Rothkoff Elder Weblog

Many LGBT seniors find it difficult to survive in today’s health care system. GenSilent interviewed LGBT seniors and others for insights into this growing problem. In a recent publication from the Institute for Multigenerational Health, The Aging and Health Report: Disparities and Resilience among LGBT Older Adults states, “The five services and programs identified by participants as being most needed for LGBT older adults are senior housing (66 percent), transportation (62 percent), social events (62 percent), support groups (55 percent), and legal services (53 percent).

Our office is sponsoring a continuing education seminar for social workers and case managers on LGBT issues during our March professional seminars.  Please refer to our firm website for dates and times. 

Learn more about GenSilent's documentary on LGBT seniors.

I am not surprised that Joe Paterno died at the age of 85 after undergoing treatment for lung cancer.  My guess is that the lung cancer, although it would have eventually taken his life, was not the immediate cause of his death.  I  believe that Joe Paterno died of a broken heart after being fired as the head coach of Penn State football. Bear Bryant, the legendary Hall of Fame coach of Alabama football, although not fired, similarly died soon after leaving the head coach position. 

Likewise, it is not uncommon for a surviving spouse to pass away soon after the death of a spouse.  I wrote about the loss of a spouse in my winter 2010 newsletter which I am posting below.

We are very pleased to welcome to our office David Goldwasser as our Health Insurance Specialist.  David brings over ten years of experience in health insurance advocacy and coordination.  David previous served as the State Health Insurance Assistance Program (SHIP) Director for Camden County. 

David’s responsibilities include providing health insurance client advocacy and assisting clients in coordinating Medicare and other health insurance benefits for maximum coverage.  With the changes already in place as well as the future changes to our health care delivery system, David’s expertise is a welcome addition to the elder and disability services we offer.  David can be contacted at David@rothkofflaw.com.

On December 21, 2011, Governor Christie signed into law "Physician Orders for Life Sustaining Treatment" or POLST.  The law moved NJ in line with more than 30 other states.

POLST allows individuals to remain in control when facing a life-limiting or teminal illness.  With POLST, an individual can choose whether or not to be resusitated, and can authorize a healthcare proxy to make decisions on their behalf if they become incapacitated.

POLST has to be signed by a physician or nurse practitioner, and unlike a living will, it has authority of a physician order and becomes part of their medical records, following the patient from one healthcare setiing to another, including home, hospital, nursing home, or hospice.    

A POLST form would only be valid if signed by the patient, or the patient's legal representative, as well as the attending physician or nurse practitioner, along with the date of signature.  A patient can amend or revoke a POLST form, or request treatment other than what was ordered on the form.  The patient can also spell out whether their healthcare representative or proxy has the authority to revoke or modify the POLST in the event the patient loses decision making capacity. 

The new law provides for a central database where health care providers can be notified of a patient's preference for care.

Many U.S. surgeons fail to discuss their patients' wishes in case a risky operation goes awry, and even more would not operate if patients limited what could be done to keep them alive, a survey found. Such medical wishes and plans for end-of-life care, called "advance directives," outline what can and cannot be done if patients are unable to decide for themselves. The most famous examples are so-called living wills. But the restrictions are debated among doctors, said the survey, published in the Annals of Surgery.

"(Surgeons) feel the advance directive basically ties their hands behind their back, and they're not given the tools to get them through the surgery," said Margaret Schwarze, an assistant professor at the University of Wisconsin School of Medicine and Public Health, who was one of the survey's authors. She and her colleagues asked 912 surgeons who regularly perform risky operations 14 questions on how they discuss a patient's advance directives and whether the directives influence their decision to operate. More than four out of every five surgeons discussed which forms of life support the patients would like to limit, but only about half asked specifically about the patient's advance directive, which can include restricting the use of feeding tubes and ventilators to keep a person alive. "I think some surgeons just don't discuss advance directives because they think it's so irrelevant," Schwarze added.

Source/more: Reuters Health