Friday, May 15, 2015

Consumer Watchdog Takes Aim at Senior-Centered Professional Designations

Consumer Watchdog Takes Aim at Senior-Centered Professional Designations

In its oversight of financial markets that cater specifically to seniors, the Consumer Financial Protection Bureau is taking issue with professional designations used by those in the business—whether that be in managing finances or working for senior housing solutions for those in need. 
Drawing attention to the widespread use of designations such as Certified Senior Advisor (CSA) and Certified Specialist in Retirement as well as estate planners, financial advisors and insurance agents with special designations, the CFPB says it is launching an effort to change the current system. 
In a report released to Congress today the agency found the market is confusing, risky, and can be misleading for consumers. 
The Consumer Financial Protection Bureau is working with federal and state regulators to monitor and enforce improvement across professional markets that use special designations to show they are qualified to work with senior buyers. 
“We found that these so-called advisers may use any of more than fifty different senior designations to promote their services to older Americans,” said CFPB Director Richard Cordray in a call with members of the press. “With such a bewildering array of titles and acronyms, it is no wonder that older Americans are often confused and misled by these titles.”
The CFPB estimates there are tens of thousands of professionals with one or more of the roughly 50 designations, including those who work with retirees on financial planning, retirement income plans, estate planning, insurance and other such services.
Part of the problem, the agency says, is there’s no way for consumers to distinguish between the designations and whether they are accredited. While some require several hours of continuing education, others require entire degree programs and years of university study. 
“The designations can be earned from places as varied as a three-hour online course offered by a for-profit company to a two-year graduate degree from an esteemed university,” Cordray said. “Our research found that the training and standards required to attain these credentials varies enormously.”
The CFPB is working with Congress, the SEC and FINRA on recommendations to make the market more transparent for senior consumers. Because retired people have little opportunity to recover from a poor financial decision later in life, CFPB staff said, the initiative is increasingly important. 
Citing more than 400,000 U.S. insurance agents according to the Bureau of Labor Statistics and more than 200,000 financial advisors, CFPB staffers said the problem is getting worse. 
“There are literally hundreds of thousands of people engaged in this. Many do use senior certifications,” one member of CFPB staff said. 
With approximately $18 trillion at stake—the 2009 estimated net worth of the U.S.’s 65+ households—and the growing number of older adults, adding protections is becoming increasingly important. Although people aged 60 and older currently make up just 15% of the population, they are estimated to account for at least 30% of investment fraud victims, the CFPB report said. 
Toward the lack of supervision and enforcement around senior designations, the CFPB has made several recommendations to Congress toward streamlining the process and reducing confusion around the issue including implementation of training standards to obtain the designations, setting standards of contact for those who old them and increasing supervisions and enforcement. The enforcement will span both the federal and state levels, the CFPB says. 
“Seniors may assume that a financial adviser has their best interest at heart, when that is not necessarily the case,” Cordray said. “If they fall prey to a scam, they may be too embarrassed or too frail to pursue legal action.”

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Tuesday, May 12, 2015

“We live too long, and we die too slowly.”

 “We live too long, and we die too slowly.”
Jane Gross,former reporter at The New York Times

When people go through any major life change—graduation, marriage, parenthood—there is often a period of learning and preparation. However, we are rarely given the opportunity or skills to get ready to care for an elder. If you have recently found yourself in a caregiver position, you may be unsure where to start or whom you can reach out to for help. 

Navigating the world of caregiving can be overwhelming for adult children, many of whom are thrust into caregiving roles almost overnight. CARING FOR MOM & DAD explores some of the major challenges caregivers face, including managing a work-life balance and dealing with the financial burden of caregiving.  

Americans are living longer than ever before. Who will take care of those who can no longer care for themselves? How do you make the best eldercare decisions without compromising your family's overall economic security? It's a complicated question, but one well worth devoting some time and creative thinking. Making decisions about health care, home care, and housing needs can be both overwhelming and costly.  

CARING FOR MOM & DAD (on PBS; check local listings) seeks to answer these questions as it explores the emotional, health, and financial challenges that many caregivers face every day.

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Monday, May 11, 2015

Whistleblower Fired for Speaking Out Against Lax Oversight of Assisted Living Facilities in Massachusetts

Went Public Last Fall With 7 Page Memo Detailing Severe Under-staffing in Agency Responsibility to Protect Elders from Abuse.

When Antonellis’ assertions were rebuffed, he went public in a story published on the CommonWealth website in September. You can read Commonwealth’s expose about EOEA at the following link: the detailed

After he continued to speak out, he was fired in November. The Patrick administration declined to comment on why he was fired, citing the confidentiality of personnel matters. Antonellis declined to release his termination letter on the advice of his attorneys.

Like Antonellis, many attorneys who focus on elder issues have raised concerns about poor oversight of assisted living facilities. Rebecca Benson, a Boston elder law attorney, says she supports the efforts of Elder Affairs to improve protections for residents of assisted living facilities, but she says the problem starts with the agency’s enforcement of current regulations.

“Its current regulations are quite solid, but the agency does not do a very good job of enforcing them. So why would anything be different with new regulations?” Benson asks. “What needs to happen is for Elder Affairs to vigorously enforce whatever the regulations are. Perhaps with a new administration that will happen.”

Eldercare in An Age of Scarcity is a service of Informed Eldercare Decisions of Dedham MA. 
Bob O'Toole is the editor and can be contacted at

Your comments are always welcome as long as they are not "anonymous".
Informed Eldercare Decisions, LLC.
611 High Street-P.O. Box 163
Dedham, MA 02027
Providing services to elders and family caregivers
faced with difficult care planning decisions for more than 20 years

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Massachusetts Ranked Last Place in Assisted Living Oversight

Mass Office of Elder Affairs Fails Miserably to Regulate Assisted Living FacilitiesMay 6 2015

By Bob O'Toole, President, Informed Eldercare Decisions

For months now there has been growing concern about the quality of care in assisted living facilities (ALF's) in Massachusetts.

Many residents of these facilities move in when they are in relatively good health. They typically need some assistance with their activities of daily living but do not need to be in a nursing home. Nursing homes are health care facilities that are regulated by the federal government which delegates that responsibility, in Massachusetts, to the state's Department of Public Health (DPH).

Assisted Living Facilities are considered to "housing" not health care facilities and are regulated by law, by the Executive Office of Elder Affairs (EOEA). But as residents age and their physical and mental faculties deteriorate, their need for assistance sometimes outstrips the ability of ALF's to provide the care their residents need.

In October of last year(2014) Peter Antonellis, a former long-time employee at Elder Affairs was fired after speaking out publicly about EOEA's lax oversight of assisted living facilities. “Having only two ombudsmen to cover over 200 facilities throughout the state is absurd,” he says. “There is no way that just two people can do the job the way it needs to be done.” Ann Hartstein, the secretary of Elder Affairs, insisted that the assisted living ombudsman program was operating properly. “All complaints are responded to,” she says. “I don’t believe that we need to make any improvements at this point.”

Antonellis, who had expressed concerns internally about the agency’s oversight of assisted living facilities for years, finally sent a memorandum in 2013 detailing his concerns to the state secretary of health and human services and the Elder Affairs general counsel.

In his seven-page memorandum, Antonellis said he believed poor management at Elder Affairs was endangering the safety of residents living in assistant living facilities. He noted, for example, that there are no procedures in place for how to handle incident reports from assisted living facilities dealing with such matters as falls, residents wandering off, abuse, and adverse medications. Antonellis said the agency does almost no analysis of the data it collects, which means any pattern of problems at a particular facility are likely to go undetected.

Eldercare in An Age of Scarcity is a service of Informed Eldercare Decisions of Dedham MA. 
Bob O'Toole is the editor and can be contacted at

Your comments are always welcome as long as they are not "anonymous".
Informed Eldercare Decisions, LLC.
611 High Street-P.O. Box 163
Dedham, MA 02027
Providing services to elders and family caregivers
faced with difficult care planning decisions for more than 20 years

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Thursday, May 7, 2015

"Aging Life Care" is New Brand Name Adopted by Geriatric Care Managers

"Aging Life Care" ( is the new brand name recently adopted by the group that has been known as the National Association of Professional Geriatric Care Managers"


Aging Life Care / geriatric care management is a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges. Working with families, the expertise of Aging Life Care Professionals™ provides the answers at a time of uncertainty. Their guidance leads families to the actions and decisions that ensure quality care and an optimal life for those they love, thus reducing worry, stress and time off of work for family caregivers through:

Assessment and monitoring
Planning and problem-solving
Education and advocacy
Family caregiver coaching
Long-distance caregiving

Aging Life Care Professionals are engaged to assist in a variety of areas, such as:

Housing – helping families evaluate and select appropriate level of housing or residential options
Home care services – determining types of services that are right for a client and assisting the
family to engage and monitor those services
Medical management – attending doctor appointments, facilitating communication between
doctor, client, and family, and if appropriate, monitoring client’s adherence to medical orders
and instructions
Communication – keeping family members and professionals informed as to the well-being and
changing needs of the client
Social activities – providing opportunity for client to engage in social, recreational, or cultural
activities that enrich the quality of life
Legal – referring to or consulting with an elder law attorney; providing expert opinion for courts
in determining level of care
Financial – may include reviewing or overseeing bill paying or consulting with accountant or
client’s Power of Attorney
Entitlements – providing information on Federal and state entitlements; connecting families to
local programs
Safety and security – monitoring the client at home; recommending technologies to add to
security or safety; observing changes and potential risks of exploitation or abuse
Long-distance care – coordinating the care of a loved one for families that live at a distance;
including crisis management
Local, cost-effective resources are identified and engaged as needed.
A care plan tailored for each individual’s circumstances is prepared after a comprehensive assessment.
The plan may be modified, in consultation with client and family, as circumstances change.
Aging Life Care Professional

ELDERCARE IN AN AGE OF SCARCITY: Who Will Care and Who Will Pay?
is a service of  Informed Eldercare Decisions and edited by Bob O'Toole

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Monday, May 4, 2015

Pros & Cons of Continuing Care Retirement Communities: (USA Today)

Robert Powell, Special to USA TODAY October 18, 2014

Most people want to age in place. But for those who don't, one option to consider is a continuing care retirement community or CCRC.

CCRCs offer a variety of living options — from independent living to assisted living to nursing care — all within one community. And on paper, there's plenty to like about CCRCs, which allow aging Americans the chance to stay in one place but move from one type of residence to another as their health care needs change.

To be sure, there's a cost for this sort of convenience. Entrance fees for CCRCs, of which there are some 2,000 nationwide, can run anywhere from $100,000 to $1 million, and monthly fees can range from $3,000 to $5,000, if not more.

At the moment, some 600,000 people live in a CCRC, but experts say many residents and prospective residents overlook the financial risks they take on when signing a contract to move into a CCRC. "Few CCRC residents understand the financial risks they took on when they signed the contract," James Sullivan, a certified public accountant with Core Capital Solutions in Naperville, Ill., wrote in a recent article about the subject. Read: What CPA planners need to know about continuing care retirement communities.

If fact, worst case, you could lose your entire investment should the CCRC go bankrupt. And that's why financial planners and others say you should ask hard questions about the financial status of whatever CCRC you're considering before signing any contract and moving into a facility of this sort.

But what questions should you ask, and, equally important, what are the right answers to those questions? Here's what Sullivan and Brad Breeding, a certified financial planner, president of LifeSite Logics in Raleigh, N.C., and author of What's the Deal with Retirement Communities? had to say.

What can you tell me to help me feel confident about your long-term financial viability?

The prospective resident is looking for real answers here, not just general responses or avoidance. Answers such as this are what you're looking for: "Financial stability is of utmost importance to us. We have been in operation for 20 years and have never had financial difficulties. We have maintained an occupancy ratio in excess of 90% for the past three years. We have extremely low staff and resident turnover, etc., etc. Our management team has 50 years of experience and manages more than 40 CCRCs across the United States, etc., etc."

 "... several CCRCs have in recent months filed for bankruptcy protection."

If any portion of the entry fee is refundable — either if I decide to move out or at death — what are the stipulations for receiving the refund? Does my unit have to be re-occupied first? Is there a maximum time limit upon which I'll receive the refund regardless? Do I (or my heirs) continue to pay the monthly fees until it is re-occupied? Keep in mind that while such stipulations usually aren't viewed favorably from a resident's financial perspective, they actually contribute positively to the financial stability of the provider, which ultimately benefits the resident.

Is the care consistent from one living arrangement to the next? "When you enter a CCRC you are assuming that the facility provides not only a nice independent living area but is equally as good at providing assisted living and skilled nursing," says Sullivan. But these represent very different services.

"You may enter a facility well known for its independent living area and its excellent food but find out later that the attached skilled nursing facility is not particularly good," says Sullivan. "In that case, you made a wrong choice."

Robert Powell is editor of Retirement Weekly, contributes regularly to USA WEEKEND, USA TODAY, The Wall Street Journal and MarketWatch and teaches at Boston University.

Published by Informed Eldercare Decisions, Dedham MA www.elderlifeplanning

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Thursday, April 30, 2015

The hard truth about Alzheimer’s drugs...THEY DON'T WORK!!

The hard truth about Alzheimer’s drugs

Aricept, Exelon, and Razadyne do little to help most people and pose risks

Published: April 16, 2014 03:00 PM

Alzheimer’s disease, the most common form of dementia, is a terrible thief. Over time it robs people of their ability to remember, learn, and reason, cutting them off from friends and family and eventually even their own sense of self. The companies that sell Alzheimer’s drugs peddle hope to people looking for a way to ease the pain and frustration. But a hard look through the research paints a far more disappointing picture.
Marketing for the Exelon Patch reassures people that the active ingredient “has been studied for over a decade in clinical trials” and that it has “been shown to benefit cognition, which includes things like memory, reasoning, understanding, and communication, as well as improve overall function.” Marketing for Aricept characterizes giving the drug to a loved one as an act of responsibility and caring. “I want to give to the man who gave me so much love,” says a woman as she kisses the cheek of an older man.
It’s true that Alzheimer’s drugs have undergone extensive study. But the overall results are far less encouraging than the ads portray. Most people who take them don’t experience a meaningful benefit. More than half experience side effects. And they’re expensive, costing anywhere from $140 to more than $656 monthly.
And through it all, the thief continues unchecked—none of the drugs can reverse the disease.
“Unfortunately, studies consistently show that for the typical patient, the Alzheimer’s drugs on the market slow the decline of memory, learning, and reasoning by only a modest amount," Steven Woloshin, M.D., professor of medicine at the Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth, said. "And they can cause bothersome and potentially serious side effects. Unfortunately, the drugs don’t affect the progression of the underlying disease.”
To clearly spell out the risks and benefits of these medications, Consumer Reports Best Buy Drugs commissioned Informulary, a company founded by Woloshin and another Dartmouth professor, Lisa Schwartz, M.D., to review the evidence for three drugs approved by the Food and Drug Administration to treat mild-to-moderate Alzheimer’s—donepezil (Aricept and generic), galantamine (Razadyne and generic) andrivastigmine (Exelon patch, Exelon capsules, and generic). Their analysis is summarized in Drug Facts Boxes (see separate links above), which are similar to the Nutrition Facts found on packaged foods.
The Drug Facts Boxes reveal that after six months on the drugs, most of the patients show no improvement in mental functioning, based on their doctors’ assessments and tests of basic thinking skills. Among the few who do benefit, the improvement is typically slight. “The available studies have not shown that the drugs help achieve what we would consider major goals of dementia treatment, prolonging people’s ability to live independently or improving quality of life for either patients or caregivers,” Woloshin said.
Even a small benefit or chance of improvement might be worth it if Alzheimer’s drugs were risk free. But they are not. They can cause side effects such as insomnia, nausea, muscle cramps, diarrhea, and reduced appetite, all of which can be troublesome for people with dementia. Rarely, the drugs may cause more serious side effects such as internal bleeding and a slowed heart rate that could be potentially dangerous.
Because the risks and expense outweigh the benefits for most people, Consumer Report’s Best Buy Drugsdoes not recommend any Alzheimer’s medication as a Best Buy. (Read the free report here.)
Of course, the decision on whether you or a loved one who is affected by Alzheimer’s disease should use a medication is a personal one. Patients and their families who decide to try a drug could start with generic donepezil, which is not more effective than other drugs, but is one of the less expensive choices and has a lower rate of side effects. If there’s no improvement in symptoms after a few months, it makes sense to consider tapering and stopping the drug.
If treatment is continued, people should be reluctant to tolerate a lot of side effects and should stop the drug when the disease has progressed substantially—for example, to the point that a patient requires institutionalization.

—Teresa Carr
Editor's Note:
This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

Eldercare in An Age of Scarcity is a service of Informed Eldercare Decisions of Dedham MA. 
Bob O'Toole is the editor and can be contacted at

Your comments are always welcome as long as they are not "anonymous".
Informed Eldercare Decisions, LLC.
611 High Street-P.O. Box 163
Dedham, MA 02027
Providing services to elders and family caregivers
faced with difficult care planning decisions for more than 20 years

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Monday, April 27, 2015

When Dementia Strikes Financial Skills are Often the First to Go

 There are 44.7 million people 65 and older, representing 14 percent of the population, according to the most recent census data, but, within 10 years, they will swell to an estimated 66 million. This group collectively holds trillions of dollars in wealth, but are often left to manage their own finances, even as they become increasingly vulnerable.

About half of adults in their 80s either have dementia, or at least some cognitive impairment without dementia, researchers said.

“If you can detect emerging financial impairment early, you can also step in early and protect the person,” said Daniel Marson, a neuropsychologist and director of the Alzheimer’s Disease Center at the University of Alabama at Birmingham. “It may be if you step in two months from now, they won’t be in a position to make a poor decision or be exploited a year from now.”

 Preventing these situations is often difficult. Knowing exactly when to get involved can be fraught, whether you are an adult child or a trusted adviser. 

There are a series of early warning signs of financial decline, which Dr. Marson identified in a recent study, which is being submitted for publication and was funded by the National Endowment for Financial Education and the National Institute on Aging.

 You can learn more about Signs of Financial Decline in Elders at:

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Wednesday, April 22, 2015

More than 1,500 Physicians Call for Dr. Oz to Resign in Recent Survey John Oliver Talks About Dr. Oz


(78%) of Physician Social Network voted that he should resign from his faculty position at Columbia University. (As of April 27) 

Of the 2,029 physicians who participated in the Sermo poll as to what Dr. Oz should do next, more than 1,500 physicians (78%) voted that he should resign from his faculty position at Columbia University.  More than 450 (24%) believe he should have his medical license revoked.  

John Oliver blasts Dr. Oz for 'shameless pandering'

 Oliver insisted, Oz knows that there's no such thing as a "miracle pill," which is why Oz told the Senate subcommittee last month that "there’s not a pill that long term is going help you long term lose weight and live your best life without diet and exercise."

So why then had Oz done things like touting green coffee bean extract -- a compound that may actually be harmful -- as "magic beans" on his show? 
"Here's the issue: Dr. Oz is a doctor and one with degrees from two Ivy League schools," said Oliver, who wasn't won over by Oz's argument that he does "personally believe" in some of the products he plugs on his show, even though he recognizes that "often times they don’t have the scientific muster to present as fact." John Oliver's Expose of Dr. Oz

Tuesday, April 21, 2015

Gullible Consumers, Many of Them Frail Elders, Ignore Growing Criticism by Medical Professionals of "The Dr. Oz Show”

"The Dr. Oz Show,” which is among the most highly rated daily television programs in the nation, has been criticized for several years for promoting worthless nutritional supplements for personal financial gain. Now the scrutiny of "America's Doctor" (He has trademarked that name.) is growing intense as a group of physicians have asked Columbia University Medical School to fire Dr. Mehmet Oz from its faculty, citing his history of weight loss and health quackery. In response, Dr. Oz insisted he's not a quack and only wants to help people  

In an April 16 letter addressed to Dr. Lee Goldman, dean of Columbia Medical School, 10 prominent physicians from around the country say Dr. Oz's "egregious lack of integrity" makes him unfit to remain on the faculty of the Ivy League institution.

"Dr. Oz has repeatedly shown disdain for science and for evidence-based medicine, as well as baseless and relentless opposition to the genetic engineering of food crops," reads the letter (see above). The letter continued:

"Worst of all, he has manifested an egregious lack of integrity by promoting quack treatments and cures in the interest of personal financial gain.

Dr. Oz is guilty of either outrageous conflicts of interest or flawed judgements about what constitutes appropriate medical treatments, or both. Whatever the nature of his pathology, members of the public are being misled and endangered, which makes Dr. Oz's presence on the faculty of a prestigious medical institution unacceptable."

Dr. Henry I. Miller of Stanford University told CBS News Dr. Oz is "a menace to public health" who should not be on the faculty of a prestigious medical institution.

"He's been so wrong and so misleading and so unconstructive and antisocial on that subject, I thought enough is enough," said Dr. Miller.

Miller added: “He’s a quack and a fake and a charlatan. I think I know the motivation at Columbia. They’re star-struck, and like having on their faculty the best-known doctor in the country. But the fact is that his advice endangers patients, and this doesn’t seem to faze them."

In response, a Columbia rep sided with Dr. Oz, saying, “Columbia is committed to the principle of academic freedom and to upholding faculty members’ freedom of expression for statements they make in public discussion."

On April 17, Dr. Oz released the following statement in response to the physicians' calls for his firing, insisting he's not a quack.

"I bring the public information that will help them on their path to be their best selves. We provide multiple points of view, including mine which is offered without conflict of interest. That doesn't sit well with certain agendas which distort the facts.

Other sources of criticism are mounting. Here are just a few examples:

" Oz is an experienced surgeon, yet almost daily he employs words that serious scientists shun, like “startling,” “breakthrough,” “radical,” “revolutionary,” and “miracle.” There are miracle drinks and miracle meal plans and miracles to stop aging and miracles to fight fat. Last year, Oz broadcast a show on whether it was possible to “repair” gay people (“From Gay to Straight? The Controversial Therapy”), despite the fact that Robert L. Spitzer, the doctor who is best known for a study of gay-reparation therapy, had recanted"

"Oz has been criticized by scientists for relying on flimsy or incomplete data, distorting the results, and wielding his vast influence in ways that threaten the health of anyone who watches the show. "

"when he tells his audience, with no credible evidence, that red palm oil may reduce the risk of Alzheimer’s disease, is he empowering people? Or is he encouraging them to endanger their health with another “miracle”? 

"Dr. Mehmet Oz, known for his syndicated daily talk show, “The Dr. Oz Show,” came under some intense fire from Congress ...  Members of the Senate’s consumer protection panel scolded the celebrity doctor for making misleading claims about various weight-loss aids – notably the dietary supplement known as green coffee extract.  

The panel maintained that many of his claims were unscientific, arguing that Dr. Oz is encouraging money-hungry supplement peddlers to take advantage of an unsuspecting public.

"I get that you do a lot of good on your show," Chairman Claire McCaskill told Dr. Oz at the hearing, "but I don't get why you need to say this stuff, because you know it's not true."

"Oz's dubious medical advice wouldn't be such a problem if people saw the show as merely entertainment — if they simply watched the show but didn't take its claims to 

heart. But it's clear viewers really do heed his advice. There's the case of a man who followed Oz's suggestion of curing insomnia by pouring uncooked rice into socks, 

heating them in a microwave, and wearing them to bed. The man got second- and third-degree burns on his feet. He sued, but the case was thrown out because the judge determined that Oz cannot establish a physician-patient relationship through TV."

"Not everyone agrees with the judge's reasoning. Rochester New York medical student and blogger Benjamin Mazer has been publishing anonymous stories sent into him from health professionals about the impact Oz has had on patient care. One reported that her dad had a heart attack and five stents placed in his heart, which required himto take aspirin and Plavix to prevent blood clots. "He was watching Dr. Oz, who said Plavix was not necessary, so he stopped taking it. About a month later, he had another massive [heart attack] and coded and had to be shocked back to life." She continued: "My dad admitted to following Dr. Oz's advice and not asking his own cardiologist.""

The making of Dr. Oz
How an award-winning doctor turned away from science and embraced fame
by Julia Belluz on April 16, 2015

Last Week Tonight with John Oliver: Dr. Oz and Nutritional Supplements (HBO)

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Wednesday, April 15, 2015

Don’t Underestimate How Much Help Aging Parents Need At Home

by Robert E. O’Toole, President, Informed Eldercare Decisions
 Lots of people think of the possibility that their aging parents might need a little help. The parents may be struggling, but don’t want anyone coming into their home. They say “I’m fine” when their children suggest a helper. So, they all wait.

According to Carolyn Rosenblatt writing for, families seldom calculate the actual cost of help until a crisis hits. Like a fall and broken hip. After the hospital and then the rehab facility the next step is typically back home. Then the elder needing care or their adult children are shocked to discover that Medicare does not cover a home care worker to be there to help mom with her bath and meal preparation. Medicare covers only those services they consider “skilled care” such as nursing visits, physical therapy, occupational and speech therapy.

 Medicare does not cover anything else that is categorized as help with “activities of daily living” also known as “custodial care.” This is the type of care most elders need for the longest period of time either at home or in a facility. According to the annual Genworth “Cost of Care” survey in many parts of the country long-term care services not covered by Medicare or some other form of insurance can run as high as $100,000 per year. The concern is whether the adult children are going to have to pay for that help out of their own pockets.

Many aging parents do not have the income to cover this help. The article cited a report from the Congressional Budget Office cue about how many hours of daily assistance an aging person is likely to need. The CBO report says that those with functional limitations who receive assistance from others primarily rely on custodial care to obtain the assistance they need. Generally, this means family caregivers. The number of hours of paid care is highest for people who have difficulty with three or more activities of daily living and who are 85 or older. Many are widowed and thus without a spouse to care for them. People under age 85 with limitations in three or more ADLs who live at home rather in a care facility receive an average of 9 hours of assistance per day. People age 85 or older with that degree of impairment typically receive about 11 hours of assistance per day, mostly informal. The cost of a home care worker who provides basic care paid out of pocket, according to the 2012 Met Life study of costs of long term care is $20 per hour.

If you pay a worker to come to your 85 year old parents’ home to care for them with three functional limitations and dementia, the cost will be an average of $102,200 per year for daily, 14 hour a day help. Since most elders cannot afford this, the writing is on the wall. Family members provide much of the needed help themselves. Will this be you? Long term care insurance is the only private benefit that covers home help with activities of daily living, the kind of help most elders need. But most people in the U.S. don’t have it. The CBO report cites statistics from report prepared by LifePlans, Inc. among the adult U.S. population only about 3 percent had LTC insurance in 2011.

 "Eldercare in an Age of Scarcity" is a service of Informed Eldercare Decisions,
Dedham, MA 02027

Providing services to elders and family caregivers
faced with difficult care planning decisions for more than 20 years

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Friday, April 10, 2015

Nursing Home Tries to Prevent Public from Learning the Truth about Safety Inspections

 One patient choked to death, another claimed he was raped.

Memphis TV station exposes very disturbing details about problems at a local nursing home.

The “On Your Side Investigators” at Channel 3 in Memphis also discovered these same details could be kept secret.

An inspection report from federal and state health surveyors shows Signature Healthcare at St. Peter Villa in MidTown Memphis was hit with more than 20 deficiencies in August of 2014. The survey shows one resident choked to death after the facility failed to provide the proper diet, neglected to monitor the patient during meals, and never even attempted a maneuver to stop the choking.
It also reveals Signature Healthcare at St. Peter Villa “failed to thoroughly investigate” an alleged rape.

The resident wasn’t sent to the ER for a rape kit, and the nursing home never even notified police.

The local television investigators recently uncovered problems at another Memphis nursing home owned by the same company. Several viewers of the TV report confirmed the horrific details and encouraged the station to continue to inform the public but now some members of the Tennessee state legislature are trying to make it illegal for the public to be informed of dangerous and abusive conditions in the state’s nursing homes. The surveys that reveal the details of poor quality care for frail elderly patients revealed by WREG could soon be kept secret, if a bill sponsored by Tennessee State Senator Brian Kelsey and Representative Leigh Wilburn becomes law.

Senate Bill 889 would prohibit survey and investigation results from being used as evidence in malpractice cases.

You can read a copy of this legislation at the TV station’s Web site:

 Cameron Jehl is a Memphis Attorney who has sued nursing homes before. He opposes the proposed legislation. “If the nursing homes violates federal law and federal regulations, they’re required to comply with in order to keep and take care of the elderly, then they should be held accountable for their actions,” Jehl said.

However, Senator Kelsey says attorneys will sometimes misuse negative survey results to paint nursing homes with a broad brush, rather than focusing on a single incident that led to a injury or fatality.


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