Tuesday, April 7, 2020

Surge on wills: Fearing death by coronavirus, people ask lawyers to write their last wishes

Apr. 3--Lawyers are being bombarded with requests to write wills, update estate plans and prepare health surrogate or "pull the plug" documents as people are confronted by the realization that they could be diagnosed with COVID-19 and dead within days.

"Estate planning is a fairly morbid topic. Nobody wants to do it. But it's not an if proposition; it's a when proposition," said Joshua Rosenberg, partner at Kelley Kronenberg who specializes in estate planning, elder law and probate and guardianship litigation. "Because of coronavirus, people have come to the abrupt conclusion that they cannot procrastinate. You could be infected and very quickly find yourself in a life or death situation."

As the coronavirus crisis escalates, catastrophic projections of 100,000 to upwards of 240,000 deaths in the United States are forcing people to act on long-deferred intentions to get their affairs in order. No one is immune. Legal experts urge all mortals -- not just the elderly and not just the wealthy -- to put their end-of-life plans in writing.

"We are seeing a tidal wave, at least a doubling in the volume of calls and inquiries," said Miami lawyer Bruce Stone. "Clients who thought they could delay this item on their to-do list are now in panic mode and want it finalized immediately."

The last time estate planners experienced a surge was in 2012, when people worried that Congress would lower the threshold of the estate or "death" tax.

"Back then it was mainly rich people worried about money," Stone said. "This is worse. Now people are afraid they are going to die."

Top priorities are creating a living will that states your wishes should you become incapacitated, designating a surrogate or proxy to make medical decisions, granting power of attorney to someone to make financial and legal decisions and preparing advance directives such as a Do Not Resuscitate order.

A plan, including a last will and testament or trust that spells out what happens to your assets and who will be guardian to minor children upon your death, spares you the mess on "Succession," the HBO TV series about an aging media mogul playing power games with his heirs. Peace of mind is preferable to the family in-fighting, exorbitant legal costs and hours in court your survivors will encounter if you leave your fate in limbo.

"You do not want to get turned back into the court system or find yourself a ward of the court and face the indignity of having your life dragged through court," Rosenberg said.

He and Stone cited the case of Terri Schiavo, the Florida woman who lived in a persistent vegetative state from 1990 to 2005 as her husband fought to remove a feeding tube and her parents fought to keep her connected. At one point, Gov. Jeb Bush intervened to have the tube reinserted. After years of lawsuits, injunctions, appeals and stays, Schiavo was allowed to die. She was 41.

"In the Terri Schiavo case, there was no written recitation of whether she wanted to be kept on life support or not," Rosenberg said. "Her husband and her parents had different goals. The case illustrates all the painful battles and financial disasters that can befall your loved ones if you don't have a living will."

Coronavirus has presented a new wrinkle in the best-laid plans. Typically, your health care surrogate would be in the hospital with you advocating for your desires if you are not able to express yourself. But the COVID-19 disease is closing off hospitals to visitors and confining patients to isolated circumstances. Lawyers recommend adding language to your documents that will authorize your surrogate to give instructions over the phone, by email or during an online conference. And make sure to amend any old documents that may have prohibited intubation.

"We're hearing heart-wrenching accounts of patients on a gurney in the hallway of a hospital hooked up to a ventilator with no loved one by their side, and families saying goodbye on cell phones or walkie-talkies," Stone said. "I feel like the grim reaper but I'm telling clients you've got to assume you may die alone. Your family can't get in to see you or talk directly to your doctor. Because of the nature of coronavirus, no hospital can let people in off the street."

Coronoavirus has erected a major obstacle for Floridians: State law requires two in-person witnesses when a will or other documents are signed. Quarantines and social-distancing rules make it difficult to round up witnesses. Florida has been slow to adopt electronic and remote signing laws approved by other states.

"For wills, trusts, surrogacy forms and power of attorney, Florida's new statute allowing online execution will not be effective until July 1," Stone said. "Many states have changed, relaxed or suspended these laws to catch up to modern digital times but we are stuck with very strict rules in Florida."

The Florida Bar is hoping to introduce legislation that will retroactively validate any end-of-life documents completed without in-person witnesses during the coronavirus health emergency, Stone said.

"I was talking to an elderly couple, they both have medical problems, they are sequestered now and their deadline for an updated living will has been accelerated," said Stone, former president of the American College of Trust and Estate Counsel and an adjunct professor at the University of Miami School of Law. "You should still draw it up, name surrogates and sign it even without witnesses. Something is better than nothing. You can always revise it later."

Rosenberg is being flooded with requests for elder law guidance. Older adults and their relatives are struggling with urgent and awkward circumstances where they are confined to nursing homes or senior communities where no visitors are allowed. Some have dementia, Alzheimer's, memory loss or other geriatric issues.

"People are cut off and don't know where to turn," Rosenberg said. "'How do we care for our loved ones? How do I make sure my grandmother is getting services when I can't even visit her? How do I help her update her documents when they haven't been touched in years and she needs to designate new people? What if my father gets the virus? What if I die and there's nobody to look out for my parents?'"

Rosenberg talked to a woman in an Adult Living Facility whose husband had dementia and recently died. She has no immediate family nearby, friends can't visit and she has difficulty using a computer. Another woman came to South Florida to take care of her ill mother, got stranded here after the outbreak spread and now her brother is being uncooperative as they try to decide on a facility and end-of-life plan for their mother.

In another instance, he spoke to a woman who has been contemplating divorce for a long time "but she'd never pulled the trigger and now she's afraid of what will happen to her property if she gets infected," Rosenberg said. "She says, 'If I die, he gets all the money, runs off with another woman and nothing goes to my kids.' They also had a business together and need a business succession plan.

"In this area of law we are dealing with intricate personal issues. It's akin to social work. We're attorneys at law but also counselors at law. We're not suing people. We are trying to make sure people are properly cared for."

Just as you are preparing your home and adjusting your hygiene for coronavirus, so should you make choices about what happens if you become incapacitated or die, Rosenberg said. How do you want your funeral to be conducted? Cremation? Organ donation? Who gets the cherished heirlooms? According to Caring.com, only 37 percent of Americans have a will.

It's possible to make a will online. Consult websites such as Cake ("Navigating mortality? We'll be your guide"), Gentreo ("Life happens") and Willing ("Legal wills made easy"). But lawyers caution that do-it-yourself wills have their pitfalls, and are not necessarily easier and cheaper than consulting with an estate-planning specialist who knows state law.

Stone highly recommends reading the information offered by the American College of Trust and Estate Counsel on their website and watching its new video, "Getting Your Affairs in Order: Essential Legal Documents."

The Real Property, Probate, and Trust Law Section of the Florida Bar provides access to vital information on its website.

Rosenberg's firm, Kelley Kronenberg, has created a coronavirus text hotline and is posting coronavirus resources.

Full Article & Source:
Surge on wills: Fearing death by coronavirus, people ask lawyers to write their last wishes

Riverside nursing facility has a third of patients test positive for coronavirus

RIVERSIDE, Calif. - One third of the patients at a 90 bed nursing facility have tested positive for the coronavirus according to the Riverside County University Health System.

The Extended Care Hospital of Riverside on Magnolia Avenue in Riverside has closed to new patients and staff is not allowed to work at other facilities to try and contain the virus. Sick patients have been isolated and all are being monitored.

“We will be seeing more and more of these outbreaks in the community,” Dr. Kaiser stressed. “This is a vulnerable population and we’ll take all the steps necessary to protect them. But these steps can only work effectively if people stay home, stay apart, and cover up their faces in public to reduce overall transmission.”

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Riverside nursing facility has a third of patients test positive for coronavirus

Monday, April 6, 2020

Oregon veteran survives coronavirus, celebrates 104th birthday

It was a very happy 104th birthday for World War II veteran William Lapschies on Wednesday.
The Lebanon, Ore., resident celebrated with family members after surviving a recent bout with the coronavirus, according to media reports.

“He is fully recovered. He is very perky – and he is very excited,” daughter Carolee Brown told OregonLive.com.

Photos posted online showed Lapshies at his outdoor birthday bash at the Edward C. Allsworth Veterans’ Home in Lebanon, celebrating with balloons and a large “Happy Birthday” sign – while seated in his wheelchair and wearing a mask.

The party attendees practiced social distancing, except for when some nursing home staffers, who also wore masks, provided some aid to Lapschies.

The festive occasion was a little more subdued than that in 2016, when about 250 people gathered to help Lapschies mark his 100th birthday, OregonLive.com reported.

More than a dozen people linked to the veterans’ home had tested positive for the virus also known as COVID-19, FOX 12 Oregon reported. Two of those affected died, officials told the station.

Oregon also recently saw a 95-year-old veteran in Yamhill County survive the virus.

“I survived the foxholes in Guam, I can get through this bulls---,” Bill Kelly said, according to a Facebook post by his granddaughter, Rose Ayers-Etherington.

Full Article & Source:
Oregon veteran survives coronavirus, celebrates 104th birthday

Coronavirus: Louisville judge places defiant patients under house arrest

A Kentucky judge is ordering some Louisville residents who tested positive or came in contact with coronavirus to stay at home. (DanielB/Pixabay)
LOUISVILLE, Ky. — A Kentucky judge has ordered two Louisville residents to stay inside their home after refusing to isolate themselves amid coronavirus concerns.

The two people live in the same house, but only one has been diagnosed with COVID-19, WHAS reported.

Jefferson Circuit Court Judge Charles Cunningham issued the order Friday, telling both people to remain at home and isolate themselves. The person who tested positive March 23 was seen by health officials taking a walk Thursday, Cunningham told the television station.

Monday, a Louisville police officer, who was in contact with both people, was sent home after reporting to work with a raised temperature, WHAS reported.

It wasn’t the first case involving Louisville residents defying stay at home orders.

According to court documents, one man who tested positive went shopping March 21, WHAS reported.

Under state law, Louisville Metro Public Health and Wellness has the authority to issue an “order of isolation,” the television station reported. The order is then signed by a circuit judge and deputies attach a GPS monitoring device to the patient. If the patient leaves their home, they could be arrested, WHAS reported.

Officials with Louisville’s chapter of the Fraternal Order of Police said they are concerned about officers coming in contact with patients, and said people who test positive should be held accountable if they leave their homes.

“We are more than capable of handling anything the city throws at us, but in order for us to be confident in doing that, we need to know that we’re being taken care of as much as possible," FOP Lodge 77 spokesman Tracy Dotson told WHAS. "We don’t think it’s too big of an ask to be tested and to do the proper equipment that we need to do this job, and to do the ask that the city and the judges are asking us to do.”

Full Article & Source:
Coronavirus: Louisville judge places defiant patients under house arrest

Shortage of home healthcare workers tied to coronavirus

by Kyndell Kim

Click to Watch Video
LAS VEGAS (KSNV) — The impacts of the coronavirus pandemic are impacting the lives of people across the country, including the elderly and those living with disabilities.

"Independence is everything for people," said Alexandra Herold, founder of Patti + Ricky.

Harold's website, pattiandricky.com, specializes in adaptive items and clothing for people living with disabilities or medical conditions, including the elderly.

"They have to be more independent because they can’t have home health aids," explains Herold.

Herold said since the start of the coronavirus pandemic, older individuals and those living with disabilities are finding their regular caregivers called to other medical duties, including the simple need to stay away as a practice of social distancing.

From medical organizers to clothing items with magnetic closures instead of tricky buttons or zippers, she's hoping her items can help -- from the person seeking more independent in the absence of a home healthcare worker to the family member stepping up to fill the roll.

“There’s so much change for individuals with disabilities and the elderly right now,” says Herold. "Change is hard for anyone."

Full Article & Source:
Shortage of home healthcare workers tied to coronavirus

Sunday, April 5, 2020

From The Silver Standard’s Elder Abuse Reform Now Project: No One Would Believe You Are in Your 70's

On August 23, 1973 Jan-Erik Olsson pulled a loaded submachine gun and fired at the ceiling of a bank in Stockholm, Sweden. After wounding a policeman, Olsson and a partner took four bank employees hostage, herding them into a bank vault.

He then quickly established a first-name relationship with the hostages and, over a period of six days, swung back and forth between threats of physical harm and acts of thoughtfulness, created an atmosphere where the hostages’ fear of and reliance on their captor resulted in a reaction now referred to as Stockholm Syndrome.

The robber’s benevolent acts curried the sympathy of his hostages. “When he treated us well,” said one hostage, “we could think of him as an emergency God.” They began to fear the police more than their captor. One hostage called the Prime Minister and pleaded with him to let the robbers take her with them in the escape car, saying that she fully trusted him and she feared that the police “…will attack and cause us to die.”

Once the robbers were captured, the hostages embraced, kissed, and shook hands with them. One shouted to the handcuffed criminals, “…I will see you again.” Some days later, one asked a psychiatrist, “Is there something wrong with me? Why don’t I hate them?” The psychiatrists explained that their experience was similar to that of a shell-shocked POW—the hostages had become so emotionally indebted to their abductors that they began to see the abductors, rather than the rescuers, as their saviors.

Just think, four people—all young, healthy, and in complete control of their faculties—and every one of them was totally brainwashed over a period of just six days…six days.

A great deal of financial elder abuse comes through deception and undue influence very similar to this sort of brainwashing,. It most often takes place in locations where there are no witnesses o step in. Usually, it starts out clothed in a velvet glove, but it ends all too frequently in tragedy—and even violence and death. It comes from family, bankers, lawyers, financial advisors, helpful neighbors, tradesmen, housekeepers, caregivers, and total strangers.

Most of us know a woman in her 70s or early 80s—a mother whose husband of many years, the person who dealt with home repairmen and almost all financial decisions, is now gone. One who has begun to find more and more of her friends names showing up on the obituary page, and others who can no longer drive. One whose children live hectic lives with children, grandchildren, and jobs. And the winter weather keeps her at home and alone too much.

A couple of friends may be trying to get her to follow their move to sunny Florida. She is in excellent health, she has all her wits about her, and her kids have been worried about the direction her life has been taking, so everyone decides Florida is just the answer

Things look good—she found a nice house to buy, the kids talk to her every few days and are delighted to hear she has landed next to a lovely couple who drop in every few days to make sure she is OK and offer to do her shopping at the same time they do theirs.

The neighbor husband says she does not need to hire someone to mow her tiny lawn—he is happy to do it when he mows his own lawn.

When she is not feeling well, the wife recommends a doctor, takes her there, and then brings her soup for the next few days.

Soon, she is frequently receiving gifts of homemade meals and flowers from their garden.

Her roof springs a leak and he offers to deal with the roofing man for her and, when she writes the check for the work, he mentions that he has a nephew who is very good at helping seniors increase their income.

The nephew is a lovely young man. But, she thinks she will just keep this to herself and not tell her children. “They always think I’m helpless… wait until they see how much money I make,” she thinks.

The neighbors take her to a social club, and for the first time in a long time she is with a group of people laughing and dancing and enjoying themselves. A very nice man asks her to dance. He’s a little younger than she but later he calls and asks her out to dinner. He brings her gifts—he’s a bit flirty—it feels so good—she’s alive again.

The seduction has begun.

Or perhaps it’s a widower in his 60s. He married his high school sweetheart. Though life gave them some bumps in the road from time to time, they were a team, they always got through it together. Now he has sold his business for a very healthy sum, or retired with a good pension, and they are going to do all the things they could not do while busy raising children and building his business. Then, disease killed all those dreams. Now, he is alone without the one who always had his back and who had always been there to bring sunshine into a grey day.

At first, friends made sure to keep him busy, but months go buy and that dwindles off. He has lunch with his retired friends, and plays golf as often as weather allows. He has taken to going to movies in the afternoon—not much fun alone.

He can never find anything he is looking for; he keeps forgetting to renew his prescriptions, he ran out of clean shirts and can’t find the name of the laundry. Some nights he eats at a restaurant alone, others he stops by the Chinese take-out or that pizza place they had both liked, or he gets one of those delicious roast beef sandwiches they always ordered from their favorite deli.

When he gets home, the lights are off—it’s so quiet. She always had music playing. He opens his sandwich, gets himself a drink, and settles into his cozy chair. The sandwich doesn’t taste as good as it used to. He turns on the news, but there is no one to discuss it with, and it’s all the same old same old anyway so he turns it off. He settles in with a book—it’s so quiet.

After a few months, he hires someone to take care of the housework. Her resume is impressive. She is working to support her unwell mother while trying to save enough to go to go back to college—It’s also nice to have someone around who is always interested in what he has to say.

She makes things he likes to eat and brings them to him as a surprise. Soon she is cooking dinner for him. She seems to always know just where everything is. He has clean shirts, his meds are always at the bedside, dinner is hot and delicious—almost as good as his wife’s. She is young yet she finds his conversation fascinating. She tells him he is much more interesting than men her age. She tells him, to look at him, no one would believe he was in his 60s.

Now, the lights are on when he gets home—it’s no longer quiet, and there is someone there who finds him attractive and interesting.

The seduction has begun. It may take more than six weeks, but it won’t take long.

Margaret Singer, Ph.D. (1922–2003) was a clinical psychologist and adjunct professor of psychology at the University of California, Berkeley, and a nationally renowned expert on cults and brainwashing. In the 1990s doctor Singer, by that time a senior citizen herself, turned her attention to the problem of undue influence in elder abuse, saying, “People who are clearly competent from a legal and psychological standpoint are making decisions that just don't make sense to us. Undue influence seems to offer an explanation… People use their roles to exploit the trust, dependency, and fear of others…They use this power to deceptively gain control over decision making.” 
I am a good example of a tough old bird who wants to help the
other old birds see to it that their roofs and swings and cages
don't get stolen. ~
Margaret Singer
Obtaining frequent access to a senior citizen provides an abuser with an opportunity to censor mail and, using all manner of excuses and explanations, reduce outside contact and visits, especially from family and close friends. With comments from the abuser, the senior begins to feel they have been brushed aside by loved ones and makes it easy for the abuser to convince the senior that they are the only one who really care about them. According to Doctor Singer, they frequently start to infantilize the senior, or over medicate them, and soon the older person feels totally dependent on the abuser. She says they create a “siege mentality” similar to the brainwashing of captives and hostages. They terrorize seniors into believing that only they can protect them from being removed from their home and placed in an institution or from having all their possessions and means of support taken from them. Some use what are commonly called “gaslighting” techniques, making them question their own memory, perception, or judgment, and weakening their self-esteem. They also frequently use reduction of food as a weapon. Both fear and nutritional deprivation will incapacitate even the most intelligent person, let alone an elderly person who is beginning to experience a feeling of helplessness, abandonment by those they love, and distrusting their own memory. Or, worse yet, they have been convinced their loved ones are plotting against them, which often results in the victim identifying with the abuser and rejecting those who love them and are trying to save them.

In the documentary The Unforgivable Truth, produced by The Silver Standard, you can hear a very distressed mother screaming at her daughter to go away because “Don says you can’t be here”—even though Don has her living in a dirty house, sleeping in filthy sheets, without regular healthy home-cooked meals, cut off from the daughters with whom she has always been very close, and clearly terrorized. All of this is the absolute opposite situation from that which she enjoyed under the protection of her loving daughters. Yet, she is rejecting the daughters. In the end she died alone in that dirty bed.

Dr. Singer stresses the importance of remaining actively involved in the life of loved ones who are elderly. Do all you can to keep them in a position where the possibility of their falling victim to brainwashing or undue influence is greatly diminished.

Make sure they have plenty of mental stimulation.

Visit as often as you can.

Call frequently—it does not have to be a long conversation, just check in a couple of times a day to let them know you love them.

Arrange visits from friends or individuals from their religious organizations.

Make sure they eat three nutritious meals a daily …stock their freezer.

Make sure that any dentures fit properly so eating is not a problem.

Make sure a log is kept of medication intake.

Make sure their eyes are examined regularly.

Make sure they have the proper lenses in their glasses.

Make sure their hearing is checked regularly and hearing aids provided if necessary.

Make sure they have books on tape if reading is not possible.

Make sure they have both a radio and a TV.

If possible, arrange to have them taken to a senior center, church group, or social organization once or twice a week.

If possible, make arrangements for them to participate in bridge, or other game, book, or Bible study groups.

If they are fragile, have the mail sent to your office or a lawyer’s office, and do it before they get to a point of being vulnerable to anyone who might have inappropriate motives.

If a home health care worker, or anyone else, tells you they are too ill for you to visit, drop in anyway—take some bright flowers—you don’t have to stay long

It is best to do everything possible to prevent the situation from happening in the first place. However, sometimes a close relative or friend can step in and save the senior. But that is only if the abuser is not also a guardian—which is all too often the case.

When you have a loved one who is clearly in decline, gather family and discuss guardianship by family members before a stranger, family services, or the court system gets involved.

One by one each of us can try to protect those we love, but the instances of elder abuse in this country, especially financial elder abuse, are growing at an alarming rate. A shocking number of American seniors, who should be enjoying their golden years, are suffering and dying from the tragic circumstances of elder abuse.

In the end, no matter how hard individuals try to prevent it or stop it once it has begun, elder abuse will only become a sin of the past when every state makes the penalties for abusing a senior so harsh that it's not worth taking the chance.

Note: Much of the information on Dr. Singer was taken from a 1996 interview by NCPEA

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No One Would Believe You Are in Your 70's

From The Silver Standard’s Elder Abuse Reform Now Project: In 2020 America Animals Receive More Humane Care Than Our Senior Citizens

By Mary West

Studies show that the care of America’s elderly and infirmed not only fails to meet federal nursing home regulations but federal laws governing the treatment of animals 

Just how badly are some nursing home residents treated? Do they receive better care than animals in a zoo or dogs in a kennel? A recent report issued by the Long Term Care Community Coalition (LTCCC) compared animal care standards to the experiences of individuals in long-term care facilities. The authors concluded that care of the elderly and infirmed often not only fails to meet federal nursing home regulations—it also falls short of requirements for humane animal treatment.

A 2014 study by the OIG found that one third of Medicare 
beneficiaries who enter a nursing home are harmed 
within approximately two weeks. 
 
The LTCCC report was based on research that evaluated several categories such as abuse, nutrition, and medical supervision. Guidelines for animal care mandated by federal law and oversight agencies served as standards on which to base the comparisons of nursing home experiences. Each category assessed revealed cause for alarm. It’s frightening to think that a precious parent, grandparent, aunt, or uncle may not receive even the basic treatment due a pet.

Abuse and Neglect

According to the Standards for New World Primates, physical abuse and punishment-based training should never be used in handling non-human primates. While federal standards prohibit the abuse of nursing home residents, state and federal oversight agencies are lax in enforcing them.

Mistreatment and neglect top the list of concerns relating to long-term care because they cause suffering that takes many forms. The harmful effects can be so severe that they culminate in death.

Statistics like a 2019 report issued by the U.S. Department of Health and Human Services Office of Inspector General (OIG) underscore how abuse has serious outcomes. It estimated that one in five Medicare claims from nursing home residents visiting the emergency room stemmed from mistreatment.

Furthermore, once someone is admitted to a long-term care facility, the abuse frequently starts quickly. A 2014 study by the OIG found that one third of Medicare beneficiaries who enter a nursing home are harmed within approximately two weeks.

46 percent of older residents in long-term care facilities 
had impending or current dehydration 
 
Nutrition and Hydration

The Animal Welfare Act states that hamsters and guinea pigs should be fed daily and that the chow needs to be palatable, free of contamination, and sufficiently nutritious to meet the animals’ needs. Federal standards for nursing home residents stipulate that meals be appetizing, healthy, and appropriate in size.

Sadly, individuals in long-term care facilities aren’t always treated as well as rodents. It’s not unusual for them to receive insufficient food and water, the fundamental necessities for life.

A 2004 study published in the Journal of Gerontology discovered that 64 to 80 percent of nursing home residents consumed less fluid and food than amounts recommended in federal guidelines. In a 2020 article featured in Age Ageing, the authors estimated that 46 percent of older residents in long-term care facilities had impending or current dehydration.

Dehydration is a condition that can be life threatening if not caught in time. In a 2019 hearing held by the U.S. Senate Committee on Finance, legislators heard the account of an Alzheimer’s resident in an Iowa facility who was denied water for several days. The person died after developing dehydration.

Food and water safety is also an issue. A 2019 report in Fair Warning detailed often-unreported problems in nursing homes such as moldy ice machines and food-borne disease outbreaks.

Freedom from Restraints

Guidelines from the 2016 American Association of Zoo Veterinarians note that physically restraining animals without sedation should be reserved for use only during medical procedures. Federal requirements mandate that nursing homes shouldn’t use physical or chemical restraints on residents for purposes of convenience or discipline.

All of us have felt sympathy for a dog that is chained much of the time and not allowed to run loose within a fenced-in enclosure. Individuals in long-term care facilities are sometimes similarly restrained.

Bedrails, one form of physical restraint, represent a source of preventable harm because residents can climb over and around them. A New York Times review reported that from 1995 to 2012, bedrails were implicated in 550 deaths. These restraints are sometimes necessary, but they shouldn’t be used without supervision.

Nursing homes frequently use drugs to sedate residents for the convenience of caregivers. A 2018 Human Rights Watch report said that in an average week, they administer antipsychotic medications to 179,000 individuals who haven’t been diagnosed with the disorders. The drugs promote docility, but their sedating actions have significant side effects. Use of medications as chemical restraints is unacceptable.

Skin Care

In 2020, standards listed by the Associations of Zoos & Aquariums advise staff to inspect the skin of elephants daily and treat problem areas. Federal nursing home standards specify that residents receive skin care to prevent and treat pressure sores.

Because of mobility limitations, individuals in long-term care are in constant danger of pressure sores, but they aren’t afforded the skin care recommended for elephants. LTCCC reported that more than 93,000 nursing home residents have these maladies. Pressure sores can become infected and take months to heal; if untreated, they result in complications, some of which lead to death.

Medical Supervision

Under the Animal Welfare Act, attending veterinarians should examine each marine animal in their care once a month, which must include an interview with a staff member familiar with the creature. Federal rules for nursing homes call for a doctor to examine every resident once a month for the first three months after admission and once every two months thereafter.

Adequate medical supervision can prevent or reduce many perils of living in a long-term care facility. If problems are caught early, they can often be remedied; but when staff is short, many issues go undetected. Data from Medicare.gov showed that in 2018, oversight agencies issued 3,876 citations for insufficient numbers of nurses and doctors in nursing homes.

The LTCCC report cited several cases of disorders that occurred due to a lack of doctor and nursing care. One involved the failure to monitor an individual getting intravenous therapy, which resulted in electrolyte imbalances and a decline in neurological functions. In another case, the lack of staff compliance to provide doctor-ordered range of motion exercises and splints to a resident’s impaired joints led to the worsening of contractures. Surveyors noted both violations as “no harm.”

Most people have heard of the mistreatment that some nursing home residents endure, but it’s sobering to know the extent and scope of the problem. The reality that individuals often don’t get the quality of care experts advocate for animals is a terrible indictment of America’s health care system. Although we treasure our pets, the value of human life is so much greater. Our country’s seniors, who have given decades of love and service to their families and communities, deserve that the same care be reciprocated to them when they are frail and infirmed.

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In 2020 America Animals Receive More Humane Care Than Our Senior Citizens

COVID-19 Scams and the Elderly: Inspiring Savvy Seniors

By Laine Crosby

Coronavirus scams are becoming more ingenious every day. You may be aware of some of the pharming scams in the news lately where sites spoofing the World Health Organization or Johns Hopkins University are accessed through links that look like valid websites. These sites direct traffic to another site to capture personal information that can later be used to commit fraud and identity theft. They also install malware on your computer to gain access to all your information. 

But seniors are particularly vulnerable during the coronavirus crisis. Here are a few of the current scams targeting older Americans. When you create elder abuse training for your first line of defense—your tellers and bankers—be sure to include these, drawn from ABA’s free-to-share suite of coronavirus consumer resources: 

  • Phishing and supply scams. Scammers impersonate health organizations and businesses to gather personal and financial information or sell fake test kits, supplies, vaccines or cures for COVID-19. 
  • Stimulus check or economic relief scams. The government is preparing to ease the economic impact of the virus by sending money by check or direct deposit. However, the government will NOT ask for a fee to receive the funds, nor will they ask for your personal or account information. 
  • Charity scams. Fraudsters seek donations for illegitimate or non-existent organizations. 
  • Delivery of malware. Often through “virus-tracking apps” or sensationalized news reports. 
  • Provider scams. Scammers impersonate doctors and hospital staff, claim to have treated a relative or friend of the intended victim for COVID-19 and demand payment for treatment.
  • Bank/FDIC scams. Scammers impersonate FDIC or bank employees and falsely claim that banks are limiting access to deposits or that there are security issues with bank deposits.
  • Investment scams often styled as “research reports.” Fraudsters claim that products or services of publicly traded companies can prevent, detect or cure COVID-19. 

 

Banker training is key to stopping scams 


Compliance professionals know that training is how the best organizations ensure consistent quality. If your bank does not have a program to educate older Americans on scams, now is the time. It’s a good idea to include the latest COVID-19 scams information on your website, in emails or communications to your older customers and on your bank’s app. Make sure your first line of defense knows: 
  • How to fill out suspicious activity reports. 
  • Where within your organization to report scams. 
  • When to contact law enforcement. 
  • What to tell your older customers.  
Since banks are considered essential businesses and have remained operational during the pandemic, you may see seniors continuing their branch banking activities. This is a good opportunity to educate bankers and seniors alike on these new pandemic-related scams and how to maintain a watchful eye. Safe-practices signage in branches is a good idea to have since customers are more germ conscious about handling collateral materials. 

Educating seniors is even more crucial in California, where banks cannot deny a customer’s access to funds, even for their own protection. Other states have protective rules, but in states such as California, the law is silent on what actions a bank may take with respect to suspected elder financial abuse.

ABA’s free Frontline Compliance Training courses for members include modules covering much of this content—including elder financial exploitation and information security red flags—for tellers and other frontline personnel.

 

10 tips for seniors


Your bank can start helping seniors by passing along these 10 tips to help them become aware of scams:

1. Watch out for phishing scams. Phishing scams use fraudulent emails, texts, phone calls and websites to trick users into disclosing private account or login information. Do not click on links or open any attachments or pop-up screens from sources you are not familiar with, and NEVER give your password, account number or PIN to anyone.
2. Ignore offers for a COVID-19 vaccine, cure or treatment. Any medical breakthrough will not be first reported through unsolicited emails or online ads.
3. Rely on official sources for the most up-to-date information on COVID-19. Visit the websites from the Centers for Disease Control and Prevention and your state’s health department to keep track of the latest developments.
4. Remember that the safest place for your money is in the bank. It’s physically secure and it’s federally insured. When you deposit your money at a bank, you get the comfort of knowing that your funds are secure and insured by the government. You don’t have the same level of protection when your money is outside the banking system.
5. Do some research before making a donation. Be wary of any business, charity or individual requesting COVID-19-related payments or donations in cash, by wire transfer, gift card or through the mail.
6. Keep your computers and mobile devices up to date. Using the latest security software, web browser and operating system is the best defense against viruses, malware and other online threats. Turn on automatic updates so you receive the newest fixes as they become available.
7. Recognize and avoid bogus website links. Cyber criminals embed malicious links to download malware onto devices or route users to bogus websites. Hover over suspicious links to view the actual URL where you will be routed. Fraudulent links are often disguised by simple changes in the URL. For example: www.ABC-Bank.com vs ABC_Bank.com.
8. Change your security settings to enable multi-factor authentication for accounts that support it. Multi-factor authentication—or MFA—is a second step to verify who you are, such as a text with a code.
9. Before you make any investments, remember the high potential for fraud right now. You should be wary of any company claiming the ability to prevent, detect or cure coronavirus. For information on how to avoid investment fraud, visit the website of the Securities and Exchange Commission.
10. Help others by reporting coronavirus scams. Visit the FBI’s Internet Crime Complaint Center at ic3.gov to report suspected or confirmed scams. You can also stay up-to-date on the latest scams by visiting the FTC’s coronavirus page at ftc.gov/coronavirus.

ABA bank resources to keep seniors safe


ABA’s Safe Banking for Seniors program includes free turn-key resources for bankers, which banker training materials and customer handouts and infographics that can be used as branch signage. Additional tools can help seniors be aware of fake check scams, joint bank account requests, money mule scams, online dating scams, phishing and more.

ABA’s program also includes presentation lessons, participant activities, communications tools and promotional materials. You’ll find a free webinar on the top financial scams by generation, and a wide variety of other resources including a financial education training portal, state statutes and the DOJ (Department of Justice) initiative.

Full Article & Source:
COVID-19 Scams and the Elderly: Inspiring Savvy Seniors

Saturday, April 4, 2020

One nursing home offers grim advice: Take your loved ones home

by Suzy Khimm and Laura Strickler

Since suffering a traumatic brain injury five years ago, Eliot Loshak, 87, has been unable to get out of bed on his own. His eyesight is heavily damaged, and he needs help from the staff at his Manhattan nursing home just to call his only daughter, Pam.

With the coronavirus now spreading through the nursing home, Pam Loshak fears for her ailing father — and for the staff members at the Mary Manning Walsh Home, who don't have enough personal protective equipment to slow transmission of the disease, despite their hands-on care for those most vulnerable to the virus.

ArchCare, which runs the facility and four other nursing homes in the New York area, has been forced to outfit staff members in rain ponchos and beautician gowns to stretch their dwindling supply of protective gear, according to Scott LaRue, president and CEO of the company, which is affiliated with the Archdiocese of New York. Employees are given one N95 mask — meant to be single-use — to last an entire week.

"I don't feel safe," an aide at one ArchCare facility said, declining to be named for fear of retaliation.

More than 200 of ArchCare's 1,700 nursing home residents are infected with the coronavirus, and more than 20 have died, LaRue said. At least 10 staff members are also infected, with one in the hospital on a ventilator.

Click to Watch Video
The risks are so serious that LaRue is advising family members to pull residents out if feasible. "If you have the ability to take your loved one home, and that's possible, I would encourage you to do so," he said. "There will be better isolation and better limited contact in a home than there would be in a nursing home."

LaRue says just a few families have done so, as the medical and personal needs of most residents are too complex to handle at home.

The ArchCare aide said that staff members are only being given one disposable gown for their entire shift, even if it becomes soiled, and they must constantly circulate between residents who are infected and those who are not.

"How do you expect to use the same gown? We are cleaning them, wiping their mouths, there's stuff on us," the aide said. "I feel like I'm spreading the virus."

While one area of the nursing home where she works had once been designated for infected residents, there are now so many who are sick that they are mixed in throughout the entire facility, the aide added.

Pam Loshak, 42, a publicist who lives in Harlem, is painfully aware of the risks her father faces if he stays at his nursing home, but she doesn't know where else he could go. Eliot Loshak needs a motorized lift and two people just to move him to a chair, and he frequently suffers from health problems that require expert attention.

"I live alone in an apartment — there's just no way I could give him the care he needs," Pam Loshak said.

She is grateful to the nursing home staff for carefully tending to her father, but is pained to think of what could happen as the virus spreads. Her father already has respiratory problems because fluid builds up in his lungs while he's bedridden, she explained. If her father gets infected, she fears, "he would die for sure."

'It is impossible for us to stop the spread'


Over the past week, coronavirus infections at nursing homes have skyrocketed: More than 400 long-term care facilities around the United States now have infected residents, according to the Centers for Disease Control and Prevention — a 172 percent increase in a single week. In New York state, one in four nursing homes have cases of the virus; 1,228 residents have tested positive and 224 have died, according to a spokeswoman for the state health department.

But nursing homes have been unable to get enough protective gear and tests, in part because overwhelmed hospitals are getting the supplies first, industry executives and groups say.

"We seem to be a second-tier priority," said Stephen Hanse, president and CEO of the NYS Health Facilities Association-NYS Center for Assisted Living, which represents long-term care facilities.

News

That has made it harder for nursing homes to slow the transmission of the coronavirus among staff members and elderly residents. Those over the age of 70 and with underlying health conditions are significantly more likely to die from the virus.

In Washington state, which reported the first coronavirus cases in the U.S., 35 people died after an outbreak at the Life Care Center of Kirkland, a skilled nursing facility. A CDC report found that a lack of personal protective equipment and staff members who continued to work while sick helped fuel the deadly outbreak, which quickly spread to other nursing homes in the area.

In recent days, similar cases have exploded across the country. At one facility in Stafford, Connecticut, three residents have died and at least six employees are now infected, with staff reporting a lack of protective gear and limited testing. At two nursing homes in southwest Pennsylvania, infections are mounting among both residents and staff, who say they don't have enough masks to protect themselves. In Louisiana, where 13 residents have died in a single nursing home, one 130-bed nursing home reported having no personal protective gear at all.

"We're in a situation where it is impossible for us to stop the spread of the virus," LaRue said. "They say this is our highest-risk population — the one we have to protect the most — and they're not giving us what we need to do that."

Employees are trying their best to keep scarce equipment clean and to limit visits to the rooms of different patients, the ArchCare aide said. But it is impossible to avoid hands-on contact while assisting residents with eating, bathing, toileting and other basic tasks, in addition to the medical care they regularly receive from staff doctors and nurses. One supervisor suggested that staff members use garbage bags to protect their gowns, the aide said.

Protective gear is especially critical in nursing homes since many residents have physical limitations or dementia that prevent them from being able to cover their mouths when they cough, or from wearing a mask themselves.

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"Nursing homes and all long-term care providers desperately need PPE," the American Health Care Association, which represents nursing homes and other long-term care facilities, said in a statement Monday.

Last week, ArchCare executives made an urgent plea to New York City for 28,000 gowns and 28,000 face shields to protect their nurses, aides and other employees.

The city's emergency management department sent less than 1,000 of each — not even a full day's supply for ArchCare's five facilities, LaRue said.

When asked about the shortages facing New York City nursing homes, a spokesman for the city Department of Health and Mental Hygiene said officials are "working furiously" to supply them with protective equipment.

"These facilities will get weekly supplies of personal protective equipment based on need, as well as emergency orders should the need arise," the spokesman, Michael Lanza, said. The state health department said it was "communicating regularly with nursing home providers and industry leads" about their needs for protective gear.

Last week, New York state officials and a local hospital association helped ArchCare track down 4,000 gowns and 4,000 face shields, but that doesn't come close to meeting the need, LaRue said.

Supplies have been scarce on all levels of government: Many states, including New York, have only received a fraction of the personal protective equipment and other critically needed supplies that they have requested from the federal government's stockpile, prompting growing calls for President Donald Trump to use a wartime law to broadly coordinate production and distribution.

The Trump administration, however, has narrowly limited its use of the law and continues to tell states to buy the supplies themselves from private vendors. But the massive demand for masks, gowns, face shields and other equipment has created chaos as states, hospitals, nursing homes and other facilities are all competing to purchase the same critically needed supplies.

On Monday, ArchCare finally found a vendor who agreed to sell $237,000 worth of face shields and hazmat suits, shipped from China within a week, according to an invoice provided by the company.

But the deal fell through at the last minute after ArchCare discovered that a bank account set up to receive the funds was "opened with fraudulent documentation," according to a company email.

ArchCare and other nursing homes are now appealing to private donors to help fill the need.

"Everyone we serve has the right to the same resources, and their life is just as valuable as anybody else's," LaRue said.

A widespread problem


Nursing homes are also facing a lack of testing, which makes it even harder for them to contain the virus. While more private labs have begun offering coronavirus tests, testing at nursing homes remains highly limited because of a shortage of swabs and other components needed to conduct the tests, as well as restrictive state guidelines.

On March 21, New York state issued an advisory stating that any nursing home residents or health workers in the New York City area with symptoms of acute respiratory illness "should be presumed to be COVID-19," and that testing for those residents "is no longer necessary."

That has made it impossible to identify and isolate all the residents who are infected from those who are not, LaRue said. "If I had my druthers, I'd do widespread testing, and I would test every employee."

ArchCare struggled last week to find just 30 tests from a private lab, which quickly ran out.

The problem is widespread, according to the American Health Care Association: "We have heard from many providers about residents and staff getting declined when trying to be tested. This is extremely worrisome."

Highland Care Center, a nursing home in Queens that is not owned by ArchCare, had a resident hospitalized with the coronavirus last week. Other residents are also showing symptoms, which the facility reported to the city health department, but they still haven't been tested, the facility's administrator, Don Morris, said. "We don't know if they are coming to test."

A 'frightening' lack of communication


As the virus overtakes nursing homes across the country, many families feel helpless and increasingly cut off from their loved ones.

To protect residents from outside infection, New York and many other states have banned visitors from nursing homes. Updates from the management may be limited and sporadic: The Centers for Medicare and Medicaid Services requires nursing homes to notify family members if their relative has a confirmed coronavirus infection, but not if others in the facility have tested positive.

External oversight is also limited: The federal government has temporarily suspended routine health and safety inspections to focus on high-risk facilities, and state ombudsmen are also currently barred from visiting nursing homes and most assisted living facilities.

At ArchCare's Mary Manning Walsh, families were notified Monday that staff-assisted videoconferencing with residents would be suspended for safety reasons, and they were asked to limit calls to the facility. "I ask for your patience in knowing that if someone is not getting back to you immediately, they are directly treating our community," Michael Monahan, the facility's director, wrote.

In an email accompanying the notice, Carlotta Gladding, a member of the residents council, urged families to be patient as staff members are "doing their utmost best to provide safe care for your loved ones."

Image: Carlotta Gladding and her 105-year-old-aunt. (Courtesy of Carlotta Gladding)




Image: Carlotta Gladding and her 105-year-old-aunt. (Courtesy of Carlotta Gladding)
 
But Gladding, whose 105-year-old aunt is at the facility, acknowledges how difficult it has been for families to be cut off from residents as the virus has spread.

"It's nerve-wracking and frustrating and frightening, especially since you may have no communication with your loved one," she said.

Pam Loshak has limited her own phone calls to spare the staff and last spoke with her father in mid-March, when visitors were first banned. She told him to try and cover his mouth if he had to cough, but she knew even that would be tough, given his weak muscles and limited motor control. She tried to be as reassuring as possible, and let him know she was OK.

"Just sit tight," she told him.

Editor’s Note: Suzy Khimm, an author of this article, is related to a resident at the Mary Manning Walsh Home.

Full Article & Source:
One nursing home offers grim advice: Take your loved ones home