ASA Generations - Generations: The Latest Age-Related News, Articles and Opinions http://generations.asaging.org/ en Housing: Often Overlooked but a Critical Pillar for Older Adults http://generations.asaging.org/housing-older-adults-health-inequities-policy <span class="field field--name-title field--type-string field--label-hidden">Housing: Often Overlooked but a Critical Pillar for Older Adults</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Sat, 07/18/2020 - 01:19</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/ageism-culture" hreflang="en">Ageism &amp; Culture</a></div> <div class="field__item"><a href="/economic-security" hreflang="en">Economic Security</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-journal" hreflang="en">Generations Journal</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">Why is housing a backburner issue, how does it determine health, what are the inequities and how might we fix it?</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><h6>Abstract</h6> <p>Housing is central to older adults’ life outcomes. Housing’s affordability, physical quality, and location can impact physical and mental health. Housing policies and practices have systematically limited access to homeownership for persons of color and segregated many into disadvantaged neighborhoods. For many, this has curtailed economic and wealth building opportunities over the life course and exposed them to negative health consequences of segregated neighborhoods. Encouraging and supporting equitable access to safe and quality housing options for older adults should be a role for all aging services stakeholders.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><h6>Key Words</h6> <p>housing policy, social determinants of health, homeownership, equity, discrimination, COVID-19</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><hr /><p class="dropcaps">Housing policy tends to be overlooked when it comes to older adults. Attention is focused on programs and services that help older adults to stay in their homes—homemaker supports, personal care assistance, or meal deliveries—but housing fails to command the same consideration.</p> <p>Maybe this is because housing policy, in my opinion, has broadly been a backburner issue. Despite the housing affordability “crisis” that has been impacting broad swaths of American households for years, for example, housing is infrequently addressed in presidential or other election campaigns.</p> <p>Part of the challenge is that housing in America is viewed as a private market good, and framed as a way to build wealth. As such, housing policies, regulations, and practices are largely viewed through the lens of homeownership, increasing and protecting home values, and allowing market forces to dictate response. For example, the largest federal housing subsidy remains the mortgage interest deduction, even after the Tax Cuts and Jobs Act of 2017 lowered the cap on the size of the mortgage on which interest can be deducted (Thornton and Estep, 2019). In many cities, a large proportion of land is zoned exclusively for single-family homes (Manville, Monkkonen, and Lens, 2019).</p> <p>Recently, however, the aperture on housing has been expanding. As the social determinants of health gain attention and racial and ethnic inequities are spotlighted, we’re recognizing housing’s role in physical and mental health and life opportunities.</p> <h3>Social Determinants of Health</h3> <p>The social determinants of health are the social, economic, and physical conditions under which people are born, grow, live, work, and age. These conditions affect a person’s health risks and outcomes. Housing—including stability and affordability, physical structure, and location—is a key social determinant.</p> <p><strong>Affordability and stability: </strong>Individuals who are unstably housed, which may mean they are falling behind on rent, moving frequently, or staying with friends or relatives, are more likely to experience poor health than those who are stably housed. Research has found that people who are housing insecure are less likely to have a usual source of medical care, more likely to delay doctor’s visits and to use the emergency room for treatment, report poor or fair health, or report poor health that limits their daily activities (Stahre et al., 2015; Braveman et al., 2011).</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘Housing in America is viewed as a private market good, and framed as a way to build wealth.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Studies also have found housing instability is related to elevated stress levels, depression, and hopelessness (Center for Housing Policy and Enterprise, 2007). Unsurprisingly, high housing costs can force people to make tradeoffs with other essentials like food, healthcare and medications, and heating or cooling (Joint Center for Housing Studies of Harvard University [JCHS], 2019).</p> <p><strong>Physical structure:</strong> Quality and safety deficits in one’s home can be detrimental to health. Water leaks, poor ventilation, dirty carpets, or bug infestations can produce mold, dust mites, or other allergens associated with poor health. Lack of heating or air-conditioning, leading to extreme high or low indoor temperatures, has been associated with increased mortality. Structural features such as steep stairs, holes in floors, or inaccessible bathrooms and kitchens can result in accidents and injuries (Braveman et al., 2011).</p> <p><strong>Location: </strong>The environment in which one’s home is located can also impact health and well-being. Older adults often spend decades in their communities and thus experience higher levels of exposure to neighborhood conditions. In addition, as older adults retire or become less mobile, they may spend more concentrated time in their neighborhood.</p> <p>Research shows that living in disadvantaged neighborhoods—characterized by high poverty—is associated with weak social ties, problems accessing healthcare and other services, reduced physical activity, health problems, mobility limitations, and high stress. The difference can be explained, in part, by the characteristics of people living in these neighborhoods, but also studies suggest that neighborhood characteristics may independently influence older residents’ health and well-being. Disadvantaged neighborhoods often have more crime, more pollution, poorer infrastructure, and fewer healthcare resources. Walkability; accessibility (including public transportation); safety; availability of public resources, like community centers, parks and libraries, and grocery stores with nutritious food; and healthy air all are related to health behaviors and outcomes (Mather and Scommegna, 2017, Bell et al., 2013, Braveman et al., 2011).</p> <h3>Housing Inequities</h3> <p>Today’s neighborhoods are shaped by mortgage lending practices started almost 100 years ago. In the 1930s, the Home Owners Loan Corporation graded neighborhoods according to lending risk, which was based largely on their minority makeup. Neighborhoods with racial and ethnic minorities were deemed “hazardous” and outlined in red on maps. The newly created Federal Housing Administration (FHA) would not insure loans in or near these neighborhoods, which effectively led to the entire mortgage industry refusing to make home loans to persons of color. As home ownership is a key source for building wealth in this country, this set the stage for the racial wealth gap that persists today.</p> <p>Additionally, the FHA also encouraged the use of race restrictive covenants by lowering the mortgage risk on individual properties with exclusionary deed language. It also often required that developers receiving construction loans place race restrictive covenants in their subdivisions’ property deeds (Rothstein, 2017). This denied African Americans the opportunity to participate in the postwar housing boom and to move to new suburbs, trapping them in inner cities that faced declining investment.</p> <p>Discriminatory lending practices were legal until 1968, when the Fair Housing Act was passed. Despite being outlawed, discriminatory and predatory lending practices and residential segregation continue today (Massey, 2015).</p> <p>It is important to understand the impact of these housing practices on many current and future older adults of color.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘In 2018, 82 percent of white adults ages 65 and older owned a home, compared to 62 percent of black older adults.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Black older adults have had less opportunity to purchase a home. In 2018, 82 percent of white adults ages 65 and older owned a home, compared to 62 percent of black older adults (JCHS, 2019). For those who were able to buy, many have been limited to neighborhoods with lower home value appreciation and-or may have only had access to unfavorable loan products and terms. In 2012, the median home value for black households ages 65 and older was $93,000, compared to $165,000 for older white households (Butrica and Mudrazija, 2016).</p> <p>These circumstances inhibited minority older adults’ opportunity to accumulate wealth over their lifetime. In 2013, the median net worth of African American older adult households ($56,700) was roughly one-fifth of the median net worth of white older adult households ($255,000) (Rosnick and Baker, 2014). While this difference cannot be attributed to home ownership alone, home equity is a primary way for American households to gain wealth</p> <p>Because the housing stock in redlined areas tends to be older, older adults’ homes in these neighborhoods may be in greater need of repair (Perry and Harshbarger, 2019). With lower home values or growth in home values, older adults of color may have less equity that could be tapped into to finance needed repairs or modifications to help maintain the safety and accessibility of their home. This could put them at risk for falls or other injuries. Also it could limit their ability to ambulate in and out of the home, leading to social isolation. Similarly, they have less equity to tap into to pay for services to help them age in place, if needed.</p> <p>Historically redlined neighborhoods have been and generally remain more segregated and more economically disadvantaged today than other neighborhoods (Perry and Harshbarger, 2019). These neighborhoods have faced a legacy of disinvestment, which has impacted economic opportunities, access to resources, and the physical environment.</p> <p>Evidence suggests segregation is a primary cause of racial difference in income by impacting access to education and employment opportunities (Williams and Collins, 2001). Lower incomes in addition to lower opportunity for home ownership has impacted the ability of older adults of color to build wealth to help support them in retirement.</p> <p>Disadvantaged and segregated neighborhoods have less access to options for buying affordable and healthy food and fewer healthcare resources (United States Department of Agriculture, 2009; Gaskin et al., 2012).</p> <p>Disadvantaged neighborhoods also often have higher crime, more environmental pollution, and poor infrastructure (sidewalks, street lighting, and traffic-calming measures). These elements can influence residents’ sense of safety and willingness or ability to engage in physical activity (Center on Social Disparities in Health, 2015).</p> <h3>The COVID-19 Effect, on Housing</h3> <p>Housing is probably not the first thing that comes to mind when considering the effects of COVID-19 on older adults. The economic impact of the pandemic, however, is potentially concerning, particularly for near retirees. Drawing on the 2008 Great Recession for comparison, experts predict the COVID-19 pandemic could diminish current and future retirement savings, as well as threaten public and private retirement systems (Johnson, 2020).</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p style="margin-bottom:14px">Older adults may be more inoculated from the economic impact of the pandemic than younger persons, as many are already retired and-or own their home outright. However, some near retirees may have lost their jobs, thus potentially impeding their ability to save for retirement. This could impact their future ability to sustain housing costs or inhibit future choices about housing, such as making repairs or modifications, or moving to an alternative housing type. For some lower-wage near retirees without a savings cushion, it could have a more immediate and lasting impact on their ability to afford housing costs.</p> <h3>Why Does This Matter for Aging Services Stakeholders</h3> <p>Housing is a broad and complex topic, and aging services stakeholders may not understand the connection to their role, or know how to engage. But the discussion above shows that an older adult’s housing situation plays a fundamental role in their ability to maintain health and quality of life. Aging services providers and policymakers should consider it a key platform supporting the implementation or success of their services and initiatives.</p> <p><strong>Affordability: </strong>Housing affordability is a fundamental problem in this country, including for older adults. Nearly 10 million older adult households, both owners and renters, are cost-burdened and pay more than 30 percent of their income for housing (JCHS, 2019). Excessive housing costs can lead to tradeoffs on other necessities like food or medications, living in unsafe conditions, or, at the extreme, homelessness.</p> <p><strong>Options: </strong>Zoning and other land-use regulations often create and protect single-family development, which can limit the range of housing types and impact affordability in neighborhoods. Rental housing or alternatives such as accessory dwelling units or cottage housing may be excluded. This limits opportunities for older adults to leverage their housing for income or care needs or to downsize or move to an alternative housing type to fit their changing needs and interests and remain in their neighborhood, where they have history and a social network.</p> <p><strong>Opportunity: </strong>Older Americans’ life course contributes to their health (Vega and Wallace, 2016). The ability of many older adults of color to purchase a home has been systematically limited, impeding a primary path for building economic opportunity and wealth; and many have been segregated into disadvantaged neighborhoods, limiting economic opportunity and exposing them to environments that increase risks for health problems.</p> <p>While many aging services stakeholders may not be engaged in housing delivery or policy, the success of their services and supports often is intertwined with the stability and quality of their client’s or constituent’s housing. Aging services providers and policymakers should look for opportunities to support or encourage initiatives that will provide older adults (particularly lower income elders and older adults of color) with adequate housing. This could include paying attention to and being an ally around funding for the creation and preservation of affordable housing stock and rental subsidies, mechanisms for financing home repairs and adaptations, reforms to local and state land-use regulations and building inclusionary zoning opportunities, granting approvals for construction of new affordable senior properties, promoting and enforcing equitable housing finance opportunities, and eliminating barriers to fair housing.</p> <p>Where we live has a profound impact our opportunities and outcomes in life. It’s important to recognize this for today’s older adults and to shape the prospects for future older adults.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><hr /><p><em>Alisha Sanders, M.P.Aff., is director of Housing and Services Policy Research at LeadingAge, in Washington, DC.</em></p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><hr /><h6>References</h6> <p>Bell, J., et al. 2013. “Access to Healthy Food and Why it Matters: A Review of the Research." Oakland, CA: PolicyLink. tinyurl.com/l8l4flw. Retrieved May 22, 2020.</p> <p>Braveman, P., et al. 2011. “How Does Housing Affect Health?” <i>Issue Brief #7</i>. Princeton, NJ: Robert Wood Johnson Foundation. <a href="https://www.rwjf.org/en/search-results.html?at=Braveman+P">tinyurl.com/y82zk7oh</a>. Retrieved May 22, 2020.</p> <p>Butrica, B. and Mudrazija, S. 2016. “Home Equity Patterns Among Older American Households.” <a href="tinyurl.com/y9n6zfpw">tinyurl.com/y9n6zfpw</a>. Retrieved June 11, 2020.</p> <p>Center for Housing Policy and Enterprise. 2007. “The Positive Impact of Affordable Housing on Health: A Research Study.” <a href="tinyurl.com/y8oonp4k">tinyurl.com/y8oonp4k</a>. Retrieved May 22, 2020.</p> <p>Center on Social Disparities in Health. 2015. “How Do Neighborhood Conditions Shape Health?” <a href="tinyurl.com/y7bxt6ya">tinyurl.com/y7bxt6ya</a>. Retrieved May 29, 2020.</p> <p>Gaskin, D., Dinwiddie, G., Chan, K. and McCleary, R. 2012. “Residential Segregation and the Availability of Primary Care Physicians.” <em>Health Services Research</em> 47(6): 2353-2376. <a href="tinyurl.com/y8s3yzw6">tinyurl.com/y8s3yzw6</a>. Retrieved June 11, 2020.</p> <p>Johnson, R. 2020. “Seven Ways the COVID-19 Pandemic Could Undermine Retirement Security.” <em>Urban Wire.</em> <a href="tinyurl.com/ybloxa5p">tinyurl.com/ybloxa5p</a>. Retrieved May 29, 2020.</p> <p>Joint Center for Housing Studies of Harvard University. 2019. <em>Housing America’s Older Adults 2019</em>. Boston, MA: Joint Center for Housing Studies of Harvard University.</p> <p>Manville, M., Monkkonen, P., and Lens, M. 2019. “It’s Time to End Single-Family Zoning.” <em>Journal of the American Planning Association</em> 86(1): 106–12. <a href=" tinyurl.com/y9m989zl">tinyurl.com/y9m989zl</a>. Retrieved June 2, 2020.</p> <p>Massey, D. 2015. “The Legacy of the 1968 Fair Housing Act.” <em>Sociological Forum </em>30(1): 571–88.</p> <p>Mather, M., and Scommegna, P. 2017. “How Neighborhoods Affect the Health and Well-Being of Older Americans.” <em>Today’s Research on Aging</em>. Washington, DC: Population Reference Bureau. <a href="tinyurl.com/y94ztxr9">tinyurl.com/y94ztxr9</a>. Retrieved May 22, 2020.</p> <p>Perry, A. and Harshbarger, G. 2019. “America’s Formerly Redlined Neighborhoods have Changed and so Must Solutions to Rectify Them.” <a href="tinyurl.com/yczg24ko">tinyurl.com/yczg24ko</a>. Retrieved May 22, 2020.</p> <p>Rosnick, D., and Baker, D. 2014. “The Wealth of Households: An Analysis of the 2013 Survey of Consumer Finances.” Center for Economic and Policy Research. <a href="tinyurl.com/ybzk5h7z">tinyurl.com/ybzk5h7z</a>. Retrieved May 29, 2020.</p> <p>Rothstein, R. 2017. <em>The Color of Law: A Forgotten History of How Our Government Segregated America.</em> New York: Liveright.</p> <p>Stahre, M., et al. 2015. “Housing Insecurity and the Association with Health Outcomes and Unhealthy Behaviors, Washington State, 2011.”<em> Preventing Chronic Disease</em> 12: 140511. <a href="tinyurl.com/ydy7m3e4">tinyurl.com/ydy7m3e4</a>. Retrieved May 22, 2020.</p> <p>Thornton, A., and Estep, S. 2019. “Take Stock of Spending Through Tax Code.” <a href="tinyurl.com/y9r9fvne">tinyurl.com/y9r9fvne</a>. Retrieved June 2, 2020.</p> <p>United States Department of Agriculture. 2009. “Access to Affordable and Nutritious Food: Measuring and Understanding Food Deserts and Their Consequences.” Report to Congress. <a href="tinyurl.com/yx5hwfxo">tinyurl.com/yx5hwfxo</a>. Retrieved May 29, 2020.</p> <p>Vega, W., and Wallace, S. April 2016. “Affordable Housing: A Key Lever to Community Health for Older Americans.” American Journal of Public Health, 106(4): 635–6. <a href="tinyurl.com/yc4anlh9">tinyurl.com/yc4anlh9</a>. Retrieved June 3, 2020.</p> <p>Williams, D., and Collins, C. 2001. “Racial Residential Segregation: A Fundamental Cause of Racial Disparities in Health.” Public Health Reports, Volume 116. <a href="tinyurl.com/y7sm7lml">tinyurl.com/y7sm7lml</a>. Retrieved June 2, 2020.</p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/13" hreflang="en">Housing</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p>By Alisha Sanders</p> </div> </div> <div class="field field--name-field-issue field--type-entity-reference field--label-above"> <div class="field__label">Issue</div> <div class="field__item"><a href="/summer-2020" hreflang="en">Summer 2020</a></div> </div> Fri, 17 Jul 2020 23:19:02 +0000 asa_admin 43 at http://generations.asaging.org Averting a Housing Crisis and Shining a Light on Inequities in Elder Housing http://generations.asaging.org/housing-crisis-older-adults-alisha-sanders <span class="field field--name-title field--type-string field--label-hidden">Averting a Housing Crisis and Shining a Light on Inequities in Elder Housing</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Tue, 07/07/2020 - 23:12</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/economic-security" hreflang="en">Economic Security</a></div> <div class="field__item"><a href="/innovation-social-impact" hreflang="en">Innovation &amp; Social Impact</a></div> <div class="field__item"><a href="/justice-equity" hreflang="en">Justice &amp; Equity</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-journal" hreflang="en">Generations Journal</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">‘I wanted to recognize the key role of the “shelters” in which most older adults live.’</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><figure role="group" class="caption caption-img align-right"><img alt="Alisha Sanders headshot" data-entity-type="file" data-entity-uuid="ea630ef1-65f7-4b82-8ad0-d5ccb53e452c" src="/sites/default/files/inline-images/Sanders-Alisha.png" style="margin:8px" /><figcaption>Summer Generations Guest Editor Alisha Sanders</figcaption></figure><p class="dropcaps">When asked about her motivation for guest-editing this Summer issue of Generations, Guest Editor Alisha Sanders said, “I wanted to help bridge two worlds­­–to help aging services people understand more about housing and to help housing people understand more about older adults.”</p> <p>Sanders directs housing and services policy research at LeadingAge, in Washington, DC, and is thrilled that Generations chose to devote an edition of the journal to housing.</p> <p>“Housing doesn’t often get emphasized in the aging services world,” said Sanders. “My intent with this collection of articles was to keep the focus on ‘housing’ and not slide into residential care settings. That’s not to say those settings aren’t crucial, and of course there are important policy and practice issues to address in that realm. But I wanted to recognize the key role of the ‘shelters’ in which most older adults live, to help people to fully understand the housing situations of older adults, where gaps exist and which issues need addressing,” she added.</p> <p>At LeadingAge, Sanders studies programs and models that link affordable senior housing communities with health and supportive services. With colleagues and partner organizations, they’ve built a new knowledge and evidence base on the implementation and outcomes of these initiatives to help foster their spread.</p> <p>“I’ve always been passionate about housing policy, and sort of ‘fell into’ the older adult aspect,” Sanders said. She stayed in the older adult arena, however, because she’s intrigued by the way housing intersects with other aspects of older adults’ lives, and how central the combination can be to quality of life, especially for low-income older adults.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘I wanted to recognize the key role of the “shelters” in which most older adults live.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Sanders also feels it is critical to recognize older adults in housing discussions, as currently they are often left out. A perception remains that older adults tend to live in stable situations in housing they own. But older adults face significant gaps in access to quality, affordable housing, and many live in precarious situations. And there are a burgeoning number of older adults with no housing at all. Plus, as the work LeadingAge and others have done has shown, housing can play a key role in addressing social and health needs as well.</p> <p>“I hope these articles will help to reveal the significant implications housing policy has on other aspects of life, particularly for persons of color. Current U.S. housing policy is strongly intertwined with economic opportunity and security, which is clearly shown in the disparities in homeownership rates, home values, and wealth between white older adults and black older adults,” said Sanders.</p> <p>She points to a r<a href="https://www.redfin.com/blog/redlining-real-estate-racial-wealth-gap/">ecent study</a> showing that homeowners in previously redlined neighborhoods—in which, until 1968, federal government policy effectively denied mortgage loans to people of color—have gained 52 percent less in home equity over the past 40 years than homeowners in previously greenlined areas.</p> <p>“Home equity is a key component of wealth in this country,” said Sanders. “And this study found that black homeowners today are about five times more likely to own a home in a formerly redlined area than a greenlined neighborhood. So many black homeowners are not able to realize the same potential wealth-building benefit as white homeowners because they have been tracked into segregated neighborhoods that have faced decades of underinvestment.</p> <p>Many older adults will be unable to afford the care they will need as they age in the years to come, and housing is at least one contributor to this lack of funds. Many elders of color would have been denied the opportunity to purchase a home or would have been limited to neighborhoods that experienced and continued to experience years of disinvestment, thus earning far less in home equity. To the extent that an older adult may tap into home equity or sell a home to help support care needs, this source of funds is limited for those whose housing equity opportunities have been curtailed. </p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Black homeowners are about five times more likely to own a home in a formerly redlined area.</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Of course, for many older adults who were lower-wage workers over their lifetime, buying a home was never an option. Many of these older adults tend to rely largely on Social Security for their retirement income. According to the <a href="https://www.ssa.gov/news/press/factsheets/basicfact-alt.pdf">Social Security Administration</a>, Social Security makes up 90 percent or more of the income for 45 percent of unmarried older adults. In May 2020, the <a href="https://www.ssa.gov/policy/docs/quickfacts/stat_snapshot/">average monthly benefit for retired workers was $1,512</a>. Given high rent costs across the country, it is clear that many lower-income renters will struggle to find affordable options. </p> <p>Sanders encourages ASA members to become allies to housing advocates and help push for expansions in rental subsidies, learn more about local or state housing advocacy organizations to build collaborations, and get out and help advocate for better housing policies, building and land use regulations, and funding initiatives.   “An older adults’ housing situation can have implications on their health, functionality, and quality of life--all of which many ASA members are addressing,” said Sanders. The success and optimization of the services they are providing can be intertwined with the safety and quality, accessibility, and affordability of their constituents’ housing. Sanders hope this collection of articles will help build ASA members’ understanding of housing issues and the connection they can have to their work.</p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/23" hreflang="en">Line of Classic Rusty Blue Rural US Mailboxes</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p>By Alison Biggar</p> </div> </div> <div class="field field--name-field-issue field--type-entity-reference field--label-above"> <div class="field__label">Issue</div> <div class="field__item"><a href="/summer-2020" hreflang="en">Summer 2020</a></div> </div> Tue, 07 Jul 2020 21:12:35 +0000 asa_admin 8 at http://generations.asaging.org Overcoming the 'silver tsunami' http://generations.asaging.org/silver-tsunami-older-adults-demographics-aging <span class="field field--name-title field--type-string field--label-hidden">Overcoming the &#039;silver tsunami&#039;</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Tue, 07/07/2020 - 07:00</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/ageism-culture" hreflang="en">Ageism &amp; Culture</a></div> <div class="field__item"><a href="/innovation-social-impact" hreflang="en">Innovation &amp; Social Impact</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-today" hreflang="en">Generations Today</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">Aging is a first-person experience.</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">The phrase “silver tsunami” drives me nuts. It is a common expression used to describe the unprecedented increase in the number of older people in the world, and it is used even in the aging services sector. People employ this doomsday term as a way of demonstrating they are “in the know” about the demographics of aging.</p> <p>Fact check: a tsunami is a large wave that results in vast destruction and mass casualties. A natural disaster of catastrophic proportions, it is planned for, mitigated against and feared.</p> <p>Unfortunately, this phrase is fun to pronounce. Silver tsunami became embedded in our collective psyche because of its alliteration. And, to some, the phrase sounds clever.</p> <p>Using silver tsunami to describe population aging was intentional as a shorthand description of the burden that will befall the country when millions of people grow old, get sick and need care. It is an economic term, based in calculations of increasing cost. On the nation’s balance sheet, the great silver tsunami rests squarely in the liability column. This drain on financing is coming. Be aware. Be warned. Plan ahead.</p> <h2>Re-Evaluating Impacts of Longevity and the Meaning of Aging</h2> <p>I am all for planning ahead. Increasing numbers of older people will strain our healthcare resources, place increased burden on caregivers and accelerate a workforce shortage. I do not take issue with cost concerns. My protest lies elsewhere.</p> <p>The term silver tsunami fails to account for the asset of increasing numbers of older people, many of whom are reaping the benefits of better health and increased longevity. Its economic assumption presupposes a future of healthcare delivery that resembles the past. We are re-valuing how, and what, we pay for in healthcare and where we should invest in prevention. Even the delivery of long-term care will evolve in the future.</p> <p>Also this phrase does not convey what it means to get old and be old. The swell of people in the wave are individuals, with lives of purpose, meaning, and, yes, difficulty. Aging is a first-person experience.</p> <p>But our culture remains awash with negative images and stereotypes of older people. Ageism is used to diminish and devalue people and is a convenient way to divide adults into two categories: us and them. Ageism distracts from the fundamental truth that advanced age is a period of human development.</p> <p>The FrameWorks Institute is the research partner for the <a href="https://frameworksinstitute.org/reframing-aging.html">Reframing Aging Project</a>, an initiative sponsored by eight leading organizations in the field of aging. FrameWorks has developed strategies for changing the way we think and speak about aging. Consider this question, “What do older people need?” The answer to this question brings to mind an abstract group of old people who will need transportation, housing, care and so forth.</p> <p>As an exercise, now ask the same thing differently, “What will I need when I get old?” The issues of aging are not about other people. The issues of aging are about everyone. Older people are individual glimpses of our future selves, given time.</p> <h2>People Live Longer but Better Lives</h2> <p>In 2017, a person reaching age 65 had an average life expectancy of 19 additional years. A child born in 2017 could expect to live more than 30 years longer than a child born in 1900. In the span of a life, where were those extra years added? Although the average life expectancy has increased, additional years weren’t tacked on at the end. Americans are enjoying more and better years before the declining years of advanced age.</p> <p>In 2009, Harvard Professor Sara Lawrence-Lightfoot wrote a book called “<a href="https://www.amazon.com/Third-Chapter-Passion-Adventure-Years/dp/0374532214">The Third Chapter: Passion, Risk, and Adventure in the 25 Years After 50</a>.” Professor Lawrence-Lightfoot’s research has led her to conclude that this third chapter is a stage of life when “many women and men are embracing new challenges and searching for greater meaning in life.”</p> <p>Marc Freedman, CEO and founder of <a href="https://encore.org/">Encore.org</a>, explores meaning and purpose in people older than age 50. Freedman is the creative force behind <a href="https://purposeprize.encore.org/">The Purpose Prize</a>, an award given to “demonstrate that older people comprise an undiscovered, and still largely untapped, continent of solutions to an array of pressing societal challenges.” His organization works to innovate “new ideas and models to leverage the skills and talents of experienced adults to improve communities and the world.”</p> <p>These are the assets I’m talking about. Experienced adults can improve the world. They are cherished members of their families and communities. Older people in the third chapter of life are finding additional purpose and exploring creativity. A true accounting of a future full of 95 million older people must be balanced, with an eye toward planning for both the burden of care and the benefit of contribution.</p> <p>Personally, I prefer the term “age wave.” You can ride a wave, but it can capsize you. We must prepare for both. It is essential that we understand the impact on the U.S. economy when, in 2060, nearly 25 percent of the population will be older than age 65. Who will provide care when those individuals reach advanced age? How will it be paid for?</p> <p>These challenging questions have already arrived with the front edge of this surge. In an August 2019 <a href="https://www.washingtonpost.com/business/economy/this-will-be-catastrophic-maine-families-face-elder-boom-worker-shortage-in-preview-of-nations-future/2019/08/14/7cecafc6-bec1-11e9-b873-63ace636af08_story.html?arc404=true">article</a>, The Washington Post explored in detail the elder boom and worker shortage currently facing the state of Maine. The article predicts the issues confronting Maine are a preview of the nation’s future.</p> <p>As we prepare for this wave, we also must plan to surf it. Millions of us will have time and experience to share. We need to be healthy enough to do so, mentally and physically. It is essential we devote additional time and more resources to healthy aging, as individuals who are growing older and as a nation concerned about health.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><hr /><p><em>Kathy Greenlee, J.D., previously served as U.S. Assistant Secretary for Aging and Kansas Secretary for Aging. She is a member of the Board of Directors of the National Council on Aging, and member of the Generations Editorial Advisory Board.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/7" hreflang="en">Tsunami</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p><strong>Op-Ed</strong><br /> By Kathy Greenlee</p> </div> </div> <div class="field field--name-field-issue field--type-entity-reference field--label-above"> <div class="field__label">Issue</div> <div class="field__item"><a href="/july-aug-2020" hreflang="en">July-Aug 2020</a></div> </div> Tue, 07 Jul 2020 05:00:00 +0000 asa_admin 10 at http://generations.asaging.org The WISH Act: A Proposal for Federal LTSS Insurance for Catastrophic Costs http://generations.asaging.org/wish-act-federal-ltss-insurance-ruinous-costs <span class="field field--name-title field--type-string field--label-hidden">The WISH Act: A Proposal for Federal LTSS Insurance for Catastrophic Costs</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Tue, 07/20/2021 - 16:00</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/health-well-being" hreflang="en">Health &amp; Well-being</a></div> <div class="field__item"><a href="/economic-security" hreflang="en">Economic Security</a></div> <div class="field__item"><a href="/innovation-social-impact" hreflang="en">Innovation &amp; Social Impact</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-now" hreflang="en">Generations Now</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">‘It’s time to stop pretending that we mostly won’t live into old age, or that most of us won’t need LTSS.’</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">All members of ASA know that the United States has a wholly inadequate set of “arrangements” for supporting people who need long-term supports and services (LTSS), about half of whom are past retirement age. And they know the situation is on course to become dire within a decade, when so many in the Baby Boomer generation encounter the disabilities associated with aging.</p> <p>Potential reforms abound—better pay and benefits for care workers, single point of entry to services, skilled physicians, integrated teams, comprehensive care planning and so on. But all of these reforms will be stymied if there’s no money, and the funding has to be sustained into the future—not just as a short-term fix.</p> <p>To address this situation, Rep. Tom Suozzi (D-NY) has introduced a remarkable bill, the <a href="https://suozzi.house.gov/media/press-releases/suozzi-introduces-legislation-transform-american-elder-care-create-federal-long">Well-Being Insurance for Seniors to be at Home (WISH) Act</a>, which would create a social insurance trust fund to cover long periods of LTSS needs, thus making it possible for workers to plan responsibly for the risks of disability in old age.</p> <h4>How the WISH Act Would Benefit Everyone</h4> <p>The WISH Act has a great many good effects: reviving the long-term care insurance industry, reducing the need to spend down to Medicaid, saving state and federal Medicaid programs from dire financial consequences, providing a targeted supplement to Social Security at just the time the beneficiary needs it most, educating Americans about the need to plan for LTSS risks in old age, improving pay and benefits for caregivers, and more.</p> <p>And it does all of this with a truly modest mandatory insurance contribution from wages—0.3 percent from workers, 0.3 percent from employers. Someone making $50,000 per year, about the median income in the country, would be paying $150 per year, or less than 50 cents per day.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>The WISH Act requires a modest mandatory insurance contribution from wages—0.3 percent from workers, 0.3 percent from employers.</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>The trust fund would be separate from other trust funds and would require 40 quarters (10 years) of having earned the current equivalent of $5,600 per year to qualify for full benefits. Pro-rated benefits start at six quarters. The benefit would be enough to pay for a national average of about six hours of paid caregiving, or about $3,600 per month, paid in cash like Social Security.</p> <p>To qualify for benefits, the worker must be older than full retirement age and either dependent in two or more Activities of Daily Living or sufficiently cognitively impaired to require nearly full-time supervision and assistance. This is the standard that most long-term care insurance plans use and is ensconced in the HIPAA regulations.</p> <p>In addition, the person must have had this level of disability for a waiting period that depends upon their earnings record, while contributing to the WISH Trust Fund. Low-wage earners in the lower 40 percent of earnings would only wait one year, and those with higher earnings would add one month for each 1.25 percentiles above the 40th percentile.</p> <p>For example, the median wage earner would wait 20 months, the 70th percentile person would wait three years, and the highest earners would wait five years. Once begun, the benefit is life-long. This strategy rests on two observations: first, the definition of catastrophic financial burden differs for workers with different opportunities to save, own homes, invest in insurance, and raise families to help; and second, the cost of LTSS does not differ much for poor or wealthy people.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>'It is really the long-range plan for eldercare for us all.'</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>The upshot when fully operational is that LTSS would have an infusion of payouts that total around $100 billion per year (in current dollars). The bill includes substantial education about LTSS risks and costs, in addition to the obvious education of having money taken from your paycheck each payday. Many people would learn to plan ahead to protect their ability to manage during disability in old age, without bankrupting their families. Long-term care insurance providers will fill in the waiting period and the additional costs of LTSS beyond the WISH benefit with much more affordable and flexible offerings.</p> <h4>Let’s Not Repeat History, and Instead Take Action on the WISH Act</h4> <p>Many ASA members will remember the push for the CLASS Act, which was part of the Affordable Care Act but could not be implemented because the finances could not work with a voluntary enrollment. The need for something to address LTSS costs has persisted, and WISH is a thoroughly responsible response!</p> <p>It does not address the urgent needs or the short-term reforms we need in eldercare, and it does not help current retirees or younger people living with disabilities (until their own old age, provided they’ve worked a little over some years, which is true of most persons living with disabilities in working age). It is really the long-range plan for eldercare for us all. If it had been enacted in 1990, we would not be looking at having enormous numbers of elders unable to afford housing, food and medical care within a decade.</p> <p>Admittedly, we are late to act, but it’s time to stop pretending that we mostly won’t live into old age, or that most of us won’t need LTSS. The opportunity to grow old was still uncommon in the middle of the last century, when Medicare and Medicaid came into being. Having that longevity opportunity now, for most Americans, is a remarkable achievement. But it requires some changes in how we manage to pay for our needs, and the WISH Act would be a major part of that reform.</p> <p>To get the WISH Act passed will require substantial public interest and support. Call your Congressman and Senator. Explain the importance of this Act. Ask them to co-sponsor. Let’s stop kicking that cursed can down the road!</p> <hr /><p><em>Joanne Lynn, MD, is a Health &amp; Aging Policy Fellow in the office of Rep. Thomas R. Suozzi (D-NY), in Washington, DC.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/26" hreflang="en">Caregiver and patient talking with support person</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p>By Joanne Lynn</p> </div> </div> Tue, 20 Jul 2021 14:00:01 +0000 asa_admin 455 at http://generations.asaging.org New Medical Nutrition Therapy Act Would Benefit Those with Medicare http://generations.asaging.org/medical-nutrition-therapy-act-aids-medicare <span class="field field--name-title field--type-string field--label-hidden">New Medical Nutrition Therapy Act Would Benefit Those with Medicare </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Wed, 07/14/2021 - 20:05</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/justice-equity" hreflang="en">Justice &amp; Equity</a></div> <div class="field__item"><a href="/health-well-being" hreflang="en">Health &amp; Well-being</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-now" hreflang="en">Generations Now</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">The MNT Act would promote health equity among minority communities with higher rates of nutrition-related chronic diseases. <br /> <br /> </div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">Almost all Medicare beneficiaries have at least one chronic condition and more than <a href="https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-Conditions/Chartbook_Charts">two-thirds</a> live with multiple chronic conditions. What they don’t have is ready access to nutrition care. Studies have shown that Medical Nutrition Therapy (MNT) is a cost-effective service for treating <a href="https://www.andeal.org/topic.cfm?menu=5284&amp;cat=4171">obesity</a>, <a href="https://www.andeal.org/topic.cfm?menu=5284&amp;cat=4085">diabetes</a>, <a href="https://www.andeal.org/topic.cfm?menu=4085&amp;cat=4070">hypertension</a>, <a href="https://www.andeal.org/topic.cfm?menu=5284&amp;cat=5231">dyslipidemia</a>, <a href="https://www.andeal.org/topic.cfm?cat=4107&amp;menu=5312">HIV infection</a>, <a href="https://www.andeal.org/topic.cfm?menu=5294&amp;cat=5444">unintended weight loss</a> and other chronic conditions in older adults. Counseling provided by a registered dietitian nutritionist (RDN) as part of a healthcare team can positively impact <a href="https://www.andeal.org/topic.cfm?menu=5284&amp;cat=5233">weight</a>, <a href="https://www.andeal.org/topic.cfm?menu=4085&amp;cat=3676">blood pressure</a>, <a href="https://www.andeal.org/topic.cfm?menu=4085&amp;cat=3676">blood lipids</a> and <a href="https://www.andeal.org/topic.cfm?menu=4085&amp;cat=3676">blood sugar control</a>.</p> <p>The Medical Nutrition Therapy Act of 2021 (<a href="https://www.congress.gov/bill/117th-congress/senate-bill/1536/">S. 1536</a>/<a href="https://www.congress.gov/bill/117th-congress/house-bill/3108/">H.R. 3108</a>) recently introduced by Sens. Susan Collins (R-ME) and Gary Peters (D-MI) and Reps. Robin Kelly (D-IL) and Fred Upton (R-MI) would expand much needed MNT access for Medicare recipients.</p> <h4>Why Expanded Access Is Necessary</h4> <p>According to the CDC, <a href="https://www.cdc.gov/chronicdisease/about/costs/index.htm">90 percent of the nation’s $3.8 trillion</a> annual healthcare expenditures is spent on treating individuals with chronic and mental health conditions. Care for individuals with multiple chronic conditions is especially costly in the Medicare population. Yet currently, Medicare Part B <em>only </em><a href="https://www.medicare.gov/coverage/nutrition-therapy-services">covers </a>outpatient MNT for diabetes, renal disease and post-kidney transplant. While this is important, so many other chronic conditions could benefit from attention to nutrition, too.</p> <p>In a <a href="https://bmjopen.bmj.com/content/2/6/e001871.long">national survey</a> of primary care physicians, respondents identified RDNs as the most qualified healthcare providers to help patients with weight loss. Also, the National Lipid Association <a href="https://www.lipidjournal.com/article/S1933-2874(15)00380-3/fulltext">recommends </a>nutritional counseling by RDNs to promote long-term adherence to an individualized, heart-healthy diet.</p> <h4><a href="https://www.eatrightpro.org/-/media/eatrightpro-files/advocacy/legislation/mntactissuebrief2021_final.pdf?la=en&amp;hash=E156E5408B3D12937B52FCA5FD8CFFBFF7B12409">Chronic Disease Burden in Older Adults</a></h4> <p> </p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><figure role="group" class="caption caption-img align-center"><a href="https://generations.asaging.org/sites/default/files/inline-images/chartnutrition.png"><img alt="Chronic Disease Burden in Older Adults Charit" data-entity-type="file" data-entity-uuid="90b7f3bc-2890-4555-8b92-b29fa23f743f" height="423" src="/sites/default/files/inline-images/chartnutrition.png" width="685" /></a> <figcaption><a href="https://generations.asaging.org/sites/default/files/inline-images/chartnutrition.png">Click to view full size</a></figcaption></figure><p> </p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>The COVID-19 pandemic has highlighted the importance of strong nutrition, and many diet-related chronic conditions were shown to contribute to poor COVID-19 outcomes. Minority populations have long faced chronic disease health disparities due to socioeconomic inequalities and reduced access to healthcare, healthy foods and safe places to be active. It is these same groups that are now disproportionately impacted by COVID-19.</p> <p>The compounding effects of systemic inequalities, food insecurity, reduced access to care, and now COVID-19, underscore the need to provide equitable access to MNT in Medicare. Also, many Medicare recipients, particularly underserved populations, regularly receive care from nurse practitioners, physician’s assistants, clinical nurse specialists or psychologists. However, these providers are barred from directly referring their patients to MNT services.</p> <h4>What the Medical Nutrition Therapy Act of 2021 Covers</h4> <p>Passage of the MNT Act would significantly expand access to crucial nutrition care services. Here’s what the bill would do:</p> <ul><li>Expand Medicare Part B coverage of outpatient MNT to beneficiaries with prediabetes, obesity, high blood pressure, high cholesterol, malnutrition, eating disorders, cancer, gastrointestinal diseases including celiac disease, HIV/AIDS, cardiovascular disease and any other disease or condition causing unintentional weight loss;</li> <li>Authorize the Secretary of Health and Human Services to further expand the benefit to other diseases based on clinical guidelines;</li> <li>Allow nurse practitioners, physician assistants, clinical nurse specialists and psychologists to refer their patients for MNT; and</li> <li>Promote health equity among minority communities with higher rates of nutrition-related chronic diseases.</li> </ul><h4>How You Can Take Action Now to Increase MNT Access and Utilization</h4> <p>The Academy of Nutrition and Dietetics is a proud champion of the Medical Nutrition Therapy Act, which is supported by nearly 50 <a href="https://www.eatrightpro.org/-/media/eatrightpro-files/advocacy/legislation/mnt-act-supporting-organizations-list_may2021.pdf?la=en&amp;hash=A359D77A3588795A7A82EC44D9C07EA294AE1690">national organizations</a>. You can add your national organization to the list of supporters <a href="https://docs.google.com/forms/d/e/1FAIpQLSf_s1-2VXK7mBInYEW4Cd_lsp3zQsHQriVykeiu-aOBggRhEA/viewform?usp=sf_link">here</a>. To give your personal support, visit the Academy’s <a href="https://www.votervoice.net/EATRIGHT/1/campaigns/85059/respond">Action Center </a>and urge your members of Congress to sign on to the Medical Nutrition Therapy Act. You can also promote access to MNT right now, for your patients/clients with diabetes or renal disease. Let these patients know that Medicare fully <a href="https://www.medicare.gov/coverage/nutrition-therapy-services">covers </a>RDN visits with no out-of-pocket costs.</p> <p>Current referral rates for eligible beneficiaries are <a href="https://jandonline.org/article/S2212-2672(18)30801-3/fulltext">unfortunately low</a> and thus there is a great need to educate patients/families and their physicians about this benefit. The Academy has developed <a href="https://www.eatrightpro.org/payment/getting-started/referrals-and-primary-care-partnership">resources </a>to help primary care providers partner with and refer to RDNs for improved patient health and well-being.</p> <p>For more information on the MNT Act, visit the Academy’s <a href="https://www.eatrightpro.org/advocacy/legislation/all-legislation/medical-nutrition-therapy-act">MNT Act webpage</a>.</p> <hr /><p><em>Hannah Martin, MPH, RDN, is a director of Legislative and Government Affairs at the Academy of Nutrition and Dietetics in Washington, DC.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/140" hreflang="en">Mother and daughter prepare meal together</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p><strong>From Our Sponsors</strong><br /> By Hannah Martin</p> </div> </div> Wed, 14 Jul 2021 18:05:59 +0000 asa_admin 454 at http://generations.asaging.org Stop the Scam! How to Avoid Rental Scams http://generations.asaging.org/stop-scam-how-avoid-rental-scams <span class="field field--name-title field--type-string field--label-hidden">Stop the Scam! How to Avoid Rental Scams</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Wed, 07/14/2021 - 08:20</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/economic-security" hreflang="en">Economic Security</a></div> <div class="field__item"><a href="/ageism-culture" hreflang="en">Ageism &amp; Culture</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-now" hreflang="en">Generations Now</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">Scam artists use photos of a real property, or hijack a legitimate listing, to create a real estate advertisement.</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">One big perk of retirement can be travel, but to ensure trips are stress-free, it’s best to know how to avoid rental scams that can target even the most seasoned traveler.</p> <p>Renting or purchasing properties in different parts of the country opens the door for adventure, but unfortunately it can also open the virtual door for scam attempts. Caution must be used when making any type of payment involving rental properties, purchasing real estate or buying a timeshare. Asking a lot of questions is critical, as is shying away from anyone who tries to pressure buyers into sending money immediately.</p> <h4>How Does the Rental Scam Work?</h4> <p>A scam artist uses photos of a real property, or hijacks a legitimate listing, to create a real estate advertisement. The problem with this appealing property, however, is that it is not actually available for rent or purchase. It is likely the scammer stole photos of a house owned by someone else—someone who has no idea that their home is being used to con people. The scammer advertises the property—a condo, house or timeshare—online, often on a free classified website.</p> <p>The scammer’s listing will usually stand out because it will be offered at an astonishingly affordable price that is significantly cheaper than comparable properties in the neighborhood. In addition, the house will often offer every amenity, such as waterfront views, short walks to private beach access and the promise of a quiet street with ample parking.</p> <p>This looks like an amazing deal, so naturally people reach out to the listed contact and ask to tour the property. A seemingly sincere response comes back, saying something like, “I’d love to give you a tour but unfortunately, this beautiful home belongs to my ailing parents who I am currently moving across the country to live with me. I won’t be able to show you the unit as I am assisting them, but I have received many offers already and would be happy to take a security deposit to hold this unit for you.”</p> <p>This is a red flag. A legitimate landlord or property manager would be willing to arrange for someone local to show potential renters or buyers the property. If the seller asks for a deposit to “hold” a rental before the potential renter/buyer can see it in person, it could be a scam.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘It is never necessary to send money or provide personal information without viewing the unit or meeting the owner in person.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>These scam artists also know that many retirees find second homes or vacation rentals in parts of the country in which they do not live. It’s best to send a trusted friend who’s local to drive by the rental or ask for a live video tour. Scammers often target people planning to move and advertise homes listed at an address that does not exist, thinking their targets will have no chance to double-check house numbers.</p> <p>The photos, amenities and price can seem close to perfect. If a house sounds too good to be true, it probably is. Renters or buyers should never allow a scammer to pressure them into sending money before signing a lease to hold this “ideal” home, because it likely does not exist.</p> <h4>How to Avoid the Scam</h4> <p>Any situation that would involve an upfront payment or the provision of personal and sensitive information needs to be researched thoroughly. And the company listing the property should be investigated to ensure it is legitimate, as well as the individual who’s selling or renting the property.</p> <p>It is never necessary to send money or provide personal information without viewing the unit or meeting the owner in person. It’s easy to do a quick search on the owner, real estate management company and listing, to ensure legitimacy. And if the same ad is listed under a different name, that’s a clue it may be a scam.</p> <p>For those planning to buy a vacation home or a timeshare, or rent a place to stay, these tips are crucial:</p> <ul><li>Never send a money transfer to anyone not known personally.</li> <li>Never use a money transfer to pay for a property found on an online marketplace listing.</li> <li>Avoid any situation that asks buyers to act immediately or pressures them into sending money before seeing the property.</li> <li>Watch for poorly written correspondence or listings with misspellings and poor grammar.</li> <li>Never provide personal or sensitive information to an unknown individual, especially anyone only corresponded with via email.</li> <li>When moving to a new city and planning to rent sight unseen, ask a friend or colleague to visit the rental property before sending money.</li> <li>If communicating with a property owner on a website or app such as Airbnb or VRBO, never accept an offer to move the conversation to text or email in order to avoid potential risks.</li> </ul><p>More information on scams and how to protect against them is available at the Western Union Consumer Protection Center at www.wu.com/fraudawareness.</p> <hr /><p><em>April Payne is a senior analyst, social media, at Western Union in Denver, Colo. She will be appearing on <a href="https://asaging.org/asa-studios#ASALive">ASA LIVE</a> July 15, at 1 p.m., to discuss such scams. </em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/364" hreflang="en">Rental house</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p><strong>From Our Sponsors</strong><br /> By April Payne</p> </div> </div> Wed, 14 Jul 2021 06:20:23 +0000 asa_admin 400 at http://generations.asaging.org Pushing Back Against Improper Nursing Facility Evictions http://generations.asaging.org/pushing-back-against-nursing-facility-evictions <span class="field field--name-title field--type-string field--label-hidden">Pushing Back Against Improper Nursing Facility Evictions</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Tue, 07/13/2021 - 20:23</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/justice-equity" hreflang="en">Justice &amp; Equity</a></div> <div class="field__item"><a href="/health-well-being" hreflang="en">Health &amp; Well-being</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-now" hreflang="en">Generations Now</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">‘Facilities very rarely have just cause when they seek eviction for a reason other than nonpayment.’</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">For nursing facility residents, the first rule for avoiding eviction is stupefyingly simple: Don’t move out.</p> <p>Really. I’m not kidding. Don’t.  Move.  Out.</p> <p>Even if the rule is simple, of course, the reality of nursing facility evictions can be anything but. I have the luxury of approaching evictions from the attorney’s perspective. I well understand the vast difference between representing someone in an eviction, and facing eviction yourself. And, to be sure, eviction from a nursing facility presents unusual difficulties. Facing an eviction dispute in an apartment rental situation is hard enough, but pressure is magnified when you receive around-the-clock care from your eviction adversary.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘The law is generally in the resident’s favor.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>That being said, the first rule remains: Don’t move out. This rule is based on an important truth: the law is generally in the resident’s favor. Specifically, if a resident has paid the bill, a facility rarely has grounds to evict. So, in most cases, if the facility threatens eviction or even serves an eviction notice, the resident can fight back and win by staying put and (if an eviction notice has been served) requesting a hearing.</p> <h4>Federal Eviction Law</h4> <p>As COVID recedes to a certain extent, one part of returning to “normal” is an increase in eviction rates. The legal requirements have not changed. Eviction is governed by federal law that applies across the country to any nursing facility that accepts Medicare and/or Medicaid. Because virtually every facility accepts one or (more likely) both of these payment sources, the federal law almost always governs. Under this law, furthermore, eviction is allowed only for six narrow reasons.</p> <ol><li>Nonpayment.</li> <li>The resident needs care that can’t be provided in a nursing facility.</li> <li>The resident does not need nursing facility care.</li> <li>The resident’s presence endangers others’ health.</li> <li>The resident’s presence endangers others’ safety.</li> <li>The facility is going out of business.</li> </ol><p>The facility generally must give a 30-day written notice of any eviction, although in certain limited circumstances the facility may give “practicable” notice of less than 30 days. To contest an eviction notice, the resident can request an administrative hearing, which will be held in front of a state hearing officer. Exact details vary from state to state.</p> <h4>Residents Usually Are in the Right</h4> <p>In my experience, nursing facilities are more likely to be on solid ground when they allege nonpayment. Some residents do fail to pay and, in a straightforward nonpayment case, a facility has the right to evict, provided that it has complied with procedural requirements.</p> <p>On the other hand, facilities very rarely have just cause when they seek eviction for a reason other than nonpayment. The vast majority of these eviction attempts are based on reasons Number 2, 4 and 5—in short, the facility is claiming that eviction is justified by the resident’s care needs or behavior. Supposedly the resident needs care that cannot be provided in the facility, or is endangering others by living in the facility.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>'Truly “dangerous” residents are few and far between.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>As a practical matter, however, there are virtually no residents who need care beyond what a nursing facility can provide, and nonetheless wish to stay in the facility. If, for example, a person needs to be hospitalized, or requires the ventilator care that rarely is available in nursing facilities, he or she will not need much convincing to move to the type of facility that can provide the necessary services.</p> <p>Likewise, truly “dangerous” residents are few and far between. A resident with severe dementia may present care challenges and (on a more personal level) irritate both staff and other residents, but the resident with dementia rarely possesses the malice or physical strength to truly endanger others.</p> <h4>Two Common Types of Improper Evictions</h4> <p>Although the law sharply limits nursing facility evictions, too many facilities use eviction as a routine business tool. In one common situation, a facility tells a resident that she must leave when her Medicare Part A coverage is ending, because the facility supposedly is a “rehabilitation facility” that doesn’t provide “custodial care.” This is false. Even if Part A coverage is ending, the resident should be able to stay in the facility with a different reimbursement source, either Medicaid or private payment.</p> <p>As a result, the facility has no grounds to force the resident out—in truth, they simply are following a Medicare-optimizing business strategy. This resident will be replaced by a different Medicare-reimbursed resident who, after a few weeks in the facility, will in turn be replaced by yet another Medicare-reimbursed resident. And so it goes, indefinitely. References to “rehabilitation facilities” or “custodial care” obscure the reality that the facility likely is Medicaid-certified and, when residents’ Medicare reimbursement ends, it is obligated to accept Medicaid as well.</p> <p>A second common situation involves a resident who allegedly requires care beyond the facility’s capacity. In my experience, the resident threatened with eviction in this scenario generally possesses some combination of the following: 1) greater than average care needs, 2) a significant level of dementia, 3) a difficult personality (or a family member with a difficult personality), and 4) payment made through Medicaid. In these cases, eviction is absolutely counterproductive—the facility often proposes to transfer the resident to a second nursing facility, which obviously begs the question as to why one nursing facility but not another can provide the necessary care. Indeed, the resident’s condition almost always is well within a nursing facility level of care. Instead of eviction, a facility should address a supposedly “difficult” resident through care planning, which under federal law must include the resident, the resident’s physician, facility staff and others.</p> <h4>What To Do</h4> <p>Even through residents usually are on the right side of the law, they oftentimes lose, generally because they fail to follow the don’t-move-out rule. When threatened with eviction, they feel pressure and leave “voluntarily.” They may be unfamiliar with their rights under federal law and, in any case, are intimidated by the facility’s threats.</p> <p>Justice in Aging has developed two online resources to assist residents and their advocates. The guide “<a href="https://www.justiceinaging.org/wp-content/uploads/2019/01/25-Common-Nursing-Home-Problems-and-How-to-Resolve-Them_Final.pdf">25 Common Nursing Home Problems—and How to Resolve Them</a>” offers step-by-step advice for residents on eight specific eviction situations. Also, Justice in Aging will soon offer an online toolkit specifically for attorneys and aging network professionals. The toolkit provides template documents for court filings and administrative hearing briefs, as well as consumer education materials for identifying improper evictions.</p> <p>In addition, and most importantly, readers of this article are likely in a position to make a real difference. The evictions discussed in this article are common only because they are accepted as “business as usual”—not just by nursing facilities, but also by the broader aging services network. You, the reader, can and should push back when a nursing facility threatens eviction inappropriately. Given the pressure faced by residents and their families, they should not have to confront these problems alone.</p> <hr /><p><em>Eric Carlson is a Directing Attorney for Justice in Aging, in its Los Angeles office, where he maintains a national practice of policy advocacy, litigation and education. He is author of the legal treatise “Long-Term Care Advocacy” (LEXIS Publishing).</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/392" hreflang="en">Nursing Home Room</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p>By Eric Carlson</p> </div> </div> Tue, 13 Jul 2021 18:23:54 +0000 asa_admin 453 at http://generations.asaging.org Family Caregivers: Underrecognized and Essential http://generations.asaging.org/family-caregivers-underrecognized-and-essential <span class="field field--name-title field--type-string field--label-hidden">Family Caregivers: Underrecognized and Essential</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Fri, 07/09/2021 - 16:00</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/justice-equity" hreflang="en">Justice &amp; Equity</a></div> <div class="field__item"><a href="/health-well-being" hreflang="en">Health &amp; Well-being</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-now" hreflang="en">Generations Now</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">Caregivers are part of the connective tissue that binds families, often across generations. </div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">Following CDC guidance and a general relaxing of many city and state COVID regulations as our summers kicked off, many of us have begun to remove our masks. There is a sense of relief and joy at seeing long-hidden faces of loved ones, friends and even strangers.</p> <p>Ironically, the pandemic has all along been the great “un-masker,” revealing the people most important and necessary in our lives, from healthcare workers to grocery clerks to delivery drivers. Surprisingly, it has brought to light another hidden cadre of unsung heroes 53 million people strong, a group that was hard at work before the pandemic struck, labored tirelessly throughout its course, and will continue their work far into the future.</p> <p>They are the family caregivers who provide essential support each day to older family members and friends in need.</p> <p>Think about it: <a href="https://www.aarp.org/caregiving/basics/info-2020/unpaid-family-caregivers-report.html">more than 53 million people</a>—one in five adults in the United States—provide unpaid and critically needed help to those who can no longer live independently. Estimates suggest that the care they provide is <a href="https://rrf.issuelab.org/resource/caregiving-in-the-u-s-2020.html">worth nearly half a trillion dollars</a>. That is an economic contribution larger than all government outlays for institutional and community-based long-term services and support combined. This makes family caregivers the nation’s largest healthcare workforce, an indispensable foundation on which the health and social service delivery system for older adults rests.</p> <h4>Pandemic Exacerbates Care Situation</h4> <p>Here in Chicago and throughout the nation, the pandemic separated loved ones and friends. Many older relatives, whether in their homes, apartments or assisted living facilities, suffered from the lack of regular visits and attention. Conversely, some caregivers have been living every day in close quarters with their family members, without respite and other supports upon which they traditionally rely.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Family caregivers provide care worth nearly half a trillion dollars.</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Pandemic or not, it is not an easy job. Caregivers are often stressed by trying to master highly technical, traditionally medical-nursing tasks for which they have not been trained. Increasing numbers care for more than one older adult and must juggle caregiving with meeting the needs of children or grandchildren—leaving little time to care for their own health and well-being. <a href="https://www.thecopeinitiative.org/findings">A recent CDC survey</a> found that more than two-thirds of all parents and caregivers of adults reported adverse mental health symptoms during the pandemic.</p> <p>Caregiving is also costly. Many caregivers give up jobs or go part-time, posing a threat to their future financial security and that of their families. Family caregivers spend, on average, <a href="https://www.aarp.org/caregiving/financial-legal/info-2019/out-of-pocket-costs.html#:~:text=The%20study%20found%20that%20family,more%20from%20the%20care%20recipient.">nearly $7,500 a year out of their own pockets</a> to meet the needs of the older family members in their care. It’s not going to get any easier as aging baby boomers, who tend to have smaller families than their parents, may soon need care.</p> <p>What can be done to support this underappreciated army of carers?</p> <ul><li><strong>Make caregivers visible.</strong> Many see themselves simply as spouses, daughters or sons, fulfilling a natural family obligation. This is understandable and admirable, but it means that many people do not get the support they need, because they view caregiving programs as being for others, not themselves. However, health and social service providers are positioned to identify caregivers and connect them to needed resources. Full implementation of the <a href="https://www.aarp.org/politics-society/advocacy/caregiving-advocacy/info-2014/aarp-creates-model-state-bill.html">CARE Act</a>, which has been passed in more than 40 states, including Illinois, can help, requiring health systems to identify, assess and train caregivers of older patients before they are discharged back to their home.</li> <li><strong>Strengthen federal and state funding for caregiver support.</strong> Attention to this issue has grown at all levels of government, but funding has not. Many states support the lowest income caregivers, but those who are near-poor or have moderate incomes lack the same assistance. Federal appropriations for the <a href="https://acl.gov/programs/support-caregivers/national-family-caregiver-support-program">National Family Caregiver Support Program</a> have been increased through the COVID emergency. This expansion should be sustained.</li> <li><strong>Scale programs that work and adapt them for different populations and contexts.</strong> Several support programs, such as the <a href="https://www.caregiver.org/resource/savvy-caregiver-program/">Savvy Caregiver Program</a> and <a href="https://www.benrose.org/-/bricareconsultation">BRI Care Consultation</a>, have demonstrated tangible benefits—improving health and well-being and lowering hospital admissions and other costs. These proven programs need help to get to scale and to ensure they provide the same benefits to a wide range of racial and ethnic communities that they provide to the general population. A recent publication from the Diverse Elders Coalition, <a href="https://www.diverseelders.org/wp-content/uploads/2021/03/DEC-Toolkit-Final-R2.pdf">Caring for Those Who Care</a>, provides a wealth of helpful guidance for innovators and providers on this critically important topic.</li> </ul><p>Caregivers are part of the connective tissue that binds families, often across generations. Each day, their efforts help to link disparate and poorly coordinated parts of the health and social services systems. In a time when so much separates us, caregivers hold us together. We need to step up and help them help us. It’s essential.</p> <hr /><p><em>Mary O’Donnell, MA, is president of RRF Foundation for Aging in Chicago.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/162" hreflang="en">Family Caregiver</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p><strong>OpEd</strong><br /> By Mary O’Donnell<p></p></p> </div> </div> Fri, 09 Jul 2021 14:00:00 +0000 asa_admin 450 at http://generations.asaging.org Critical Race Theory Can Help Us Foster Equity for All, Including Elders http://generations.asaging.org/critical-race-theory-can-foster-equity-all <span class="field field--name-title field--type-string field--label-hidden"> Critical Race Theory Can Help Us Foster Equity for All, Including Elders</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Fri, 07/02/2021 - 22:15</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/justice-equity" hreflang="en">Justice &amp; Equity</a></div> <div class="field__item"><a href="/ageism-culture" hreflang="en">Ageism &amp; Culture</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-now" hreflang="en">Generations Now</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">‘CRT challenges us to look beyond our feelings and examine the impact our words and actions have on others.’</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">Like many places across the country, my local school system recently faced a <a href="https://apnews.com/article/government-and-politics-nv-state-wire-nevada-race-and-ethnicity-racial-injustice-6185b8f9c5b56e1fa1347b7f4a203a52">controversy</a> over <a href="https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/civil-rights-reimagining-policing/a-lesson-on-critical-race-theory/">Critical Race Theory (CRT)</a>, or the practice of examining the role of race and racism in society, taking into account the historical and ongoing legacy of discrimination and racism and the intersection of other identities including sexuality, gender identity, disability, age and others.</p> <p>It’s a confounding conversation to watch unfold because, as a white person who works hard to earn the title of an ally to BIPOC, CRT offers clarity and transparency in a way that explains the inequity I witness and holds promise, when put into action and advocacy, for equity. Its framework has helped me to understand the role I play, personally, in systems of inequality, as well as how those systems function at a societal level and their impact on individual lives.</p> <p>CRT influences the choices I make as the Community Engagement Manager at ASA. From the imagery I select for our websites and other materials, to the blog post ideas I propose in Newsroom meetings, and the language I use (or don’t use) in ASA’s communications. It’s something I put work and energy into daily, because I know that the impact of my actions and language are just as important, if not more so, than my intentions.</p> <p>And I imagine that’s where a lot of confusion about CRT lies. Racism often is understood as an individual’s beliefs about race. But CRT challenges us to look beyond our feelings and examine the impact our words and actions have on others. Specifically, it asks us to unpack how we (as individuals and as a society) unintentionally perpetuate racism.</p> <h4>CRT’s Role in Achieving Equity for Elders</h4> <p>And, to that end, I think CRT has an important role to play in achieving equity in aging and in the delivery of services and support to older adults. Not only does CRT expose our own, often unintentional, racism, it also challenges us to analyze how racism exists in the laws, systems and structures understood to be foundational to our society.</p> <p>In the arguments against CRT I often hear that we should just treat everyone the same. This idea, however, fails to take into account centuries of history (including genocide of indigenous people, slavery, Jim Crow, segregation, redlining and more).</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Many ASA members bring a deep and valuable understanding of CRT to their work.</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Speaking about the disproportionate impact of evictions on Black women in <em>Evicted: Poverty and Profit in the American City</em> (2016), Matthew Desmond writes, “equal treatment in an unequal society could still foster inequality.”</p> <p>Certainly for Black older Americans, a lifetime of experiencing discrimination and racism cannot be fixed or even mitigated by equal treatment. And in accepting that as true, we can clearly see that laws and regulations that purport to treat everyone equally can, and do, sustain inequality.</p> <table align="center" border="0" cellpadding="10" cellspacing="10" style="width: 85%;"><tbody><tr><td style="text-align: center; vertical-align: middle; background-color: rgb(153, 227, 255);"> <h5>Resource<br />  </h5> <a href="https://www.storybasedstrategy.org/the4thbox"><img alt="Step into the 4th Box" data-entity-type="file" data-entity-uuid="a5d33b42-ebea-48b2-80a9-54e56f7f5e5e" height="171" src="/sites/default/files/inline-images/4thBoxApp_AppStorePromo_square.png" width="217" class="align-center" /></a> <p><strong><a href="https://www.storybasedstrategy.org/the4thbox">The 4th Box</a></strong><br /> from the<br /><a href="https://www.storybasedstrategy.org/">Center for Story-based Strategy</a></p> </td> </tr></tbody></table><p><br /> Critical Race Theory troubles the notion that if you work hard enough, you can succeed by exposing racism in structures and policies. For example, housing. In her <a href="https://generations.asaging.org/homelessness-older-adults-poverty-health">article </a>in the Summer 2020 issue of Generations Journal, Dr. Margot Kushel notes the impact residential covenants and redlining, poor enforcement of Fair Housing Act policies, predatory lending practices and other systems have had in contributing to the racial wealth gap between Black and white households and the three-to-four times higher risk of homelessness for Black Americans than white Americans.</p> <p>This kind of analysis is incredibly helpful when we look at some of the realities of aging in the United States and understanding CRT can help us interrupt structural racism.</p> <h4>Lessons in CRT from On Aging 2021</h4> <p>I saw the tenets of CRT in many presentations at this past April’s On Aging 2021, ASA’s annual conference. The conference theme was Equity and it was clear that many ASA members brought a deep and valuable understanding of CRT to their work. Taking a closer look at some of those moments, and the lessons shared, might help to further clarify the role CRT can play in aging and gerontology.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><h4>Strategies for Providing Culturally-Responsive and Trauma-Informed Services to Address Elder Abuse</h4> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--video paragraph--view-mode--default"> <div class="field field--name-field-video field--type-entity-reference field--label-hidden field__item"><div class="media-video view-mode-default"> <div class="field field--name-field-media-video-embed-field field--type-string field--label-hidden field__item"><iframe src="/media/oembed?url=https%3A//youtu.be/Qi3Ta_WyWiI&amp;max_width=854&amp;max_height=480&amp;hash=EJdEyYB5XveODoki0iP3U-vbDXWgkOyOdRAY7IHrZUM" frameborder="0" allowtransparency width="854" height="480" class="media-oembed-content" title="Strategies for Providing Culturally-Responsive and Trauma-Informed Services"></iframe> </div> <div class="clearfix text-formatted field field--name-field-description field--type-text-long field--label-hidden field__item"><p>Vivianne Mbaku, Senior Staff Attorney at Justice in Aging, and Sarah Galvan, Directing Attorney for Justice in Aging's Elder Rights team present a case study during their On Aging 2021 workshop, Strategies for Providing Culturally-Responsive and Trauma-Informed Services to Address Elder Abuse.</p> </div> </div> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>In the session, “Strategies for Providing Culturally-Responsive and Trauma-Informed Services to Address Elder Abuse,” Vivianne Mbaku, Senior Staff Attorney at Justice in Aging (JIA), and Sarah Galvan, Directing Attorney for JIA's Elder Rights team, explored the overlooked impact of adult protective services (APS) and police involvement in cases of elder abuse and the need for other forms of providing resolution and addressing harm (i.e., restorative justice). For some older adults, informing the police and/or APS can have unintended consequences and many older adults from marginalized communities will avoid reporting elder abuse or seeking assistance due to fear of discrimination and mistreatment. Mbaku notes that these fears are well-founded and based upon lived experience. For professionals, understanding the full picture and communicating that with older adults, is crucial.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><h4>What Is Successful Community-based Programming: Intergenerational, Queer and Anti-racist</h4> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--video paragraph--view-mode--default"> <div class="field field--name-field-video field--type-entity-reference field--label-hidden field__item"><div class="media-video view-mode-default"> <div class="field field--name-field-media-video-embed-field field--type-string field--label-hidden field__item"><iframe src="/media/oembed?url=https%3A//www.youtube.com/watch%3Fv%3DOMwKoI8QLKY&amp;max_width=854&amp;max_height=480&amp;hash=ydFWRRdMa0mriJ7M4MeDuHynG0dHFVZ7eM_U6ErFMKA" frameborder="0" allowtransparency width="854" height="480" class="media-oembed-content" title="What Is Successful Community-based Programming: Intergenerational, Queer and Anti-racist"></iframe> </div> <div class="clearfix text-formatted field field--name-field-description field--type-text-long field--label-hidden field__item"><p>A clip of Katie Garber and Tomme Faust-McCauley presenting "What Is Successful Community-based Programming: Intergenerational, Queer and Anti-racist" at On Aging 2021, the annual conference of the American Society on Aging.</p> </div> </div> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>In “What Is Successful Community-based Programming: Intergenerational, Queer and Anti-racist” presenters Katie Garber and Tomme Faust-McCauley explored key concepts of CRT, such as intersectionality, and why they are important in understanding the different experiences of aging in the United States. They went on to examine the intergenerational impact of redlining and policing and how, even when statutes and practices change or evolve, racism and discrimination can simply change shape but remain.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><h4>Navigating the Patchwork: Civil Rights for Older Adults</h4> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--video paragraph--view-mode--default"> <div class="field field--name-field-video field--type-entity-reference field--label-hidden field__item"><div class="media-video view-mode-default"> <div class="field field--name-field-media-video-embed-field field--type-string field--label-hidden field__item"><iframe src="/media/oembed?url=https%3A//www.youtube.com/watch%3Fv%3D0zJexLLefu8&amp;max_width=854&amp;max_height=480&amp;hash=6E9XUQ3up3sUmj93E68E6sor2HqGPMB7d2bi7DDQwEQ" frameborder="0" allowtransparency width="854" height="480" class="media-oembed-content" title="Navigating the Patchwork: Civil Rights for Older Adults"></iframe> </div> <div class="clearfix text-formatted field field--name-field-description field--type-text-long field--label-hidden field__item"><p>A short clip from the National Forum on Older Adults Covid-19 and Access to Justice featuring Denny Chan, Directing Attorney for Equity Advocacy at Justice in Aging speaking about civil rights for older adults.</p> </div> </div> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>During the “National Forum on Older Adults, COVID-19 and Access to Justice,” Denny Chan said, “discrimination is alive and well in our society. It is baked into the systems that we are all operating in.” Then he explored how Crisis Standards of Care (CSS) during the height of the COVID-19 pandemic used ageism and racism to devalue the lives of older people and people of color. He shared that patients who did not have serious comorbidities were given priority of care over “those who have illnesses that limit their life expectancy.” However, not everyone has the same life expectancy, and Chan points out that Black older adults have significantly lower life expectancy than white older adults, exposing the underlying racism in the CSS that would give priority to someone with the most life years left by disadvantaging older adults of color.</p> <p>These examples from On Aging 2021 demonstrate the importance of thinking critically about the systems that older adults (and everyone) face regularly and how unpacking the impact as opposed to simply accepting the intention, can reveal how discrimination truly is “baked in.” CRT offers an immensely helpful foundation for this work that, when combined with advocacy, can dismantle those systems in favor of laws, regulations and social structures that foster equity.</p> <h4>Continuing the Conversation</h4> <p>I’m looking forward to continuing these conversations and learning how Critical Race Theory is impacting the work of ASA members across the country at next year’s conference (April 11-14, 2022 in New Orleans). The theme for On Aging 2022 is Advancing Economic Security and the <a href="https://asaging.org/on-aging-call-proposals">call for proposals</a> is open through Aug. 15.</p> <hr /><p><em>Betsy Dorsett, MA, is the community engagement manager for ASA and lives outside of Reno.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/388" hreflang="en">Hands</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p>By Betsy Dorsett</p> </div> </div> Fri, 02 Jul 2021 20:15:23 +0000 asa_admin 448 at http://generations.asaging.org In Memory: ASA Member and LAIN Leader Tom Callahan http://generations.asaging.org/memory-asa-member-and-lain-leader-tom-callahan <span class="field field--name-title field--type-string field--label-hidden">In Memory: ASA Member and LAIN Leader Tom Callahan</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Fri, 07/02/2021 - 21:01</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/justice-equity" hreflang="en">Justice &amp; Equity</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-now" hreflang="en">Generations Now</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">Tom had the uncanny ability to put everyone at ease and to make spaces for those who may otherwise have felt marginalized.</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><figure role="group" class="caption caption-img align-right"><img alt="Tom Callahan" data-entity-type="file" data-entity-uuid="2f0bdcbc-cdd9-4114-8756-6d8d5b3853a5" src="/sites/default/files/inline-images/Tom%20Callahan%20Profile%20Pic%203.1%20%28In%20Memoriam%20%284%29%20%281%29.jpg" style="margin:10px" /><figcaption>Thomas P. Callahan</figcaption></figure><p class="dropcaps">The LAIN Family and ASA are heartbroken at the passing of former LAIN member, Thomas P. Callahan, our colleague and friend who died on Thursday, June 24. He died suddenly in the presence of his life partner and other family members.</p> <p>Tom served on ASA's LAIN Council from 2013 to 2017. He organized numerous presentations for the ASA membership on issues germane to LGBTQ/SGL people. Tom was a visionary on issues of aging and was a true servant leader with a generous spirit.</p> <p>We all knew of his commitment to Mary's House for Older Adults, where he served as the Secretary of the Board of Directors, and chaired the Development and Public Relations committees. Tom was a delight to all of us who knew and worked with him. He had the uncanny ability to put everyone at ease and to make spaces for those who may otherwise have felt marginalized. We will miss him.</p> <p>Our sincerest condolences to Tom's life partner, Tom Harkins; his sister Maureen Callahan and other family members; Dr. Imani Woody and the Mary's House for Older Adults, Inc. family; Carl Archer and the Archer Law Office.</p> <p>The family is asking that in lieu of flowers, contributions in Tom's name be made to Mary's House for Older Adults, <a href="https://www.maryshousedc.org/p/tom-callahans-legacy.html">Tom Callahan's Legacy | Mary’s House For Older Adults–DC (maryshousedc.org)</a>.</p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/202" hreflang="en">Candle</a></div> </div> Fri, 02 Jul 2021 19:01:13 +0000 asa_admin 447 at http://generations.asaging.org The Long, Winding Road to Long-term Care Reform http://generations.asaging.org/long-winding-road-long-term-care-reform <span class="field field--name-title field--type-string field--label-hidden">The Long, Winding Road to Long-term Care Reform</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Fri, 07/02/2021 - 18:54</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/ageism-culture" hreflang="en">Ageism &amp; Culture</a></div> <div class="field__item"><a href="/health-well-being" hreflang="en">Health &amp; Well-being</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-now" hreflang="en">Generations Now</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">This represents the largest expansion of Medicaid HCBS in American history. </div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">The COVID-19 pandemic has shaped a <a href="https://thehill.com/blogs/congress-blog/healthcare/526916-giving-direct-care-workers-a-raise-is-a-win-win-heres-proof">growing national consensus</a> that long-term care is harmfully inaccessible due to lack of coverage, long wait lists and inconsistent quality, and that direct care workers working in homes and communities are unprotected, underpaid and undervalued. However, the spring and summer have proven to be a frustrating time for long-term care–reform advocates.</p> <h4>The Promise of the American Jobs Plan</h4> <p>As part of the Biden administration’s “<a href="https://www.whitehouse.gov/build-back-better/">Build Back Better</a>” vision, the <a href="https://www.whitehouse.gov/american-jobs-plan/">American Jobs Plan</a> is the first of two proposals to follow the <a href="https://www.whitehouse.gov/american-rescue-plan/">American Rescue Plan</a>. The original proposal released in March by the White House allocated <a href="https://howardgleckman.com/2021/04/01/biden-proposes-the-biggest-medicaid-home-based-long-term-care-expansion-in-history-but/">$400 billion (spent over eight years) toward Medicaid’s home- and community-based services (HCBS)</a>. On the heels of the American Rescue Plan, which included a one-year, <a href="https://www.kff.org/medicaid/issue-brief/medicaid-provisions-in-the-american-rescue-plan-act/">$12 billion increase in federal spending toward Medicaid HCBS</a>, this is the largest expansion of Medicaid HCBS in American history.</p> <h4>What Happened (to HCBS and Long-term Care Reform)?</h4> <p>In the first iteration of the Jobs Plan, infrastructure is broadly defined to include not only “traditional” physical infrastructure, but human infrastructure in the form of affordable education and childcare, expanded access to long-term care services, and transforming caregiving work from precarious and low-paying to middle-class jobs with benefits and collective bargaining powers.</p> <p>Between April and June, Senate Republicans presented three counter proposals that consistently opposed the original proposal’s breadth, cost and corporate tax increases, and each proposal left out long-term care reform. When negotiations between the Biden administration and Senate Republicans collapsed in June, negotiations changed hands to a bipartisan group of Senators. The bipartisan agreement reached on June 24, <a href="https://static.politico.com/0a/08/398515524e38ab4807521dcfbd92/bipartisan-infrastructure-framework-two-pager-final-7.pdf">at $1.2 trillion, while being the largest infrastructure investment to date</a>, still leaves out human infrastructure initiatives (including the $400 billion investment in Medicaid HCBS).</p> <h4>Moving Forward</h4> <p>Despite increasingly limited proposals and the latest omissions of caregiving infrastructure initiatives in bipartisan negotiations, the conversation on long-term care reform and investment in caregiving infrastructure is far from over.</p> <p>A scaled back version of HCBS investment may still be on the table. The Senate expects to consider the bipartisan package in July and the Biden administration’s larger proposal will not see final votes until the fall. During that time, the Biden administration and Democratic leadership have announced they will pursue “<a href="https://www.usatoday.com/story/news/politics/2021/06/15/infrastructure-fast-track-transportation-climate-democrats-plan/7702749002/">two-tracks</a>”: a bipartisan bill and reinstating cast-off initiatives through budget reconciliation (a parliamentary strategy that bypasses the filibuster process and allows a simple majority to pass legislation).</p> <p>This approach is mired in uncertainty. <a href="https://www.businessinsider.com/bipartisan-infrastructure-plan-eldercare-affordable-housing-american-jobs-plan-biden-2021-6">Progressive Democrats have signaled they will not support the bipartisan bill without securing a broader infrastructure package through budget reconciliation. And some Republicans have indicated they will withdraw support from the bipartisan bill if it is linked to a reconciliation package.</a></p> <h4>Better Care Better Jobs Act</h4> <p>The same day that the bipartisan group announced a compromise agreement on the American Jobs Plan, a group of Democrats introduced the “<a href="https://www.aging.senate.gov/imo/media/doc/Better Care Better Jobs Act One Pager SBS 06223.pdf">Better Care Better Jobs” Act (BCBJA) in the Senate and the House</a>. The BCBJA absorbs many of Biden’s proposals for increased HCBS funding and strengthening and expanding the HCBS workforce. It would permanently increase by 10 percent the <a href="https://www.kff.org/medicaid/state-indicator/federal-matching-rate-and-multiplier/?currentTimeframe=0&amp;sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D">Federal Medical Assistance Percentage (FMAP)</a> for states. A condition for states to receive this increase is that they promote recruitment and retention of direct care workers by addressing HCBS payment rates. The legislation would also make permanent both the <a href="https://www.medicaid.gov/medicaid/eligibility/spousal-impoverishment/index.html">spousal-impoverishment protections in Medicaid</a> and the <a href="https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person/index.html">Money Follows the Person</a> program. The bill has already garnered support from <a href="https://www.paproviders.org/better-care-better-jobs-a-proposal-for-transforming-home-and-community-based-services/">more than 40 co-sponsors in the Senate</a>.While the ultimate path toward much needed reform remains uncertain, the national conversation on long-term care isn’t over.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><table border="0" cellpadding="10" cellspacing="0" style="width: 100%;"><tbody><tr><td style="background-color: rgb(153, 227, 255);"> <h4>Timeline</h4> <ul><li><strong>March 11, 2021:</strong> The American Rescue Plan is passed.</li> <li><strong>March 31, 2021: </strong>The American Jobs Plan (“Jobs Plan”) proposal is released by the Biden administration. <ul><li>April 5, 2021: The Senate Parliamentarian decides that the Budget Act could be used to create multiple reconciliation bills within one fiscal year.</li> <li>Would allow Senate Democrats multiple attempts to pass legislation through the Senate on a majority vote.</li> </ul></li> <li><strong>April 7, 2021:</strong> Made in America Tax Plan is released. <ul><li>Sets forth tax proposals to pay for infrastructure investments, and proposes a raise to the corporate tax rate and global minimum tax (measures that would largely reverse the 2017 Trump administration’s tax plan).</li> </ul></li> <li><strong>April 22, 2021: </strong>Senate Republicans issue a counterproposal. <ul><li>Total: $568 billion.</li> <li>Cuts initiatives toward care for older adults and disabled people, and funding for affordable housing, among other things. Focuses on physical infrastructure.</li> <li>Changes the funding mechanism to joint spending from state and local governments and encourages private-sector investments and financing.</li> <li>Does not propose any corporate or international tax increases and leaves the 2017 tax cuts passed under President Trump.</li> </ul></li> <li><strong>April 28, 2021: </strong>The American Families Plan (“Families Plan”) is announced.  <ul><li>May 21, 2021: Biden issues a counteroffer in response to Senate Republican counterproposal. Cuts his original proposal down to $1.7 trillion.</li> <li>May 27, 2021: Senate Republicans issue a second counteroffer. Total: $928 billion. <ul><li>Includes $604 billion for physical infrastructure.</li> <li>An agreement was not reached.</li> </ul></li> </ul></li> <li><strong>May 28, 2021:</strong> The Senate Parliamentarian makes another decision that a revised budget reconciliation must pass through “regular order,” meaning it must go through committee and have floor amendment votes during a “vote-a-rama.” <ul><li>This thwarts Senate Democrats, who were hoping to use reconciliation to achieve infrastructure goals.</li> <li>Reconciliation can still be used, but the process is onerous because they would need at least one Republican on the Senate Budget Committee to vote with them; a “vote-a-rama” might be a moment where the Democratic Party divides; and the Senate Democrats have only one more reconciliation vehicle to pass Biden’s key legislative priorities this year.</li> </ul></li> <li><strong>June 4, 2021: </strong>Biden rejects the third counteroffer from Senate Republicans that would add $50 billion to the $928 billion in the second counterproposal. <ul><li>Rejected because the Republican counterproposal did not grow the economy, tackle the climate crisis or create new jobs.</li> <li>At $978 billion, Senate Republicans did not include human infrastructure, and did not include a plan on how to pay for an infrastructure bill.</li> </ul></li> <li><strong>June 8, 2021: </strong>Biden ends his infrastructure negotiations with Senate Republicans, and begins new negotiations with a bipartisan group of senators (G10). <ul><li>The G10 drafts an $880 billion infrastructure bill, which was circulated to a broader group of more than 20 centrist Senators for support.</li> </ul></li> <li><strong>June 10, 2021:</strong> Bipartisan group of Senators reached a compromise on infrastructure. <ul><li>This would allot $1.2 trillion over eight years.</li> <li>The deal does not increase taxes, though it includes an option to index the gas tax to inflation. <ul><li>This might be a tough sale for the broader Senate Democratic Caucus.</li> </ul></li> </ul></li> <li><strong>June 24, 2021:</strong> A bipartisan agreement (G21) on a pared-down infrastructure plan is reached. <ul><li>Total: $1.2 trillion over eight years.</li> <li>Does not include any funding for human infrastructure, i.e., improving the working conditions and wages of workers involved in the care economy and more.</li> <li>The question remains: how to pay for this?</li> <li>This is not the final iteration. A congressional budget process called reconciliation might allow other White House priorities to be tacked on later.</li> </ul></li> <li><strong>June 24, 2021: </strong>The “Better Care Better Jobs Act” is announced.</li> </ul></td> </tr></tbody></table><h4> </h4> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><hr /><p><em><a href="https://history.princeton.edu/people/pallavi-podapati">Pallavi Podapati</a> is ASA’s Program Development intern and a pursuing her doctorate in history at Princeton University. Her research covers labor, disability and social policy.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/18" hreflang="en">Capitol</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p>By Pallavi Podapati</p> </div> </div> Fri, 02 Jul 2021 16:54:24 +0000 asa_admin 446 at http://generations.asaging.org The FDA Was Wrong: Aducanumab Shows No Clinical Benefit http://generations.asaging.org/fda-was-wrong-aduhelm-shows-no-clinical-benefit <span class="field field--name-title field--type-string field--label-hidden">The FDA Was Wrong: Aducanumab Shows No Clinical Benefit </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Tue, 06/29/2021 - 19:37</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/health-well-being" hreflang="en">Health &amp; Well-being</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-now" hreflang="en">Generations Now</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">‘Aducanumab’s rejection should have been without controversy.’</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p><strong>Editor’s note: </strong>With all the recent news on the FDA’s approval of Aduhelm (aducanumab), the new drug used to treat Alzheimer’s, ASA wanted to give our readers informed opinions on the topic from experts in the aging sector. Below is a piece arguing against the FDA approval of Aduhelm. <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="c797fb86-6772-4588-b15b-2bbf32893727" href="/unmet-need-and-science-warrant-approval-aduhelm">Click here to read the piece arguing in favor of the FDA approval</a>.</p> <p>The opinions expressed in this article are those of its author. They do not necessarily reflect the opinions or views of ASA management or its members.</p> <hr /><p> </p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">Evidence is absent that aducanumab, the new BioGen medication to treat Alzheimer’s disease (AD), has clinical benefit. Two truncated studies and one ascending dose trial did not demonstrate clinical benefit for people with prodromal AD (MCI due to AD) or mild AD dementia. Even if one chose to value a claimed, “pre-specified,” post-hoc, unadjusted P = 0.012 for the primary outcome in one of the trials, while ignoring the wholly negative and discordant outcomes of companion trial, the “best case” effect of 0.39 drug-placebo mean difference on the CDR-sb (Clinical Dementia Rating scale) is trivial. It’s a difference so small that it can’t be clinically recognized.</p> <p>Moreover, the –1.4-point mean difference on the ADAS-cog14 (Alzheimer’s Disease Assessment Scale) represents a small fraction of the effect of marketed cholinesterase inhibitors like donepezil. As comparisons, the established mean clinically important difference (MCID) for the CDR-sb is 1.0 point and for the ADAS-cog11 is about 3.0 points.</p> <p>Aducanumab’s rejection should have been without controversy. Both the FDA’s independent statistical reviewer and the PCNS (Peripheral and Central Nervous System) advisory committee could not infer evidence for clinical benefit for it, the latter unanimously voting 10 to 0, with 1 uncertain vote, against approval.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘The FDA nonetheless approved aducanumab using an alternative accelerated approval pathway.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Indeed, the FDA eventually agreed with this assessment, recently issuing explanatory memos (<a href="https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/aducanumab-marketed-aduhelm-information">June 22, 2021</a>) that aducanumab didn’t show efficacy or clinical benefit that would support regular marketing approval. That is, the FDA would not provide approval based on the FDA’s typical substantial evidence standard for effectiveness. In an ironic piece of regulatory jujitsu, however, the FDA nonetheless approved aducanumab using an alternative accelerated approval pathway.</p> <p>In a nutshell, accelerated approval is full approval (not provisional approval as is often thought) but based on a surrogate biomarker that is considered “reasonably likely” to predict clinical benefit. The latter phrase is FDA-speak meaning the surrogate marker is unvalidated, without sufficient clinical data behind it, but simultaneously expressing hope that in the future the surrogate biomarker may be validated or shown to correlate with clinical outcome. In brief, accelerated approval is marketing approval based on an unvalidated biomarker.</p> <h4>Redefining Alzheimer’s, and Its Treatment</h4> <p>The prescribing label for aducanumab states it is indicated for treating Alzheimer’s disease based on reduction in amyloid beta plaques observed in patients treated with it. Period. This subtlety may be lost or, more likely, ignored by most consumers, physicians, and stakeholders who will have been influenced by others to talk about clinical efficacy. <a href="https://www.fiercepharma.com/marketing/alzheimer-s-association-campaign-more-time-supports-biogen-s-aducanumab-awaiting-fda">Publicity campaigns</a> by the Alzheimer’s Association saying that aducanumab alters clinical decline or preserves function, or <a href="https://alzheimersnewstoday.com/2021/06/03/alzheimers-association-aducanumab-biogen-means-more-time-merits-approval/">gains time at home</a>, are without foundation.</p> <p>Like many senescence-related conditions, Alzheimer’s and other dementias are complex conditions with multiple determinants. A single intervention, even if tied to pathogenetic pathways, is unlikely to show distinct benefit. Thus far the disease has defied effective treatment except for cholinesterase inhibitors' small effect on cognition. One approach when faced with a daunting, intractable challenge is to redefine the problem and reconceptualize the solution.</p> <p>The idea of defining Alzheimer’s disease based strictly on biomarkers has taken hold in some quarters. In this formulation, Alzheimer’s is seen as a proteinopathic diathesis manifesting simply as amyloid plaques, misfolded abnormal tau protein and neuronal loss, i.e., essentially what pathologists see on microscopic examination.</p> <p>This definition then reduces to simple equations. Alzheimer’s pathology equals amyloid plaques; Alzheimer’s disease equals plaques and tau tangles. As both are detected by PET scan and inferred from CSF analysis, this “new” Alzheimer disease can be reliably defined by biology alone. Just as rationally, it follows that, as plaques are the defining element of Alzheimer’s, the absence or removal of plaques must mean “not-Alzheimer’s” in the former and effective treatment in the latter. But this doesn’t necessarily mean a benefit for cognition; and, indeed, there is no meaningful correlation between change in plaques and clinical ratings.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘One approach when faced with a daunting, intractable challenge is to redefine the problem and reconceptualize the solution.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>The FDA, biotech, and Alzheimer’s advocacy fields are now in a conundrum the public may not yet quite appreciate. Having changed the definition of Alzheimer’s and the criteria for substantial effectiveness of treatment to plaque removal they have no basis for reversing this approval or requiring confirming studies that would clearly demonstrate clinical benefit. Plaque reduction is the benefit.</p> <p>There is no doubt that aducanumab markedly reduces plaque to normal in nearly half of patients treated with it. Actual clinical benefit, although much desired, appears optional. Requiring Biogen to prove clinical benefit, if possible, would not be a good look for scientific reductionism explained above.</p> <p>This FDA, Biogen, Alzheimer’s Association collaborative approval of aducanumab is fundamentally flawed. By removing clinical effectiveness standards, the FDA has pari passu lowered safety standards. In the absence of clinical benefit, no treatment is safe. We may believe that most brain edema and hemorrhage, very common <a href="https://www.dementiacarecentral.com/aboutdementia/treating/aducanumab">potential side effects of aducanumab</a>, are asymptomatic and can be managed, but some of it is quite severe. We will learn much more about safety over the next year of marketing and prescribing.</p> <p>Advertising from Biogen and the Alzheimer’s Association, as well as the litany of paid promotional events from physicians will gin up the perceived need for aducanumab, and exacerbate older people’s, with or without cognitive impairment, fear of missing out. Physicians and other clinicians have an intrinsic wish to help and will be inherently incented to prescribe. This will drive demand, consume energy, and allow many to feel they are fighting the good fight. We have much work to do to understand any potential for aducanumab.</p> <hr /><p><em>Lon S. Schneider, MD, holds the Della Martin Chair of Psychiatry and Neuroscience, professor of psychiatry, neurology, and gerontology at the Keck School of Medicine of USC and the USC Leonard Davis School of Gerontology in Los Angeles. Schneider also directs the USC State of California Alzheimer’s Disease Center and the clinical core of USC National Institute on Aging Alzheimer’s Disease Research Center clinical core. He served as a senior scientific advisor at the NIMH, on the American Psychiatric Association Committee for Practice Guidelines in Alzheimer’s and Other Dementia, the World Federation of Societies of Biological Psychiatry Task Force on Dementia.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/373" hreflang="en">FDA</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p><strong>Point/Counterpoint</strong><br /> By Lon S. Schneider</p> </div> </div> Tue, 29 Jun 2021 17:37:33 +0000 asa_admin 445 at http://generations.asaging.org Unmet Need and Science Warrant Approval of Aducanumab http://generations.asaging.org/unmet-need-and-science-warrant-approval-aduhelm <span class="field field--name-title field--type-string field--label-hidden">Unmet Need and Science Warrant Approval of Aducanumab </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Tue, 06/29/2021 - 19:04</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/health-well-being" hreflang="en">Health &amp; Well-being</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-now" hreflang="en">Generations Now</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">‘While not a cure, this new drug is the first FDA-approved treatment to reduce one of the defining brain changes of Alzheimer’s disease.’</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p><strong>Editor’s note:</strong> With all the recent news on the FDA’s approval of Aduhelm (aducanumab), the new drug used to treat Alzheimer’s, ASA wanted to give our readers informed opinions on the topic from experts in the aging sector. Below is a piece arguing in favor of the FDA approval of Aduhelm. <a data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="45827329-79f4-4542-b8ef-3a0134e61ff9" href="/fda-was-wrong-aduhelm-shows-no-clinical-benefit">Click here to read the piece arguing against the FDA approval</a>.</p> <p>The opinions expressed in this article are those of its author. They do not necessarily reflect the opinions or views of ASA management or its members.</p> <hr /><p> </p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">Let me start with the most essential point first. The Alzheimer’s Association fully supports the Food and Drug Administration’s (FDA) recent accelerated approval of Aduhelm (aducanumab).</p> <p>As the world’s largest nonprofit funder of Alzheimer’s disease research and a relentless advocate for more than 6 million Americans living with the disease and their caregivers—we believe the science, combined with the unmet need, warranted accelerated approval. And because the approved therapy—the first for Alzheimer’s disease in nearly two decades—may help some people living with early-stage Alzheimer’s and mild cognitive impairment.</p> <p>I offer this critical takeaway upfront to ASA members and stakeholders because I don’t want it lost amid headlines surrounding the drug’s approval.</p> <h4>We Support the Drug for What it Is and What it Can Be</h4> <p>The Alzheimer’s Association supports the FDA’s accelerated approval of Aduhelm for what it is—the first treatment for Alzheimer’s disease since 2003 and the first to address the underlying biology of Alzheimer’s, in people with Mild Cognitive Impairment (due to Alzheimer’s) and early-Alzheimer’s dementia. And for what it can be—a pivotal milestone which begins a new era in Alzheimer’s treatment and research where the same progress we have witnessed in combating many other major diseases may finally develop for the millions now facing Alzheimer’s, a terminal disease.</p> <p>While not a cure, this new drug is the first FDA-approved treatment to reduce one of the defining brain changes of Alzheimer’s disease—the clumping of amyloid plaques in the brain—that disrupts brain function. According to the FDA, this reduction in amyloid plaques is reasonably likely to lead to a reduction in the clinical decline due to Alzheimer’s disease.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘This could mean more time for individuals to actively participate in daily life.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>This could mean more time for individuals to actively participate in daily life, have sustained independence and hold on to memories longer. For individuals living with Alzheimer’s and their families these simple daily activities—that many of us take for granted—mean everything.</p> <p>We recognize the drug may work differently for everyone, and may not work for some individuals. The Alzheimer’s Association has been consistent in its position that Aduhelm be made available specifically to the population represented in the clinical trials—people with mild cognitive impairment (MCI) due to Alzheimer’s disease and early Alzheimer’s dementia. Experts from the Alzheimer’s and scientific community expressed widespread agreement on this important point during a recent scientific meeting convened by the Alzheimer’s Association to discuss steps forward in wake of the FDA’s approval, attracting more than 2,700 registrants from 90 countries.</p> <p>For millions more living with Alzheimer’s who fall outside this category, Alzheimer’s and dementia researchers must leverage this important milestone, using it as a springboard to accelerate new advancements. With more than 100 therapies in the current Alzheimer’s pipeline—exploring multiple pathways for combating the disease—the opportunity for new and potentially better treatments has never been more promising. This is critical because there is consensus in the Alzheimer’s research community that slowing and stopping the disease may not come from a single therapy, but rather by combining proven treatments into powerful combination therapies that have worked well in combating other disease conditions.</p> <h4>Without a First Approval, There Can't Be a Second or Third</h4> <p>History has shown that approvals of the first drug in a new category will invigorate research, increase investments in new treatments and generate greater innovation. We have seen it happen for heart disease, cancer and HIV, where the first treatment for these disease conditions spurred additional treatments and new advancements that have benefited patients. We must do the same for Alzheimer’s.</p> <p>However, the promise and potential of this new treatment—or any future treatment—will never be fully realized unless it is affordable and accessible for all who could benefit. At a cost of $56,000 per year, the current price is unacceptable. This price poses an insurmountable barrier to access for too many families impacted by Alzheimer’s. It complicates and jeopardizes sustainable access to this treatment, and may further deepen issues of health equity. The Alzheimer’s Association has called on drugmaker Biogen to change its price.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Approvals of the first drug in a new category often invigorate research, increase investments in new treatments and generate greater innovation.</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Families impacted by Alzheimer’s already face significant challenges, accessing treatments that could help them should not be another. Eliminating barriers to access is the Alzheimer’s Association highest priority and we will do everything in our power to ensure access to the drug, any tests needed during the treatment process and other associated costs for all who will benefit. We’re committed to working with the Centers for Medicare &amp; Medicaid Services (CMS)—and with the private payer community—to remove barriers to coverage for those who would benefit from this treatment.</p> <p>The Alzheimer’s Association and many others in the scientific community see the approval of Aduhelm as an important step forward. Without the first approved treatment, there cannot be the second or third or fourth, each improving on earlier treatments. There is much more work to do in our fight to end Alzheimer’s and all other dementias and the Alzheimer’s Association remains steadfast in our work.</p> <hr /><p><em>Kristen Clifford, MBA, is the chief program officer at the Chicago-based Alzheimer’s Association and lives in Austin, Texas.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/371" hreflang="en">Infusion</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p><strong>Point/Counterpoint</strong><br /> By Kristen Clifford</p> </div> </div> Tue, 29 Jun 2021 17:04:04 +0000 asa_admin 444 at http://generations.asaging.org New Toolkit Offers Ways to Better Connect with Diverse Family Caregivers http://generations.asaging.org/toolkit-helps-connect-diverse-family-caregivers <span class="field field--name-title field--type-string field--label-hidden">New Toolkit Offers Ways to Better Connect with Diverse Family Caregivers</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Thu, 06/24/2021 - 16:00</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/justice-equity" hreflang="en">Justice &amp; Equity</a></div> <div class="field__item"><a href="/health-well-being" hreflang="en">Health &amp; Well-being</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-now" hreflang="en">Generations Now</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">&#039;The toolkit is informed by the voices and perspectives of diverse elders themselves, as well as their caregivers.’</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">Equitable access to care, services and supports for older adults and their caregivers <em>has always been</em> one of the main pillars of The Diverse Elders Coalition (DEC), founded in 2010, which comprises six member organizations representing African American/Black, American Indian and Alaska Native, Asian American and Pacific Islander, Southeast Asian American, Hispanic/Latinx and LGBT+ communities. The DEC’s partnership with the American Society on Aging (ASA) reflects a shared commitment across the Coalition, the ASA membership and the broader ASA community to champion all elders as they age.  </p> <p>The COVID-19 pandemic has provided a powerful reminder that some elders are particularly vulnerable, marginalized and in danger of being left behind—BIPOC and LGBT+ elders were at the epicenter of the pandemic, and continue to suffer disproportionately. The fact is that older adults and caregivers from diverse communities have always been particularly vulnerable; but during the pandemic, these vulnerabilities among diverse communities have become more pronounced and much more visible.</p> <p>For example, the lack of translated COVID-19 information made available to limited English proficient older adults and caregivers led to confusion and misinformation in many diverse communities. Years of discrimination, neglect and disregard deterred many diverse older adults and caregivers from getting medical assistance during a time when they needed it the most. At the end of the day, numerous equity disparities left unaddressed over many years led to severely disproportionate rates of COVID-19 infections, hospitalizations and deaths among diverse communities, with black and brown people dying at rates two to three times those of the population in general.</p> <p>As we emerge from the pandemic, all of us who focus on improving the quality of life for older adults must heighten our commitment to eliminating these disparities and addressing the acute, particular needs of diverse elders. Fortunately, we now have an exciting resource that was specifically created to help address the challenges of diverse communities as they age.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>As we emerge from the pandemic, we must heighten our commitment to eliminating disparities and addressing the acute, particular needs of diverse elders.</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>The Diverse Elder Coalition’s new toolkit—<a href="https://asaging.org/diverse-family-caregivers-toolkit">Caring for Those Who Care, Resources for Providers: Meeting the Needs of Diverse Family Caregivers</a>—was put together to help professional and voluntary caregivers, providers and a wide array of professionals better understand the unique realities and challenges diverse caregivers face and best practices they can employ to better care for diverse family caregivers, and ultimately, the older adults they care for. This toolkit, made even more relevant by what we learned during the pandemic, represents the culmination of DEC-sponsored original research, the expertise of the Coalition’s six member organizations and feedback from physicians, researchers, social service providers and aging-focused organizations across the United States. Concentrating on the multiple communities of identity and culture represented by the DEC, the toolkit offers community-specific fact sheets, caregiving and COVID-19 specific resources for healthcare providers, social services providers and aging-focused organizations.</p> <p>The six fact sheets in the toolkit focus on African American/Black, American Indian and Alaska Native, Asian American and Pacific Islander, Southeast Asian American, Hispanic/Latinx and LGBT+ caregivers. The fact sheets were developed by synthesizing data from the DEC’s original research, which included in-language focus groups and a national caregiving survey with more than 1,000 respondents from full swath of DEC communities. </p> <p>Additionally, the expertise of the DEC’s six member organizations, physicians, researchers, social service providers and aging-focused organizations across the country contributed to developing these fact sheets. It is our hope that the fact sheets provide much greater knowledge and understanding of diverse caregivers so that healthcare providers, social service providers and aging-focused organizations are better equipped to address their unique challenges. Along with fact sheets, the toolkit also offers national caregiving and COVID-19–specific resources for diverse caregivers.</p> <p>We encourage providers to share and disseminate the caregiving resources outlined in the toolkit among diverse constituents in the communities they serve. Similarly, social services providers and aging-focused organizations should share these resources with constituents as they were tailored to resolve health, financial, cultural and linguistic barriers that may burden diverse caregivers. The toolkit is interdisciplinary as it was developed with key input from professionals across a multitude of sectors relevant to the aging experiences of diverse older adults.</p> <p>Most importantly, the toolkit is informed by the voices and perspectives of diverse elders themselves, as well as their caregivers, with their insights and wisdom woven throughout.</p> <p>Now more than ever we need to make decisive changes to better respond to the realities and needs of diverse older adults and caregivers. The Diverse Elders Coalition’s <a href="https://asaging.org/diverse-family-caregivers-toolkit">new toolkit</a>, which can be found in our <a href="https://www.diverseelders.org/caregiving/">Caregiving Resources Hub</a>, is a vital resource to support those changes. Please take full advantage of these important new materials and be part of the change in your community!</p> <hr /><p><em>Michael Adams is the CEO of SAGE in New York City and chairs ASA's Board of Directors. Ocean Le is senior program coordinator of the DEC, also in New York City.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/167" hreflang="en">Caregiver</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif">By Michael Adams and Ocean Le</span></span></p> </div> </div> Thu, 24 Jun 2021 14:00:00 +0000 asa_admin 433 at http://generations.asaging.org Many Voices, One Cause http://generations.asaging.org/many-voices-one-cause <span class="field field--name-title field--type-string field--label-hidden">Many Voices, One Cause</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Tue, 06/22/2021 - 00:38</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/health-well-being" hreflang="en">Health &amp; Well-being</a></div> <div class="field__item"><a href="/innovation-social-impact" hreflang="en">Innovation &amp; Social Impact</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-now" hreflang="en">Generations Now</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">‘Sahar believes the company’s philosophy will stand out because of its holistic approach to all types of care needs.’<br /> <br /> </div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">As a relatively young industry, in-home care is experiencing incredible momentum. Not only were our services in high demand during the pandemic, but the care we provide is very much in the spotlight as part of the current administration’s 21st Century Caregiving and Education Workforce plan.</p> <p>But what I find fascinating and rewarding is to meet the people who are drawn to the in-home care industry. They come from all walks of life to begin a new business venture that is predicated on providing compassionate care to those who need it. We refer to them as “empathetic entrepreneurs.”</p> <p>Throughout the first half of 2021, SYNERGY HomeCare has continued to become more diverse with every partner who joins our franchise system. From financial planning to corporate wellness to healthcare accounting to car sales, our 2021 cohort is bringing a wealth of varied experience and new ways of thinking about how to move our industry forward.</p> <p>These new perspectives in our franchise partners will be critical as we foster innovations in how we operate and go to market. We may have many voices, but we are joined in a common cause and that makes me very excited about what lies ahead for the growing older adult population.</p> <p>Below are a few examples of empathetic entrepreneurs who represent a breadth of diverse careers, yet all share a desire to serve people who want to age in place.</p> <h5>Jeb and Martha Butler</h5> <h5>SYNERGY HomeCare of North County</h5> <h5>San Marcos, Calif.</h5> <p>Jeb had a long career in orthopedic surgical supply sales and recognized that in-home care was a growth industry that might benefit from his sales background. Martha had cared for her late dad, and her mom now lives in an assisted living facility, so they have seen firsthand the value a company like SYNERGY HomeCare can bring to clients and families.</p> <h5>Tom Nelson</h5> <h5>SYNERGY HomeCare in Campbell–Los Gatos</h5> <h5>Greater San Jose, Calif. </h5> <p>After a rewarding career spanning national corporate wellness, adaptive physical education for people with disabilities and referral-based medical fitness centers, Tom saw an incredible opportunity to apply his experience in a field with increasing demand. San Jose has a wide-open market with room for expansion that will afford Tom the privilege of serving a growing population of older adults with the personalized care they need to maintain their quality of life.</p> <h5>Dan and Kathy Root</h5> <h5>SYNERGY HomeCare of Rutherford County</h5> <h5>Murfreesboro, Tenn.</h5> <p>Dan Root spent the bulk of his career in organizational transformation, strategy and performance improvement, while Kathy has a background as a registered nurse and healthcare accounting consultant. As they searched for their next professional opportunity, they realized they could combine their skills to create a company focused on optimizing the employee experience to fuel client satisfaction. Their personal experience, combined with business backgrounds and a sincere belief that they can make a difference by running their company differently, played a big part in their decision to open a SYNERGY HomeCare company. </p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘Tom saw an incredible opportunity to apply his experience in a field with increasing demand.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><h5>Michael Mantong</h5> <h5>SYNERGY HomeCare of Huntington Beach</h5> <h5>Huntington Beach, Calif.</h5> <p>Michael Mantong, a certified financial planner with more than 25 years’ experience working with clients on personalized insurance and investment solutions, is making use of his deep knowledge of long-term care in a new business venture. Over the course of his career, he also noticed the industry becoming more transactional in nature rather than relationship-based. He was drawn to eldercare because he would be able to return to a more personalized, hands-on client relationship in a field he knew well.</p> <h5>Sahar and Fahad Mahmood</h5> <h5>SYNERGY HomeCare Round Rock</h5> <h5>Austin, Texas</h5> <p>Sahar and Fahad Mahmood are entrepreneurial siblings who are using their recently earned college degrees in healthcare information management and healthcare administration, respectively, as they launch their in-home care company. Together, they are focused on building a team of compassionate caregivers who can grow personally and professionally at SYNERGY HomeCare Round Rock. Sahar believes the company’s philosophy will stand out because of their holistic approach to all types of care needs.</p> <h5>Monica and David Conroy</h5> <h5>SYNERGY HomeCare of Lake Ridge</h5> <h5>Alexandria, Va.</h5> <p>Prior to opening their SYNERGY HomeCare franchise, Monica worked in public affairs, community affairs and public relations, while David served as the general manager of the University Club of Washington, DC, for 14 years. Monica well understands the need for respite care in the United States, as her mother has Parkinson’s and her niece is autistic. David’s long history in charitable endeavors aligns with a strong desire to provide the community with quality services by fostering a strong team of caregivers who treat one another and their clients like family.</p> <h5>Kurt and Christine Bowman</h5> <h5>SYNERGY HomeCare of North Leon County</h5> <h5>Tallahassee, Fla.</h5> <p>Kurt’s experience lies in managing teams of large enterprises; he most recently served as the general manager of a Toyota dealership. As an occupational therapist, Christine specialized in caring for older adults in nursing homes and for children, many of whom had autism. The couple’s professional experience is complemented by their involvement in making a care plan for Kurt’s 90-year-old mother that allowed her to remain as independent as possible. They engage with their clients as if they were family, because they understand and empathize with what they are going through.</p> <p>These are just a sampling of the empathetic entrepreneurs who are making a conscious decision to devote their talents and expertise to an endeavor that transcends the terms job or business venture. These entrepreneurs have committed to serving a growing population of older Americans who deserve to be valued, treated with respect and afforded dignity.</p> <p>It’s immaterial how we come to be working in support of aging or what path has led us here—what matters most is that our voices unite in a common cause that is effecting change via our words and deeds.  </p> <hr /><p><em>Charlie Young is the CEO of SYNERGY HomeCare, which is headquartered in Gilbert, Ariz.</em></p> <p><em>Photo: Sahar, left, and Fahad Mahmood are siblings who run a SYNERGY HomeCare company.</em></p> <p><em>Photo courtesy the Mahmoods.</em></p> <p> </p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/370" hreflang="en">Sahar and Fahad Mahmood </a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p><strong>From Our Sponsors</strong><br /> By Charlie Young</p> </div> </div> Mon, 21 Jun 2021 22:38:12 +0000 asa_admin 432 at http://generations.asaging.org Passing Social Security Forward: A Legacy for All Generations http://generations.asaging.org/social-security-legacy-all-generations <span class="field field--name-title field--type-string field--label-hidden">Passing Social Security Forward: A Legacy for All Generations</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Thu, 06/17/2021 - 23:30</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/economic-security" hreflang="en">Economic Security</a></div> <div class="field__item"><a href="/ageism-culture" hreflang="en">Ageism &amp; Culture</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-today" hreflang="en">Generations Today</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">It is time to expand Social Security and we can afford it.</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p><em>This article is adapted from the authors’ co-authored book, “<a href="https://thenewpress.com/books/social-security-works-for-everyone">Social Security Works for Everyone! Protecting and Expanding the Insurance Americans Love and Count On</a>” (New York: The New Press, 2021). </em></p> <p class="dropcaps">Aug. 14, 2021 is Social Security‘s 86th birthday. It was signed into law on that day in 1935. The best birthday present we can give this essential institution (and ourselves) is to expand it. In our latest book, "<a href="https://thenewpress.com/books/social-security-works-for-everyone">Social Security Works for Everyone!</a>," we explain why it is time to do so. We set forth a road map and plan that explain how to build upon the foundation set down 86 years ago and expand our Social Security system to benefit all generations, now and into the future.</p> <p>It is time to expand Social Security, to increase economic security, as we recover from today’s pandemic. The richest nation in the world can afford a large and fully-funded expansion. Whether to expand Social Security, cut it or radically change it is a matter of values, not affordability.</p> <h2>Expanding Social Security Is a Solution</h2> <p>The incomes of many among the 65 million who each month receive retirement, disability and survivors benefits are inadequate, or at risk of being so. Tens of millions of working Americans—variously estimated as between <a href="https://www.ebri.org/docs/default-source/fast-facts/ff-329-retplans-6jun19.pdf?sfvrsn=82ae3f2f_4">two-fifths</a> and <a href="http://crr.bc.edu/briefs/long-term-care-costs-and-the-national-retirement-risk-index/">two-thirds</a> of today’s workers—know they will never be able to retire with sufficient income. Substantially expanding Social Security’s modest but vital benefits will address these crises.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘As divided as America seems at this moment in history, Social Security unites us.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>And expanding Social Security is a solution to so much more. It will alleviate pressures—financial, time, and stress-related—experienced by those caring for children or disabled and ill family members of all ages. It will offset some of the perilous and rising income and wealth inequalities. And it is a timely reminder that government policies, when guided by the American people’s best instincts, can strengthen our national community.</p> <h2>Social Security Unites Us</h2> <p>At its core, Social Security invites us to reflect deeply upon the kind of society we, as a people and a nation, want. Social Security gives expression to some of our most fundamental moral values and, if we are spiritual, to our religious values, irrespective of which religious tradition that may be. The program balances individualism with an understanding that individuals thrive in the context of families and communities; that we are all joined as part of the human race and have obligations to each other. And with an understanding of how one generation fares in retirement directly depends upon how the next generation is doing during their working years, and the next at the start of life.</p> <p>As divided as America seems at this moment in history, Social Security unites us. Politicians and the media decry how polarized our nation’s politics are. Electoral maps, depicting red states and blue states, provide a pictorial representation of that polarization. Hot-button topics like abortion and immigration reform are often used by politicians to divide the electorate.</p> <p>But Americans are overwhelmingly united in our support for Social Security. Poll after poll reveals this. The findings of an <a href="https://www.nasi.org/sites/default/files/research/What_Do_Americans_Want.pdf">online survey</a> of two thousand adults ages 21 and older conducted by Matthew Greenwald and Associates (in collaboration with the nonpartisan National Academy of Social Insurance) found that a large majority of Americans believe Social Security is more important than ever, do not mind contributing to Social Security because it provides security and stability, and believe that consideration should be given to expanding its benefits.</p> <p>This view of the overwhelming majority of the American people should not come as a surprise. The America we know today would not be possible without Social Security. Moreover, Social Security embodies the best of America’s ideals.</p> <h2>The Changing Politics of Social Security</h2> <p>Despite the overwhelming support for Social Security among the American people, the discussion among political elites about the future of Social Security has been dominated, from the 1990s until recently, by twin questions: How much should we cut Social Security’s modest benefits, and how do we do it through closed-door negotiations so as not to be voted out of office?</p> <p>Democratic and Republican politicians alike spoke of their strong, unflinching support for the program (perhaps they “doth protested too much?”) and their desire to “save” it through “bipartisan action.” At times, it was difficult for the casual observer to discern much difference between the two parties when it came to Social Security.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘This is not a time for compromising the economic well-being of the middle class and the poor.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>During the Obama administration, our elected officials came closer than most people realize to cutting and, worse, beginning the dismantling of our Social Security system. When the president of the United States and the leadership of the opposition party all supported cutting Social Security in the name of deficit reduction (even though Social Security doesn’t add a penny to the deficit), when hundreds of millions of dollars were directed at making the case for cutting Social Security, when so many in the mainstream media seemed so supportive of such cuts, it is remarkable that they were stymied by the coordinated efforts of public interest organizations and the American people.</p> <p>Perhaps even more remarkable, thanks to these same forces, President Biden and the Democratic Party he heads, now support expanding, not cutting, Social Security.</p> <h2>Expanding Social Security</h2> <p>This is not a time for compromising the economic well-being of the middle class and the poor, not when <a href="https://www.washingtonpost.com/business/2019/09/26/income-inequality-america-highest-its-been-since-census-started-tracking-it-data-show/">income inequality</a> and <a href="https://www.cbpp.org/research/topics/inequality-trends?page=1">wealth inequality</a> are higher than they have ever been in the past 50 years. Not when the worldwide pandemic has exacerbated income and wealth inequality.</p> <p>This is not a time to accept cuts to our Social Security as “reasonable compromise,” as little “tweaks” that will do no lasting harm. Rather, this is the time for our elected leaders to expand Social Security, as the overwhelming majority of Americans want.</p> <p>Although couched largely in terms of economics, the debate over the future of Social Security is most fundamentally a debate about the role of government and the societal values the nation seeks to achieve through Social Security, including the right of citizens to economic and health security.</p> <p>Expanding the current program is vitally important. Moreover, the nation can, should and we believe will draw on the broader vision of Social Security, in time achieving the long-sought goal of universal, guaranteed quality healthcare, debt-free four-year college and advanced trade education, paid sick leave and family leave, as well as an adequate basic income as fundamental human rights, befitting a compassionate and rich nation.</p> <p>The Social Security we have today didn’t just happen. Past generations fought for it, protected it, safeguarded it, expanded it, and passed it forward, stronger than before, as a legacy to all of us, young, old and middle-age alike. Now it is our turn.</p> <hr /><p><em>Nancy J. Altman, JD, is president and cofounder of Social Security Works, a nonprofit organization working to protect and expand Social Security in Bethesda, Md. Eric R. Kingson, PhD, MPA, is a professor of Social Work at Syracuse University in New York, and cofounder of Social Security Works.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/374" hreflang="en">Social Security Plant</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p><strong>OpEd</strong><br /> By Nancy J. Altman and Eric R. Kingson</p> </div> </div> <div class="field field--name-field-issue field--type-entity-reference field--label-above"> <div class="field__label">Issue</div> <div class="field__item"><a href="/jul-aug-2021" hreflang="en">July-Aug 2021</a></div> </div> Thu, 17 Jun 2021 21:30:42 +0000 asa_admin 431 at http://generations.asaging.org What it Takes to Be and Remain an Age-Friendly World http://generations.asaging.org/how-be-and-remain-age-friendly-world <span class="field field--name-title field--type-string field--label-hidden">What it Takes to Be and Remain an Age-Friendly World </span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Thu, 06/17/2021 - 01:41</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/ageism-culture" hreflang="en">Ageism &amp; Culture</a></div> <div class="field__item"><a href="/health-well-being" hreflang="en">Health &amp; Well-being</a></div> <div class="field__item"><a href="/justice-equity" hreflang="en">Justice &amp; Equity</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-today" hreflang="en">Generations Today</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">As experience experts, older residents identify opportunities and challenges to aging in place and develop solutions for change.</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">In preparation for the doubling in number of people ages 65 and older across the globe, in 2006 the World Health Organization (WHO) created the Global Network of Age-Friendly Cities and Communities to ensure older residents are respected, can actively engage in their communities and be healthy.</p> <p>As the U.S. affiliate to this network, AARP began encouraging communities across the country to make their neighborhoods more accessible and inclusive. Today, there are more than 500 communities in the AARP Network of Age-Friendly States and Communities in the United States, and close to 1,000 communities worldwide working on age-friendly domains, including respect and inclusion, health, communication, housing, employment, outdoor spaces and public buildings and transportation.</p> <p>Members of the age-friendly network subscribe to five interrelated tenets including commitment, capacity, collaboration, resident involvement and comprehensiveness. Community leaders commit to a five-year process, beginning with a comprehensive community assessment, followed by developing a community-wide plan, and three years of plan implementation.</p> <p><em>Capacity </em>building occurs through acquiring resources, engaging stakeholders and collaboration between government organizations, the local aging network, private sector, community organizations, University partners and older residents.</p> <p><em>Resident involvement </em>is critical to the success of age-friendly communities. As experience experts, older residents identify opportunities and challenges related to aging in place and develop solutions for change. Finally, age-friendly work is <em>comprehensive and specific</em>, encompassing individual, social and environmental issues. A sustainable age-friendly community initiative will be actively engaged in these interlocking tenets.</p> <h2>Details, Details</h2> <p>Age-friendly community work has been happening for well over a decade. One of the biggest limitations to sustainability is finding consistent, ongoing funding and resources. Though WHO and AARP provide in-kind support, educational resources and small grants, local entities are required to cover the costs and staffing associated with the required community-wide assessment, strategic plan development and implementation and evaluation. Entering the network requires a letter of commitment from the most senior elected official in the community to work toward becoming more livable.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>The five interrelated tenets of age-friendly work are commitment, capacity, collaboration, resident involvement and comprehensiveness.</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>While entering the network is straightforward, meeting the work objectives is much more complex. Unfortunately, some communities complete the first two years of work but stall during the implementation phase due to a lack of capacity. Others struggle with launching a community assessment after entering into the network.</p> <p>The success of age-friendly communities depends upon a patchwork of private and public funding sources, strong paid and volunteer leaders and successful collaborative efforts. However, like other aging services, age-friendly communities are chronically under-funded. Canda, a national philanthropically focused organization, found that less than 1 percent of funds from the largest private foundations in the United States go to support issues of aging, and as <a href="https://www.forbes.com/sites/nextavenue/2019/09/11/why-its-time-for-more-big-foundations-to-fund-aging/?sh=73089ed42a36">Hogan </a>notes, “we’ve been conditioned to believe that government takes care of our elders. Unfortunately, in most cases, that’s just not true.”</p> <p>Funding from local private foundations is a promising trend. The Tufts Health Plan Foundation is a bold leader in this area, investing millions of dollars in more than 16 projects across Massachusetts, New Hampshire and Rhode Island. The Henry and Marilyn Taub Foundation and The Grotta Fund for Senior Care Building in New Jersey, as well as the Columbus Foundation and Osteopathic Heritage Foundations in Columbus, Ohio, have been key partners in supporting the development and implementation of age-friendly communities.</p> <p>While potential funders certainly face competing community priorities, age-friendly community work is expansive and specific. As Dr. Kathy Black with the University of South Florida notes, “age-friendly work is a mile wide and a mile deep.” Seeking funding for programs and research related to transportation, housing, emergency preparedness and technology allows communities to access funding from places that are not traditionally age-focused. As most age-friendly efforts are often led by just one or two paid or unpaid individuals, building relationships with local government officials, nonprofit leaders and older adult residents is key to building financial and social capacity. One or two paid individuals only stretch so far. Collaboration is key to sustainability.</p> <h2>Include Older Adults in Every Step</h2> <p>Fundamental to this work is the purposeful and systematic inclusion of older adults in all stages of age-friendly community development. Age-friendly communities that demonstrate a return on investment through their ability to engage hard-to-reach populations will fare well with sustainability efforts. Meaningful engagement by older residents is no small feat, and one that many community leaders are beginning to recognize as beneficial for their own work and political futures. Support from local governments for age-friendly efforts can be seen in various U.S. cities, including Washington, DC, Boston, New York City and Columbus, Ohio, where mayors and city councilmembers have demonstrated their commitment through financial investment. In California, the Governor recently revised the state budget to include funds to create an age-friendly state.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘Collaboration is key to sustainability.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Age-friendly communities solve problems through targeted universalism. Targeted universalism, according to the Othering and Belonging Institute at UC Berkeley, means setting universal goals for all and implementing targeted approaches with special populations to meet those goals. Transportation work by age-friendly communities provides one example of this approach, where the universal goal is for residents to have safe, affordable and accessible transportation to get to where they want and need to go, how and when they want to get there.</p> <p>Targeted interventions to support including older people and individuals with disabilities helps meet this goal, ultimately benefiting all residents. Age-friendly communities are addressing transportation challenges by integrating the ideas of hard-to-reach residents into existing community projects, like test-riding autonomous vehicles and developing mobility services.</p> <p>The network of Age-Friendly communities continues to evolve, much like the grassroots approach of the work itself. There is variability across different communities, with some having more capacity and resources than others. However, it is the spirit of contributing to the greater good and leveraging shared wisdom among age-friendly community leaders through sharing strategies, plans and toolkits that will ultimately determine if the goal of a more age-friendly world can be reached. The importance of disseminating successes through formal mentoring, education and research is now recognized and occurring via state-wide coalitions and through AARP’s new online information portal.</p> <p>What does it take to sustain an age-friendly community? Commitment, capacity, collaboration, resident involvement and comprehensiveness, with real financial investment by those who believe in making our social, built and service environments livable for people of all ages.</p> <hr /><p><em>Holly Dabelko-Schoeny, PhD, is an associate professor and director of Research at the Age-Friendly Innovation Center in the College of Social Work at The Ohio State University in Columbus. Katie White, MSW, is executive director of the Age-Friendly Innovation Center.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/375" hreflang="en">Grandfather and grandson</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p><strong>In Focus</strong><br /> By Holly Dabelko-Schoeny and Katie White</p> </div> </div> <div class="field field--name-field-issue field--type-entity-reference field--label-above"> <div class="field__label">Issue</div> <div class="field__item"><a href="/jul-aug-2021" hreflang="en">July-Aug 2021</a></div> </div> Wed, 16 Jun 2021 23:41:25 +0000 asa_admin 430 at http://generations.asaging.org Plan for the Road Ahead: Driving and Dementia http://generations.asaging.org/plan-road-ahead-driving-and-dementia <span class="field field--name-title field--type-string field--label-hidden">Plan for the Road Ahead: Driving and Dementia</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Thu, 06/17/2021 - 01:17</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/health-well-being" hreflang="en">Health &amp; Well-being</a></div> <div class="field__item"><a href="/innovation-social-impact" hreflang="en">Innovation &amp; Social Impact</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-today" hreflang="en">Generations Today</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">People with dementia do not typically recognize the loss of problem-solving abilities while they can still use the gas and brake pedals. </div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">As an occupational therapist and driving rehabilitation specialist, one of the hardest tasks is to inform an individual with dementia that they can no longer drive. While it is a difficult conversation with any medically at-risk driver (a person, regardless of age, who has a medical condition[s] that may affect driving performance), the person with dementia is particularly challenging. Recognizing how dementia is different from other medical conditions that preclude individuals from driving is important for understanding and developing strategies to address this most valued activity of daily living.</p> <p>This article covers three challenging aspects of this situation. The first, social isolation, is common to all who lose their ability to drive, while the other two are unique for those with dementia and/or the baby boomers.</p> <h2>Social Isolation</h2> <p>As the majority of older adults live in <a href="https://doi.org/10.1177/0733464817739154">suburban and rural America, driving is and will remain their primary mode of transportation</a>. Additionally, <a href="https://doi.org/10.1177/0733464817739154">driving cessation has adverse consequences</a>, with social isolation a likely outcome for individuals living alone or without family or friends nearby.</p> <p>Certainly, the COVID pandemic has heightened the awareness of negative consequences associated with limited social interaction, <a href="https://doi.org/10.1111/jan.14467">especially for those who have dementia</a>. When an individual in more rural areas loses their privilege to drive, it effectively ensures they will be socially isolated, unless interventions are taken to maintain social participation.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘Driving is not one skill, instead it’s a combination of many skills and abilities.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>However, those interventions must be initiated by others or prior to diagnosis, as individuals with progressive cognitive impairment will not have the capacity to problem-solve complex transportation solutions. Thus, providers should never stop with the cognitive test, but <a href="https://doi.org/10.3390/ijerph17155553">include an action plan for maintaining community mobility</a> to preserve health and quality of life.</p> <h2>Denial About Ability to Drive</h2> <p>“I have been driving for 50 (or 60, 70) years! I can still drive.” This is the most common statement a person with dementia makes to the driving specialist. And it is absolutely true—they can drive. But driving is not one skill, instead it’s a combination of many skills and abilities. These abilities fall into three categories: <a href="https://doi.org/http:/onlinepubs.trb.org/Onlinepubs/circulars/ec211.pdf">operational, tactical and strategic</a>.</p> <p>At the base level are the <strong>operational </strong>abilities—the physical components of driving, which after many decades of driving become automatic. We can steer, brake and use controls without thinking much about it. It is the preverbal “riding a bike.”</p> <p>The second level are <strong>tactical </strong>abilities, which includes executing maneuvers on the road, such as changing lanes, following road signs or slowing in response to traffic.</p> <p><strong>Strategic </strong>abilities mean making decisions like whether or not to drive, based upon conditions, or when a familiar road is closed, the ability to find another way home. While all three levels are important and may change with age, the strategic level is affected first when a person has changes in their cognitive ability. Thus, while the person with dementia continues to perform well at the operational and tactical levels, deficits at the strategic level can put them at risk. Moreover, the person with dementia does not typically recognize the loss of this problem-solving ability while they can still use the gas and brake pedals.</p> <h2>A Matter of Reputation</h2> <p>While motor vehicles have been around since the 1920s, it was not until after WWII that most families had a car. The baby boomers grew up with their vehicles and accordingly the “car” was their tool for <a href="https://www.chegg.com/textbooks/stroke-rehabilitation-4th-edition-9780323172813-0323172814?preSelection=Rent&amp;c_id=sem&amp;utm_source=google&amp;utm_medium=cpc&amp;utm_campaign=tb--long_tail-googleshopping_group6&amp;utm_content=PRODUCT_GROUP&amp;gclid=EAIaIQobChMIvoubzMyL8QIVDJSzCh1KhwqrEAQYAiABEgJg8vD_BwE&amp;gclsrc=aw.ds">social networking</a>. It was a life-changing event to get a license for teens, and seen as their ticket to independence. Thus, it is important to recognize that loss of driving is not just a loss of transportation, but also a loss of choice and self-determination. These issues need to be addressed along with the issues of transportation. In addition, particularly for men, it also can be about the car itself.</p> <p>My in-laws acquired a minivan with mobility adaptations. Because they had two additional cars and a truck, my father-in-law convinced my husband to buy his prized coupe—although nine years old, it only had 22,000 miles on it. While there were no transportation issues, a few months later my father-in-law bought a new coupe. It was his vision of driving a sporty vehicle that was important, not the method of transportation. Thus, it is a time of loss and so critical to recognize that loss may be profound for most individuals because driving is seen as a lifetime right, not a privilege.</p> <h2>Intervention</h2> <p>It is universally recognized that for people with dementia, it is not a matter of “if” they will have to stop driving, but “when.” As the most complex of instrumental activities of living (IADLs), it should be recognized and addressed <strong>early </strong>in the planning process. Recent research suggests that deficits in <a href="https://doi.org/10.1177/0733464817690679">driving performance may show the first evidence for dementia</a>, even when typical neuropsychological tests are negative. Based on this research, practitioners should be addressing driving <strong>first</strong>, before other issues that are not in the domain of public safety. The worst scenario is ignoring the issue with the potential of a devastating event such as a crash or becoming lost for an extended time.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Developing a transportation plan early that incorporates family, friends and others spreads the responsibility to a network of individuals.</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Interventions after these events are always more painful and often inadequate. <a href="https://planfortheroadahead.com/"><em>Plan for the Road Ahead</em></a> should become a “mantra” for all older adults, because research has shown <a href="https://doi.org/10.2105/ajph.92.8.1284">we will all outlive our driving ability by six to ten years</a>. Just as we plan for retirement from work and where we will live, transportation planning must be front and center. This is particularly true for those with cognitive impairment. It is critical to “try-out” strategies like ride-sharing early in the process so they become familiar.</p> <p>Developing a transportation plan early that incorporates family, friends and others (including paid services) spreads the responsibility to a network of individuals. This plan will allay fears of the individual “becoming a burden” and loss of independence if developed collaboratively and early in the disease process. Finally, research has shown that individuals with <a href="https://doi.org/10.1001/jama.2010.481">very mild or mild cognitive impairment may continue to drive</a>, although it depends upon a variety of issues such as context, environment and disease progression. Accordingly, it requires the skills and abilities of an <a href="https://doi.org/doi:10.3390/geriatrics3020025">expert in driving <strong>and</strong> in medical conditions to help make that determination</a>. The driver rehabilitation specialist who is also an occupational therapist is an ideal individual to determine fitness to drive. Alternatively, as driving is an IADL and falls within the domain of occupational therapy, a comprehensive evaluation of IADL skills by an occupational therapist, which is typically covered by insurance, is another option to pursue.</p> <hr /><p><em>Anne E. Dickerson, PhD, OTR/L, SCDCM, is a professor in the Occupational Therapy Department at East Carolina University in Greenville, editor of Occupational Therapy in Health Care and directory of ROADI (Research for Older Adult Driving Initiative.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/376" hreflang="en">Son walking with father</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p><strong>In Focus</strong><br /> By Anne Dickerson</p> </div> </div> <div class="field field--name-field-issue field--type-entity-reference field--label-above"> <div class="field__label">Issue</div> <div class="field__item"><a href="/jul-aug-2021" hreflang="en">July-Aug 2021</a></div> </div> Wed, 16 Jun 2021 23:17:11 +0000 asa_admin 429 at http://generations.asaging.org How Self-Driving Cars Can Empower a Growing Population of Older Adults http://generations.asaging.org/how-self-driving-cars-can-empower-older-adults <span class="field field--name-title field--type-string field--label-hidden">How Self-Driving Cars Can Empower a Growing Population of Older Adults</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Thu, 06/17/2021 - 01:13</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/innovation-social-impact" hreflang="en">Innovation &amp; Social Impact</a></div> <div class="field__item"><a href="/justice-equity" hreflang="en">Justice &amp; Equity</a></div> <div class="field__item"><a href="/ageism-culture" hreflang="en">Ageism &amp; Culture</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-today" hreflang="en">Generations Today</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">A self-driving service can promote wellness, offering access to healthcare or local businesses and connection to family.</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">At Ford, we believe self-driving technology has the potential to make transportation more accessible to people. Our ultimate goal is to use autonomous technology to make people’s lives better by providing a safe, trusted and affordable mobility solution. This development has the potential to improve many people’s lives, and older adults could well see many benefits.</p> <p>As in many countries, the older adult population in the United States is growing. By 2060, more than 98 million Americans will be older than age 65 and account for 25 percent of the nation’s total population, according to projections by the <a href="https://www.census.gov/content/dam/Census/library/publications/2020/demo/p25-1144.pdf">U.S. Census Bureau</a>.</p> <p>That’s a huge portion of the population—and, a significant potential market for transportation services. Self-driving technology is unique in that it can potentially offer a cost-effective option for older adults that empowers them to safely maintain their independence. A successful self-driving service can promote wellness, offering easy access to healthcare or local businesses, and provide ways to stay connected with families, friends and the community.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Some perceived barriers about self-driving vehicles are misconceptions.</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>How do we get there—and what are the obstacles? For one, some perceived barriers are misconceptions. Many people think self-driving cars will be prohibitively expensive, but at Ford they are not coming to market as privately owned vehicles. Instead, Ford is introducing self-driving vehicles through ride-hailing and delivery services. In these scenarios, self-driving vehicles only make sense as a low-cost option—to be successful they need to be affordable and cater to people’s specific needs.</p> <p>Another misconception is that older adults are unwilling to give self-driving vehicles a chance. This just isn’t the case. This population thinks that if the technology can do what it says it can do, it will have a profound impact on their life.</p> <h2>Straight from the Source</h2> <p>The research we’ve done demonstrates that older adults continue to look for mobility solutions that give them access to a couple of major necessities: healthcare and food. That’s why we’re looking into how we can tailor self-driving services to meet these needs and provide access to grocery stores and physician offices. Self-driving vehicles can not only be used to transport older adults to these critical outlets, but partnerships with grocery stores could leverage these vehicles to make easy grocery deliveries, while medical outreach programs can help manage the cost of transportation even further.</p> <p>Beyond the bare necessities, there is also an emotional side to this technology: It can help maintain this group’s freedom of movement. For those who may lose the ability or confidence to drive, self-driving vehicles can help them to maintain a vibrant social life, allowing them to pick up grandkids from school or head out to dinner with friends without having to drive.</p> <p>In our research, we identified several key areas of opportunity for self-driving technology:</p> <ul><li>Barrier-free access: Participants in our studies have made it clear that self-driving vehicles need to be easily accessible, particularly for those who use a wheelchair or require assistance from a caregiver. This includes ensuring there’s high head clearance and low thresholds to make vehicle entry easy. Such services will also need to address any technological barriers that may prevent certain older adults from using the service, like the reliance on a smartphone or on connectivity outside the home.</li> <li>Socialization tool: Many older adults see self-driving cars as enablers, helping them to get out into the world, socialize and remain part of their communities. Caregivers also see an opportunity to engage with older adults they transport in shuttles and better attend to their needs, because they wouldn’t have to concentrate on driving.</li> <li>Increased confidence: Even those who still drive or are otherwise independent believe self-driving vehicles could give them the confidence to go out at night or in inclement weather; leveraging these vehicles to take them places they may not normally go.</li> <li>On-demand services: Many current mobility solutions for older adults require them to plan far in advance. But as part of a ride-hailing service, self-driving vehicles could be summoned on short notice and allow older adults to not only maintain independence, but also spontaneity.</li> </ul><p>Of course, many older adults have expressed concerns about safety, the readiness of self-driving technology and the fear of being stranded if some type of malfunction were to occur. But here’s the thing: none of these issues are necessarily unique to older adults. Our research shows these are consistent sentiments across generations, and at Ford we are actively trying to address these issues as we prepare to launch a self-driving business in 2022.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>‘As part of a ride-hailing service, self-driving vehicles could be summoned on short notice.’</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>For one, we’re addressing a key barrier to entry by investing heavily in conversational assistance. That means one wouldn’t have to manage a trip through a device or physical interface—instead the vehicle will respond to passengers talking to it. This dramatically lowers the bar of technological know-how needed to use these services, letting people naturally engage their rides. Our vehicles also will provide access to real people immediately, by letting riders use in-vehicle features to reach others.</p> <p>As people become more familiar with self-driving vehicles, lingering fears about the technology begin to dissipate. Our Number One goal is to develop a safe, reliable service—and no vehicle is going to hit the street before we achieve that confidence.</p> <p>Self-driving vehicles promise to deliver more freedom and independence for older adults than any other mode of transit, at an affordable price. When this technology is ready for prime time, we’re confident older adults will want to hail a ride.</p> <hr /><p><em>Robert Moser, MBA, is Global Head of Experience Design at Ford Motor Company in Birmingham, Mich.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/369" hreflang="en">Ford self-driving vehicle</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p><strong>In Focus</strong><br /> By Robert Moser</p> </div> </div> <div class="field field--name-field-issue field--type-entity-reference field--label-above"> <div class="field__label">Issue</div> <div class="field__item"><a href="/jul-aug-2021" hreflang="en">July-Aug 2021</a></div> </div> Wed, 16 Jun 2021 23:13:14 +0000 asa_admin 428 at http://generations.asaging.org The Transportation Data Equity Initiative—Working to Improve Mobility for Everyone http://generations.asaging.org/transportation-data-equity-initiative <span class="field field--name-title field--type-string field--label-hidden">The Transportation Data Equity Initiative—Working to Improve Mobility for Everyone</span> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><a title="View user profile." href="/user/6" class="username">asa_admin</a></span> <span class="field field--name-created field--type-created field--label-hidden">Thu, 06/17/2021 - 00:51</span> <div class="field field--name-field-tags field--type-entity-reference field--label-above"> <div class="field__label">Tags</div> <div class="field__items"> <div class="field__item"><a href="/justice-equity" hreflang="en">Justice &amp; Equity</a></div> <div class="field__item"><a href="/ageism-culture" hreflang="en">Ageism &amp; Culture</a></div> <div class="field__item"><a href="/health-well-being" hreflang="en">Health &amp; Well-being</a></div> </div> </div> <div class="field field--name-field-channel field--type-entity-reference field--label-above"> <div class="field__label">Channel</div> <div class="field__item"><a href="/generations-today" hreflang="en">Generations Today</a></div> </div> <div class="field field--name-field-teaser-text field--type-string-long field--label-above"> <div class="field__label">Teaser Text</div> <div class="field__item">Volunteer mapping provides detailed data on sidewalk access.</div> </div> <div class="field field--name-field-paragraphs field--type-entity-reference-revisions field--label-above"> <div class="field__label">Paragraphs</div> <div class="field__items"> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p class="dropcaps">Older adults, people with disabilities and other populations are poorly served by modern map applications because these phone and web apps do not contain or account for key pieces of information about sidewalks, travel environments and community transportation options.</p> <p>The <a href="https://transitequity.cs.washington.edu/">Transportation Data Equity Initiative</a> (TDEI), a project supported by the <a href="https://www.its.dot.gov/its4us/index.htm">U.S. Department of Transportation’s ITS4US program</a> and led by the University of Washington’s <a href="https://tcat.cs.washington.edu/">Taskar Center for Accessible Technology</a> (TCAT), is developing ways to collect, validate and disseminate travel data to use in applications that will help people of all abilities to plan trips more easily—particularly older adults, veterans and travelers with disabilities.</p> <h2>Traveler Inequity</h2> <p>Modern mapping tools such as Google Maps or Moovit give travelers the unprecedented ability to locate transit services, compare travel options, filter possibilities and streamline trip information within one application. But, many populations that experience travel disadvantages do not fully benefit from these “new mobility” tools. The maps often lack information they seek (i.e., Will there be a sidewalk or curb ramp there to support me? Is this crosswalk signalized and marked? Is this bus stop lit at night?). These data often are not collected, or are not available to trip planners in a consistent, digitally readable way.</p> <h2>Collecting New Data for Better Mobility</h2> <p>To improve the ability to travel for all people, the TDEI project is developing new ways to collect and disseminate the data that describe the availability and characteristics of sidewalks, on-demand transit and transportation center layouts. This short article restricts the discussion to sidewalks.</p> <p>The presence, design and condition of sidewalks is key to the completion of nearly all trips. Sidewalks connect almost all modes of transportation. Sidewalks are not ubiquitous and even when present, limitations in their design and quality can result in obstacles to all pedestrians, albeit to varying degrees. For example, a curb with no curb ramps can be inaccessible to a person using a wheelchair, as well as a person pushing a stroller or towing a shopping cart.</p> <h2>Making a Difference</h2> <p>We are enacting this project because there is a need to collect and standardize these kinds of data. By making data high quality and consistent, trip planners can provide customized options. Most of us have used digital maps with automated routing for pedestrians and been sent through streets with no sidewalks, up unreasonable inclines or stairs we could not climb. With the new TDEI standards and high quality collection, customized trips can be automatically provided. A path recommended for someone who uses a white cane may differ from one recommended for a traveler who uses a wheelchair—both routes being right for that person, though not necessarily the shortest way to the destination.</p> <p>In 2016, Clifford Snow, a retiree living in Mt. Vernon, Wash., joined TCAT’s early efforts. Snow is an avid participant and volunteer with the open and shared data-mapping community <a href="https://www.openstreetmap.org/#map=4/38.01/-95.84">OpenStreetMap</a>. He attended several events to learn about the sidewalk mapping standard and hear recommendations on editing the map. Within less than eight months, through a combination of time spent documenting his walking trips and organizing mapping parties, Snow completely mapped the city of Mt. Vernon.</p> </div> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--quote paragraph--view-mode--default"> <blockquote> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>With eight months, organized mapping parties and detailed data entry, one man helped map an entire town.</p> </div> <footer class="blockquote-footer mt-2"> <cite title=""> </cite> </footer> </blockquote> </div> </div> <div class="field__item"> <div class="paragraph paragraph--type--text paragraph--view-mode--default"> <div class="clearfix text-formatted field field--name-field-text field--type-text-long field--label-hidden field__item"><p>Many possibilities are created using this data. Thanks to Snow’s and others’ efforts, going to <a href="https://accessmap.io/">AccessMap.io</a> (operating in Seattle, Bellingham and Mt. Vernon, Wash.) allows anyone to experiment with an existing software tool that lets travelers explore pedestrian information and to route themselves over sidewalks.</p> <p>This map application is pedestrian-centric in that it is focused on depicting sidewalk infrastructure and footpaths. Each sidewalk is color-coded to represent the level of difficulty the traveler will experience traversing it. As users change the profile to indicate their abilities, the color-coded map will change to reflect the new settings. People averse to hills can tune down the maximum uphill incline so the map suggests only those paths they will be comfortable walking up. Those seeking only to use curbs with ramps can check the box. <a href="https://youtu.be/Brm4Fps9Dhw">View this video</a> to learn about additional visual designs to explore in the map.</p> <p>When using the automated routing feature, paths are calculated based on the same personal preferences users dial in. Through joint work with local contributors, city-scale tools have been enabled allowing all travelers to plan trips that are safe and accessible to them.</p> <p>As part of the ITS4US project, there will be expanded data availability, data tools and pipelines that support traveler-centric tools like AccessMap.io. And it’s relatively easy to bring these capabilities to any community. Communities can support the growth and early reach of these data and tools.</p> <p>TCAT is building a toolkit to enable communities to prioritize and map their own sidewalks. When a community is mapped, not only can people find better walking paths, but community officials and advocacy groups can use that same data to make better data-driven decisions about where improvements are most needed to support active, healthy lifestyles, building effectively toward greener, more resilient, livable neighborhoods.</p> <p>For more information, or for anyone considering leading or joining a group in their community, please reach out to <a href="mailto:transitequity@uw.edu">transitequity@cs.washington.edu</a>.</p> <hr /><p><em>Anat Caspi, PhD, is principal scientist at the Paul G. Allen School of Computer Science &amp; Engineering and director of the Taskar Center for Accessible Technology at the University of Washington, in Seattle. Dylan Cottrell is content editor at Taskar.</em></p> </div> </div> </div> </div> </div> <div class="field field--name-field-teaser-media field--type-entity-reference field--label-above"> <div class="field__label">Teaser Media</div> <div class="field__item"><a href="/media/377" hreflang="en">people negotiating curb in wheelchair</a></div> </div> <div class="clearfix text-formatted field field--name-field-byline field--type-text-long field--label-above"> <div class="field__label">Byline</div> <div class="field__item"><p><strong>In Focus</strong><br /> By Anat Caspi and Dylan Cottrell</p> </div> </div> <div class="field field--name-field-issue field--type-entity-reference field--label-above"> <div class="field__label">Issue</div> <div class="field__item"><a href="/jul-aug-2021" hreflang="en">July-Aug 2021</a></div> </div> Wed, 16 Jun 2021 22:51:24 +0000 asa_admin 427 at http://generations.asaging.org