per year in 2000 who contributed 6% of her salary -- $200 per month -- in the first year with a company match of 3%, or $100 to start.

Continue Reading Full Article - WSJ.com

The Crucible « ChangingAging.org

by Dr Bill Thomas

This is the second in a series of posts on some new ideas I am working on.

The paragraphs below begin to introduce the concept of the crucible as an instrument of social change.

For most people most of the time, private problems issues remain private and public issues remain public. Sometimes, however, a society encounters the problem of a huge number of people (members of a single generation) moving from one life stage to to the next within a condensed period of time. When this happens, difficulties surrounding growth and change cease to be solely private matters and erupt forcefully into public life. Public issues cease to become impersonal and distant and intrude forcefully into individuals’ private lives. I use the word “crucible” accurately describes the intense conflict and uncertainty that accompany these historical passages.

Because of its size, and position in the unfolding of world history, the Post War generation was endowed with an unprecedented capacity for creating“crucible” experiences. When one adolescent becomes angry with her parents she might slam the door to her room. When millions of adolescents “question authority,” thousands of them are apt to band together and attempt to levitate the Pentagon. One teenager might sneak a cigarette behind the barn. A massive generation of young people can create an entire counter culture laced with sex, drugs, and rock n’ roll. The Post War generation’s size and influence made its fitful transition from childhood to adulthood a matter of urgent concern for the nation as a whole. This First Crucible nearly set American society on fire.

The Post War Generation’s Second Crucible is destined to become even more consequential than its first. Even as they edge into late adulthood, members of the Post War generation continue to idealize youth, vigor and productiveness. Meanwhile, the clock continues to tick. The Second Crucible will erupt as the Post War generation crashes into the end of adulthood and begins to grapple with aging and elderhood. The scale of this collision, the speed at which it will unfold and the decisions it will force on young and old alike. In the private sphere, individuals will feel alienated from their own changing minds and bodies in ways they have not experienced since puberty. In the public realm, we are already beginning to see the outlines of an intergenerational conflict that pits the young against a massive generation of people who continue (against all evidence) to believe that they are still stardust.

Posted By Dr. Bill Thomas on January 6th, 2011 | Category: Aging, Cult of Adulthood, Longevity

The Crucible « ChangingAging.org

Consumer Voice Expands Project

The National Consumer Voice for Quality Long-Term Care (formerly NCCNHR), also known as the Consumer Voice, is pleased to announce the expansion of its project Consumers for Quality Care, No Matter Where into California through support from The SCAN Foundation. In California, the Consumer Voice will partner with state and local organizations to develop strategies to address key public policy issues and to enable a strong consumer voice around the need for accessible, well-coordinated, quality care. Consumers for Quality Care, No Matter Where, is a three-year project (also funded by The Atlantic Philanthropies - see the September 29 press release at http://www.theconsumervoice.org/media), expanding the organization's national grassroots advocacy network to focus on health care issues faced by older long-term care consumers requiring care in their homes or communities. As part of the grant, the Consumer Voice will develop models for engaging consumers through five state pilot projects, including California. The project will also facilitate collaboration among national organizations to implement health reform, create a consumer perspectives report with policy recommendations responsive to the needs of a diverse, aging population and provide training and funding for consumer advocates. In the California pilot, the Consumer Voice will establish an advisory council, which will identify issues and barriers for the state's long-term care consumers. The project also includes training opportunities for California consumers and their advocates to effectively participate in systemic advocacy as well as educate them on issues specific to home and community-based services; it will conduct outreach in the state in order to compile the consumer perspectives report. "The Consumer Voice has a long history of advocating for quality care in nursing homes," said Sarah F. Wells, executive director. "We now look forward to successfully advancing consumer advocacy in all care settings. With The SCAN Foundation's additional support to expand our three-year consumer advocacy project, the Consumer Voice has an invaluable opportunity to partner with consumers and advocates in California." The Consumer Voice is widely recognized as the only national organization bringing consumers' voices directly to federal policy discussions and was instrumental in passing the 1987 Nursing Home Reform Act, which created the framework for nursing home regulation and consumer protection. The organization was also a leader in the passage of the Nursing Home Transparency and Improvement Act, the Elder Justice Act and the Patient Safety Act in the Affordable Care Act. For more information on the Consumer Voice, visit www.theconsumervoice.org. ### The National Consumer Voice for Quality Long-Term Care is a 501(c)(3) nonprofit organization founded as the National Citizens' Coalition for Nursing Home Reform (NCCNHR) in 1975 by Elma Holder. The organization represents the consumer voice at the national level for quality long-term care, services and supports by advocating for public policies that support quality care and quality of life responsive to consumers' needs in all long-term-care settings; empowering and educating consumers and families with the knowledge and tools they need to advocate for themselves; training and supporting individuals and groups that empower and advocate for consumers of long-term care; and promoting the critical role of direct-care workers and best practices in quality-care delivery. The SCAN Foundation, based in Long Beach, California is an independent nonprofit organization dedicated to advancing the development of a sustainable continuum of quality care for seniors that integrates medical treatment and human services in the settings most appropriate to their needs. The SCAN Foundation supports programs that stimulate public engagement, development of realistic public policy and financing options, and dissemination of promising care models and technologies. For more information, please visit www.TheSCANFoundation.org.

Consumer Voice Expands Project

Republicans' Deficit Ceiling Bluff an Attack on Social Security

CBO: GOP Repeal of Health Reform Will Add $230 Billion to Deficit, Eliminate Coverage for 32 Million, and Americans Will Pay More for Less | The Gavel

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by Karina

The nonpartisan Congressional Budget Office (CBO) just released an estimate of the Republican bill to repeal the Affordable Care Act and finds the GOP plan explodes the deficit and will have a devastating impact on the health of millions of Americans.

According to CBO, here’s what the GOP repeal bill means for Americans:

Adds $230 billion to the deficit over the first ten years and more than $1.2 trillion in the second decade (around one-half percent of GDP)

32 million Americans will lose health coverage

Americans will get fewer health benefits for their money

Americans purchasing health insurance on their own will see their costs rise

Health care premiums for Americans getting coverage through large employers will go up

CBO: GOP Repeal of Health Reform Will Add $230 Billion to Deficit, Eliminate Coverage for 32 Million, and Americans Will Pay More for Less | The Gavel

Related articles

• The CBO tells Republicans what they don't want to hear (washingtonmonthly.com)
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• GOP won't count cost of repeal (politico.com)
• Repealing health-care reform would cost hundreds of billions of dollars -- and Eric Cantor knows it (voices.washingtonpost.com)
• Republicans Ignore That Health Care Repeal Would Cost $143 Billion Over Ten Years (alan.com)
• "Dems amp up defense of health care reform" and related posts (ibabuzz.com)
• Funny how Boehner and Cantor used to like CBO (americablog.com)
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Military Technology Helps Wheelchairs Detect Hazardous Terrain | Wheelchair Accessibility Blog and Disability News

by Destiny

Researchers are working on developing a wheelchair that can detect hazardous terrain and self adjust its settings to move more smoothly and safely over different types of landscapes. The new technology helps electric wheelchair users avoid accidents involving wheels slipping, sinking, or tipping over.

The idea originated from automatic terrain-sensing controls for unmanned military vehicles and multiple four-wheel-drive automobiles that are already on the market. Emmanuel Collins from Florida State’s Center for Intelligent Systems stated that the device is known as a laser line striper and is used to recognize different terrain conditions.

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A “Blinding Flash of the Obvious” « ChangingAging.org

by Dr Al Power in Changing Aging

Here’s a “Blinding Flash of the Obvious,” or “BFO”, as our friend Jane Verity, CEO of Dementia Care Australia would say. On New Year’s Day, the New York Times slipped in an article on new approaches to dementia. My inbox lit up with forwarded copies, and many of us celebrated the recognition of something many of us have been preaching for some time.

The article has its share of language issues, such as referring to people as “difficult” or “acting out”, but it hits on several central tenets of what I have come to call an “experiential” approach to dementia. Here are a few of those ideas alluded to in the article:

• The key to addressing emotional distress is to know the person, to understand his needs as he sees them, and to work creatively to find solutions that fulfill these needs, without judgment. This often requires that we take away our paternalistic view of people with dementia as being incapable, or somewhat less entitled to choices that we all take for granted. People choosing when they get up or go to bed? “Allowing” a 96-year old to eat chocolate?? How did we get to the point where these are startling revelations??? BFO.
• There are many cosmetic and programmatic changes recommended in the article and they all have value. But the gem of the article, in my mind, is the University of Iowa study that showed how durable people’s memories are of positive or negative emotional experiences–even more so than people without dementia–and long after their memory of the details of the experience have faded.

This is important for two reasons. First it shows, as Christine Bryden said in her book Dancing with Dementia, that people who live with dementia make a journey from cognition into emotion (and eventually into spirituality). The emotional content of the moment has extremely powerful effects on a person’s demeanor from moment to moment, day to day.

This leads to the second point: in spite of the value of cosmetic changes, focused activities and programmatic approaches, the real key to well-being lies in the spaces–those individual moments that underlie every interpersonal interaction–not just during bingo, but when greeting someone, giving her a bath or helping with a meal. These interactions leave an indelible impression on a person that will determine how their days (and yours) will play out. As my mother-in-law said to my wife one day, deep into her life with Alzheimer’s, “I don’t know your name, but I know you’re my friend.” One of the best references on these moments is Nancy Pearce’s book, Inside Alzheimer’s which is coming out in a revised edition this year.

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Training, New Rules Meant to Reduce Abuse at Adult Family Homes | Seattle Times Newspaper

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By Michael J. Berens Seattle Times staff reporter

In the wake of a yearlong Seattle Times investigation that detailed widespread problems in the adult-home industry, the state has improved training for home owners, made violation reports more accessible to the public and started reporting all abuse and neglect cases to law enforcement.

This 48-hour training course, the state's first at a community college, is just one of many reforms launched this year in the wake of a Seattle Times investigation, "Seniors for Sale," which detailed systemic problems in the adult family home industry.

The Times found that the elderly have been exploited by get-rich-quick profiteers, harmed by untrained caregivers, and ignored by the state even after some died of apparent neglect. Owners even listed elderly residents as commodities in the sales ads for such homes.

The state excused abuse and neglect by owners even when it knew they had lied to investigators, provided falsified medical records or contributed to preventable deaths, The Times found.

Officials at the Washington Department of Social and Health Services, which regulates adult family homes, since have overhauled key programs.

• Adult-home owners now must publicly post state violations they've received so residents and their families can view them.

• Also for the first time, DSHS posts all enforcement actions on its website, which allows the public to more quickly gauge the quality of adult homes.

• DSHS officials now report all cases of suspected abuse and neglect in King County to law enforcement, part of a pilot program launched last month. The Times reported in September that since 2003 at least 236 suspicious deaths in adult homes were never investigated.

"There have been a lot of changes this year that will make this industry better, more accountable and better trained," said Cindi Laws, executive director of the Washington State Residential Care Council, which represents the state's 2,975 adult homes.

Laws said most adult homes provide quality care. Even so, Laws is spearheading a "quick-response team" of experienced home owners who will visit problem homes, provide training and help to correct deficiencies.
Full Article

Mentor Man Fighting for Elder Rights - news-herald.com

Image by runran via Flickr
By Tracey Read

Tom Fields' father lay dying in a hospital bed in Florida on a morphine drip for cancer.

Fields, a Mentor resident, believes that during his final hours his father was the victim of financial elder abuse by people close to him.

He said his father's wishes about his property were altered as a new will was written.

People took advantage of my father and got him to sign a document," Fields said.

"There was no protection against this. A protocol could have stopped that."

Fields is now an independent advocate fighting to get laws passed to protect families in similar situations.
Full Article

Bankruptcies Up for Older Adults, People, Americans, Seniors - AARP Bulletin

Image by Getty Images via @daylife

Filers cite lost jobs, credit card debt and empty retirement accounts

by: Bob Calandra | from: AARP Bulletin


The 55-to-64 age group made up 17 percent of filers in 2009, up from 14 percent in 2006. The 65-and-up group, meanwhile, made up 8.3 percent of all filers in 2009, a rise from 7.8 percent in 2006.

Leslie Linfield, executive director of the IFL, is concerned by numbers like these.

"A young person has the ability to rebuild themselves financially," Linfield says. "Are seniors afforded that same opportunity by virtue of their age? Are we as a society taking care of our seniors when so many have to seek bankruptcy protection to begin with?"

'It's all hole-plugging'

Older adults who lived through the Great Depression and generally shunned credit card use have begun in recent years to embrace it, perhaps out of necessity. And some are drowning in debt as a result.

According to a University of Michigan study, 67 percent of people age 65 and older who filed for bankruptcy in 2007 cited credit card interest and fees as a culprit, compared with 53 percent of those under 65.

"There's been a cultural shift in the attitude of older borrowers," says University of Michigan Law School professor John Pottow, an author of the study. "But what's equally possible is that they're just squeezed more financially. People are living longer and paying more for health care and carrying mortgages into their senior years. They're refinancing to pay off debt. It's all hole-plugging.

"We have a structural problem for older people — it's an income and expense disparity, and it's just going to get worse as people continue to live longer. We are not addressing this" as a nation, he adds.

Living on credit cards

Older adults who live on fixed incomes may have turned to their credit cards to pay for increasingly expensive medical treatment, gas, food and other necessities.

But Neil Ellington, executive vice president of CESI Debt Solutions in Raleigh, N.C., says it's often a different story for filers who are boomers. He believes that many of their bankruptcies result in large part from using debt to live beyond their means.

-Full Article

Making the Most of Washington’s Change of Mind on End-of-Life Planning

excerpt from Transcend Hospice Marketing Group blog

Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization, said, “By having Medicare cover these voluntary consultations, beneficiaries will be able to get information that will help them make their own decisions about their care and what they would or would not want at life’s end.”

While we may not have predicted a change of mind regarding the end-of-life planning provision in Medicare legislation, this recent turn of events underscores the vital importance of hospices teaching their local communities the truth about the benefits of hospice care. While Medicare may not be facilitating advance care planning, there’s nothing stopping hospice organizations from stepping to the plate and engaging their local communities in conversations about options for care and support and the end of life. Go take advantage of the opportunity!

Transcend Hospice Marketing - Making the Most of Washington’s Change of Mind on End-of-Life Planning

Social Security: Yours, Mine, and Ours

Outrage: Choice Between Home and Medical Marijuana Cancer Treatment - AARP Bulletin

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by: Michelle Diament | from: AARP Bulletin

When Robert Jones, 70, was diagnosed with cancer in 2007, he found little relief for the pain that came with his intensive chemotherapy treatments. That is, until his doctor prescribed medical marijuana, which not only eased the pain, but also helped to improve his appetite and limit anxiety.

Today, though Jones' cancer is in remission, he continues to use marijuana to stem the lingering effects of the illness. But he recently learned that the treatment could cost him his home.

In October, the Las Vegas, N.M., resident received a letter indicating that he would no longer be eligible for the federal housing voucher that helps cover his $400-a-month rent. The reason: Though Jones' use of medical marijuana is permitted in New Mexico, the drug is not legal at the federal level, wrote Gilbert Almanza Jr., executive director of the San Miguel County Section 8 Housing Program.

Jones appealed the decision, saying he didn't know what he would do without the voucher. He worried that he would be forced to live in a nursing facility.

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Seven Hospitals in Six States to Pay U.S. More Than $6.3 Million to Resolve False Claims Act Allegations Related to Kyphoplasty

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Seven hospitals located in Florida, Mississippi, Texas, South Carolina, North Carolina and Alabama have agreed to pay the United States a total of more than $6.3 million to settle allegations that the health care facilities submitted false claims to Medicare, the Justice Department announced today.

The settlements resolve allegations that these hospitals overcharged Medicare between 2000 and 2008 when performing kyphoplasty, a minimally-invasive procedure used to treat certain spinal fractures that often are due to osteoporosis. In many cases, the procedure can be performed safely as a less costly out-patient procedure, but the government contends that the hospitals performed the procedure on an in-patient basis in order to increase their Medicare billings.

"Hospitals that participate in the Medicare program must bill for their services accurately and honestly," said Tony West, Assistant Attorney General for the Department’s Civil Division. "The Department of Justice is committed to ensuring that Medicare funds are expended appropriately."

Full Department of Justice Press Release

Death Panel Legacy | GeriPal - Geriatrics and Palliative Care Blog

by Alex Smith in the GeriPal blog

Yesterday, legislation that would have reimbursed physicians for advance care planning discussions was stripped from Medicare regulations related to the Affordable Care Act (Health Care Reform Bill).

This was the second time such language was removed. The first time, of course, occurred during debate over the bill in congress. Sarah Palin said she did not want Obama's "death panels" to decide who was worthy of care. John Boehner (now house speaker) said the legislation was part of a slippery slope toward government sponsored euthanasia. Not only was advance care planning legislation stripped from the bill, so were all measures related to palliative and end-of-life care. We didn't blog about this at GeriPal because representative Bleumenauer, author of the original legislation, cautioned against crowing about it, suggesting it should be a "quiet victory."

What the administration couldn't get through congress it has turned to regulation to accomplish. On Christmas 2010, the New York Times broke the story that the Obama administration and Don Berwick, director of the Centers for Medicare and Medicaid, incorporated language into Medicare regulations related to the health care bill that would reimburse physicians for voluntary advance care planning discussions during the newly covered annual visit.

Now, preparing to defend the health care bill against a new republican majority in the house intent on repealing the Affordable Care Act, Obama has reversed course. They claim the language was removed for procedural reasons, but anyone can read between the lines.

A few thoughts about this.

Physicians should be reimbursed for time spent conducting advance care planning discussions with patients. This will incentivize high quality care. Lack of reimbursement for these long discussions is a major barrier to outpatient doctors engaging patients in the advance care planning process.

On the other hand, if I were to chose palliative care priorities for the Obama administration to focus on, this would not be tops on my list. Other issues I would rank higher (thanks to Diane Meier for many of these):

• Funding for palliative care graduate medical education (fellowship spots)
• Funding for palliative care research
• Incorporating palliative care into Accountable Care Organizations

And if I had a choice between legislation/regulation the includes advance care planning, but was likely to get hammered in congressional debate and sink as a result, and legislation/regulation without the language but with all of the other good things the Affordable Care Act accomplishes...I'd take health care reform.

This issue is important. It's just not worth the Obama administration falling on it's sword.

A Reversal on End-of-Life Planning Under Medicare - NYTimes.com

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By ROBERT PEAR

The Obama administration, reversing course, will revise a Medicare regulation to delete references to end-of-life planning as part of the annual physical examinations covered under the new health care law, administration officials said Tuesday.

The move is an abrupt shift, coming just days after the new policy took effect on Jan. 1.

Many doctors and providers of hospice care had praised the regulation, which listed “advance care planning” as one of the services that could be offered in the “annual wellness visit” for Medicare beneficiaries.

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Reform Plans Encouraging for Long-Term Care Facilities | NewsOK.com

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BY JIM KILLACKEY Oklahoman

If, when and how much Obamacare is overturned or modified, Oklahoma seniors need to be concerned about aspects of the health care reform package that directly affects their interests and those of elderly family members and friends. At issue is improving quality and safety at all of the state’s long-term care facilities: nursing homes, assisted-living centers, adult day-care centers, residential care homes and others.

Some $777 million is being used nationally during the next four years to institute reforms ranging from new criminal background checks of employees by using fingerprinting; the immediate reporting of crimes in long-term care facilities to law-enforcement agencies; tougher financial penalties for not reporting crimes of abuse; and penalties against long-term care administrators who retaliate against whistleblowers.
Facilities with repeated “noncompliance issues” will be inspected every six months instead of longer periods between inspections of long-term care locations.

“I like so much of this,” said Esther Houser, state ombudsman who’s considered the top advocate for nursing home residents and their families. Most of the reforms start in 2011 and 2012. Oklahoma currently has about 20,000 residents in 325 nursing homes. The state also has another 11,500 licensed beds for people occupying assisted-living centers, residential care facilities and intermediate care facilities for the mentally handicapped.

As Houser noted, Obamacare provides improved disclosure requirements related to nursing home ownership. “Many owners now hide behind various corporate disguises, and it has been harder for the average person, let alone enforcement agencies, to identify the true owner,” she said.

The law stipulates improvements in new compliance and ethics standards for nursing facilities intended to identify criminal or other violations. Improvements to the current www.Medicare.gov “Nursing-Home-Compare” website are being sought to provide better information for consumers.

There are benefits, too, aimed at helping long-term care centers that have high staff turnovers. There’s planned a study by the Center for Medicare and Medicaid Services, or CMS, on establishing a National Nurse Aide Registry.

There’ll be incentives to attract and support new direct-care workers for long-term care settings.

Many pros and cons exist about Obamacare requirements affecting long-term care facilities.
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