Rotary Gears Up to Eradicate Polio

Published in the Woonsocket Call on October 16, 2016

Just days ago, Louis A. Marciano came to St. Paul’s Church on a mission to get his fellow Pawtucket Rotarians more involved in Rotary International’s efforts to create a polio-free world. Marciano, a former Mount Pleasant High School football player, a coach, a World War 11 veteran who fought in the Pacific Theater and a Rotarian for over 44 years, came to publicize the upcoming World Polio Day on October 24 and give an update on the international service organization’s efforts to eradicate Polimyelitis (polio).

Polio is a paralyzing and potentially fatal infectious disease that still threatens children in some parts of the world. The poliovirus invades the nervous system and can cause total paralysis in a matter of hours. It can strike at any age but mainly affects children under five. Polio is incurable, but completely vaccine-preventable. The infectious disease is found mostly in lower-income countries where poor sanitation and limited access to clean water facilitate the spread of the virus.

A Call for Action at
the Pawtucket Rotary Club

Marciano’s calls for assistance in raising funds to pay for polio inoculations for children and ratcheting up the awareness for Rotary’s efforts is not new. For over four decades, the former Rotary club president District 7950 Governor, has taken his fund raising campaign to end polio to 66 clubs in Rhode Island and southern Massachusetts. His efforts has received attention from his national headquarters, too. The North Providence Rotarian cherishes the Soccer Ball award “Kick Polio out of Africa” presented to him in 1998 for his efforts to eradicate Poliomyelitis

Some say that it may well “Takes a Village” to marshal the resources needed to make a world-wide impact. Over 1.2 million Rotary members belonging to 34,000 clubs world-wide work together to raise funds, advocate for government support, serve as volunteers to help immunize children, and raise awareness in their communities, said Marciano to his audience of Pawtucket Rotarians.

At the podium, the Cranston resident rattled off specifics as to why this global effort is important and is succeeding. Ending polio will save lives, is a very good investment, and most important is achievable, says Marciano.

Marciano notes, India is a prime example of one of the greatest Rotary International’s achievements in wiping out polio. “There were zero cases of polio in 2010 in India and they have been polio-free for nearly six years,” he says, noting that the World Health Organization has officially certified India polio-free in 2014. [According to Devin Thorpe in his March 15, 2014 article published in Forbes, in the 1980s there were approximately 150,000 cases of polio every year in India]

Marciano also announced the upcoming fourth annual world Polio Day event, co-hosted with the U.S. Centers for Disease Control and Prevention, to be held on Oct. 24. The event streaming live from CDC headquarters in Atlanta, Georgia, is expected to bring together more than 50,000 viewers around the world to learn from celebrities and experts about the progress to eradicate polio. For information about World Polio, go to

While winding down his talk, Marciano acknowledges that there is still work to do but Rotary is moving closer to its goal of finally wiping polio from the face of the earth.

Carol Pandak, Director of Rotary’s PolioPlus program, agrees with Marciano’s assessment. “For more than 30 thirty years, Rotary has harnessed the dedication of community leaders around the world in support of polio eradication. When we started this effort, nearly 1,000 children a day were paralyzed by this disease. Today, there have been only 27 cases [Afghanistan (8); Nigeria (4); Pakistan (15)] in the whole world. Rotary remains fully committed to this important effort until every child is protected from this disease.”

From the Beginning

Rotary’s effort to eradicate polio began in 1979, with a multi-year project to immunize six million children in the Philippines. The international service organizations, “PolioPlus program, was established in 1985.

As indicated by the “plus” in PolioPlus, Rotarians also provide support for related health services, such as distributing Vitamin A and zinc tablets, providing bed nets to prevent malaria, assisting with preventative inoculations for other diseases, including measles, rubella, mumps, tuberculous, and other childhood diseases. The “plus” also means a system of advocacy and fundraising, and infrastructure and partnerships that will support the fight against infectious disease long after polio is gone.

Rotary also works closely with partners in the Global Polio Eradication Initiative (GPEI), including the World Health Organization (WHO), the US Centers for Disease Control (CDC), UNICEF, the Bill & Melinda Gates Foundation, and the governments of the world in this public health initiative.

Today, Rotary has given more than $1.6 billion to immunize more than two billion children against polio in 125 countries to wipe the infectious disease from the face of the earth. It is estimated that Rotary’s advocacy efforts have played a role in decisions by countries to contribute more than $7.2 billion to the effort.

Rotary’s polio initiative has also caught the attention of others. As far back as 2008, one of America’s biggest philanthropists came to the table to fight the war against polio. The Bill & Melinda Gates Foundation announced that every dollar Rotary committed to polio eradication would be matched two-to-one by the Foundation up to $35 million a year through 2018. Since this Foundation began its partnership with Rotary more than $2 billion has been contributed to Rotary’s polio eradication effort.

These funds help to provide much-needed operational support, medical personnel, laboratory equipment.

Public figures and celebrities have also joined Bill & Melinda Gates as ambassadors to help educate the public about polio through public service announcements, social media and public appearances. They include: Kristen Bell and Archie Panjabi; WWE superstar John Cena; supermodel Isabeli Fontana; Nobel Peace Prize laureate Archbishop Emeritus Desmond Tutu; action movie star Jackie Chan; boxing great Manny Pacquiao; pop star Psy; golf legend Jack Nicklaus; conservationist Jane Goodall; premier violinist Itzhak Perlman; Grammy Award winners A.R. Rahman; Angelique Kidjo and Ziggy Marley; and peace advocate Queen Noor of Jordan. These ambassadors help educate the public about polio through public service announcements, social media and public appearances.

Until polio is eradicated, all countries remain at risk of outbreaks, says Marciano.

Experts say that $1.5 billion is urgently needed to sustain the polio eradication initiative. Without full funding and political will power, polio could return to previously polio-free countries, putting children at risk contracting this paralyzing disease. From every corner of the globe Rotarians are gearing up on October 24 to garner support to wipe polio out, once and for all.

Winning the Votes of Older Women

Published in Pawtucket Times on October 10, 2016

On Oct. 7, Washington Post reporter David Fahrenthol’s story broke detailing a three minute video of GOP Presidential candidate Donald Trump wearing a hot microphone during a 2005 bus ride with former-host Bill Bush, of “Access Hollywood” to the set of “Days of Our Lives” where the real estate mogul had a walk on cameo on the soap opera. The video captured Trump saying “And when you’re a star they let you do it. You can do anything …Grab them by the p—y. You can do anything” and crudely describing his failed attempts to seduce a woman while being recently married.

Reaction came swiftly to Trump’s locker room banter with Bush. “No woman should never be described in these terms or talked about in this manner. Ever,” said Reince Priebus, the chairman of the Republican National Committee, who was doing damage control to keep woman voters from voting Democrat. The leaked video has also resulted in a number of Republican Senate and House candidates running in November to withdrawal their endorsements of Trump.

This is horrific,” Democratic Presidential Candidate Hillary Clinton said on Twitter, noting a link to the Washington Post article. “We cannot allow this man to become president.”

The embattled Trump initially issued a statement and later a video to try to defuse the controversy and get his flailing campaign back on track 30 days before the November presidential election.

Many political pundits believe that Trump’s off-the-cuff comments that are derogatory to woman, a powerful voting block who decide elections, might just block his chances of becoming the next occupant of the White House.

Women’s Campaign Issues

One day before the politically damaging Washington Post article appeared detailing Trump’s lewd comments in a leaked video, AARP, the nation’s largest aging advocacy group, released survey findings highlighting issues of importance to women voters ages 50 to 69 in key battleground states.

“Older women voters – particularly women of the Boomer generation — could help decide the 2016 presidential election,” said AARP Executive Vice President Nancy LeaMond. “Yet many of their real concerns are being ignored and their questions overlooked in a largely issueless campaign. The candidates still have an opportunity to talk to these women about the issues that matter to them.”

The 27 page report, Women Voters Ages 50 +: Economic Anxieties, Social Security, and the 2016 Election, says that heading into this year’s presidential election, Democratic candidate Hillary Clinton has a whopping 15 point lead (48 percent) over the GOP’s standard bearer Donald Trump (33 percent) among woman over age 50. The findings also indicate that older woman favor Democrats running for Congress by a narrower margin (47 percent are inclined to vote for a Democrat while 36 percent inclined to vote for a Republican).

AARP’s survey results noted that majority of woman age 50 and over believe that Clinton will do a better job than Trump in addressing family caregiving (Clinton, 57 percent; Trump, 27 percent), education (56 percent; 31 percent), environment (55 percent; 29 percent) and health (53 percent; 35 percent). The Democratic presidential candidate is also perceived by older woman as having a slight advantage over Trump in controlling government spending and controlling the budget deficit (44 percent; 43 percent).

“It’s the Economy Stupid”
Plus Retirement Issues

As to the economy, the majority of the older woman respondents across these 15 battle ground states worry about pocketbook issues such as prices rising faster than their income (61 percent) and having to pay too much in taxes (54 percent. Four in ten (41%) worry about having prescription drug expenses they cannot afford. Women with lower household incomes are especially likely to worry about these pocketbook issues.

Also, the AARP survey found that many women also worry about retirement security, including their ability to care for themselves as they age (45 percent), not having financial security in retirement (41 percent), and whether Social Security will be there when they retire (38 percent). These retirement-related issues are of particular concern to women with lower household incomes.

Additionally, most women (53 percent) say that the nearly 25 percent cut in Social Security benefits that would result from not addressing the solvency of Social Security would impact them, including 32 percent who say it would impact them “a lot.”

Fixing Social Security is a key issue to older woman voters. The AARP survey noted that the vast majority of women voters ages 50+ (72 percent) say that the next president and Congress should address Social Security immediately.

Most women (67 percent) also favor giving a caregiver credit in calculating Social Security benefits to people who take time off from work to care for loved ones, says the report.

Social Security is flying under the radar screen of the voter. The survey findings noted that few women say that they have heard about the candidates’ plans for Social Security. About one in three (34 percent) say they have seen or heard anything from Clinton, and even fewer (20 percent) say that they have seen or heard anything from Trump.

The AARP survey found that over 54 percent of the respondents are currently, or have been, a family caregiver providing unpaid care to an adult loved one. More than eight in ten (85 percent) women voter’s ages 50+ think it is important for the presidential candidates to talk about how they would support family caregivers who provide unpaid care to aging parents or spouses or other adult family members.

Finally, four in ten (41 percent) women are not confident that they will be able to cover the cost of care for an aging or elderly parent, spouse, or other family member.

Women: A Powerful Voting Block

According to the Center for American Women in Politics, “In recent elections voter turnout rates for women have equaled or exceeded voter turnout rates for men. Women, who constitute more than half of the population, have cast between four to seven million more votes than men in recent elections.“

Only weeks will tell if embattled Trump can overcome the political backlash generated from his locker room banter degrading woman, political insiders predicting that the gender vote gap might just historically widen.

AARP’s survey findings provide sound advice to Clinton and Trump and congressional candidates who are scrambling for last minute votes, especially from married women, younger millennials and women living in the nation’s suburbs. The women’s voting block might just surely tilt the election to a candidate in many legislative districts.

New Study Looks at Better Ways to Instruct Caregivers

Published in Woonsocket Call on October 2, 2016

A new report released by United Hospital Fund and AARP Public Policy Institute, using feedback directly gathered from caregivers in focus groups, provides valuable insight as to how video instruction and training materials can be improved to help caregivers provide medication and wound care management.

AARP Public Policy Institute contracted with United Hospital Fund (UHF) to organize the discussion groups, which took place in March through December of 2015 and were conducted in English, Spanish, and Chinese. A new report, , released on September 29, 2016, summarizes key themes from the discussions and suggests a list of “do’s and don’ts” for video instruction.

Gathering Advice from Caregivers

In a series of six discussion groups with diverse family caregivers — 20 women and 13 men of varying ages and cultures (Spanish and Chinese) — in New York, participants reported feeling unprepared for the complex medical and nursing tasks they were expected to perform at home for their family member. The participants reported that educational videos lack instructional information and also failed to address their emotional caregiving issues. Stories about poor care coordination came up during the discussions, too.

“These discussion groups gave family caregivers a chance to describe their frustration with the lack of preparation for tasks like wound care and administering medication through a central catheter. But participants also demonstrated how resourceful they were in finding solutions on their own,” said Carol Levine, director of UHF’s Families and Health Care Project and a co-author of the report.

According to Levine, this initiative to study caregiver perspectives on educational videos and materials is an outgrowth of a 2012 report, Home Alone: Family Caregivers Providing Complex Chronic Care, released by UHF and the AARP Public Policy Institute. The findings of this on-line national survey of a representative sample of caregivers noted that 46 percent of family caregivers across the nation were performing complicated medical and nursing tasks such as managing medications, providing wound care, and operating equipment for a family member with multiple chronic conditions. These caregivers felt they were not being adequately prepared by the health care system to perform these tasks and they told researchers that they were often stressed, depressed, and worried about making a mistake. Most of these caregivers had no help at home.

The new caregiving report is an important resource for AARP’s broader national initiative known as the Home Alone AllianceSM which seeks to bring together diverse public and private partners to make sweeping cultural changes in addressing the needs of family caregivers. “The wealth of information we learned from these discussion groups has guided the development of our first series of videos for family caregivers on medication management, and will inform future instructional videos,” said Susan C. Reinhard, RN, PhD, Senior Vice President of AARP Public Policy Institute and co-author of the report. Specific segments of the first series of videos include Guide to Giving Injections; Beyond Pills: Eye Drops, Patches, and Suppositories; and Overcoming Challenges: Medication and Dementia. The videos are on the AARP Public Policy Institute’s website and United Hospital Fund’s Next Step in Care website. Additional video series will focus on topics including wound care, preventing pressure ulcers, and mobility.

In preparation for the discussion group (lasting up to 2 hours and held on different days and locations) ), UHF staff reviewed literature on video instruction and adult learning theory for patients and caregivers and selected several currently available videos on education management and wound care to show to caregivers to stimulate discussion and cull feedback on content and presentation style. Felise Milan, MD, an adult learning theory expert at Albert Einstein College of Medicine, was a consultant to the project.

A New Way of Teaching

For UHF’s Carol Levine, one of the biggest insights of this study was the resourcefulness shown by caregivers in “finding information [about managing medication and wound care] that they had not been provided, creating their own solutions when necessary.” “These are strengths that are seldom recognized,” she says.

“We found that caregivers were eager to learn how to manage medications and do wound care more comfortably for the patient and less stressful for themselves. Providers often use the same techniques they would use to train nursing students or other trainees, and are not aware how the emotional attachment of caregiver to patient affects the tasks, and how adults need learning based on their own experiences, not textbook learning,” says Levine, stressing that providers need more time to work with caregivers to provide follow-up supervision.

Existing teaching videos used for providing information to caregivers were generally found not to incorporate adult learning theory, says Levine, noting that they were intended to teach students, not caregivers. “In watching the videos, the caregivers clearly stated that they wanted to see people like themselves learning to do the tasks, not just a provider demonstrating them. They also didn’t respond well to attempts at humor. For them, these tasks are serious business, and they want information, not entertainment,” she added.

Levine says that she believes that videos and interactive online instruction can be a powerful tool in helping caregivers learn and practice at home. “We encourage other organizations to consider developing videos in the area of their expertise, and we encourage all who communicate with caregivers to look at the list of “Dos and Don’ts” for advice about presenting information in ways that caregivers can best absorb it [detailed in her recently released report].

“However, we strongly believe that good clinical advice and supervision are essential. Videos are not “instead of” they are “along with” clinical care,” adds Levine.

CARE Act Gives More Info to Rhode Island Caregivers

“The report reflects the need to make family caregivers more confident that they have the knowledge and instructions to provide the best possible care of their loved ones,” said AARP State Director Kathleen Connell. “This is why implementation of the CARE (Caregiver Advise, Record, Enable) Act will be so important here in Rhode Island, as it addresses some of the anxiety that accompanies a patient’s hospital discharge.

“In most cases, hospitals do their best to prepare patients for discharge, but instruction has not always been focused on preparing a designated caregiver for medical tasks they may be required to perform. The CARE Act is designed to provide caregivers with the information and support they need. As the report indicates, an instructional video may not always answer all their questions. Like physicians, caregivers feel they should abide by the ‘first do no harm’ approach. And that’s hard sometimes if there is uncertainty that comes from a lack of instruction. Caregivers also are especially tentative about treating wounds and managing medications.

“This can lead to some unfortunate outcomes: Patients can suffer when mistakes are made; caregivers feel increased or debilitating stress; and hospitals readmission rates go up.
“In short, we need to listen to caregivers and all work together to support the work they do.”

For a copy of the caregiver report, go to

Older Americans Impacting the Economy Economy

Published in Woonsocket Call on September 25, 2016

Sometime in your life you might have heard this comment — older people are a drain on the economy. A newly released AARP report shatters this myth once and for all by detailing a rise in spending and workforce contributions of aging baby boomers.

AARP’s 28 page report, The Longevity Economy: How People Over 50 Are Driving Economic and Social Value in the US, takes a hard look at how our nation’s population of 111 million 50-plus consumers impacts the economy.

According to this report, released on September 20, the 50-plus age groups generates a whopping $7.6 trillion in economic activity (a $500 billion increase from 2013), including $5 trillion in consumer spending by people 50-plus. The researchers say the increases reflects the nation’s shifting demographic and spending patterns of this group due to longer life spans and prolonged employment.

Older Adults a Powerful Economic Force

The 50-plus cohort represents a powerful force that drives economic activity and the growth of this age group and has a transformative impact on the nation’s products and services.

According to the report, produced by Oxford Economics for AARP, members of the Longevity Economy are employed longer and making contributions within the workforce. In addition, the economic activity that comprises the Longevity Economy generates $1.8 trillion in federal, state and local taxes. As older people extend their work lives, they are fueling economic growth past the traditional retirement age of 65 as well as combating myths about how aging affects the economy.

“As the 50-plus demographic continues to grow, the market opportunities are too large to ignore,” said Jody Holtzman, senior vice president of market innovation, AARP. “With those in the ‘longevity economy’ wanting to maintain independence, employment and health for as long as possible, opportunities abound for companies to develop products and services to meet the demand. This report offers a strong roadmap for companies to address the needs of the 50-plus population.”

Look for the nation’s Longevity Economy to be more ethnically diverse. The report notes that by 2050, Black, Hispanic, Asian, and other non-white groups will make up 45 percent of the 50-plus population, compared with 26 percent in 2015. Demographic changes will influence the types of goods and services that the 50-plus population consumes and invests in, say the researchers.

Aging baby boomers and seniors will be a “contributing force” in the workplace and heavily into entrepreneurship. The report’s findings indicated that people age 50-plus are working longer, earning wages, spending more money, generating tax revenue, and producing economic value for an extended period of time. Those aged 55-64 have had the highest rate of entrepreneurial activity in the nation and over the last 10 years and one in three US businesses in that timeframe was started by an entrepreneur aged 50 or older.

The report’s findings pierces the long-held stereotypes that as one ages they become less productive, not as quick and agile when compared to younger employees. Researchers say while these observations may be true in some occupations, however, the report’s data suggests that in many instances productivity may increase in your later years. This may occur because older workers who are more highly educated are employed in more knowledge-based professions and less physically active ones.

Researchers observed that the Longevity Economy supported job sustainability. The AARP report found that in 2015 alone, nationwide spending by people aged 50 supported more than 89.4 million jobs and more than $4.7 trillion in the nation’s labor income — 61 percent of all U.S. jobs and 43 percent of labor income was related to this groups’ spending, impacting health services and education.

Meanwhile, the AARP report notes that The 50-plus population has a strong desire to stay independent and active while they age, resulting in businesses developing new technologies – such as remote monitoring, smartphone apps and ambient computing – that cater to them.

Finally, the AARP report found that baby boomers are not stingy. They donate at a larger rate than younger generations, with 80 percent of those 65-plus giving to charity in 2015. When not working boomers spend a lot of their time volunteering, too – individuals 55-64 spend 128 hours per year while those 65-plus spend 133 hours per year. In addition, 83 percent of the nation’s household wealth is held by those over 50 years old, say researchers.

In the Ocean State…

“In Rhode Island, we know that the 50+ population is an economic driver,” said AARP Rhode Island State Director Kathleen Connell. “On the younger end, the demographic represents key leaders in business, education and government. Sometimes it seems as if the ‘young innovators’ get all the press, but this core of established, successful and still quite energetic Rhode Islanders is undeniable. At the other end of the spectrum, $2.9 billion dollars in Social Security benefits are paid out to Rhode Islanders and a large portion of that spending is here in the state. Total economic output is estimated at $4.98 billion. People also would be surprised to know that Rhode Islanders 65 and older comprise 18 percent of the workforce.

“They are caregivers and philanthropists as well,” Connell added. “And their volunteer service is valued at $148 million a year. However, this is not to deny that many older people have real and pressing needs. That will grow as a percentage of the state’s population and we need to plan for those realities.

“Younger entrepreneurs are important to the state’s future,” Connell concluded. “But the brightest, in my opinion, recognize the 50+ population as both a market and a resource. Many are tapping the generation that came before them as an advantage as they grow their own successes. We want to see more of that. It’s a win-win we can’t pass up.”

It is no surprise to economist Ed Mazze that consumers age 50-plus are the most important demographic group for businesses to target. He says there are over 120 million people in this group (the baby boomers (born 1946 to 1964) and the Silent Generation (born from 1925 through 1945).

Mazze, Distinguished Professor of Business Administration at the University of Rhode Island, notes that boomers are willing to spend on technology, use social media, purchase online and represent a good market for many luxury products. “Many new products have been created for the Silent Generation in areas of food and pharmaceuticals and other products have been redesigned and reengineered such as appliances, automobiles and furniture for ease of operation,” he says.

“There are many in both markets still willing to pay full price for the products and services they buy if they feel they are getting full value for these purchases. These are two important consumer market segments that should not be neglected,” adds Mazze.

New Approach to Support Caregivers Needed

Published in Woonsocket Call on September 18, 2016

Currently 18 million people across the nation provide assistance with activities of daily living, transportation, finances, wound care and giving injections to their aging parents, spouses, family and friends. AARP Rhode Island estimates that 148,000 Rhode Islanders are caregivers. The future is bleak for those requiring caregiving assistance in the near future. According to a recently leased report by The National Academies of Sciences, Engineering, and Medicine (NASEM), the need for family caregivers will drastically increase but demographic shifts reduce the potential pool of caregivers to tap.

Being a Caregiver in America

The 340 page NASEM report (taking 20 months to produce) calls for the retooling of the nation’s health and long-term care delivery system through team based care (using a person and family care model approach) and policy changes to better support family caregivers in the delivery of care to older Americans.

The recommendations detailed in Families Caring for an Aging America, released on September 13, 2016, challenges policy makers “to transform the health care experience for older adults and their family caregivers,” says Nancy Morrow-Howell, PhD, president of the Washington, D.C.-based The Gerontological (GSA) Society of America, the nation’s largest interdisciplinary organization devoted to the field of aging. “The approach requires a multidimensional, interdisciplinary effort that spans diverse settings of care. GSA strongly supports this effort to create a person- and family-centered model for team-based care that recognizes and rewards the role of the family caregiver,” she notes.

Adds Richard Schulz, who chaired NASEM’s Committee on Family Caregiving for Older Adults (consisting of 19 caregiving experts) that oversaw this study and who serves as Distinguished Service Professor of Psychiatry, University of Pittsburgh, “Ignoring family caregivers leaves them unprepared for the tasks they are expected to perform, carrying significant economic and personal burdens.”

Schultz adds, “Caregivers are potentially at increased risk for adverse effects in virtually every aspect of their lives – from their health and quality of life to their relationships and economic security. If the needs of the caregivers are not addressed, we as a society are compromising the well-being of elders. Supporting family caregivers should be an integral part of the nation’s collective responsibility for caring for its older adult population.”

According to a release, NASEM’s highly anticipated report noted that by 2030, 72.8 million U.S. residents – more than 1 in 5 – will age 65 or older. According to the National Survey of Caregivers, in 2011, 17.7 million people – or approximately 7.7 percent of the total U.S. population aged 20 and older – were caregivers of an older adult because of health problems or functional impairments. This estimate does not include caregivers of nursing home residents.

Furthermore, being a caregiver is not a short-term obligation, says the report, noting that the median number of years of family care for older adults with high needs is around five years. The proportion of older adults who are most likely to need intensive support from caregivers – those in their 80s and beyond – is projected to climb from 27 percent in 2012 to 37 percent by 2050.

A Shrinking Pool of Caregivers

The NASEM’s Family Caregiving Committee says that little policy action has been taken to prepare the nation’s health care and social service delivery systems for this demographic shift. While the need for caregiving is rapidly increasing, the number of the potential family caregivers is shrinking. Current demographic trends – including lower fertility, higher rates of childlessness, and increases in divorced and never-married statuses – will decrease the pool of potential caregivers in the near future. Unlike past years, aging baby boomers and seniors will have fewer family members to rely on for their care because they will more likely be unmarried or divorced and living alone, and may be even geographically separated from their children.

The in-depth report found that family caregivers typically provide health and medical care at home, navigate a very complicated and fragmented health care and long-term services and support systems, and serve as surrogate decision makers. Although these individuals play a key role caring for older adults with disabilities and complex health needs, they are oftentimes marginalized or ignored by health care providers. Caregivers may be excluded from treatment decisions and care planning by providers who assume that they will provide a wide range of tasks called for in the older adult’s care plan.

Confirming other research studies, the committee found that caregivers have higher rates of depressive symptoms, anxiety, stress, social isolation, and emotional difficulties. Evidence also suggests that they experience lower physical well-being, elevated levels of stress hormones, higher rates of chronic disease, and impaired preventive health behaviors.

Those taking care of very impaired older adults are at the greatest risk of economic harm, because of the many hours of care and supervision they provide. However, caregiving can provide valuable lessons, helping the caregiver deal with difficult problems and bringing them closer to the recipient of care.

Next Steps

NASEM’s report calls for the next presidential administration to take immediate action to confront the health, economic, and social issues facing family caregivers. Also, the committee urges the secretary of the U.S. Department of Health and Human Services, in collaboration with other federal agencies, and private-sector organizations, to develop and implement a National Family Caregiver Strategy that recognizes the essential role family caregivers play in the well-being of older adults.

The report recommends that the nation’s health and long-term care systems must support caregiver’s health, values, and social and economic well-being, as well as address the needs of the of a growing caregiver population that is both culturally and ethnically diverse.

Federal programs (such as Medicare, Medicaid and Veterans Affairs) must also develop, test and implement effective mechanisms to ensure that family caregivers are routinely identified, assessed, and supported. Payment reforms can motivate providers to engage caregivers in the delivery of health care, too.

AARP Rhode Island State Director Kathleen Connell agrees with the NASEM’s report’s assessment that the importance of a caregiver’s role in an aging society cannot be overstated. At her organization she clearly sees an increased demand for caregivers and knows all-to-well the impact of a shrinking pool of potential caregivers on those in need.

“It is essential that we take action now to do all we can to remove obstacles and additional financial strain and mitigate physical and mental stress where possible for caregivers,” says Connell. AARP has compiled a wealth of research and information on aging issues that can be accessed on

Final Thoughts…

On Jan. 1, 2016, a new Rhode Island law took effect that would help Rhode Islanders avoid costly and time-consuming red tape when exercising health care, financial and other legal responsibilities for their out-of-state, elderly loved ones.

Why reinvent the wheel? Rhode Island law makers, the state’s Division on Elderly Affairs and the Lt. Governor’s Long-Term Care Coordinating Council can do more to support the state’s growing caregiver population. With the next session of the Rhode Island General Assembly starting in January 2017, state officials and lawmakers can reach out to other states to learn what state-of-the art caregiver programs can be implemented here.

For a copy of the report go to:

We Haven’t Turned the Page on Reading Yet

Published in Woonsocket Call on September 11, 2016

In May 1897, the great American humorist, novelist, publisher and lecturer Samuel Clemens – who we all know as Mark Twain – was in London on a world-wide speaking tour. In this City someone had started a rumor that he was gravely ill, ultimately the rumor changing to he had died.

When Twain was told that one major American newspaper actually printed his obituary, when he was told about this by a reporter, he quipped: “The reports of my death are greatly exaggerated.”

As the rumor about Twain’s death was “greatly exaggerated” those lamenting the decreasing number of Americans who read print books, even predicting its demise with the advent of e-books, audio books and computer tablets is not correct, says a new Pew Research Center Survey released. Researcher Andrew Perrin notes in his study, “Book Reading 2016” that printed books remain more popular than books in digital formats for American Readers.

AAmericans Love Print Books

According to the survey findings, released on September 1, 65 percent of Americans have read a print book in the last year, more than double the share that has read an e-book (28 percent) and more than four times the share that have listened to an audio book (14 percent).

While the total share of Americans who have read a book in the last 12 months (73 percent) has remained consistent since 2012, nearly four-in-ten Americans read print books exclusively. Just 6 percent of Americans are digital-only book readers, adds the Pew Research Center Survey findings.

Although print remains the most popular book format, Americans who do read e-books are increasingly turning to multipurpose devices such as smartphones and tablet computers, says Pew Research Center Survey findings. The share of e-book readers on tablets has more than tripled since 2011, and the number of readers on phones has more than doubled over that time, says.

Perrin’s 9 page report also details other key findings.

The study found that 84 percent of American adults read to research specific topics of interest, while 82 percent read to keep up with current events, 80 percent read for pleasure, and 57 percent read for work or school. Also, 19 percent of Americans under the age of 50 have used a cellphone to read e-books, and cellphones play a relatively prominent role in the e-reading habits of blacks (16 percent) and those who have not attended college (11 percent).

As to education, the study found that college graduates are nearly four times as likely to read books – and twice as likely to read print books and listen to audio books – compared with those who have not graduated high school. In addition, Americans read an average, or mean, of 12 books per year; however, the typical, or median, American has read 4 books in the last 12 months.

Finally women (77 percent) are more likely than men (68 percent) to read books in general, and they are also more likely to read print books (70 percent). However, men and women are equally likely to read digital-format books such as e-books and audio books.

Book Buying Strong in Rhode Island

Jennifer Massotti, who manages both the Barrington and Cranston locations for Barrington Books, has some thoughts about the recently released report. “The survey findings support the reading style and buying trends that we have seen from our loyal customer base for years. The majority of our customers prefer to read from a physical book. Even those who use their smart phones to research titles, still come in looking to buy the book instead of ordering it online or downloading. This could be personal reading preference or in support of the localism movement. Either way, book buying is strong,” she says.

Massotti does not see book stores becoming obsolete because of today’s digital age. “While the advent of e-readers and online buying options certainly altered the book industry several years back, it has not been the nail in the proverbial coffin that everyone predicted … If anything, there has been a resurgence in the independent bookstore industry, specifically. Brick and mortar stores that are supported by and steeped within their communities are thriving,” she says.

Massotti says, “In fact, in the last year, RI and neighboring MA have seen that growth first-hand with the highly anticipated opening of three new bookstores. It’s a feel-good time in our industry.”

But, the general manager of Barrington Books notes, “downloading a book to your smartphone is convenient and serves a purpose to some. But it doesn’t come close to replicating the authentic experience one finds when perusing the carefully curated stacks in a bookstore, or engaging in a conversation with a like-minded bookseller.”

According to Massotti, bookstores aren’t like most other retail outlets that are in the business of selling goods; bookstores, and books, are the original social media. “It’s a sharable experience, it’s about community. You can’t get that delivered to your door or your phone,”

As to the future of reading, Massotti firmly says that e-books and digital formats will never replace print books.

Self-Publishing Leaves a Legacy

Author Steven R. Porter, a publisher, and president of the Association of Rhode Island Authors (ARIA), representing over 260 independent and traditionally published authors who live and write in Rhode Island, says that Rhode Islanders love to read locally written books and to chat with the authors. “Readers also find great value in a signed book. There is something special about reading and sharing a book that the author held in their hands. The bottom line is that people who love to read are voracious. They can’t get enough. And we can’t write them fast enough,” he says.

Porter has seen an “explosion of self-published books”in the last 5 years, but more recently, the rate has leveled off. “I think most of the leveling has to do with the fact that there were thousands of frustrated writers in the world and when the gates finally opened, and they all rushed through at the same time,” he says, noting that improved information and technology has efficiently assisted authors getting their books to market.

“Seniors are publishing more and more every day. I think there is an inherent need in all of us to have some sort of legacy. That legacy for many may be achieved through your life’s work, or through your family, says Porter. It is the “ultimate expression of immortality,” he says.

Like Massotti, Porter agrees with the findings of the Pew Research Center’s report on book reading in America. “More people are writing than ever before, and reading than ever before. It’s a great time to be a writer and a reader!,” he says.

To read the report, go to

Remembering Abby

Published in Woonsocket Call on September 4, 2016

In March 2009, we formally adopted an impaired chocolate Labrador with a host of medical problems. With the signing of legal papers, four-year-old Abby met Murray, her elder adoptive canine sibling, who was also a chocolate Labrador.

Four months earlier Abby had arrived at the Pawtucket Animal Shelter, weak, malnourished and showing signs of abuse. She appeared to suffer from blindness and a host of other medical ailments. Animal Control Officer John Holmes had sought veterinary care for her, but the medical testing came back inconclusive. It could be a brain tumor or lead poisoning affecting her vision, he would tell us, which for many potential families seeking adoption may be unappealing.

Officially Adopting Abby

According to Holmes, Abby’s Labrador Retriever breed made her a very popular candidate for adoption, but when people learned about her medical issues they had second thoughts. Abby might just be a good younger companion for our 11-year-old chocolate lab, Murray. We had good luck with this breed and were looking to adopt another chocolate lab.

Six months prior to Abby’s “official adoption” we made an unusual request from the Pawtucket Animal Shelter asking if a “foster care” arrangement could be made to see how well Abby got along with Murray. Having nothing to lose and everything to gain – they agreed.

When Abby came home our first priority was to try to make her gain some weight, which she eventually did. She adjusted well to Murray and her new surroundings, but during the first week she would have a seizure. We watched helplessly as this four year old canine shook all over, with her tongue lolling, her mouth foaming and her eyes rolling back into their head. It was not pleasant to watch, and we initially thought she was dying. Ultimately, with anti-seizure medication her seizures were under control and Abby thrived by gaining weight and becoming increasingly playful to the aging Murray.

We were extremely happy with the new addition to the family, even though we were now taking care of two medically needy pets instead of just one. Abby was given her daily pill in peanut butter to control seizures and Murray, a diabetic, was given insulin shots twice a day.
Health issues would force us to put Murray down in 2010. It would take months for Abby to adjust to his passing. She just knew her companion was gone. But, over the years she adjusted to being the only pet in our household.

Getting Into the Household Routine

A new regiment took over, and every morning, like clock-work, Abby would carefully walk up the stairs, ending up at my bedroom door. The routine shaking of her head, her dog tags would jingle, sending the message to me that it was time to start the day. She was telling me to get up, serve her breakfast and let her outside. As the years began to pass and she grew older, her medical issues became more prominent and it was difficult for her to walk those stairs.

Abby’s internal clock would also place her at the front door at 9:00 p.m. for her nightly walk, too. She had now become a visible fixture in my neighborhood of Oakhill. Neighbors would see us taking our daily nightly walk, but when I began walking by myself they hesitated before asking me “is Abby ok.” No, I say, she is not.

The Moment of Truth

It happened quickly the day before we were to take her on vacation with us. We came home to find her with legs spread out on the floor with no ability to stand up. Her once healthy appetite suddenly diminished. After almost a week of veterinary care my wife, Patty and I came to a decision to end the suffering of Abby, our 11-year-old chocolate Labrador. Looking to ease her pain and reduced quality of life, we made the hard and painful decision to put her down. After all, Abby was an integral part of our family.

Pet owners will share the trauma of putting their furry friend to sleep. Many may even tell you they relive their decision for decades, while some vow never to get another pet for fear of reliving the moment.

So as I pen this weekly commentary in a very quiet house. Abby’s water and food bowls are put away. Her cremated ashes and collar will be placed next to Murray’s wooden box containing his ashes, which sits on the mantle of our fireplace in the living room.

We think about her daily, may be more than once. But, perhaps there will be a time when we will bring another shelter animal into our house, hopefully a female chocolate Labrador. Maybe even two.

To cope with the loss of your pet go to