Obama v. GOP: Healthcare showdown

When President Obama took office two years ago, the GOP had much more than a mere inkling that a healthcare overhaul was on the horizon.  Fast-forward to the final days of 2010, and an attempt at a repeal may be just around the corner. 

It comes as no surprise that healthcare is still a hot topic - but there is a twist - many did not predict the upcoming degree of Republican control in the House. 

Aside from the mega-issue of healthcare, there are other pressing issues too; national debt; national security; internet freedom; and global warming.  But according to The Hill, the healthcare debate is at the very top of the list as far as points of contention go in early 2011.

The Hill today said Republicans in the House will remain firm with their intentions to repeal Obama’s healthcare law early in 2011.  But the Democrats do maintain control of the Senate, which means that the GOP may have to resort to devices aimed at thwarting the bill indirectly through tightfisted budgetary tactics.     

We reported last week that the Supreme Court will likely have to decide whether the key provision of the healthcare law requiring mandatory insurance is constitutional.  According to CNN, “a new national poll indicates that a majority of Americans oppose that provision in the bill Congress passed earlier this year.”  Only 38% of those surveyed are on-board.

Besides the mandatory insurance uncertainty that will take some time to sort out, what will Democrats do in the mean time to prevent the GOP from hampering the healthcare law? If the law becomes deadlocked, there is a good chance that Americans will still see some form of the bill come to fruition; it just may come with conceded spending cuts elsewhere.   

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Veteran misses filing deadline due to mental illness: Fair?

A U.S. veteran from Maine was denied veteran’s benefits, and argues he was unable to file an appeal because of a mental disability. 

The case was argued before the Supreme Court earlier this month. 

Francis M. Jackson, a veterans’ disability benefits attorney from Maine explained the case is so important “because it raises issues of substantive due process and essential fairness.”  To make clear the injustice at issue, Jackson pointed to the fact that the appellant was unable to meet the deadline due to a service-connected disability.  But will things bode well for the Veteran? Just three years ago, the Court held that a convicted murderer could not appeal after he filed just two days late.  However, in that case the judge misinterpreted the deadline as set forth by Congress.  

Veterans’ disability compensation is paid to vets who are injured as a result of their service to the country.  If denied a request for benefits, the veteran has 120 days to file a notice of intent to appeal. 

The case is Henderson v. Shinseki (No. 09-1036).  Mr. Henderson is veteran who developed paranoid schizophrenia while serving in the Korean War.  Mr. Henderson was denied home care by the Veteran’s Administration, after which he filed his notice of appeal 15 days late.  His lawyer says his disability prevented him from meeting the deadline.

Henderson’s view: The 120-day time limit can be extended by a judge in the event that fairness and justice would require it.  The contention is that since the entire process was created by Congress for veterans to be treated justly and fairly, the 120-day limit was not meant to be rigid and unyielding.

Shinseki’s view (The Secretary of Veterans Affairs): The 120-day time period IS to be strictly applied.  Thus, any changes must come from Congress itself.

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Read Washington Post Article. 

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How longevity is influenced by eating habits (From CNN)

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House passes "biggest food safety overhaul in 70 years"

U.S. food safety system is preparing for massive reform.  It’s time to loosen up the belt for the holiday season, but are you taking adequate measures to prevent an untimely bout with food poisoning?

The House of Representatives just passed legislation that is being called “[the] biggest overhaul in more than 70 years.” (MSNBC) This legislation has already cleared the Senate and just needs Obama’s signature. 

According to the U.S. Centers for Disease Control and Prevention, food-borne illnesses kill 3,000 people a year in the U.S and sicken another 48 million.  The legislation would empower the FDA to recall food even if a business doesn’t want to voluntarily recall the tainted item itself, and would also place further accountability on food manufacturers to take more in-depth measures that would prevent contamination.

It is important to distinguish between real food poisoning and Gastroenteritis, a condition that causes similar symptoms.  Food poisoning occurs due to bacteria presence in food or drink, whereas gastroenteritis is caused by a bacterial or viral infection.  Both can cause diarrhea and vomiting, and young children and the elderly are more susceptible to dehydration.

How cold should my fridge be?  “The most favorable temperatures for bacterial growth are in the range of 40 to 140 degrees Fahrenheit,” explains WVU extension service on Refrigerator and Freezer Safety. 

What about freezing food? Freezing meats and other food does slow bacteria growth, but it is important not to refreeze food after you thaw it because bacteria is dormant while frozen but still able to resume growth.  Frozen food should be stored at around 0 degrees Fahrenheit.

For more on safe food handling, check out the USDA Food Safety and Inspection Service article by William Schafer, entitled A Quick Consumer Guide to Safe Food Handling.  

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Tips for caregivers to combat holiday stress (from CNN)

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Most likely: Supreme Court will have to decide constitutionality of mandatory insurance

The mandatory insurance debate represents an intersection (or a train wreck, depending on how you look at it) between federal powers, Congressional constitutional boundaries, and state interests.  At issue is whether Americans can be required to buy medical insurance, and if so, whether penalties can be enforced for noncompliance. The states that oppose the multi-trillion dollar reform argue that among other things, state governments would get stuck with the bill in the long run.  Analysts agree that the case will eventually be decided by the Supreme Court. 

Late last week in Pensacola Florida, Obama’s legal team disputed the argument that a mandatory insurance policy would be unconstitutional.  20 U.S. states adhere to the view that such insurance policies would exceed the limits of the constitution. 

Presiding Judge Roger Vinson of the U.S. District Court in Florida articulated the need for patience from both sides.  Commenting on how long it would take to reach a decision, he said “I cannot give you a date certain.”  According to reuters, Judge Vinson made the comment after three hours of testimony. 

Earlier last week, a Virginia Federal Judge opined mandatory health insurance is unconstitutional.  Judge Henry Hudson thinks that Congress does not have authority under the Commerce Clause (Article I, Section 8, Clause 3) to mandate health insurance.  The power wielded by Congress and the Federal government by way of the Commerce Clause is explained by the Court in its’ 2005 landmark (and controversial) decision, Gonzales v. Raich, 545 U.S. 1 (2005):   

The Commerce Clause emerged as the Framers' response to the central problem giving rise to the Constitution itself: the absence of any federal commerce power under the Articles of Confederation. For the first century of our history, the primary use of the Clause was to preclude the kind of discriminatory state legislation that had once been permissible. Then, in response to rapid industrial development and an increasingly interdependent national economy, Congress “ushered in a new era of federal regulation under the commerce power,” beginning with the enactment of the Interstate Commerce Act in 1887 and the Sherman Antitrust Act in 1890. (emphasis added).

The key issue – whether the government can force the public to buy a commercial product – will undoubtedly remain at the forefront of national media coverage until either the Supreme Court issues its view, or when the law goes into effect starting in 2014

.Image courtesy of: http://hubpages.com/hub/inauguration-day-clip-art

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Hospitalized seniors can make great strides with just a few steps

A recent study conducted at the University of Texas Medical Branch at Galveston suggests that senior citizens who stay mobile in hospitals can decrease the length of their stay.

“Using [special step activity] monitors, we were able to see a correlation between even relatively small amounts of increased mobility and shorter lengths of stay in the hospital,” explained Steve Fisher, lead author of the recent report published in the Archives of Internal Medicine. Fisher further explained, “Mobility is a key measure in older people's independence and quality of life generally, and this study suggests that's also true in the hospital setting,"

162 senior citizens participated in the study by wearing a small device to monitor steps while hospitalized. Adjustments were made to account for varying levels of illnesses, so the correlation between activity and hospital-stay time was not undermined by unintended variables. Read the source article here.

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How expensive will nursing homes be in 2020?

The cost of growing old is a concept Baby Boomers are beginning to wrestle with as they contemplate long term care options for both themselves and their aging parents. But in today’s age of economic uncertainty and rising care costs, more dependent adults are relying on family members for care. The Wall Street Journal recently reported on a growing trend - compensating a relative to save money. In citing a report by the National Alliance for Caregiving and AARP, the WSJ pointed out that  more than 43 million Americans cared for a friend or relative age 50 or older in 2009. This number has increased by more than 27% since 2004! But this strategy can have drastic consequences that must not be ignored.

Genworth Financial has posted a tool to view median care costs by state, plus future projected costs. Below are some key figures for the Commonwealth of Virginia:

Type of Care - 2010 Median Cost/Year in Virginia - 2020 Projected Cost

Nursing Home Private Room - $73,000  - $118,909

Assisted Living Private Room - $43,182 - $70,339

Adult Day Health Care - $13,780 - $22,446

Home Health Aide - $41,184 - $67,084

If a family opts for relative-care, they must ensure that the relative can provide the assistance that is actually needed. Other important considerations include: Whether to pay the family member, how much to pay, and whether those facts should be disclosed to other family members. And of course, the person receiving the care should always be comfortable with their caretaker. The WSJ article referenced above suggests complete disclosure to the entire family, as a way to ease potential tension. Another important point – if Medicaid eligibility is a goal, there is no substitute to consulting an Elder Law Attorney. Medicaid laws may require a caregiver to be compensated in a specific way.  One common misconception is that Medicaid is only available for the poor. To the contrary, Medicaid is available to anyone who can legally qualify. An Elder Law Attorney should be consulted for Medicaid asset protection planning, because as this article alluded to above, there are nuanced and complicated qualification rules.



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Good cholesterol linked to reduced Alzheimer’s risk

Alzheimer’s disease is the 7^th leading cause of death and costs about 172 billion dollars annually.[1] Due to the disease’s debilitating nature, more than 10 million caregivers of individuals with the disease are unpaid family members, friends, or volunteers. For these reasons, it is no surprise that research and medical trials are ongoing to combat the disease. Just as important as research from the scientific community, is knowledge of the steps people can take to reduce their risk for developing the disease. The December issue of Archives of Neurology reported that a high level of “good” cholesterol has been found to be linked to a reduced risk for developing Alzheimer’s.[2]

Senior Journal reported on the study from the Archives, explaining that researchers studied 1,130 healthy adults from a pool of Medicare recipients from New York, to study a possible relationship between HDL and Alzheimer’s symptoms.

While the researchers conclude that higher HDL cholesterol was associated with a lowered risk of developing Alzheimer’s disease, they also note that “[a]n important consideration in the interpretation of the results is that it was conducted an urban multiethnic elderly community with a high prevalence of risk factors for mortality and dementia.” In other words, as applied to younger individuals, the correlation between HDL and reduced risk for developing Alzheimer’s is unclear.

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[1] Alz.org, Alzheimer’s Facts and Figures (2010), available at http://www.alz.org/alzheimers_disease_facts_and_figures.asp

[2] Senior Journal notes that the study was supported by the National Institute on Aging, the Charles S. Robertson Memorial Gift for Research in Alzheimer’s Disease and the Blanchette Hooker Rockefeller Foundation.

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In some States, Medicaid costs are going up, coverage is going down, and lives are being snuffed short

Massachusetts’ Medicaid program enjoyed success, at least initially. Boston (.com) reported that the state’s Medicaid program enrolled about 250,000 new members since mid-2006. What’s more is that the success of Massachusetts Medicaid led to the lowest rate of uninsured individuals in the entire U.S.  That was back in 2006: Since the recession started in 2008, state budgets across the nation have struggled to remain viable and stay out of the red. For Massachusetts, part of its budget problem may stem from statistics which show increasing Medicaid costs.

Gary Gottlieb, president of Partners HealthCare, noted in an interview that doctors who are willing to treat Medicaid patients have seen reimbursement rates cut. With Medicaid costs climbing, there is an increased “burden on the commercial industry.”

State Medicaid budget cuts could figuratively pronounce a death sentence to some Americans. In a tragic story out of Arizona, written by Elizabeth Schulte from SocialistWorker.org, on the very same day, a father of six discovered that he was matched up with a long awaited bone marrow donor, but due to a change in State Medicaid coverage rules, the operation was not affordable. The Arizona man was offered money for the operation from an anonymous donor, but by the time the State had denied him and the donor came forward, he died.

According to a transplant specialist at the University of Arizona College of Medicine (speaking to the Times), “[t]he most difficult discussions are those that involve patients who had been on the donor list for a year or more and now we have to tell them they’re not on the list anymore…” To make matters worse, Medicaid budget cuts won’t solve the budget crisis alone, at least in Arizona. According to the New York Times, Arizona has nearly a $2.6 billion shortfall, and the transplant cuts would only alleviate $800,000 of that debt amount in the current fiscal year.

With the examples detailed above of Massachusetts’ and Arizona’s Medicaid woes, we can speculate that for some states, at least two conditions exist: First, we know that more people need Medicaid assistance now than before the “Great Recession.” We also know that some states are balancing their budgets by limiting what Medicaid will cover, including lifesaving operations, even where a donor exists! Whether legislators find other areas to cut wasteful spending in lieu of important Medicaid benefits will be an important focal point moving forward.   

Image Credits

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The Perfect Holiday Caregiver: It’s all a state of mind

The holidays are always a wonderful time of year for family gatherings, reflection on what we have and the spirit of giving. The television is packed with specials showing relationships and families coming together for the holidays.

But the holidays can also be a time of stress and sadness for those who are caring for family members that are struggling with health problems, frailty, dementia and loss. Those who care for these individuals may feel overwhelmed, frustrated, depressed or resentful as they watch “perfect” families enjoying the holidays. There are many surveys and documents that show that caregivers are highly susceptible to these feelings. If you are a caregiver, there are measures you can take to avoid this.

First; Remember, that you are not alone.

If you are new to caregiving or have been caring for someone for a very long time, remember that the perfect family on television is not reality for many Americans. You are not the only one with these challenges. A recent study by the National Alliance for Caregiving and AARP found that 44.4 million Americans age 18 or older are providing unpaid care to an adult.   In fact according to the survey provided by the National Family Caregivers Association:

• The typical caregiver is a 46-year-old Baby Boomer woman with some college education who works and spends more than 20 hours per week caring for her mother who lives nearby.
• Female caregivers provide more hours of care and provide a higher level of care than male caregivers.
• Almost seven in ten 69%) caregivers say they help one person.
• The average length of caregiving is 4.3 years.
• Many caregivers fulfill multiple roles. Most caregivers are married or living with a partner (62%), and most have worked and managed caregiving responsibilities at the same time (74%).

Second; Find help.

There are many resources available to a caregiver. Some of these include family members, friends, a local religious group, elder care agencies and homecare providers. The internet provides many great resources and help. The National Care Planning Council offers many articles, brochures and local referrals to help caregivers find the help that they need.

“When my husband’s stepfather was released from the hospital in December of 2009, he called us to give him a ride home. Once he was home, we quickly realized that he was not able to care for himself at all. He lived alone and we found ourselves driving back and forth three or four times a day to assist all of his needs. It was overwhelming and frightening to suddenly become a caregiver to a man we weren’t even that close to. With my husband working full time days, I became his primary caregiver. I would pack up my two little girls every day to come with me to take him to the doctor, do his laundry and feed him his meals, do his grocery shopping and help him with his bills. I had no idea what his finances were like or how to pay his medical bills. He was too sick to care or even understand what I was saying to him.  I quickly realized I was going to have to find help. First I called his children. They were sympathetic, but gave all kinds of excuses as to why they could not help.   Next, I went to the internet. I went to the website for National Care Planning Council www.longtermcarelink.net and found and contacted a Care planner in my area. The Care Planner came to my stepfather’s house and met with the two of us. They helped me get organized and set up time to meet with someone to explain his Medicare services and what my next steps would be. It was such a relief to have a plan and to know what to do.” MH- Salt Lake City, Utah

Most family members are willing to help, but just don’t know what to do. Many caregivers feel that they are the only one who can give the best care. It is important to communicate with other family members about what kind of help you need and let them know specifically what they can do.
A number of organizations and private companies will give you advice and guidance -- many for free. If your care recipient has a very low income, you might get free help from your local Area Agency on Aging. A lot depends on available funds. Click here for a nationwide list of agencies.
A good source for professional advice is the rapidly growing business of non-medical home care companies. Most will offer free consultations and will provide paid aides to help you with your loved-one with such things as bathing, dressing, shopping, household chores, transportation, companionship and much more. These people may also help you coordinate adult daycare or other community services.

You may wish to pay for a formal assessment and care plan from a professional geriatric care manager. Even though it may cost you a little money to hire a care manager, this could be the best money you will ever spend. Care managers are valuable in helping find supporting resources, providing respite, saving money from care providers, finding money to pay for care, making arrangements with family or government providers and providing advice on issues that you may be struggling with.
Lastly; it is important to take care of yourself first in order to give effective and loving care.
Stephen Covey tells a story in his book The Seven Habits of Highly Effective People about a man who is sawing a tree. A woman approaches and asks the obviously exhausted man how long he has been sawing the tree. He tells her that he has been there for hours.

She says “Well, I see that your saw is dull, if you would just sharpen your saw you would be able to saw it much faster and with less effort.”
He replies, “I don’t have time to stop and sharpen my saw, I need to chop this tree down now!”
It seems pretty silly that the man just doesn’t stop for a few minutes to make the work easier. It is common for caregivers to do the same thing. They focus on caring for their loved one and run themselves down instead of stopping to “sharpen their saw”.

Covey states that “sharpening the saw” is to take care of yourself by keeping your physical, mental, emotional and spiritual self balanced. There is joy and respite in balancing all of these areas in our life. This is what makes us efficient and happy. Here are some ways for you as a caregiver to sharpen your own saw:

• Maintain a positive attitude. Take time to be grateful for everything that is good in your life. There is always something. Adjust your expectations for the holiday season. If you aren’t expecting that perfect holiday family picture, then you won’t be angry and frustrated that it isn’t something you have right now. It is always possible to change your attitude and perceptions, but it is not always possible to change your circumstances.

• Eat healthy food and be sure to get some exercise. Do this in small increments if it is too overwhelming to plan menus. Drink more water, cut down on sugary snacks, pick up some vegetables and fruit to grab.  Walk or do marching in place. Run or walk up and down stairs if that is all the time you have right now.

• Forgive and let go of frustrations, anger, resentment and guilt. These are common feelings for caregivers. The best thing a caregiver can do for their own emotional health is to clear out these negative thoughts and feelings. Get counseling, talk to a friend or family member or simply write down the negative feelings to get them out of your system. Never take your anger and frustrations out on those you care for.

• Take time to do something you enjoy and give yourself a little bit of rejuvenation everyday. Laughter is a great stress reliever. Find something funny to read or get on the internet and find a funny video to watch.

• During the holidays, be easy on yourself. If you enjoy holiday activities, then get out there and do them. Ask someone to help with your caregiving duties even if it is just for an hour or two to shop or to see a concert or movie. There are day care facilities or home care services available for short term care. See www.longtermcarelink.net for a service in your area.

Being a “perfect” caregiver during the holidays does not have to look like the perfect on-screen holiday family. How you handle your circumstance will be the key to creating your own peace, happiness and cheer during the holiday season. The holidays can be a time of reflection on good things. Your attitude and a little care for yourself can make a big difference in the care that you give in the coming year.

Image Credit:

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Talking parrot provides clues in chilling elder abuse case

A parrot could possess vital clues to a horrific South Carolina case of elder abuse. Suffering from sores that resulted from an extended period of neglect, a 98 year-old woman was found in the home where she was supposed to have been receiving her primary care from her 60 year old daughter. The victim was suffering from bedsores, and investigators think she had not been turned in more than a week. The woman died just several days after being taken from the home by authorities. St. George Police Lt. Eric Bonnette told the Post and Courier that it was “the worst case [he’s] ever seen.”  

Authorities commented on a key component from the crime scene: "The parrot was mimicking, 'Help me. Help me.' Then he would laugh…" Lt. Bonnette goes on to say, "[w]e think he was mimicking the mother when he said, 'Help me. Help me,' and mimicking the daughter when he laughed."

The daughter and primary caregiver of the deceased is charged with a South Carolina elder abuse statute.

Image Credit:
Image: Salvatore Vuono / FreeDigitalPhotos.net

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Does WikiLeaks pose a threat to our best students?

Brandon / FreeDigitalPhotos.net

The WikiLeaks fiasco has appropriately gained widespread international media attention and analysis. But some of the effects of the situation reach farther than one might initially presume. For example, did you know that the US government instructed its employees not to read the leaked cables?

Evan's recent WikiLeaks article was quoted by FOX News - be sure to check it out!

In an article by CNN,  the WikiLeaks prohibition is explored on another level. The article posits the question: Could reading WikiLeaks cost a student his or her future job? CNN reports that experts they spoke with refer to this inquiry as a "gray area," but that some universities have sent warnings to students about negative repercussions that could result.

One way that WikiLeaks indulgences could lead to job problems later is due to the fact that the documents are considered classified. If this is the case, how will federal agencies determine whether the person in question viewed the documents purposefully? This is a good question, because the documents are plastered across the World Wide Web. Certainly, there are some people out there who have inadvertently clicked on one of the numerous links to either the documents themselves or a related news story.  How the US government and employers handle this scenario may determine the employment of thousands and thousands of prospective job hunters down the road. For now, only time will tell (and it may take some time), as the government is struggling with damage control enough as it is. Evan H. Farr on Google +

Evan Farr quoted by Fox News on healthcare privacy

The WikiLeaks security breach has stirred much conversation...but not just regarding the leaked cables themselves. The entire ordeal is raising numerous questions ranging from national security to constitutional issues.

FOX News referenced Evan Farr's article on his Virginia Elder Law Blog. which pointed out that as a result of this massive security breach, an important lesson can be learned in the world of Health IT.

If you missed Evan's latest article, "Should the WikiLeaks Fiasco Raise Healthcare Privacy Concerns," you can read it here.



Image: IMG_4739 - Julian Assange, Wikileaks. - Photo Espen Moe 2010 Creative Commons License Evan H. Farr on Google +

Elizabeth Edwards made honorable decisions, even in last days

Elizabeth Edwards lost her battle with cancer on Tuesday at the age of 61. She will be remembered as a an acclaimed author, lawyer, activist, and most importantly – a mother of four. Her later years tested her traits of patience, forgiveness, strength, and courage.

Born in 1949, Elizabeth stood by her husband John Edwards’ side during his tenure as Senator, and later, when he was the nominee for vice-president. Elizabeth Edwards advocated for universal health care and is said to have influenced her husband’s political views in this area.

The last decade of Elizabeth’s life was documented by the media; extramarital issues and cancer both plagued her, but she was resilient despite those struggles. When Elizabeth succumbed to breast cancer this week, she was with her family in her home. The decision to forego treatment and remain at home was a decision that was made after doctors indicated that further treatment would be of limited effect.  Read the CNN article for more details on her final hours.

The decision to remain at home instead of in a hospital facility is becoming an increasingly popular choice for terminally ill patients.

“Americans increasingly are treated to death, spending more time in hospitals in their final days, trying last-ditch treatments that often buy only weeks of time, and racking up bills that have made medical care a leading cause of bankruptcies.” Daily Caller

*Image From Wikipedia, the free encyclopedia

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CDC recommends flu vaccinations

“Christmas sales are in full swing and flu season is starting to pick up,” emphasized a CNN report yesterday. The Centers for Disease Control and Prevention recommends that everyone over 6 months get vaccinated.

If you get sick, the CDC website is a great resource for measures you can take. You can view their information about antiviral drugs here.

Preventing the flu is especially important for kids and the elderly. Some tips you can implement right away are listed below:

-         Don’t leave the house if you are sick.

o       Read this interesting NY Times article on the benefits of staying home when you feel like pushing yourself.

-         Get vaccinated

o       “This is the first flu season in which the Centers for Disease Control and Prevention  is recommending that most everyone older than 6 months of age get a flu vaccine.” – CNN, Dr. Gupta’s Blog

-         Wash your hands frequently, especially after you come into contact with others

o       Read Mayo Clinic’s “Do’s and Don’ts “ of hand washing.

-         Get adequate rest for immune system help

o       Part of staying healthy is getting rest and plenty of hydration.

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3 tips to effectively talk to your senior Parents about their driving skills

The family members of seniors may be in the best position to monitor and keep track of the seniors roadway safety. There are more Seniors on the road now than ever. Consumer Reports Health recently pointed out that the number of licensed drivers aged 70 and above is on the rise. According to a recent Senior Journal article, people with dementia have little trouble passing driving tests. As a result, families of seniors play an important role in ensuring that their driving capabilities are up-to-par.

For more tips on how to get around or how to help a loved one transition from private to public transportation, visit Seniordrivers.org.

Tip 1: Keep the Mood Light.

The first tip involves your approach to the conversation. Keep the atmosphere light, and communicate that you are concerned because you care. Explain why you are inquiring the matter. If possible, arrange for other family members or a family doctor to engage in the conversation as well. The larger the support group, the better.

Tip 2: Do Your Homework.

Did you know that some states have special requirements specific to older drivers? If a state law applies to your parent, it may be a way to have the person’s skills assessed in an objective manner. You can start your research here, (www.iihs.org/laws/olderdrivers.aspx)

Tip 3: Make a Plan and Consider Alternative Methods of Transportation

If you start a conversation with your parent about their inability to drive safely, your parent may initially seem defensive. No one likes to hear that they can’t do something as well as they used to. It may be helpful to present to your parent a well-thought out plan to demonstrate mobility is still possible.

*Tips based in part from the AAA Foundation, How to Help an Older Driver

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Looking for love may take 3 months or more off lifespan

A Harvard study earlier this year concluded that men who “matured” in a social environment where women were scarce may have a shorter life span of at least three months. The study is published in the August issue of the journal Demography.  Read the Seniorjournal article too.

The authors note that “[a] 65-year-old man is typically expected to live another 15.4 years. Removing three months from this block of time is significant.”

Researchers think they might have an explanation. Searching for a mate is stressful, and stress can lead to both mental and physical issues.  

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Easy way to explain (or understand) the cons of Probate

 Why Most People Want to Avoid Probate

First, it requires frustrating intrusion by the court, lawyers, and the public into a very emotional, private, family time. A judge may have to determine who is a legitimate creditor, and may have to rule on distributions to children and other beneficiaries. Your estate may have to hire a lawyer to shepherd the executor through the legal maze.

Second, all of your affairs will become public knowledge. The contents of your will would be on file in the courthouse, for all to read and wills are read. They are read by salesmen, by newspaper reporters, and by the morbidly curious, all seeking in one way or another to take advantage of the publicity required by the probate process.

Third, probate takes time. Unless your executor is absolutely certain that there are no debts owed by the estate (a rare occurrence, since almost everyone leaves some small debts behind) and is to accept personal responsibility for your debts, the Virginia probate law mandates that your assets not be distributed for one year after you die, to allow creditors time to petition the court for full payment. Any assets distributed before that time come with a heavy cost for your executor he or she is personally liable for the repayment of all of this amount, even if the beneficiaries to whom distribution is made have already spent the amount distributed. Thus, your executor will likely be very hesitant to distribute before all debts and taxes are paid. The court, not your family, will supervise and authorize the settling of all debts and the payment of inheritances, in its time and with its delays.

Fourth, on a national average the probate process takes from five to eight percent of your family estate out of the hands of your beneficiaries and gives it to the courts and other outside individuals. In Virginia, this is usually lower, but can also be higher in the event of unusual circumstances, such as a will contest. Planning with a trust can save the average American family about $30,000 in probate fees, attorney fees, and court costs alone, according to a national study by the AARP. The up front cost of a trust is only slightly higher than just a will, but the savings in the end can make the initial expense more than worthwhile.

Fifth, if you are not competent at any time before your death, the trustee of your living trust can serve as the caretaker of your property. This can avoid the expensive and embarrassing public guardianship/conservatorship proceeding, where your children have to prove that you are not able to manage your own affairs. A living trust combined with a power of attorney can provide the most complete protection available. Evan H. Farr on Google +

Fire destroys 93 year-old's proof of military service; now he can't get benefits

Veteran’s proof of military service burns in fire; VA not willing to make exception

A 93 year-old veteran from CA can’t get the benefits he says he is entitled to, even though he was drafted in 1943, and served in the U.S. Navy during World War II.

Bakersfieldnow reports that the veteran is having difficulty in obtaining benefits he would be entitled to, but for the fact he can’t prove he was honorably discharged. The VA office can’t move forwared without proper documentation, but the documents may not exist. A county representative believes the papers were destroyed in the fire of 1973 (in St. Louis.)

"I feel like I'm not a human anymore, because the computer says I'm not alive," Quinlan told Eyewitness News.  The problem isn’t even his fault. "They had a huge fire in St. Louis, and all these records are gone."  

Although these days we have means to ensure data is not lost because of accidents or disasters, veterans who have lost key documentation in the past are currently in need of reformed VA policies.  

Evan H. Farr on Google +

“Seniors and dependent adults are vulnerable in our State”

The National Adult Protective Services Association (NAPSA) has been working with the state-level Adult Protective Service agencies (APS) as part of an ongoing effort to remain up-to-date on the budget issues. The most recent update reported in a newsletter by NAPSA paints a grim financial portrait. What’s worse is that the budget shortfalls are leading to less productivity and more reports of abuse.

According to NAPSA, a survey of APS agencies across the nation yielded 81 results from 30 states. The common thread among responding APS agencies was one of fiscal woe. Budgets were slashed just over 13% for the average APS branch. As if to add insult to injury, two-thirds of the responses indicated reports of abuse as having risen 24%. Almost a quarter of the reporting states has, or is in the process of, reducing or eliminating certain types of investigations.

One representative (from a responding state) said, “Counties have had to make draconian cuts to their social service programs . . . The state has also cut funding to . . . Adult Day Care, Alzheimer’s Day Care: all these programs provided a safety net which has been all but shredded. Seniors and dependent adults are vulnerable in our state.”

Read the newsletter from NAPSA here - State APS Program Budgets Slashed Across US - “The situation is grave”

Evan H. Farr on Google +

Should the WikiLeaks fiasco raise healthcare privacy concerns?

Read the FULL Article here



With roughly 250,000 documents released by WikiLeaks and with the aid of some popular media outlets, the ramifications of the diplomatic cables will be far-reaching. My initial thoughts were mixed: perhaps this latest WikiLeaks embarrassment will sound the alarm bells for governments and private industries to protect sensitive information more closely; perhaps it will lead to the development of more sophisticated information technology tools and training methodologies. On the other hand, it is impossible to ignore the obvious – that the United States government failed to prevent a massive theft of classified data. As a result, the logical question raised is “how we can expect, in the future, government agencies (federal, state, or local), or even private industries, to keep sensitive data confidential?”

This chart represents the source of the cables

Read the FULL Article here

In my recent article on the importance of Electronic and Personal Health records, I discussed why the electronic storage of medical information is beneficial to patients, and how the use of smart health information technology can save money and lives. There is no denying that we are living in the “information age,” and to resist this transition would be counterintuitive and counterproductive. But, we also are living in the post-9/11 era. Thus, we must strike a balance between our privacy rights & expectations, and our safety.

Living to 100 becoming more common, stress reduction is key

The senior citizen population is quickly growing; but did you know that centenarians are expected to reach the 800,000 mark by 2050? Even more shocking – this number was estimated to be only slightly over 50,000 in the year 2000.* This is a projected 16-fold increase in this segment of the population, within a 50 year period!

The way we handle our stress levels on a day-to-day basis over our entire lives may be the key to longevity. The formula to long life, based on recent studies, appears to be a combination of healthy living + the ability to cope with stress.

According to Senior Journal, researchers from the University of Georgia have concluded, “[h]ow we feel about ourselves and our ability to adapt to an accumulation of challenging life experiences may be as important – or more important – than health factors in determining if we survive to be 100 years old.”  The study is published in Current Gerontology and Geriatrics Research.

Most studies in the past that have examined longevity have looked at genetics and health habits. But only a few consider mental, social, and psychological factors. The concept of “mind over matter” was expressed by Leonard Poon, lead author of the study, who said “What is happening to you matters, but more importantly, it is your perception of what is happening to you that is really important for your individual health.”

What common traits do healthy centenarians possess? Personality traits like conscientiousness and openness are tied to happiness in old age. Conversely, and as one might expect, neurotic and anxious individuals are less healthy.  The research was performed over an eight year period.  240 men and women, age 100 and older, participated in the study.

*According to Leonard Poon, Director of the Institute of Gerontology in the UGA College of Public Health, quoted by Senior Journal.

Evan H. Farr on Google +

Therapeutic horseback riding beneficial for recovering U.S. servicemen and women

Did you know that “therapeutic horseback riding” may be beneficial for individuals who suffer from disabilities? Saddling-up may seem like an odd choice for therapy, but according to some studies, it is one of the best therapeutic activities for people with physical, mental, and/or emotional disabilities.

Why is horseback riding beneficial? Horseback riders must exercise awareness, perception, balance, confidence, and discipline. Best of all, most would describe it as an enjoyable activity. Most importantly, the focus of this type of therapy is on the rider’s ability, not his or her disability.  

The Northern Virginia Therapeutic Riding Program (NVTRP) is making waves. The organization, which is located in Clifton, Virginia, offers various ways to engage this form of therapy. Among the various methods, is “Hippotherapy.”  A therapist uses the horse’s movements as a way to treat impairments and reach functional goals. Another method, “Interactive Vaulting,” tests strength, balance, and courage and resembles gymnastics on horseback. The risk of injury is mitigated, as the program can be tailored to each participant’s individual abilities.

Not only does the NVTRP offer various therapeutic riding programs, but it also proactively reaches out to those in need. The NVTRP has collaborated with the government to provide a riding program for recovering servicemen and women. A major aspect that should not be overlooked by people considering therapeutic riding is the team-building atmosphere that is inevitably created.

For more information on therapeutic horseback riding and the NVTRP, visit their website here. Evan H. Farr on Google +

Louisiana may wait another year for Medicaid overhaul

The Associated Press has reported that Louisiana may have to wait another year for a Medicaid overhaul. The State Secretary of Health, Bruce Greenstein, believes that the plan to coordinate private insurers within the Medicaid system would improve patient health care and save money. Whether the overhaul should include private insurers is being debated. Health care providers are not currently on the same page; they propose an alternative plan that does not include private insurers.

Baton Rouge sources reported that Secretary Greenstein stated that the state-level leaders including Governor Jindal will keep pressing their plan. The state wants to permit private insurance companies to engage in management responsibilities via the Louisiana Medicaid program.

If the “coordinated care” plan, as it has been referred to, meets expectations - it will cover women and children primarily, and about 800,000 of the 1.2 million citizens receiving Medicaid.

Evan H. Farr on Google +