Awareness and changes to deal with elder abuse

I have taken a couple months off from posting and now I have a lot of catching up to do.

Although elder abuse has gotten attention and legislation in recent years, it appears to be on the rise still.

As reported in the New York Times "New Old Age" blog, a federal report highlights the inadequacies of adult protective services around the country.

One possible bright light:

The chairman of the Special Committee on Aging, Senator Herb Kohl, Democrat of Wisconsin, reintroduced the Elder Abuse Victims Act at Wednesday's hearing. The bill would establish an office of elder justice within the federal Justice Department charged with protecting the elderly by strengthening law enforcement responses to abuse.

A good start, but other measures are in order as well. Definitely a topic for future posts!

Paying for long-term care

In these tough economic times, who wants to think of one more discretionary expense to add to the monthly budget? But, as this piece in the New York Times discusses, future long-term care costs for an individual could exceed $1 Million!

Long-term care insurance has been around for several decades, yet many people roll the dice as to whether they purchase it or not. Besides the statistics of one's chances of needed expensive nursing home care, the article also looks at the reasons we often choose not to obtain such protection.

While some excuses for not having insurance are incorrect or somewhat inaccurate (e.g, thinking Medicare will pay (which it doesn't), expecting our own savings to be sufficient, and counting on family members to care for us), "there is also a great deal of justified skeptism about the long-term care insurance industy."

On that skeptical side, some insurance companies are looking at raising their premiums by double-digit increases.

Wisconsin's Office of the Commissioner of Insurance (OCI) has a helpful guide on its website. Furthermore, Wisconsin is one of a number of states that offers Long-Term Care Insurance Partnership program to encourage the purchase of long-term care insurance by offering greater asset limits for Medicaid coverage. Search the OCI website for more information on all related topics.

Aiming for 100+

The New York Times recently ran a story about living to age 100 and beyond. The centenarians who were interviewed were examples of good living, good luck, and good outlooks. Referring to several studies, the article reviewed the usual reasons for longevity--genetics (although not as big a factor as many might guess), caring for one's health, and a positive attitude.

As one 99-year-old interviewee put it, “I am blessed and I’ve worked on it. You’ve got to work, be cheerful and look for something fun to do. It’s a whole attitude. "

Last year, I posted about a collection of stories from diverse and interesting centenarians.

Golden (years) opportunities

For age is opportunity no less
Than youth itself, though in another dress,
And as the evening twilight fades away
The sky is filled with stars, invisible by day.

A few lines of Longfellow quoted in a New York Times essay about aging and the potential for freedom and happiness in old age. In a surprising example, the writer learned that those living in their later years, even with advanced old age, are not simply resigned to loneliness and sadness.

"Aging in place" may be a choice for some, but not for all

"Aging in place" has come to mean elders living in their homes as long as possible, with the necessary and appropriate accomodations coming to them. Often, this means adapting the physical aspects of the house (e.g., grab bars in bathrooms) and in-home assistance for personal care or health care.

A recent Washington Post story explores the options of aging in place for elders, including the necessity of doing so for some because of the recession.

"One of the unwritten tragedies of the current housing price collapse is that for a host of reasons [e.g., money, job security, depreciated properties], a higher share of older Americans will be 'forced' to age in place, who might otherwise have considered alternative housing arrangements," said Stephen Golant, a gerontologist and geographer who teaches at the University of Florida.

But as a whole, many people may choose to stay in their homes for as long as possible. (Who among us hasn't heard an elderly relative express such a preference, especially over nursing home care.)

The article continues by quoting Peter Bell, executive director of the National Aging in Place Council: "Boomers may be more cognizant of the need to plan ahead because they have had to deal with their parents in a reaction mode."

Furthermore, most of the considerations of home accessability and personal care apply to people with disabilities of any age.

A recent story from the New York Times explains how architectural design, whether original or adapted, can successfully accomodate various levels of ability. As the designer featured in the story said, "[People] are only disabled if they can't do what they want to do. Architecture can eliminate disability by design."

(Photo by kamaru; used by permission.)

The difference "-ly" makes

In my law school elder law class, we discussed how being an "elder" is often honored and admirable, but "elderly" is nearly a derogatory term.

Jane Gross's New York Times blog, the New Old Age, includes this discussion about terms often used for elders in our society.

The International Longevity Center in New York City and the Aging Services of California have compiled a stylebook "to guide media professionals through the minefield of politically correct and politically incorrect ways of identifying and portraying the elderly."

For example,

[In addition to sparing use of "elderly," and avoiding "senior citizen" and "golden years,"] “feisty,” “spry,” “feeble,” “eccentric,” “senile” and “grandmotherly” are also unwelcome terms, patronizing and demeaning, as is calling someone “80 years young.”

The "Wollongong Senior Citizens Centre" photo is just for kicks. Maybe it should be reworded, "Older Adults Centre"?

(Photo by vanessapr; used by permission.)

Nursing home "five star" rating system

Medicare has launched a new online system for rating and comparing nursing homes. Besides the various tools to explore nursing home information, the site also provides some basic information on alternatives to nursing home care.

In a charmingly colloquially phrased opinion piece, the Honolulu Advertiser summarizes the new system this way:

The long-term care of Hawai'i's kupuna [honored elders] will become a bigger issue in the future, as more of the population gets older and in need of more intensive care.

Certainly, efforts to put more state and federal funding into at-home care — so-called "aging in place" — should be a priority. It can be more cost-effective, more comfortable for the kupuna and help open up nursing home beds for those who really need that higher level of care.

Making sure Hawai'i's nursing homes offer the highest quality care possible is a joint responsibility — the government, the industry and consumers all have a role to play.

The rating system, while not perfect, provides a useful measure of how we're doing and more important, how we can improve.

A recent report (pdf) on effectiveness of programs for helping low-income Wisconsin residents to live at home or in facilities than nursing homes shows that alternatives cost less than typical nursing home care. The next big goal is to expand the programs across the state so that the alternatives are available to all who want them.

(Photo by laughlin; used by permission.)

Assisted living options

The New York Times' excellent series, "The New Old Age," continues with 10 Things to Know About Assisted Living. The general information is quite good about what to consider in looking at assisted living arrangements. Another general web resource for all types of elder residential options is "A Place for Mom," which is a national referral service.

However, remember that although nursing homes are heavily regulated on the federal and state levels, assisted living apartments and homes are regulated much less, and only on the state level. So, whether looking at the services a facility offers, the medical options, or any other contract terms for assisted living, consult local or state resources too. For example, in Wisconsin, Community Based Residential Facilities (CBRFs, for short) can offer home-like settings for many types of needs, (dementia/memory care, for one), but CBRFs can only offer limited medical care. As a starter on Wisconsin resources, see the Department of Health Services website section on CBRF resources.

For more information on a national level, check out the Assisted Living Consumer Alliance.

(Photo by jonrawlinson; used by permission.)