Our readers will all be familiar of the issue of elder abuse, and the various forms that it can take. It is also well-known that elder abuse if underreported, giving rise to challenges in determining just how common it is and how incidence rates may be fluctuating within the context of our aging population.
A new study by Comparitech explores the issue of the underreporting of elder abuse and extrapolates reported incidents and studies regarding underreporting to gain an appreciation of how commonly it is actually occurring in the United States. Comparitech estimates that at least 5 million cases of financial elder abuse occur every year in the United States alone. While damages of $1.17 billion are reported, it is believed that the actual losses to seniors total $27.4 billion.
Technology also appears to be playing a role in increasing rates of elder abuse. Comparitech found that 1 in 10 seniors were victims of elder abuse and that the use of debit cards have become the most common tool in defrauding them of their funds. With phone and email scams on the rise in recent years, underreporting is anticipated to become a growing problem while incidence rates continue to increase without any way to determine exactly how many seniors are affected.
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These days, life expectancy is longer than ever. We have previously blogged (for instance, here and here) about some considerations and consequences of having a longer life expectancy. A recent article in The New Yorker considers aging, and in particular, anti-aging now that people are generally living longer. The online version can be found here: Can We Live Longer but Stay Younger?
One of the problems with living longer, as highlighted in the New Yorker article, is that we still must deal with the challenges and realities of aging. What we really want is not eternal life but rather, eternal youth.
The article discusses several efforts to address or counteract the types of issues that we face as we age. For instance, a geneticist at Harvard has successfully extended the life of yeast, and is moving on to human trials. A Harvard molecular biologist, George Church, has had success reprogramming embryonic stem cells to essentially turn an old cell into a young cell. Church’s work has been done so far on mice and dogs, but there are plans to commence human clinical trials within the next five years.
The goal of the work being done by Church is to live better, not necessarily longer: “The goal is youthful wellness rather than an extended long period of age-related decline.” The article discusses the nature of this age-related decline, through the illustration of a “sudden aging” suit that allows the wearer to experience the physical challenges of aging, including boots with foam padding to produce a loss of tactile feedback, and bands around the elbows, wrists, and knees to simulate stiffness. The point of the aging suit is to help create empathy and understanding about how difficult each and every task (an example was reaching up to a top shelf and picking up a mug) can be for older adults, both physically and mentally. So the question becomes, if we are living so much longer, but with age, every day and every task becomes much more difficult, what can we do to counteract that?
The work being done related to anti-aging and the creation of products to make older people’s lives easier is interesting and seems to be moving in new directions. For instance, the article mentions the difficulty of marketing certain products aimed at older people, because we do not like the idea of buying something that reminds us that we are old. So instead of selling a personal-emergency-response system to send an alert and seek assistance in the event of a fall, or some other physical emergency, in the form of a pendant worn around the neck, it is suggested that the most effective such device would be an iPhone or Apple Watch app.
Unfortunately, the issue of dementia is still a concern. There still does not appear to be a cure in sight for Alzheimer’s or other forms of dementia. The causes remain unclear. The effects, however, are evident. One of the individuals mentioned in the article was Professor Patrick Hof, who studies brains. On the physical effects of dementia on our actual brains, Professor Hof notes that “[y]ou can’t tell any difference, even under extreme magnification, between an aging non-demented brain and a younger human one…But, holding an Alzheimer’s brain in your hand, you can see the atrophy.” It appears that there is still a lot of work to be done in this area, in particular.
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Our blog has previously featured posts about the concept of aging in place. Survey results suggest that the vast majority (93% of respondents aged 65 or older) of Canadians wish to continue living at home for as long as possible as they age. Benefits of aging in place may include lower costs (relative to living in long-term care), increased comfort, slower advancement of memory loss, strengthening of social networks, and continued independence and self-determination.
For many, with old age comes physical limitations that may result in decreased mobility and expose seniors to an increased risk of accidents while living at home, whether they are living with or without the assistance of caregivers or other support, absent sufficient safety measures. We recently discovered a guide to making homes senior-safe, which is available online for free through the Senior Safety Reviews website.
The guide features the following:
- 34 practical tips to assist in preventing falls;
- Measures that may assist in the prevention of theft, elder abuse, burns and fires;
- Technology that can be used to promote at-home safety; and
- Preparing the home for extreme weather.
The guide reports that, notwithstanding the goal of many individuals to remain at home into old age, only 1% of homes are currently equipped to safely facilitate aging in place.
This user-friendly guide may be of assistance to older clients and supportive family members in allowing seniors to safely age in place.
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A recent survey commissioned by HomeEquity Bank suggests that the majority of older Canadians plan on staying in their homes as they age (otherwise known as aging in place) rather than downsizing and/or moving into assisted living or retirement communities. 93% of survey respondents aged 65 or older felt that it was important that they remain at their current home throughout retirement. 69% of them advised that their primary reason for wishing to remain at home was to maintain independence as they age.
The older respondents (75 years or older) advised that it was important to them that they remain in their current home to stay close to family, friends, and/or the community (51%) and that emotional attachment and memories were also contributing factors (40%).
In order to remain living at home as long as possible into retirement, advance planning in terms of finances and logistics may be necessary. A recent article appearing in Forbes suggests that the following steps, unrelated to financial planning, may be especially useful in facilitating successful aging in place:
- Maintaining social connections to avoid social isolation;
- Identifying who will help, whether family members, friends, or public services;
- Planning for the transition as needs change over time and identifying the resources and services available in the community;
- Preparing the home to accommodate increased needs (for example, by installing grab bars and a chair in the shower);
- Reviewing and updating the plan to age in place as may be necessary (due to a change in health, available support, or financial constraints).
Notwithstanding one’s plans to continue living at the family home, increasing longevity, a lack of liquidity, unrealistic expectations in terms of income sources after retirement, and the high cost (or local inaccessibility) of caregiving services may contribute to a decision to sell the home and relocate earlier than intended.
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A perpetrator of elder abuse has recently been sentenced to three years in prison by an Ontario Court.
The man from Markham, Ontario had obtained assistance from a friend, an employee of a major national bank, in creating a power of attorney, which he put forward as a document prepared for and executed by his mother, Royale. Royale’s savings, which had been in the hundreds of thousands of dollars, were depleted to less than $15 and she was forced to live in a public nursing home.
After she learned that her funds had been stolen, Royale reported her son’s actions to the police before her death. In her videotaped police statement, Royale says, “It makes me very sad, but he has to pay the consequences.” She was visibly upset by the idea of placing charges against her son, but nevertheless proceeded to do so. In June of this year, Royale’s son was convicted of both theft and fraud over $5,000.
Unfortunately, situations like that involving Royale are all too common. A recent study suggests that one in ten American seniors are affected by elder abuse. Further, it is estimated that only one in ten victims of elder abuse actually report it. Many seniors may be reluctant to report elder abuse due to fear of what the abuser may do to them and a belief that the police and/or social agencies will not be able to provide meaningful assistance.
Incidents of elder abuse highlight the importance in establishing incapacity plans and in appointing attorneys for property and personal care that can be trusted and who can protect the grantor’s rights if he or she is unable to do so.
Royale’s other surviving children now plan to commence civil proceedings against their brother and the financial institution whose employee was involved in the creation and use of the fraudulent power of attorney.
This recent sentence sends a strong message about the seriousness of elder abuse and the lengths to which the justice system will go in order to punish those who take advantage of members of our aging population.
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As the population continues to age and individuals are living longer, healthier lives, various demographic changes are developing.
One trend among seniors in good health is to spend several months of the year travelling abroad. Such activity was historically limited to wealthier members of the population, who could afford to retire early and/or take long periods of time away from work. However, according to a recent article in the Daily Mail, more and more British seniors are spending their retirements travelling and are funding the expeditions by what is referred to as “S.K.I. – Spending the Kids’ Inheritance”.
A new BBC series called the Millionaire’s Holiday Club follows older travellers as they explore the world with ITC Luxury Travel Group. While there is clear desirability behind spending money that would otherwise form assets of one’s estate on travel, some of the individuals credit other reasons as motivation for spending more money than they otherwise might on vacations. Some participants of the television series wish to leave their children an inheritance sufficient to allow for financial security, but not so large that it discourages them from working to earn a living and funding their own luxurious travel. Others report that they choose to travel as a way of remaining independent as they age.
For some seniors, travelling without a travel insurance plan risks incurring significant healthcare costs in a foreign jurisdiction. Due to costs that typically increase with age, travel insurance may be less accessible for older individuals who choose to travel, and especially those who have experienced serious or chronic health conditions. Depending on age and medical history, travel insurance simply may not be an option, and should be a serious consideration of a senior in deciding whether or not to travel. While there is nothing wrong with enjoying oneself by frequent travel, older individuals should be careful to ensure that they retain enough money to fund their ongoing costs of living, which can significantly exceed projected costs with time and the deterioration of physical and/or mental health.
Have a great weekend.
Our population is aging but living longer. This has resulted in an increase in the prevalence of dementia and other aging-related conditions associated with cognitive decline, and a corresponding increase in the use and activation of powers of attorney.
As estate litigators, our firm is beginning to see a rise in power of attorney disputes between siblings and other family members. These types of disputes are often emotionally fuelled by longstanding sibling rivalry or distrust among family members, and can result protracted litigation and expensive legal bills.
Often a sibling or other family member will have concerns that the appointed attorney is acting improperly or is failing to fulfill his or her duties. In these circumstances, the sibling or family member may have concerns with respect to a lack of transparency or feel that they are being left out of the decision-making process.
It is useful for these individuals to know that the Substitute Decisions Act, 1992 (the “SDA”) imposes certain obligations upon an attorney, which may assist in addressing these concerns.
The SDA states that an attorney has a duty to consult with family members and keep them informed as to the incapable person’s health and wellbeing (ss. 32(5)) and that an attorney has a duty to foster personal contact between the incapable and his or her supportive family members (ss. 32(4)).
The SDA also states that an attorney has a duty to keep proper records and to provide updates regarding the incapable person’s financial circumstances (ss. 32(6)).
The SDA also states that an appointed attorney must also obtain and review a copy of the incapable person’s Will (s. 33.1). If the Will provides that a specific item of property is to be given to a particular beneficiary, the attorney must retain that property for that beneficiary unless it is essential to sell the item in order to satisfy the incapable person’s legal responsibilities or otherwise provide for the incapable person (ss. 35.1(1)).
These duties are ongoing and an attorney can generally be held personally liable for any damages that results from a breach of his or her duties.
The Office of the Public Guardian and Trustee has published a brochure that outlines the duties and powers of an appointed attorney for property in greater detail, which can be viewed here.
Communication is often the key to resolving these types of disputes between family members. However, where there is a breakdown in communication, the assistance of a litigator or mediator who specializes in this practice area is often helpful.
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We have recently highlighted some of the interesting ways in which medical and technological experts and policymakers across the globe are responding to dementia. With an aging population and the increasing prevalence of Alzheimer’s disease and other dementias, there is a growing need to focus on how to create a more dementia-capable society.
In instances where a individual living with dementia is no longer able to make decisions regarding their care, that responsibility falls to the individual’s substitute decision-maker. Substitute decision-makers may be required to make important and difficult decisions about the incapable person’s care, such as the use of caregivers and home support services.
Individuals who are tasked with making decisions regarding the care and companionship for people living with dementia may soon have a new option available to them. Reuters recently profiled Nadine, a humanoid robot developed by scientists at the Nanyang Technological University that may someday be used as a companion for individuals living with dementia.
According to the university, Nadine is a “social robot,” which means that she has a memory and personality of her own and is able to exhibit moods and emotions. Nadine currently works as a receptionist at the university, and could also serve as a personal assistant or companion to the elderly.
Nadine’s creator, Professor Nadia Thalmann of the Nanyang Technological University, has suggested that Nadine may be particularly useful as a companion for individuals who are living with dementia. She is quoted in Reuters as saying, “if you leave [individuals with dementia] alone they will be going down very quickly. So these people need to always be in interaction.”
With human-like features and emotional intelligence to boot, Nadine provides an interesting example of the creative ways in which technology could address the needs of people living with dementia. We recently highlighted another example: the story of “Paro” the harp seal, a Japanese automoton that was one of the earlier robotic inventions to be used in dementia care. However, it remains to be seen if this new technology will ultimately be put to use in individual and institutional care settings.
In the meantime, if you would like to see Nadine the humanoid robot at work, don’t miss this YouTube video of Nadine interacting with Professor Thalmann.
Thank you for reading and have a great weekend,
As many of our readers are likely aware, China’s prohibition against having more than one child per couple will expire at the end of the year. Since the late 1970s, most Chinese families have been limited to one child each. The one-child policy was created to help offset China’s rapid population growth rate that doubled China’s population to well over one billion during the twentieth century. As of January 1, 2016, however, after more than thirty years, Chinese parents will finally be able to have a second child if they choose to do so.
The change in Chinese policy has been triggered by what has been referred to as a “demographic time-bomb“. According to the United Nations, the number of individuals aged 65 and older in China will increase from 131 million to 243 million by the year 2030. Without an increase in China’s birthrate, there simply will not be enough people available to care for the elderly in the future.
The goal of the Chinese government in ending the one-child policy is to increase the country’s birth rate by approximately two million per year. Despite the end of China’s one-child policy, the additional births that will result may or may not meet the demands of the aging population. It is now expected that fewer parents than originally anticipated will take advantage of the new two-child policy, due to high costs of living in China’s urban centres and a small number of parents who have so far applied for an early exemption to the one-child maximum. If this is any indication of how many Chinese parents will choose to have a second child, it is unlikely that the population will rebalance itself before the numbers of Chinese residents over the age of 65 explodes.
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The increasing prevalence of Alzheimer’s disease and other dementias means that policymakers and various sectors – including the legal community — have to think about how to create a more dementia-capable society.
For instance, I recently blogged about DementiaHack, a Toronto-based hackathon designed to bring medical experts on dementia together with developers and designers to think of innovative technological products to address the needs of individuals living with dementia, caregivers and researchers.
For those who are interested in learning more about dementia, the Toronto Star recently ran an excellent series of articles about local and global responses to the increasing prevalence of dementia.
I found it particularly interesting to read about the lessons that can be learned from Japan’s experience, where dementia currently affects 4.62 million people. As the article notes, Japan’s health ministry and 11 other ministries and agencies implemented a strategy in 2012 to address the challenges of dementia. The government also introduced a long-term care insurance program in 2000 that requires residents to pay monthly insurance premiums after they turn 40. By contributing to the program, residents become eligible to access services such as dementia daycare.
Beyond governmental action on dementia, the Star also profiled the Dementia Support Caravan initiative in Japan, which aims to educate and empower people across the country to better support the needs of people living with dementia. And for a Canadian spin on the Japanese experience, be sure to check out this article about “Paro”, a robot that was inspired by a Japanese engineer’s encounter with a Canadian harp seal and that is now being used in dementia care.
The Toronto Star ended its series on dementia with an editorial calling on the provincial and federal governments to create a national strategy. It remains to be seen if policymakers will heed the call to action, but the series offers remarkable insight into how other countries are responding to the increasing prevalence of dementia.
Thank you for reading and have a great weekend.
Umair Abdul Qadir