Articles Posted in Elder Law

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.

According to the Long Term Care Consumer Price Index, the overall costs for long-term care insurance coverage increased 8.6% compared to the costs last year. Researchers found that these costs affected both men and women at varying age levels that are currently paying for or are interested in purchasing long-term care insurance for possibly future needs.

Increased Costs for Long-Term Care Insurance

The American Association for Long-Term Care Insurance group has estimated that a healthy 55 year old man can expect to pay $1,060 per year for $164,000 in long-term care insurance benefits. This amount is fifteen percent higher than the 2014 cost of $925. However, the 2014 figure was a fifteen percent decline from 2013, which means that for healthy middle age men the annual premium has stayed steady between 2013 and 2015.

In a report released last week by the National Institute on Retirement Security (NIRI), fewer Americans are concerned that they will not have enough money to live on in their retirement. While 86% of Americans agree that the country is in the midst of a retirement crisis, a number that increases to 92% for millennials, more people are taking control of their retirement savings and feeling better about their living expenses once they stop working.

Results of the Report

Every two years, NIRI polls thousands of Americans to see how they feel about their financial security for retirement. They also poll people about their views on government policies and legislation that could help those reaching retirement age. Compared to the results in 2013, the overall percentage of people concerned about their retirement outlook fell from 85% down to 74%. In addition, more people polled expect the money in their pension plans to be there when they retire at 84%, up from 79% in 2013.

While some say that it takes a village to raise a child, others are now saying that it takes a crowd to pay for rising medical costs. As more caregivers are expected to pay for their loved one’s medical costs out of pocket, they are turning to the internet and crowdfunding websites for help. Certain crowdfunding websites are now dedicated portions of their sites specifically for health care expenses or specific diseases that need treatment.

Crowdfunding Websites

Crowdfunding, also known as crowdsourcing, uses a page on the internet to talk about the issue at hand and raise money for costs. It relies on friends, family, and strangers alike to donate money to the particular cause. Websites like YouCaring.com, GiveForward.com, GoFundMe.com, and Fundly.com are all examples of websites where people can go online and ask for help.

Families of China’s political elite and senior Communist Party leaders are now fighting for a more unusual cause: the right for their seniors to die with dignity. Failure to take every measure possible to keep these people alive is considered shameful and is often confused with euthanasia in China. As a result, the elite are given every possible treatment to prolong their lives, despite it not being their final wishes.

New Group Efforts

Children and grandchildren of some of China’s highest ranking officials have come together to discuss the issue of dying with dignity. Many recall family members that spent their final days strapped to machines and tubes instead of living out that time peacefully at home. The group’s goal is to help patients in China say no to certain types of medical interventions and instead seek palliative care.

The federal government announced on Thursday that it was changing the way that it rates nursing homes, adjusting the curve that it uses to measure the quality of the communities to make it more difficult to earn four and five star ratings. Using the new guidelines, officials said that many nursing homes’ ratings will likely fall, but the information will not be made public until February 20.

Current Ratings System

Currently, nursing homes are rated on a one to five star scale on the website, Nursing Home Compare a widely used federal website that evaluates more than 15,000 facilities across the country. Unfortunately, the system relies heavily upon unverified information that resulted in notoriously poor nursing homes receiving top marks. Two of the three major criteria used in the current ratings system, staffing levels and quality measure statistics, were self-reported by the nursing homes and not audited by the federal government.

An 89 year old man who was charged in the killing of his 86 year old roommate at a Buffalo, New York nursing home facility has died. Chester Rusek, 89, passed away in the Erie County Medical Center, where he was being treated for multiple medical issues. He was charged with manslaughter in the November 2012 killing of his roommate in the assisted care facility, Salvatore Trusello, 86.

The authorities stated that Mr. Rusek used a two pound magnet to beat Mr. Trusello to death as he laid in his bed at the senior living community in Tonawanda. Mr. Trusello survived the initial attack but died one month later due to his injuries. Mr. Rusek told police at the time of the attack that he believed that Mr. Trusello was stealing from him. Mr. Rusek’s attorney has stated that once a death certificate is filed, the prosecutors plan to dismiss the charges.

Violence in Nursing Homes

A number of elderly people create an advance directive that states that they do not wish to have life-saving measures performed in the case of a medical emergency. But now, more seniors are adding a new provision to their advance directives that state that if they develop a certain level or form of dementia or Alzheimer’s disease they do not want any type of nutrition or hydration. It has started a quiet debate among medical professionals over whether seniors who develop dementia can use this method to hasten the end of their lives in an advance directive.

Use of an Advance Directive for Dementia

The measure at issue is called “voluntarily stopping eating or drinking,” otherwise known as VSED, and it is a common end-of-life strategy for elders dying of a terminal illness. However, only a handful of people have incorporated the strategy into their advance directive as it pertains to dementia and Alzheimer’s disease.