Monday, October 24, 2016

Guardianship Abuse is the Subject of a Second Political Ad: "Nevada's Guardianship System - Ripe for Abuse"


See Also:
NASGA:  Marcy E. Dudeck, NV/CA victim

New Ad Shows How Catherine Cortez Masto Ignored Pleas for Help From Family Taken Advantage of by Nevada's Guardianship Program

Koch Ads Return to Nevada With Spot Against Cortez Masto

Koch Group Drops New Ad in Nevada Senate Race

Lawyer cuffed, jailed for estate thefts

Thad Jelinske
Waukesha — A Milwaukee corporate lawyer who regulators say had multiple conflicts of interest while representing a former client's estate was sentenced Wednesday to 30 days in jail as a condition to 18 months of probation.

Thad Jelinske, 56, of Wauwatosa was led away in handcuffs after Circuit Judge Michael Aprahamian rejected the prosecutor's recommendation of a $3,000 fine as part of a plea bargain in the case.
"You're the attorney. You're supposed to be trusting and honest in everything you do," the judge said. "When you break that trust, the whole system suffers."

Jelinske was charged in September with three misdemeanor counts of theft in a business setting. He pleaded no contest to each charge Wednesday before sentencing.

District Attorney Sue Opper said the case was unusual in that it came to her office after years of litigation in probate court, and without any police investigation. She said the three misdemeanors were the most efficient charges her office could file without extensive further review of the voluminous record.

Opper said she felt $1,000 fine on each count was fair and appropriate given the collateral consequences to Jelinske — the loss of his position, money paid back to the estate by him and his firm, the likely loss of his law license and the serious damage to his reputation.

Jelinske apologized in court but offered no explanation for his conduct other than bad judgment.

His attorney, Michael Fitzgerald, said Jelinske did do some positive things for the estate but was in over his head.

But Aprahamian, a former litigator at Foley & Lardner, read from the probate judge's order that found Jelinske and his firm engaged in bad faith and deliberate misrepresentation to a "shocking" level.

The judge said if an employee for Sears or Kwik Trip had embezzled like Jelinske they'd likely go to jail, and it would send the wrong message if lawyers avoided such punishment just because they might also lose their license for the behavior.

Aprahamian also denied Jelinske's request to surrender to jail at a later date. "Sometimes it's important to stand up and be taken into custody," he said, and Jelinske was handcuffed and led off in his gray suit.

Shortly after he was charged criminally, Jelinske was also hit with an ethics complaint from the Office of Lawyer Regulation that lays out in far greater detail what the complaint calls his major mishandling of an estate left by a former client. It seeks an 18-month suspension of his law license.

Jelinske, a partner at a Milwaukee business law firm Mawicke & Goisman, had little if any experience in probate matters when he became the personal representative to the estate of Robert S. McCloud, who died in 2011. Park Bank, the estate's main creditor, became a party to the probate of the estate after the bank's lawyer felt Jelinske was not forthcoming about the estate's assets.

The bank's lawsuit was later combined with the probate matter and a trial was held in 2014. Circuit Judge Michael Bohren, who presided, rejected Jelinske's contention that he and the law firm made honest mistakes in billing the estate thousands of dollars and claiming a "success fee" of $42,000 for selling McCloud's residence.

More than $100,000 in fees have been returned to the estate, and no outstanding restitution was ordered as part of the sentence in the criminal case.

Bohren also ordered Jelinske to pay Park Bank's costs and fees, which it claims amount to $250,000. That amount has been negotiated to a confidential settlement, lawyers said Wednesday.

The criminal complaint charged that Jelinske cashed a $573.61 insurance check intended for the estate and kept the money without recording a receipt and wrote himself a check for $834.65 from an estate-related account, both in 2011. A third count charged that in 2012 Jelinske deposited a $1,565.52 payment on a life insurance policy for his former client directly into Jelinske's own account and failed to include the payment in a 2013 inventory of the estate filed with a Waukesha County court.

The OLR complaint says he also spent estate funds on suits, Allen Edmonds shoes and to pay off his wife's American Express card bill, and lied during a probate court trial in 2014 and submitted false sworn court records.

Full Article & Source:
Lawyer cuffed, jailed for estate thefts

Sunday, October 23, 2016

Assisted-suicide law prompts insurance company to deny coverage to terminally ill California woman

The Washington Times reported that the California Assisted-suicide law prompted an insurance company to deny coverage to a terminally ill California woman.

Bradford Richardson, from the Washington Times reported that Stephanie Packer, a wife and mother of four who was diagnosed with a terminal form of scleroderma, said that her insurance company initially indicated it would pay for her to switch to a different chemotherapy drug based on the recommendation of her doctors but shortly after the California assisted suicide law went into effect, her insurance company denied her treatment.

Richardson reported Packer as saying:
“And when the law was passed, it was a week later I received a letter in the mail saying they were going to deny coverage for the chemotherapy that we were asking for,” 
She said she called her insurance company to find out why her coverage had been denied. On the call, she also asked whether suicide pills were covered under her plan. 
“And she says, ‘Yes, we do provide that to our patients, and you would only have to pay $1.20 for the medication,’”Mrs. Packer said.
Stephanie Packer believes that legalizing assisted suicide creates an incentive for insurance companies to deny terminally ill people coverage. Packer stated:
“As soon as this law was passed — and you see it everywhere, when these laws are passed — patients fighting for a longer life end up getting denied treatment, because this will always be the cheapest option,” 
The attitude also changed in her support group:
After the right-to-die movement began garnering national attention, Mrs. Packer said she noticed a change in tone at her support groups for terminally ill patients. While the meetings were formerly positive and encouraging, she said the specter of suicide now hangs above them like a dark cloud. 
“And people, once they became depressed, it became negative, and it started consuming people,” she said in the video. “And then they said, ‘You know what? I wish I could just end it.’ “
Stephanie Parker is not the first person to be denied chemotherapy but offered assisted suicide. Several years ago Barbara Wagner and Randy Stroup, in Oregon, were denied medical treatment but offered assisted suicide.

Full Article & Source:
Assisted-suicide law prompts insurance company to deny coverage to terminally ill California woman

Learn More About Physician Assisted Suicide on "Family Talk"

Note:  CA, WA, OR and VT have passed Assisted Suicide legislation.  MT and NM are close.  

Former Ethics Board Chair Being Sued For (INCREDIBLY) Unethical Elder Abuse

In my 2012 documentary film, Last Will and Embezzlement, Hollywood icon (the late) Mickey Rooney, who had been the victim of elder financial exploitation, warns the audience, “If it can happen to Mickey Rooney, it can happen to anyone.” Today, in Massachusetts, a 28-count elder abuse / elder exploitation lawsuit is pending against an astounding 66 defendants — including 15 attorneys — one of whom, I was appalled to learn, is John O. Mirick (Mirick, O’Connell, DeMallie & Lougee), the former Chair of the Massachusetts Board of Bar Overseers (what others would refer to as the Legal Ethics Board).

This landmark lawsuit, filed by Attorneys Coreen Goodwin and James Bailey Brislin, alleges a shocking, even ghoulish RICO scheme to actually imprison an elderly couple in a nursing home for the final, horrific year of their lives, steal their money and property during that year, conceal their wills from the rightful executors, then thoroughly plunder their estates after their deaths, just six days apart.
Sound improbable? Maybe even fictitious? It’s not. In fact, it’s a lot more common than you might imagine. Since I released my film, I have become privy to stories of avarice and thievery, murder and depravity, that would curl your hair and turn your stomach. This is one such tale, and over the coming weeks and months, I will be sharing with you the chronicles of one woman (Sarah, the victims’ daughter) who chose to earn a law degree, not only to obtain post-mortem justice for her parents, but to dedicate the rest of her life to saving others from suffering the same fate.
This is not just your average David and Goliath story – this is David simultaneously battling more than sixty Goliaths, including some of Boston’s largest and most prestigious law firms, two real estate agencies, two health care conglomerates, a nursing home, a funeral home, a surety bond company, five nurses, a social worker, a doctor, and a fire department captain – all of whom, in one way or another, were (allegedly) complicit in the conspiracy to hasten the end of the Oultons’ lives (the Oultons being the elderly couple in question), and then unlawfully pillaging their entire estate.

In November of 2011, Carol Oulton was admitted to Marlborough Hills Nursing Home to recover from a broken leg, but was overdosed (allegedly) by staff within 24 hours of her arrival, whereupon she was rushed to UMass Memorial Hospital, in a coma. Sarah, who was caring for her dad, Donald, who suffered from dementia, decided that if her mom recovered, she (Sarah) wanted to find her mom a better place to recuperate.

However, the suit alleges, the Oultons’ other three children conspired with Marlborough Hills and their attorneys to force Donald into that facility, as well, and then blocked both Donald and Carol from ever having contact, in any manner, with Sarah or any of their friends. On top of that, they separated the couple – forced them to live apart.

So that was it – they had no way out, no-one to lean on, and no way to get help. That was how this loving couple, married more than fifty years, spent the final year of their lives: alone, isolated, being victimized in every way possible, separated from everything and everyone they had ever known or loved, until their deaths, one year later. (Click to Continue)

Full Article & Source:
Former Ethics Board Chair Being Sued For (INCREDIBLY) Unethical Elder Abuse

New Ultrasound Technique Could Wake Coma Patients

A new study out of UCLA has shown promise with ultrasound techniques that use sonic stimulation to excite the neurons in the brain’s central core for processing information, known as the thalamus. The procedure, known as low-intensity focused ultrasound pulsation, has potential as a therapy to help coma patients awake from comas and recover from serious brain trauma.

The researchers created a device about the size of a tea cup saucer that can create a small sphere of acoustic energy targetting different regions of the brain to stimulate brain tissue. In their latest study, the device was used to help a 25-year-old patient recover from a traumatic brain injury. Researchers say that the technique could eventually be transitioned into a portable device like a helmet to provide a cost effective treatment that could be used to “wake up” patients into a more conscious state.

Before the ultrasound treatment, the 25 year-old patient had shown minimal signs of consciousness and could only perform the smallest movements when asked. After one day of treatment with the new ultrasound technique his responses showed significant improvement, and after three days of treatment the patient had gained full consciousness and language comprehension. Eventually he was able to communicate through head nods and even make a fist bump gesture to one of his doctors.

Detecting and treating traumatic brain injuries have become an area of increasing focus as emerging technologies pave the way for less invasive diagnostic and therapeutic tools. Over the summer researchers from the University of Aberdeen developed software that can be used with ultrasound equipment to provide accurate brain scans for patients who suffered traumatic brain injuries. A few weeks earlier, researchers from MIT announced a new algorithm that uses speech to diagnose mild traumatic brain injuries. The technology aims to use vocal biomarkers like elongated syllables and vowel sounds to detect possible brain injuries.

However, these emerging new diagnostic methods are only half the battle as researchers continue to explore new and innovative therapeutic solutions that can actually treat traumatic brain injury. This new technique aims to be the first to explore the use of ultrasound techniques to target and treat specific areas of the brain that have experienced trauma non-invasively—specifically the thalamus, an area of the brain that usually experiences significant impairment following a coma or serious brain injury.

Given that there aren’t many recognized treatment options for patients in a coma or vegetative state, UCLA researchers remain hopeful that this new technique could have a significant impact on patients who are left with few other alternatives. The ultrasound device only emits a small amount of energy, so the technology is extremely safe for human trials, and also provides a non-invasive approach to therapy.

Following their most recent results with the 25 year-old patient, UCLA researchers plan to begin testing the procedure on more individuals this fall at the Ronald Reagan Medical Center in Los Angeles. The group hopes to learn more about the effects of the device, and fine tune its ability to target specific areas of the brain once they’re able to gather more data from additional patient responses. 

Full Article & Source:
New Ultrasound Technique Could Wake Coma Patients

Saturday, October 22, 2016

U.S. Just Made It a Lot Less Difficult to Sue Nursing Homes

Elizabeth Barrow case
The federal agency that controls more than $1 trillion in Medicare and Medicaid funding has moved to prevent nursing homes from forcing claims of elder abuse, sexual harassment and even wrongful death into the private system of justice known as arbitration.

An agency within the Health and Human Services Department on Wednesday issued a rule that bars any nursing home that receives federal funding from requiring that its residents resolve any disputes in arbitration, instead of court.

The rule, which would affect nursing homes with 1.5 million residents, promises to deliver major new protections.

Clauses embedded in the fine print of nursing home admissions contracts have pushed disputes about safety and the quality of care out of public view.

The system has helped the nursing home industry reduce its legal costs, but it has stymied the families of nursing home residents from getting justice, even in the case of murder.

A case involving a 100-year-old woman who was found murdered in a nursing home, strangled by her roommate, was initially blocked from court. So was a case brought by the family of a 94-year-old woman who died at a nursing home in Murrysville, Pa., from a head wound. The cases were the subject of a front-page article in The New York Times last November.

“The sad reality is that today too many Americans must choose between forfeiting their legal rights and getting adequate medical care,” Senator Patrick Leahy, a Democrat of Vermont, said in a statement on Wednesday.

The nursing home industry reacted strongly against the change. Mark Parkinson, the president and chief executive of the American Health Care Association, a trade group, said in a statement on Wednesday that the change on arbitration “clearly exceeds” the agency’s statutory authority and was “wholly unnecessary to protect residents’ health and safety.”

The new rule on arbitration came after officials in 16 states and the District of Columbia urged the government to cut off funding to nursing homes that use the clauses, arguing that arbitration kept patterns of wrongdoing hidden from prospective residents and their families.

With its decision, the Centers for Medicare and Medicaid Services, an agency under Health and Human Services, has restored a fundamental right of millions of elderly Americans across the country: their day in court.

It is the most significant overhaul of the agency’s rules governing federal funding of long-term care facilities in more than two decades.

And the new rule is the latest effort by the Obama administration to rein in arbitration’s parallel system of justice that was quietly built over more than a decade.

In May, the Consumer Financial Protection Bureau, the nation’s consumer watchdog, unveiled the draft of a rule that would prevent credit card companies and other financial firms from using arbitration clauses that bar consumers from banding together in a class-action lawsuit.

While Democrats, including Mr. Leahy, have tried to get rid of arbitration through legislation, their efforts have met resistance from various industry groups. The efforts by the consumer agency and now Health and Human Services do not require congressional approval.

Like other rules put forth by the administration, the rule on nursing homes that receive federal funding could be challenged in court. But absent those challenges, the rule is scheduled to go into effect by November. Only future admissions would fall under the new rule.

The nursing home industry has said that arbitration offers a less costly alternative to court. Allowing more lawsuits, the industry has said, could drive up costs and force some homes to close.

But some government officials and elder care lawyers see a different rationale. For corporations, they say, arbitration also potentially keeps embarrassing practices under wraps.

The nursing home rule, which was first proposed in July 2015, was aimed at improving disclosure. The agency began to re-examine the rule after a chorus of patient groups raised concerns about the widespread use of arbitration.

The final version of the rule went a step further than the draft, cutting off funding to facilities that require arbitration clauses as a condition of admission.

Lawyers who work with the elderly say that people are being admitted to nursing homes at one of the most stressful moments of their lives. Distraught and often desperate for a room, prospective residents do not fully grasp what they are signing, the lawyers say.

Sometimes, that does not matter. Judges are bound by a pair of Supreme Court decisions, in 2011 and 2013, that blessed the widespread use of arbitration clauses. Those decisions have made it virtually impossible to overturn clauses, even those signed by the most vulnerable nursing home residents.

An appeals court refused to throw out an arbitration clause signed by a man who could not read or sign his name, reasoning that “illiteracy alone is not a sufficient basis for the invalidation of an arbitration agreement.”

In the last decade, arbitration clauses have affected things like cellphone contracts, employment agreements and student loans.

But even as the use of arbitration clauses spread, little was known about what happened to those who took their chances there. Companies argued that arbitration offered a simpler, swifter and less expensive alternative to court, without the headaches and delays.

Those claims, though, were largely anecdotal because arbitrations are confidential and there is no federal database that records their outcomes.

In a yearlong investigation, The Times tried to pierce the veil, getting inside the secretive proceedings. To do that, The Times examined records from more than 25,000 arbitrations between 2010 and 2014 and interviewed hundreds of lawyers, arbitrators, plaintiffs and judges in 35 states.

The proceedings bear little resemblance to court. They have been conducted in the offices of lawyers who represent the companies accused of wrongdoing.

In the case of nursing homes, The Times found many troubling examples where issues of abuse and potential neglect never made it into the public light because they were blocked from court.

In May 2014, for example, a woman with Alzheimer’s was sexually assaulted two times in two days by residents at a nursing home in Lemon Grove, Calif. A subsequent investigation by the state’s department of public health found the nursing home “failed to protect” the woman.

But when her family tried to hold the nursing home accountable in court, their case was scuttled because of an arbitration clause. Ultimately, they gave up and settled with the nursing home.

Full Article & Source:
U.S. Just Made It a Lot Less Difficult to Sue Nursing Homes

More older adults spending ‘golden years’ in homelessness

After a lifetime of working hard, Linda Boamah thought she was setting herself up for a comfortable retirement.

But the former optical-lab worker became ill with multiple chronic conditions in 2014 and in less than two years lost everything, including her house, life savings and pride.

"I couldn't work anymore because I got congestive heart failure, COPD (chronic obstructive pulmonary disease) and am diabetic," said the 62-year-old East Side resident. "The money I had saved up was quickly depleted, and I was terrified."

Thankfully, a friend stepped in and offered Boamah a room to sleep in, sparing her from becoming part of the growing population of seniors living on the streets and in shelters.

About half of the homeless in the United States are people 50 or older, studies show. The number of older homeless adults is projected to increase by 33 percent in the next decade and double by 2050.

"We're at the beginning of the wave and have an opportunity to not only improve the quality of life of these homeless and formerly homeless elders, but also extend their lives," said Katrina Van Valkenburgh, central region managing director for CSH, also known as the Corporation for Supportive Housing.

The average life expectancy for a homeless older adult is 63 years, compared with 80 for someone who always has had stable housing, she said.

Leaders from across the Midwest are meeting in Columbus this week to talk about helping this aging homeless population get into and keep affordable housing. The two-day event is hosted by CSH and National Church Residences, which specializes in low-income and affordable senior housing.

It kicked off on Tuesday with a tour of two supportive housing properties owned by National Church Residences. Today, housing experts from across the country are meeting.

Aging adults who have been homeless experience chronic illnesses and geriatric conditions 15 to 20 years earlier than the general population, said Dr. Margot Kushel, a professor of medicine at the University of California-San Francisco who followed 350 homeless people in Oakland, California.

Although the median age of the participants was 58, they had more trouble bathing, dressing and eating than many in their 70s, 80s and 90s, Kushel said. They also had a harder time using transportation, taking medication, managing money, applying for benefits and arranging job interviews.

One answer is creating more affordable and supportive housing — the theme of today's gathering. Supportive housing complexes provide tenants with tailored services such as life-skills training, alcohol and drug abuse programs and case management so they can have more stable, productive lives.

After six months of living with her friend, Boamah was able to secure an apartment in June at National Church Residences' Commons at Third near Grandview Heights.

"I was so worried before about what was going to happen to me that I was making myself even more sick," she said. "I love my new home. It's peaceful and quiet."

Though supportive housing has been available for people who have been homeless or have struggled with addiction or mental illness for decades, they need to be adapted to the unique needs of older residents, Kushel said. Rooms, for instance, need good lighting and grab bars in the bathroom. Many residents also could use personal-care attendants to help them bathe and get dressed.

Leon Williams, 63, of the North Side, said if it weren't for the supportive services at Commons at Third, he'd probably still be living in a nursing home, where he landed in 2009 after falling and dislocating his shoulder. He remained there for six years because of prostate cancer, a knee replacement and a spinal condition that forced him into a wheelchair.

"Unlike the nursing home, I can come and go when I please," he said, adding that he enjoys eating at the many restaurants near his new home.

After two bouts of homelessness, mostly recently in 2005 after a difficult divorce that led to substance-abuse problems, Jerome Johnson, 47, of the West Side, said he's glad to have found permanent supportive housing at another National Church Residences property, Commons at Buckingham, while he is still relatively young and healthy.

"It took me a lot of work and paperwork to get here, and I'm never leaving if I can help it," he said.

Full Article & Source:
More older adults spending ‘golden years’ in homelessness

Friday, October 21, 2016

The Loneliest Patients: When They Can't Make Decisions, Who Will?

The elderly man hadn’t sought medical care in 20 years when he collapsed on his way to the grocery store. At the hospital, he was diagnosed with a bloodstream infection, dementia and tuberculosis. Doctors suspected he had bladder cancer.

He’d been abusive, and estranged family members refused to help in his health care decisions. The man didn’t want any treatment, or even to be evaluated medically. But his dementia deprived him of the mental capacity to make his own decisions. Doctors kept him in acute care and treated him for TB, as public health law required, but nothing else.

Three months later, on the day his guardianship hearing was scheduled, the man died from infections. 

Could his infections, acquired in the hospital, have been treated with antibiotics? Or was there a decision not to treat the infections, to let them run their course? Either way, who decided?

Chances are, the doctor in charge did. Chances are, the decision was made “off the radar,” and did not follow hospital policy — if the hospital even had a policy. Chances are, the decision was right, but arrived at through a process that would not look good on a newspaper's front page.

The patient lived and died in Colorado, but aspects of his story are increasingly familiar in critical and acute care wards in Boston and elsewhere.

These patients go by many names: conserved, unknown and unrepresented, unbefriended, incapacitated and alone, to name a few. The sad irony is, they answer to none of them, and cannot inform their own care.

For decades, public guardians — court-appointed decision-making advocates for patients who need them — have been held up as the ideal for such cases, but funding and other support have been inadequate. And in some places, Massachusetts included, there is no public guardianship. Here, how such decisions are made varies from hospital to hospital. Some rely on private guardians; some have learned to avoid guardians.

This hardly inspires trust in the system, and the need for a process that is ethical, legal and serves the patient’s best interest is only becoming more urgent.

Why the urgency? Growing roughly commensurately with the doubling of America's senior population, the ranks of the unbefriended are set to rise from about 35 million in 2000 to a projected 72 million in 2030. In Massachusetts, people 65 and older are projected to grow in number from 860,000 in 2000 to 1.5 million in 2030.

Decisions about medical care ideally combine medical expertise about what’s wrong and what’s possible with the patient’s own wishes and values. But with the unbefriended, those wishes and values cannot be known.

In a medical system where patient autonomy rules, these patients have none.

About a half million Americans die in critical care each year, including a significant majority after a decision has been made to limit life support. How many are unbefriended is difficult to say, but the low estimate is nearly 6 percent, or about 30,000. It may be closer to twice that. In one urban hospital studied, one in four ICU patients who died was unbefriended.

In Colorado, concern over elder abuse prompted the study of this patient population. Similar studies going back three decades have been conducted by the Markkula Center in Northern California, by the American Bar Association, and the Conference of State Court Administrators, among others. Each saw a growing wave of incapacitated patients and a court system unprepared to deal with it. And each study recommended significant improvements and funding for public guardianship, but response has never met the need.

It simply costs too much, and unbefriended patients, by definition, have no constituency.

The public clearly understands the harm of hastening death, with possible exceptions for terminally ill patients suffering unbearably. But prolonging dying is often considered a lesser harm.

That is one source of the unbefriended dilemma, which pits civil rights protections against patients' best interests. And in a society that treasures individual choice so highly, a dying patient incapable of making a choice creates a profound life-and-death quandary.

Douglas White, a critical care physician and bioethicist from the University of Pittsburgh, has studied unbefriended patients closely and says, “Process is most necessary for a patient who will never leave the hospital.”

I believe hospitals need a clear, transparent process for decisions to be made internally. Any such process will spark concerns over abuse or physician bias. And yet, already there are models that are ethical, legal and worthy of public trust.

Both New York State and the Department of Veterans Affairs (the former by statute, the latter by federal policy) keep the courts and guardianship as options but give attending physicians full authority for medical decisions.

Safeguards are in place to ensure it is not the physician’s recommendation alone. Both New York and the VA require second opinions and review by a committee within the institution. Ultimately, the hospital is responsible.

Research into these patients is growing but limited. Many suffer dementia, mental illness or addiction. Some are homeless. Some have scared off loved ones; others have simply outlived them.

One small study revealed this troubling fact: Unbefriended patients continued to receive life-sustaining treatments such as feeding tubes, ventilators and antibiotics for pneumonia significantly longer than comparable patients who had decision-making surrogates.

Some patients receive too much treatment and others, too little. For many, death is prolonged. Their caregivers suffer conflict, moral distress and burnout.

In New York, for legal legitimacy, a decision to withdraw treatment with the intent of allowing death to occur must meet these criteria: the patient’s condition is incurable or irreversible; the patient is permanently unconscious and expected to die within six months; and treatment is causing unacceptable, even inhumane, suffering.

The VA policy has a curious requirement. The physician must explain to a patient that they have been determined to lack capacity. If the patient cannot understand, why require a explanation?

One reason: Capacity is not constant; for some patients, it comes and goes. More significantly, I think, the VA has created a ritual by which the physician must see the patient as a person, not an incapacitated set of symptoms.

And so it was notable in summer 2015 when a California judge ruled as unconstitutional a state law that allowed nursing home physicians to make all decisions for incapacitated patients — because the law did not require that patients be told and given a chance to object.

The ruling did not solve the problem of over-treatment and under-treatment of vulnerable patients. That problem continues, and not only in California.

But the ruling did underscore the need for an efficient and fair process that respects the patient’s best interests and civil rights. Massachusetts should protect its most isolated patients by writing this kind of policy into law. Thanks to New York and the VA, it won’t require starting from scratch.

Full Article & Source:
The Loneliest Patients: When They Can't Make Decisions, Who Will?

Protect clients and caregivers against claims of senior financial fraud

As the American population keeps growing grayer, senior financial fraud has become a hot-button issue for politicians and regulators.

Three bills designed to protect seniors from financial fraud are moving through the Senate Judiciary Committee with bi-partisan sponsorship and support.

A new model state law adopted by the North American Securities Administrators Association (NASAA) requires financial advisors and firms to report suspected financial exploitation of seniors to regulators and adult protective services offices.

NASAA also has proposed model state legislation that would allow financial institutions to place a 10-day hold on disbursements whenever firms or advisors believe harm may result to an investor age 60 or older. FINRA has requested comments on a proposed rule that would do the same for accounts of people age 65 and older.

Stronger legal protections are: 1) expanding and clarifying the definition of senior financial fraud; and 2) expanding the audience of potential victims to include anyone above a certain age (e.g., 60 or 65). In the past, some statutes have focused only on fraud against mentally impaired seniors or those living in institutions.

Claims of financial fraud often are made against family members, including those closely involved in senior caretaking.  Consider these situations, and ask yourself whether they involve senior fraud:
  • A husband is caring for his 66-year-old wife, who is temporarily incapacitated following a stroke. The husband wants to liquidate funds from the wife’s checking account, in her sole name, to pay for care. He writes and dates the check and guides the pen in her hand as she signs. Several weeks later, their daughter files a charge against him, claiming forgery.
  • A son is caring for his 85-year-old father in an assisted-living facility. The father does not have access to a computer, but does have an online account at The son goes to the site, verifies the father’s identity, and logs on with the father’s username and password. The son then changes the bank account for receiving the father’s Social Security benefits, so the son can access benefits to pay for the care facility. Weeks later, a family member sees this change, asks the father if he authorized it, and files a claim of senior financial abuse against the son.
These are possible cases of senior financial abuse – even though the caregiver has good intentions – and both situations could have been avoided with planning. Here's how: (Click to Continue)

Full Article & Source:
Protect clients and caregivers against claims of senior financial fraud