The Fifth Edition completely integrates the wide-ranging changes made by the Patient Protection and Affordable Care Act (health reform legislation), as well as other recent developments. It includes the following topics: the new Elder Justice Act responding to elder abuse and neglect; criminal background checks of workers who work with older patients; major Medicare changes, including wellness visits, filling of the Part D "doughnut hole", tax increases on both earned and investment income, and coverage of end-of-life planning services, end-of-life planning, tax increases on both earned and investment income, increased premiums on higher-income enrollees in Part D, and gradual filling of the Part D "doughnut hole"; Medicaid spousal impoverishment protection changes; revamped Medigap plan options effective July 2010; new long-term care insurance program operated by the Federal government; and more.