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The importance of advance care planning (ACP) has been increasingly recognized by health systems. However, 46%-76% of patients report engaging in ACP with lawyers, whereas only a minority report doing so with physicians. In the U.S., ACP with lawyers focuses on advance directive documents, naturally occurs outside of health care contexts, and is often uninformed by the clinical context, such as one's prognosis and clinical trajectory. These forms are regularly stored at home or at a lawyer's office and not available at the bedside when needed in a medical crisis. Yet, in contrast to clinicians, lawyers hold sophisticated knowledge about their states' advance directive law. Lawyers may also understand clients' socioeconomic context and plans more broadly, which are known to be critical for contextualizing and personalizing patient care but are often not well captured in health care. Aligning medical and legal approaches to ACP is important to ensuring the quality and value of those efforts. As an important first step toward this goal, we convened an interprofessional panel of medical and legal experts to elucidate the state of medical-legal ACP and begin to identify strategies to improve and align practices within and across professions. This article describes the historical disconnects between the medical and legal practice of ACP, recommendations and products of the interprofessional panel, and recommendations for future medical-legal collaboration.

How to ensure client's voice is not unduly influenced or restricted by 3rd parties Lawyers who commonly advise older clients or persons with disabilities know that the client is often accompanied by family members or caregivers who normally provide helpful support. Client with Diminished Capacity (a) When a client's capacity to make adequately considered decisions in connection with a representation is diminished, whether because of minority, mental impairment or for some other reason, the lawyer shall, as far as reasonably possible, maintain a normal client-lawyer relationship with the client. Recognizing this, the Court added a simple, but essential, best practice step to Comment 3: The attorney should afford the client the opportunity to communicate privately with the attorney without the presence and influence of others. [Extracted from the article]

In the United States, the voting right of persons who live in long-term care facilities has not received adequate attention. Residents can lose one of their most cherished rights and electoral credibility can be corrupted. One solution to the problems of voting in long-term care is mobile polling, a process whereby election officials bring the ballot to residents of long-term care facilities, provide voters assistance when needed, and register voters as well. This study compared mobile polling to voting as usual in selected nursing homes in the State of Vermont during the U.S. 2008 general election. Results show that among election officials and nursing homes willing to try mobile polling, it is feasible and generally well accepted by longterm care staff, residents, and election officials; reduces concerns of voter fraud and manipulation; and enhances residents' dignity and rights. The challenges of mobile polling include motivating and training election officials to perform it, providing resources to staff the homes, assuring voter privacy, and obtaining the names of the residents of long-term care facilities in order to assess the proportion of residents who voted. Features of a state or election precinct that can successfully adopt mobile polling include the ability to conduct early voting, access to paper ballots, long-term care facilities which are willing to participate, and a good relationship between the chief election administrator and election officials., The right to vote is a fundamental right in the United States as in other democracies. Over the last hundred years, democratic countries have exercised considerable efforts to assure that [...]

During 2020 and into the start of 2021, the COVID-19 pandemic swept through U.S. nursing homes and other long-term care facilities with relentless devastation, inflicting illness and death on throngs of frail older people and people with disabilities, as well as on their caregivers.[1] According to the Kaiser Family Foundation Covid-19 Coronavirus Tracker, as of March 15, 2021, there have been over 1.4 million cases of Covid-19 in long-term care facilities, including both skilled nursing homes, assisted living and other congregate care facilities, accounting for 5% of all cases in the U.S.[2] More astounding is the death rate which resulted in nearly 180,000 deaths in long-term care facilities, accounting for 34% of total pandemic fatalities in the U.S. This article examines the connection between nursing home facility size and density and the risk of COVID-19 illness and death and makes the case for a fundamental change in nursing home facility standards that would radically downsize the size and density and physical design of nursing facilities. More robust federal and state policy directives and nursing home actions can reduce nursing home infections and deaths. According to March 2021 CMS data, nursing home resident and staff Covid-19 cases combined have totaled 1,196,418, and deaths 131,921.[3] This means that 74% of all the deaths in long-term care facilities occurred in nursing homes. The increasingly complex nursing home organizations with multiple corporate owners have trended toward focusing heavily on profitability for investors.[12] The vast majority of nursing home residents, 85 percent, are older than 65 years; 45 percent of residents are 85 and older. [Extracted from the article]

Virtually every participating non-governmental organization (NGO) and many nations have argued that existing human rights instruments lack both normative standards and operational frameworks effectively applicable to older persons and therefor fail to recognize older persons as clear rights holders in all aspects of human rights laws. NGOs have played a major role in the Working Group's discussion and the OEWGA invites NGOs to participate via a fairly simple credentialing process. The Working Group has posted instructions in the past, but if not posted, use the contact email on the Working Group's web page to request them. [Extracted from the article]