Friday, January 20, 2012

Lack of Autopsies after Elderly Die Conceals Health Flaws

Abuse in nursing homes and suspicious deaths among seniors often go undetected because post-mortem examinations for seniors are becoming less common. In 2011, a National Public Radio (NPR) News and ProPublica investigation found that because of a lack of resources (both financial and staffing) many jurisdictions stopped doing autopsies on people over the age of 60 unless it was obvious that a violent death occurred.  This is as the population of individuals over the age of 65 increases in America. The investigation has uncovered more than three dozen cases in which alleged abuse, neglect, and murder of seniors that were not discovered by authorities. Only after a whistle-blower or relative pushed medical and law enforcement officials for answers were the cases reopened.

The latest report tells the case of a 76-year-old man whose death was tied to a combination of ailments related to poor care and  an "inappropriate administration of powerful antipsychotic drugs, which have potentially lethal side effects for seniors." His original death certificate said "heart failure brought on by clogged arteries." The real reasons for his death only came to light after a nursing-home staffer spoke up.  The reporting reveals that the number of U.S. autopsies performed on seniors dropped from 37 to 17 percent between 1972 and 2007. 

In the article, Dr. Kathryn Locatell, a geriatrician who specializes in diagnosing elder abuse, said: "We're where child abuse was 30 years ago. I think it's ageism -- I think it boils down to that one word. We don't value old people. We don't want to think about ourselves getting old."

To read the whole article, visit

Wednesday, January 11, 2012

Who Gets the Vacation Home?

Recently, the Wall Street Journal published an article entitled "Who Gets the Vacation Home?"   The article explores some of the issues involved with family cabins or vacation homes, including payment of expenses and the issues of access and use.  Often, once the owner of the property passes, the children have a difficult time of "splitting-up" or sharing the property.

The article suggests three possible solutions to sharing a property (and its inherent expenses): setting up a limited liability company trust, a dynasty trust, or a "qualified personal residence trust" (QPRT).  In these arrangements, family members can all contribute funds to expenses like taxes, insurance, utilities, etc.  In most situations, by gifting the property to a trust, there is the added benefit of not having to pay estate taxes.  

No matter what method is chosen, always make sure to include an "exit strategy" so that future generations can sell the property if they choose to do so.  The article gives a fine overview of a topic that often causes families confusion and strife. 

Tuesday, January 3, 2012

Home Care Workers: the Minimum Wage Controversy

Seniors typically obtain peace of mind knowing that they will be able to receive late-in-life care in an ideal setting and that the care will be of top quality.  These simple goals should not be out of reach for any older community member.  However, many seniors will be forced to deal with less than adequate care, often in institutional settings where they would rather not live.

Part of the problem is that many will not have planned for late-in-life care.  Staying in one's home while aging usually requires advance planning and ensuring that a home care worker is actually providing an appropriate level of care. Recently there has been a shortage of quality home care workers.  One of the biggest problems is that for a period these workers were exempt from minimum wage laws.  When Congress passed minimum rights legislation, all home care workers were lumped into the category of exempt employees who acted as "companions."  This was the case even for workers who engaged in a wide range of physical labor helping seniors bathe, dress, use the facilities, walk, get exercise, and eat properly.  Of course, it seems intuitively unfair for these workers to be forced to live in dire poverty at incredibly low wages and no overtime pay.

Fortunately, the legal error was recently corrected.  One reason the law took so long to change was that many of the individuals who fill these roles, often including women and those who are not native English speakers, have few advocates.  Also, as a result of the prolonged period of abysmal pay, advocates are worried that there is a shortage of well-trained, capable home health care workers.  The need for these workers is expected to skyrocket in the coming decades.

The shortage of quality caregivers makes it important for local residents to conduct proper research when deciding on an appropriate home care provider for their loved one.  Therefore, most advocates recommend going through a qualified agency to find these assistants.  Most agencies are required to perform multi-state background checks, screen for drug use, and require references. The risk of abuse or theft is always much higher when home care workers are unsupervised and unaccountable.  Home care is of little value if that home care worker is inadequate.