Articles Posted in Elder Law

There are more than 44 million people in the United States currently acting as a caregiver for an elderly or disabled loved one, and they devote a significant amount of time, money, and energy to the endeavor. According to researchers over at the Rand Corp. think tank, the informal cost of elder care in the United States that caregivers pay out of their own pocket is more than $522 billion every year and over 30 billion hours of labor. The personal and opportunity costs on caregivers are unfortunately being ignored, and it is causing serious problems for caregivers across the country.

Informal Costs of Elder Care

The Rand Corp. came to this amount by calculating the cost of unpaid work that caregivers perform for their elderly loved ones in addition to the opportunity cost of caregivers, calculated as “paychecks that could be pocketed if the caregivers were working and not taking elders to the doctor, monitoring their health and helping them with daily activities.” In total, the $522 billion spent on elder care every year by caregivers is more than the entirety of federal spending on Medicare in 2013.

Japan is facing a unique problem in its prison systems: it cannot persuade people to leave. The country has one of the highest proportions of elderly convicts in the world, and crimes committed by this cross-section of the population have quadrupled over the last twenty years. Over twenty percent of all prisoners in Japan are over the age of sixty years old, and the country is facing an issue about what to do with their elderly convicts.

Reasons for Elderly Prison Population

The costs of healthcare in Japan are increasing rapidly, and elderly prisoners face better living conditions in addition to better healthcare than they would if they were to be released. Japan is trying to reduce the number of homeless seniors by more than thirty percent by the time that they host the summer Olympic Games in 2020, but many prefer the government-subsidized life behind bars.

In Citrus County, Florida, more than one-third of the residents are senior citizens which is one of the highest rates in the country. However, in just fifteen years over one-quarter of the state will be 65 years old or older. Seeing how Citrus County operates now is giving policy makers and researchers a glimpse into the future of how the entire country will look in just a couple of decades.

A Look at Citrus County

Billboards across the county advertise home health care services, and health care is the dominating labor force for people still working. In addition, lawyers and doctors make house calls, and elderly citizens that can still get around use the county minivan system to be transported to and from the store.

In late February, the New York State Department of Financial Services (DFS) issued guidelines to financial institutions located within the state regarding prevention of elder financial exploitation. The guidelines were issued to remind banks and other lending institutions that they are allowed to report possible instances of elder financial exploitation to New York’s Adult Protective Services (APS) in addition to outlining the best practices used to identify, investigate, and report instances of elder financial abuse to the authorities.

Federal and State Reporting Law

While not mandated, DFS strongly recommended that financial institutions report any suspected elder financial abuse to APS. A joint task force of the federal OCC and FDIC released their own report in 2013 that clarified that it is not a violation of state or federal law to report suspected elder financial abuse to the relevant authorities.

In January, the Department of Veterans Affairs proposed new regulations regarding when and how a veteran is entitled to the VA pension. The proposed regulations have sparked considerable controversy and outrage over the potential penalties involved with making gifts and eligibility for the pension program.

VA Pension Program

The Department of Veterans Affairs established the VA pension as a way to help veterans and their families once a person has retired from the military. It provides tax-free, supplemental income through the pension program. Additional benefits through the pension program called “Aid and Attendance Benefits” are also offered to veterans who are unable to perform daily living activities, such as bathing, eating, dressing, and so forth. One of the main purposes of the Aid and Attendance benefits is to help veterans offset the high costs of nursing home care.

Two weeks after major surgeries, medical treatments, and life-saving procedures a doctor found his patient’s advance directive in his medical chart. Suffering from dementia and unable to communicate, the patient was unable to tell his doctors about the document that stated “he wanted comfort care only, no heroics.” This story illustrates one of a number of growing problems that medical professionals have with advance directives.

Advance Directives and Living Wills

Advance directives, which commonly include living wills and advance healthcare proxies, dictate the wishes of a person’s future care. A living will is used to communicate which treatments and procedures you would like performed in the case that you are unable to communicate them yourself. It is most commonly known for dictating whether a person wishes to be resuscitated in life threatening situations.

While it is important for everyone to plan for their future, it is especially important for a person that has been diagnosed with Alzheimer’s or other forms of dementia. The sooner that the planning begins after a diagnosis, the more likely that the person can contribute to the conversation and it becomes the less likely that problems will arise in the future. The Alzheimer’s Association has many resources available for seniors that have Alzheimer’s or other forms of dementia as well as for their loved ones, including steps to take regarding legal plans for the future.

Legal Capacity

In most cases, a person who is suffering from dementia is able to understand the meaning and importance of a legal document. As such, they possess the legal capacity to execute the document. So long as the person suffering from Alzheimer’s possesses the legal capacity to make decisions regarding their care, they should take part in legal planning.

At the American Academy of Hospice and Palliative Medicine conference earlier this month, Dr. Perla Macip spoke at a talk entitled “The 30-Day Mortality Rule in Surgery: Does This Number Prolong Unnecessary Suffering in Vulnerable Elderly Patients?” In recent years, a number of doctors and other medical professionals have questioned the thirty day mortality standard as a measure of success, particularly when it comes to elderly patients. Some go as far as argue that the standard of thirty days alive after surgery may undermine appropriate care for seniors.

Example of the Thirty Day Standard

One of Dr. Macip’s patients, “Mrs. S.” was a 94 year old patient who prior to surgery was fit and still lived in her own home. She consented to a valve replacement surgery and told physicians that her main goal was to return home. During the surgery, Mrs. S. sustained cardiopulmonary arrest and needed resuscitation. A series of complications followed, including an irregular heartbeat, fluid in her lungs, kidney damage, and pneumonia. Then, Mrs. S. had a stroke and was moved in and out of the intensive care unit, off and on a ventilator.

Last year, medical identity theft increased 22% as more U.S. patient health data becomes electronic. While it is easier for doctors and other medical professionals to readily access patient data, the process is also making it easier for cyber criminals to hack into doctors’ offices, hospitals, and insurance companies for personal information.

Medical Identity Theft

In 2014, more than 500,000 people were victimized by medical identity theft frauds and hacks. Those who gained access to the data then proceeded to use it for insurance fraud, free medical care, and other health-related illegal activities. According to the Ponemon Institute, resolving each incident of fraud costs around $13,500 in expenses. In almost twenty percent of the cases, the victims found additional or erroneous medical information added to their records by an imposter. Things like positive drug tests and other damaging information cost some victims job opportunities and caused other significant issues.