Forty years after Stonewall

Frank Rich, in this New York Times op-ed piece, gives a concise history of the Stonewall riots that launched the gay rights movement.

"Gay Americans aren't just another political special interest group. They are Americans who are actively discriminated against by federal law."

Taking President Obama to task, Rich quotes Oscar-winning screenwriter Dustin Lance Black: "There's a perception in Washington that you can throw a little bit of partial equality to gay people and that gay people will be satisfied with that."

But, the march of activism with continue for full civil rights in all states AND the federal government.

New Alzheimer's Disease research center in Wisconsin

In its summer 2009 newsletter, the South Central Wisconsin Chapter of the Alzheimer's Association describes a new Alzheimer's Disease research center for Wisconsin, located at the University of Wisconsin-Madison.

Funded by grants from the National Institute on Aging and the National Institute of Health, the center will focus on " novel diagnostic tests and potential therapies for the preventions of [Alzheimer's Disease] at a stage when patients have no clinical symptoms (preclinical stage)."

In other news, the HBO series, The Alzheimer's Project, is now available online. The website includes the videos, details about the project, and other resourses.

Zen as a dimension of healthcare (reform)

The L.A. Times reported recently that Beth Israel Medical Center in New York City offers Zen chaplains for expanded spiritual care of its patients and employees.

According to the American Hospital Assn., about 68% of public hospitals have a chaplaincy program. But few have Buddhist monks, and none compares with the program at Beth Israel -- where more than 20 Buddhist chaplains and chaplains-in-training offer bedside meditation, interdenominational prayers and other assistance to pregnant women, dying cancer patients and even stressed hospital workers.

. . .

Advocates say the availability of alternative treatments is crucial at a time when millions of Americans are struggling to pay for healthcare. Instead of relying on drugs and hospitalization, the Zen center encourages stress- and pain-relief through meditation, breathing exercises or simple conversation. Even if such methods cannot provide a cure, they can make patients more comfortable. And the Zen chaplains are able to spend more time with patients, time that busy doctors and nurses often cannot spare.

Congress takes on long-term care insurance

The New York Times' blog, "The New Old Age, " posted this entry about the current congressional discussion about long-term care insurance. The issue has many facets, including consumer protection, financial soundness, and the variables of the marketplace.

Consumers must balance premium affordability with the types of services they may want, the daily benefit amount, the length of coverage and other options, such as inflation protection. But personal needs and the marketplace can change in the decades between purchasing and using a policy, [the executive vice president of the Kaiser Family Foundation] said.

The uncertainty of guessing what care will be needed in the future and at what cost is a huge challenge for consumers. Nevertheless, Congress and insurance companies are trying to work together to provide options and incentives, given the growing pressures on the Medicaid system and Medicaid's tough asset spend-down requirements.

Aging better

A recent story in the Washington Post tells of a 50-year-long health study known as the Baltimore Longitudinal Study of Aging. The study has spanned decades for some participants, giving the researchers glimpses into long-term effects of aging.

Since 1958, a total of more than 1,400 volunteers have agreed to regularly undergo in-depth physicals and momory and other screenings conducted by the study's physicians. The resulting data span more than half a century and are a gold mine for researches interested in the aging process.

In addition to studying aspects of physical health,

[the] researchers were able to disprove the long-held belief that people get crankier as they age. Using data collected from the study's participants, they found that personaity traits don't generally change much after age 30: People who were cranky at 27 were likely to be cranky at 87.

(I love that data!)

The director of the study hopes the data and insights continue well into the future: "The definition of being old is changing; it breaking apart. [People] want to live well, no matter what their age."

Recently, Money magazine ran a story, "Rethinking your Estate Plan." It offers basic information and considerations, especially in light of the current economic environment and tax code.

You don't have to be a millionaire to worry about leaving a smaller legacy than you'd hoped - if you can leave one at all. According to estimates by the Federal Reserve, average household net worth dropped nearly 23% from a survey period starting in May 2007 to October 2008. That happened just as many Americans began feeling more pressure to help their kids who are struggling in this rotten economy.

To counter the uncertainty of the economy and build some reassurance in the future, the article suggests looking at charitable giving, estate tax consequences, how your plan to distribute your estate, whether a trust is a suitable option, and the frequency of reviewing and updating your plan.

By way of self-serving note: the article suggests you work with an attorney and "contact your attorney every three years or so and ask whether your plan needs updating."

Pet poetry

Tails of the City, the San Francisco Chronicle pet blog, recently ran a pet haiku contest. Here are the results.

Here's one of the submissions that I particularly like:

Dogs wait patiently / With their origami ears / Folded precisely. -J. Fenton

Even the best-laid plans...

can go awry. Sometime we call this "law in action"--when the legally correct thing is ignored, and the person in front of you says something else is required or expected. Case in point, the instances where same-sex partners were denied visitation access to their ill partners in hospitals. The New York Times reported on two such couples, where the access-seeking partner had a valid health care power of attorney, but was turned away anyway.

[One] case, now the subject of a federal lawsuit in Florida, is being watched by gay rights groups, which say same-sex partners often report being excluded from a patient’s room because they aren’t “real” family members.

And lawyers say the case could affect the way hospitals treat all patients with nonmarital relationships, including older people who choose not to marry, unmarried heterosexual couples and single people who rely on the support of close friends rather than relatives.

One point of contention in the lawsuit is whether a hospital has a legal duty to its patients to always give visiting rights to their designated family members and surrogates.

Stay turned for an interesting, evolving area of healthcare, family, and patient-rights law.

Celebrity, privacy, and inelegant charitable solicitation

By now, nearly everyone knows that actress Farrah Fawcett has serious cancer, and the media have reported on her every twitch. The L.A. Times ran this piece about how her medical privacy was breached for the sake of tabloid news and how her treating hospital asked for a large donation from her for a cancer foundation.

In an interview with the Times (given last August, but green-lighted by Fawcett recently), "Fawcett described how she was deprived of the choice that most other cancer patients have: when, and even whether, to share information with family, friends or strangers."

In the time since the interview, the hospital employee who leaked the information was criminally prosecuted and convicted, the medical center has attempted to remedy its policy, and the governor of California has signed a stricter medical privacy law.

On the topic of the solicited donation, the story notes:

The university went so far as to give her a prewritten letter that she could sign and fill in a dollar amount for the foundation, documents show. It also created an official-looking proposed announcement that said, "Ms. Farrah Fawcett has established a fund in the Division of Digestive Diseases with the expansive goal of facilitating prevention and diagnosis in gastrointestinal cancers."

The uncertain definition of "competence"

The excellent entries continue on "The New Old Age." Here is the discussion on mental competence, the legal way of determining whether someone has the cognitive ability to make decisions for oneself, usually meaning signing documents. Often, that determination varies even by the type of decision to be made: for example, voting, making a will, or entering into marriage may all have different thresholds for "competence."

The entry in "The New Old Age" considers competence in the context of non-deceased wealthy philanthropist Brooke Astor's later years when she had Alzheimer's disease. Here's a bit of the entry:

. . . Alzheimer’s sufferers may experience days of comparative lucidity alternating with days of bewilderment. Cognitive ability “may even vary throughout the day,” said Dr. Ronald C. Petersen, a neurologist at the Mayo Clinic who chairs the medical and scientific advisory board of the Alzheimer’s Association. “A person might be
relatively sharp in the morning and by evening be quite confused.”

Caregivers are familiar with the late-day agitation called “sundowning.” Medications, disrupted sleep, social stimulation and even a minor cold can affect these diurnal cycles. Though a variety of doctors are expected to testify during the two-month trial, they may shed little light on whether Mrs. Astor had, in legalspeak, “testamentary capacity” on a particular January afternoon in 2004, when she altered her will.

. . .

The bar for establishing testamentary capacity is set fairly low. The person in question needs to have a general understanding of her assets, know to whom bequests are normally left, and be able to state what she wants to do and explain why.