Elder Care

To avoid becoming a financial burden to her children and grandchildren, Vera Smith bought long-term care insurance. Like a growing number of Americans, the 87-year-old retiree saw it as a sensible way to cover care-giving costs not included in Medicare and conventional health insurance. But almost two years ago, Smith's insurer stopped paying benefits, contending that she violated the policy's terms by moving in with her daughter after she became too frail to take care of herself.

Responding to wrenching reports of elder abuse and neglect, the state Legislature on Wednesday overwhelmingly approved the most far-reaching changes to California's conservatorship system in nearly three decades. Lawmakers endorsed a package of reforms that would require licensing of professional conservators, who care for the state's most vulnerable adults. It would also require greater supervision of their work by probate courts.

Three days before she died, 97-year-old Carmel Bosco changed her will to leave the lion's share of her $450,000 estate to a Riverside couple, old friends who had tended her bedsores and administered her morphine in her last weeks. Bosco's family sued, and on Monday the California Supreme Court ruled that caregivers cannot benefit from changes in wills made by dependent elderly people in their final days -- even if they are longtime personal friends of the deceased.

"You don't call. You never write. You won't eat my dumplings anymore!" Chinese mothers will not have to utter those words again if the powers that be have their way. In Shanghai, the Nanjing East Road Neighborhood Committee recently took to public shaming to ensure that people attend to their aging parents. Anyone who doesn't visit at least once every three months faces having his or her name posted on a community signboard.

The Assembly Judiciary Committee on Tuesday approved an ambitious proposal to strengthen oversight of professional conservators who manage the lives and finances of adults unable to care for themselves. The legislation may face stiffer resistance next week, when the Appropriations Committee is planning to consider the cost of reforming the state's troubled system for protecting incapacitated adults.

There's no doubt that some elderly rich people, egged on by lawyers advertising "estate planning services," have moved assets in order to get Medi-Cal to pick up the cost of their care in nursing homes. Loopholes should be closed to prevent this, but it will not be quite so simple for the state to save the $150 million the Legislature is hoping for.

During his lifetime, Fletcher Jackson has had many friends, but none like Susan Townsend. His days at a Pasadena convalescent hospital begin and end with a phone call to Townsend, who visits him once or twice a week, occasionally bringing her husband and two children. The rattan bookcase in his room is from Townsend's home. The bulletin board she got him is covered with postcards from her recent trips. Sometimes, she surprises him with strawberry ice cream, his favorite.

Re "The Going Gets Tough for Schwarzenegger," news analysis, Dec. 5: It looks like Gov. Arnold Schwarzenegger has put himself in a box. The man made lots of pie-in-the-sky promises while campaigning. Now he is up against the realities of life. You flat out cannot eliminate revenue (the automobile tax) and then keep spending without raising other taxes. His solution: float a huge bond issue and bind up the next 30 years with heavy indebtedness. (Isn't that something like what Gov. Gray Davis proposed?

California's system of monitoring foster homes, child day-care centers and facilities for elderly and disabled adults is undergoing a painful transformation, forced by the budget crisis to sharply reduce inspections. Instead of the current annual spot checks of the more than 90,000 licensed facilities, 10% of them will be randomly selected for surprise visits each year. Inspections of the rest will be reduced to once every five years.

Federal regulators started with a good idea: Bring extra staff into nursing homes to help feed patients who cannot manage the task themselves. Mealtimes are so harried at many nursing homes that food is cold and unpalatable by the time patients get it, and trays are sometimes whisked away before the food is touched, much less finished. Feeding elderly patients isn't a trivial task. Malnutrition and dehydration are common risks.