Category: Health / Medical

17 Oct

Why staying well can be a living hell

Ian Hull Estate & Trust, Estate Planning, Health / Medical, In the News, Uncategorized Tags: , , , 1 Comment

Have you followed the wellness industry lately? The New York Times recently published a lengthy feature on Gwyneth Paltrow and her wellness company Goop. In it, the author describes a number of the “therapies” she learned about in the course of interviewing Paltrow and writing the article.

These ranged from more conventional wellness tips (healthy eating, cleanses, meditation) to far more radical ideas (bee-sting therapy, psychic vampire repellent, and jade eggs for vaginal therapies). It’s a fascinating (and somewhat disturbing) article. You can read it here.

Paltrow is by no means the only wellness guru out there promoting what she calls “radical wellness.” There are many – with many products and treatments to purchase if you are willing to give them a try. And despite the lack of scientific evidence that these treatments work (one woman recently died from bee-sting therapy) and the resounding criticism of many alternative treatments from the medical community, alternative wellness is flourishing.

Why is that? I can see three reasons:

  1. Social media makes it easier than ever for wellness “ideas” to go viral;
  2. Many people are suffering from a mental or physical condition that conventional therapies haven’t cured – and are desperate for answers; and
  3. The placebo effect results in many claims that a treatment “works” – and those good news stories are fed into the social media cycle.

Of course, some therapies may in fact work – but how can you tell truth from fiction? While there are hundreds of scientific studies that prove the health benefits of things like exercise, healthy eating and meditation, alternative therapies typically have only anecdotal evidence to back them up.

All to say, before you wade into a swarm of bees, get the facts first. This U.S. website lists five reliable online medical resources (such as the Mayo Clinic) that you can trust for information.

Thanks for reading!
Ian Hull

22 Aug

Life-saving drugs for free? It could happen

Suzana Popovic-Montag Estate & Trust, Estate Planning, Health / Medical, In the News, Uncategorized Tags: 0 Comments

The federal government might be getting into the prescription drug business – and it could be a life-saver for many.

In its 2018 budget, the federal government established an Advisory Council on the Implementation of National Pharmacare (prescription drug coverage). The Council’s purpose is to advise the government on the best approach to implementing a national pharmacare program.

Change could be coming
The federal government recently released a very readable discussion paper to start the ball rolling.

What would national pharmacare look like? It’s still early days – and we don’t know if the government will take over drug coverage for all Canadians, whether private insurers will continue offering workplace coverage, or whether a hybrid system will emerge.

But one of the drug coverage “hot potatoes” that could land in the government’s lap is coverage for high-cost specialty drugs for rare diseases, often called “orphan drugs.” Some of these drug treatments are truly life-saving, but costs for some are hundreds of thousands of dollars. The question is, who should pay?

Will government step up?
According to the National Post, Canada is one of the only developed countries without a regulatory framework for rare disease drugs, although previous governments have taken steps to address the issue.

The issue is that with greater numbers of highly effective, high-cost drugs being brought to market each year, access and affordability are a greater concern than ever. And as the baby boom bulge makes its way into old age, we know there will be no shortage of demand.

While the federal government is studying a potential new model for all prescription medications, a change relating to rare-disease drugs is the one that could truly be a life-saver.

Thanks for reading … Enjoy your day,
Suzana Popovic-Montag

15 Aug

Are you ready for bulletproof coffee?

Ian Hull Estate & Trust, Estate Planning, Health / Medical, In the News, Uncategorized Tags: , , 0 Comments

You know the old saying – you have to hear about something three times before you stop to consider it.

I took my full “three times” with bulletproof coffee. First it was seeing a sign in a coffee shop, then it was a display in a small boutique grocery store, and finally it was a personal trainer asking me “have you tried bulletproof coffee? It’s unbelievable.”

Okay, I had to find out what this stuff was. Even though it’s about 500 calories per serving (and typically consumed in place of breakfast), people claim you gain focus and energy – and lose weight. In a nutshell, bulletproof coffee is made in a blender with:

  • 8-12 ounces of brewed coffee
  • 1 teaspoon to 2 tablespoons of Brain Octane Oil
  • 1-2 tablespoons of grass-fed, unsalted butter or grass-fed ghee

Butter, oil, and coffee? From all the reviews I’ve read, it tastes way better than you might think. The bulletproof brew is based on a ketogenic diet, with high fat, moderate proteins, and low carbohydrates. It triggers weight loss through ketosis, a metabolic state triggered by a lack of carbs that kicks fat-burning into overdrive. The idea is that your body will draw upon fat stores as an energy source, rather than simple sugars like glucose, which is derived from carbohydrates.

It’s also supposed to boost cognitive function, bringing some mental clarity into your foggy morning routine (although regular coffee does that for most people).

Lots of people swear by bulletproof coffee, but none more than the people who make it. This blog describes it all:

And if you’re looking for a full, unbiased assessment of the product and the trend, you won’t get a more thorough analysis than this one.

I haven’t tried bulletproof coffee yet. But I will the next time I pass by a coffee shop that makes it. I’ve done my reading – now I want to see the results for myself.

Thanks for reading!
Ian Hull

30 Jul

Should advanced age be a factor considered during criminal sentencing?

Nick Esterbauer Elder Law, Ethical Issues, Health / Medical Tags: , , , , , , , , , , 0 Comments

The Supreme Court of Canada recently refused leave to appeal a decision of the Quebec Court of Appeal that raises the issue of whether old age should be considered as a factor during sentencing.

The appellant had been convicted of fraud, conspiracy to commit fraud, and laundering the proceeds of crime at the direction of or in association with a criminal organization.  A prior appeal regarding the conviction itself had been dismissed by the Quebec Court of Appeal.

The Lower Court recognized the role of the appellant as a directing mind of a criminal organization and the losses suffered by the government as a result of his fraudulent acts.  The Court had stated that age, even if it could be taken into account, was “only one factor among many”, which “cannot have a determinative impact because of the great number of aggravating factors”.

The appellant subsequently sought leave to appeal his four-year prison sentence.  The appellant asserted that, at 81 years of age and in a poor state of health, his sentence ought to be replaced with a conditional sentence to be served in the community or otherwise limited in duration to allow him the prospect of life after prison.

The Quebec Court of Appeal summarized the law as it relates to the consideration of age during sentencing as follows (at paras 38, 39, 42, 43):

The advanced age of an accused must be taken into account when determining a sentence, as Chief Justice Lamer indicated in R. v. M. (C.A.)

The age factor must, however, be considered in light of the health of the offender as it relates to his life expectancy. Consequently, the mere fact that an accused is elderly is not, in and of itself, a mitigating factor in determining a prison sentence, unless the evidence reveals that he has little chance of serving the sentence before passing away. This is increasingly true with the general aging of the Canadian population and the raised probability of longer life expectancies.

As a result, if at the time a sentence is imposed, the offender’s state of health does not suggest that he is unlikely to complete the sentence before his demise, the judge then has the necessary discretion to impose an appropriate sentence in light of all the usual factors and criteria…

It is possible that an offender’s state of health deteriorates following sentencing. This possibility increases with the age of the offender. The sentencing judge may not, however, speculate on this subject and must determine the sentence in accordance with the evidence before him when it is rendered…

The Court nevertheless considered the prison sentence to be appropriate, notwithstanding the expectation of the appellant that he may not survive it.  The Supreme Court agreed with the reasons of the Quebec Court of Appeal.

With Canada’s aging population, cases like this, in which an individual convicted of a crime is elderly and/or in a poor state of health, can be expected to increase in frequency.  The Supreme Court has confirmed that (for the time being at least), while age is a factor to be considered during sentencing, it is merely one to be assessed among others, rather than being determinative of the issue.

Thank you for reading.

Nick Esterbauer

27 Jun

Your health – don’t let your financial guard down

Suzana Popovic-Montag Estate & Trust, Estate Planning, Health / Medical, Trustees, Uncategorized, Wills Tags: , , , 0 Comments

We’re lucky in Canada – our healthcare system pays for doctor bills and hospital visits, and many employer-sponsored benefit plans provide for supplementary health insurance. Even better, universal care is actually expanding in places, such as the recent introduction of free pharmacare for those age 24 and under in Ontario.

But don’t get lulled – there are costs to healthcare. With our comprehensive public coverage, it can be easy to think that your costs will be covered if you were in an accident or experienced a serious illness. But many of us simply aren’t aware of what won’t be covered. For example, out-of-pocket costs could include loss of income (especially if you are self-employed), expensive uninsured prescription drugs and medical supplies, childcare during recovery, or even home renovations to accommodate the illness. And psychological therapy fees represent another potential cost, as mental illness is one of the leading causes of disability in Canada.

So, what can you do to ensure that you are financially prepared for a sudden, serious bad health event? Here are three options to consider:

  • An emergency fund/line of credit: You may need access to cash quickly if a health emergency arises and having a “rainy day fund” for unplanned or unexpected expenses is ideal for that purpose. A line of credit also serves this purpose, although it involves taking on debt and all the costs that that entails.
  • Disability insurance coverage to replace income: Disability insurance replaces a portion of your income if you are unable to work due to an illness or disability. Disability policies vary widely, so even if you have coverage at work, it’s worth checking whether additional personal coverage could be beneficial.
  • Critical illness insurance to cover other costs: This insurance provides a tax-free lump sum benefit upon the diagnosis of a serious illness, such as cancer, heart attack, stroke, blindness, paralysis, kidney failure and multiple sclerosis. Unlike disability insurance, the payment is not linked to your inability to return to work, and you have complete freedom to use the money any way that you wish, including paying for treatment outside of Canada that may not be covered by provincial healthcare.

Of course, rule number one is to stay healthy. But in the event you don’t, be prepared financially. A little planning can go a long way.

Thank you for reading … Have a great day,
Suzana Popovic-Montag

 

20 Jun

Are you ready for weed wine?

Ian Hull Estate & Trust, Estate Planning, Health / Medical, In the News, Uncategorized Tags: , 0 Comments

I came across a blog recently, amustreadblog.com, written by Toronto sommelier Debbie Gordon. She has a lot of great insights about wine from Canada and around the world, and I enjoyed her profile of a man I’d never heard of – Anthony von Mandl – who heads up some of British Columbia’s leading wineries, including Mission Hill.

But before producing award-winning wines that have won honours around the world, Anthony gave the world a much humbler beverage that made him a fortune: Mike’s Hard Lemonade. I realized that there are a lot of different personalities in the wine world, and a lot of different paths to the top.

Then another blog entry caught my eye that reaffirmed the “different personalities” viewpoint – cannabis-infused wine.

Yes, a California winery, Rebel Coast, is marketing Marijuana Infused Sauvignon Blanc. California laws don’t allow alcohol and THC to mix, so the weed takes priority, with 16mg THC and 0.5% alcohol. As Gordon notes, “you may get high but you definitely won’t get drunk.”

I don’t know about you but as an Ontario resident, I’m still getting used to seeing bottles of beer in my local No Frills, let alone weed-infused wine. But as legalization of cannabis comes to Canada, we’re going to be seeing a lot of things that we’ve never seen before. Weed wine may be one of them.

So, what does it taste like? Gordon attended a tasting and gave this description.

“I think it’s fair to say the blend is aromatically unique from the Sauvignon Blanc I’m accustomed to. I smell citrus, hops and something else … Ragweed?  It’s herbal. I tweet “grass” since I don’t want to offend. On the palate? I’m getting something akin to Mello Yello and aging asparagus. Also, higher acidity and rustic, savoury, herb-de-Provence flavours. “Notes of freshly picked pot,” the millennial to my right, knowingly adds.”

I don’t know about you, but I’ll likely be sticking to my inexpensive THC-free house wine.

Thank you for reading,
Ian Hull

25 May

Six Proven Ways to Prevent Dementia

Hull & Hull LLP Estate & Trust, Estate Planning, Health / Medical, Uncategorized Tags: , , 0 Comments

A recent report on the healthista.com website discusses ways to avoid or slow the progress of dementia.

First, the bad news: In the UK, one person is diagnosed with dementia every three minutes. One in twenty people develop dementia under 65, and after turning 65, a person’s risk of developing dementia doubles every five years.

Now the good news: there are various things that we can do to reduce the risk of developing dementia. These include:

  1. Stimulate your brain. This means doing more than “brain training”. Social interaction is seen as the key. Also, taking up new hobbies, interests and intellectual challenges is more beneficial than doing the things that you have always done.
  2. Develop a “cognitive reserve”. A high cognitive reserve, based on higher education, a complex lifetime occupation and high levels of social engagement helps maintain brain health. Lawyers, social workers, teachers and doctors were better protected from Alzheimer’s than shelf-stackers, machine operators and labourers.
  3. Take Aspirin. Long term use of aspirin is associated with a reduced risk of Alzheimer’s. Low doses of aspirin, traditionally associated with heart health, was found to lead to better memory and cognitive function.
  4. Take fish oil. This one is a bit controversial. Some studies have shown that fish oil slows the decline of cognitive function. However, a Cleveland Clinic post has suggested the research is not conclusive on the benefits of fish oil, and suggests that you should simply eat more fish.
  5. Help your heart, help your brain. The same processes that cause heart attacks and strokes are also associated with the development of dementia. Conversely, the lifestyle factors that help your heart can also help maintain cognitive function.
  6. Drink, eat and exercise. Drink champagne: one to three glasses a week. The phenolic compounds found in the grapes used to make champagne have the ability to increase spatial memory, improve cognitive function and promote learning and memory retention. Further, regular moderate exercise can prevent the onset of dementia. Even better is engaging in a sport, as this adds a social element, as well. Finally, a healthy diet, such as the Mediterranean diet, has been found by a number of studies to slow cognitive decline and lower the risk of developing Alzheimer’s.

More good news: in the next ten years, it is expected that research will reveal more specific actions that can help prevent Alzheimer’s and dementia.

Have a great weekend.
Paul Trudelle

02 May

What will you do for long term care?

Suzana Popovic-Montag Elder Law, Elder Law Insurance Issues, Estate & Trust, Estate Planning, Health / Medical, Power of Attorney, Trustees, Uncategorized, Wills 0 Comments

One of the challenges with demographic trends is that they tend to fly under the radar until they are suddenly upon us.

Ensuring there is adequate care for our aging population is a prime example. The oldest members of the baby boom generation are now in their early 70s, and for the most part haven’t made their way into retirement homes and long term care. In short, there’s no problem so far.

But fast forward 10 years and we may see the issue. According to the Conference Board of Canada, more than 2.4 million Canadians aged 65 or more will require paid and unpaid care support by 2026. That’s 71% more than required care in 2011. By 2046, that number is expected to rise to 3.3 million people, which is almost 10% of Canada’s current population. You can read more about the demographic trends here.

The prognosis is clear: the demand on the health care sector and assisted care facilities is only going to increase. And there is bound to be a lag in government response because governments will always deal first with any crisis at hand before dealing with future needs. For example, there is typically overcrowding in schools before new schools are built. Long term care will likely be no different.

The question is, what can each of us do on an individual basis to plan for the care we might need?

What’s your plan?

Since none of us can predict the future, the safest course of action is to assume that you will need care at some stage of your later life. According to the Ontario Long Term Care Association, the average age of a long term care resident is 85, with 90% of residents having some form of cognitive impairment and one in three using a wheelchair. There is a very real chance that you will be in that situation some day.

So what can you do now? If you’re a baby boomer, there are a few steps you can take to increase your opportunity for adequate care if you should need it. These include:

  • Having a power of attorney for both finances and personal care
  • Ensuring you have a guaranteed income stream in your later years (such as annuities or pensions). For example, you may want to defer your receipt of Canada Pension Plan payments as late as possible (age 70) to maximize your guaranteed income in later years
  • Considering products such as long term care insurance that can pay a benefit if you need care.

New products might also emerge. This recent article in the Globe and Mail discusses longevity insurance – a deferred annuity that pays out later in life.

In short, the private long term care sector may be filling the gaps in the system to an even greater degree in the future, and having the means to pay for this private care can ensure you have the care you need.

Thank you for reading … Enjoy the rest of your day,
Suzana Popovic-Montag

 

18 Apr

Pot talk: coverage for medical cannabis is here

Suzana Popovic-Montag Estate & Trust, Estate Planning, Health / Medical, In the News, Uncategorized 0 Comments

Unless there’s an unexpected shift or delay by our government, the Cannabis Act will make the use of cannabis for recreational purposes legal sometime this summer. Each province will have a system in place that provides for the sale of the drug.

While “pot for fun” is coming soon, “pot for treatment” is already here, as the use of cannabis for medical purposes is legal under the Access to Cannabis for Medical Purposes Regulations (ACMPR). Today and in the future, individuals can buy or grow medical cannabis when authorized by a doctor or nurse practitioner who is treating them.

What’s changing on the medical cannabis front is that insurance companies are exploring coverage for it under group benefits plans. One major Canadian insurance company – Sun Life Financial – recently added medical cannabis coverage as an option that companies can add to their employee plan. Don’t be surprised if this type of coverage becomes more widespread, as other insurers already offer coverage on a case-by-case basis.

Pain management is one of the principal uses for medical cannabis, and with opioid abuse a growing concern, coverage for medical cannabis could be a timely addition to group benefit plans. Under its new coverage option, Sun Life will reimburse medical cannabis expenses for five specific conditions and symptoms. Those are:

  • Cancer:
  • Multiple Sclerosis
  • Rheumatoid Arthritis
  • HIV/AIDS
  • Palliative care situations

As evidence of the therapeutic effect of cannabis for other medical conditions grows, coverage for medical cannabis may also grow to cover a greater range of medical issues. This recent article from the Harvard Medical School provides an overview of the many ways that cannabis is being used to treat a variety of medical conditions.

Thank you for reading,
Suzana Popovic-Montag

13 Apr

Achieving Medically Assisted Death

Paul Emile Trudelle Elder Law, Ethical Issues, Health / Medical, In the News, Public Policy, Uncategorized Tags: , , , 0 Comments

Section 241.1 of the Criminal Code sets out a detailed procedure for determining when medical assistance in dying can be provided. However, the medical and legal communities are still grappling with the application of the provisions.

In A.B. v. Canada (Attorney General), 2017 ONSC 3759 (CanLII), two physicians concluded that AB met the criteria for a medically assisted death. A third doctor, however, did not, as he felt that AB did not meet the Criminal Code requirement that a natural death was reasonably foreseeable. Although only two medical opinions are required, the opinion of the third doctor had a chilling effect on one of the other physicians, who declined to provide assistance to AB for fear of being charged with murder.

AB then applied to court for a determination that she met the requirements of the Criminal Code, and a declaration that she may receive medical assistance in dying.

Justice Perell, who had previously considered the issue of assisted death in another proceeding, heard the application.

Ontario and Canada took the position that a declaration should not issue, as the regime established by the Criminal Code does not require judicial pre-authorization. Further, the civil courts should not issue a declaration as such a declaration would interfere with the prosecutorial discretion of the Crown by predetermining criminal liability.

Justice Perell agreed with the position of Ontario and Canada. However, he felt that their position was “as unhelpful as it is technically correct.” The practical effect of such a position was that AB qualified for medically assisted death, but no physician was prepared to assist.

In his decision, Perell J. thoroughly reviews the legislative history of medical assistance in dying. He agrees that it is the medical practitioner and not the court that is to decide whether the Criminal Code criteria are satisfied. He agrees that the court cannot make the decision for them.

However, Perell J. expresses that some form of declaration would be “useful” and have “utility”.

Perell J. walks a fine line in his decision. He accepts that the court is not to make declarations that the Criminal Code criteria for assisted death are met: that must be done by the medical practitioner or nurse practitioner: s. 241.2(3)(a). What Perell J. does, however, is attempt to clarify what is meant by s. 241.(2)(d): the provision that requires the person to meet the criteria that “their natural death has become reasonably foreseeable”. As a matter of statutory interpretation, he declares that in AB’s case, AB’s natural death is reasonably foreseeable.

Perell J. cautions that in making a declaration, he is not conferring immunity on the physicians from prosecution. He also states that he is not finding that courts could or should grant pre-approvals for persons seeking medical assistance in dying. It is unclear as to whether this will provide much comfort to medical practitioners.

Thank you for reading.

Paul Trudelle

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