Splaine Consulting Gears Up to Update State’s Alzheimer’s Plan

Published in Woonsocket Call on July 8, 2018

With the securing of a total of $30,000 in grants, Lt. Governor Dan McKee officially begins Rhode Island’s effort to update its state’s five-year plan on Alzheimer’s Disease and Related Disorders to combat the rapidly increasing incidence of Alzheimer’s disease.

When announcing the successful fundraising effort, McKee noted that Rhode Island has been in the forefront of Alzheimer’s research. “Each day, we make great strides in expanding clinical trials and innovating treatments. Over the last few years alone, the local landscape of prevention and treatment has changed dramatically and positively. The updated State Plan will be an invaluable tool for local leaders, researchers, physicians, advocates and families as we work together to build the momentum in the fight against Alzheimer’s,” he said.

That day, Donna McGowan, Executive Director of the Alzheimer’s Association, Rhode Island Chapter, warned “We face an emerging crisis with the prevalence of Alzheimer’s disease projected to increase to as many as 27,000 Rhode Islanders by 2025. Alzheimer’s disease is a pivotal public health issue that Rhode Island’s policymakers cannot ignore. With the rapidly growing and changing extent of the Alzheimer’s crisis, it is essential that Rhode Island’s State Plan becomes a living document that stakeholders regularly consult and re-evaluate. We will continue to work diligently to ensure that the vision of our state’s Alzheimer’s Disease Plan is translated into actual public policy.”

Consultants Bring Content Expertise to Project

With two $15,000 grants provided by the Rhode Island Foundation and Tufts Health Plan Foundation, the Alzheimer’s Association, Rhode Island Chapter, as fiscal agent, released a request for proposal (RFP) for a consultant who would bring writing skills, expertise in public policy initiatives to provide programs and services to persons with Alzheimer’s disease, to the project.

Five consultants responded to the RFP and after a month long-search and a series of interviews, Michael Splaine and Kate Gordon, of Splaine Consulting, a small advocacy and government affairs consulting firm based in Columbia, Maryland, got the contract. No question, Splaine and Gordon brought the right blend of skills to the project. The consultants have provided content matter expertise to over two dozen State Alzheimer’s Plans.

Immediately prior to starting this company eight years ago, Splaine served as Director of State Government Affairs in the Public Policy Division of the Alzheimer’s Association for over 23 years, leading its grassroots network to accomplish state policy priorities, including persuading states to develop comprehensive state Alzheimer Plans in 2007-2008.

While at the Association he was a staff team member for the Association’s Early Stage Initiative (a program working to promote inclusion and programs for persons with Alzheimer’s.) and provided leadership in the Association on the government affairs aspects of the Healthy Brain Initiative, a cooperative agreement with the U.S. Centers for Disease Control, and Prevention continues this work as a consultant to the Association.

Kate Gordon, who has worked with Splaine for over 18 years, has a reputation for being a skilled health policy analyst and grassroots advocacy strategist. She brings expertise in a diverse range of health and long-term care issues topics, including federal and state policies affecting persons with dementia, caregiver interventions, and direct care worker training. Her previous work includes assisting in the development of the first United States National Alzheimer’s Plan and 18 state government Alzheimer’s disease plans.

Gordon was also awarded the prestigious 2013 HHSinnovates People’s Choice and Secretary’s Choice award winner for “Connecting to Combat Alzheimer’s.”

“Kate and I have worked with every level of government from local to global that is taking on the challenge of Alzheimer’s disease, including regionally and globally with the World Health Organization,” explains Splaine. The company’s long listing of clients includes the Alzheimer’s Association in their public health work with Center for Disease Control and Prevention (CDC), Alzheimer’s Disease International, the umbrella organization for over 90 national organizations devoted to persons with dementia, and overtime Splaine Consulting has also worked with the national center on elder abuse, Consumer Voice, Arthritis Foundation to name just a few.

The path that led Splaine Consulting to being chosen to update Rhode Island’s Alzheimer’s Plan may seem ironic to some, says Splaine, because it has most certainly brought him back home. He started his early professional life in the Ocean State, graduating Rhode Island College with a gerontology certificate, even having been married to a native Bristol resident for 41 years.

“My earliest work with people with cognitive impairment included volunteer teaching for Fr. (now Msgr.) Gerry Sabourin who was developing what was then called a special religious ed program and my field placement for Rhode Island College at two different adult day care centers,” says Splaine.

“I am thrilled to welcome Splaine Consulting to our team as we relaunch Rhode Island’s coordinated effort to fight Alzheimer’s disease and provide patients with the highest level of support and care,” said McKee. “Rhode Island is a leader in Alzheimer’s research and treatment but knowing how other states are addressing this devastating disease is essential to our success. Splaine’s experience in crafting other State Plans and their thorough understanding of the national landscape make Michael and Kate valuable partners.”

Combatting the Alzheimer’s Epidemic

The update of the State’s initial five-year Alzheimer’s Plan approved by the Rhode Island General Assembly in 2013, is a collaborative effort of the Rhode Island chapter of the Alzheimer’s Association, the Division of Elderly Affairs and the Office of the Lt. Governor. The final plan will provide state lawmakers, municipalities and the state’s health care system with a policy strategy to confront the anticipated Alzheimer’s epidemic. It will also take a look at the current impact of Alzheimer’s disease on a growing number of Rhode Islanders and most importantly, details the steps the state must take (legislatively and regulatory) to improve programs and services for people with Alzheimer’s and their family caregivers.

Once the updated report is completed and approved by the Rhode Island General Assembly, the state’s Long-Term Care Coordinating Council’s Executive Board will seek legislative and regulatory changes to carry out its recommendations to ensure that it is more than just a document—that it comes to shape the state’s public policies on Alzheimer’s.

The updated report must be completed by October 31, after which there will be a follow up survey to all stakeholders in the process to see “how we did at capturing their ideas,” says Splaine.

Now, Splaine and Gordon begin their analytical review work of reviewing the existing Alzheimer’s Disease Plan, contacting key state agencies for their input, and planning formal interviews over the next 6 weeks with key persons from care, research, academia, and persons with dementia and family caregivers.

Community input is crucial, says Splaine. “Through the Long-Term Care Coordinating Council’s Executive Board under the leadership of the Lt. Governor, caregiver subcommittee we have a survey out [to solicit comments] that will stay open through the end of August that will be available online and offline, he says. Kicking off on August 5 and concluding August 10, 18 community town meetings are scheduled to allow Rhode Islanders to give their thoughts as to what should be included in the updated State Alzheimer’s Plan.

For a schedule of community town meetings visit, ltgov.ri.gov/alz.

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New Report Says Alzheimer’s Disease Is Now Major Public Health Issue

Published in the Woonsocket Call on March 25, 2018

For the second consecutive year, total payments to care for individuals with Alzheimer’s or other dementias will surpass $277 billion, which includes an increase of nearly $20 billion from last year, according to data reported in the Alzheimer’s Association 2018 Alzheimer’s Disease Facts and Figures report recently released last Tuesday.

According to the Alzheimer’s Association, the annual report, first released in 2007, is a compilation of state and national specific statistics and information detailing the impact of Alzheimer’s disease and related dementias on individuals, families, state and federal government and the nation’s health care system.

“This year’s report illuminates the growing cost and impact of Alzheimer’s on the nation’s health care system, and also points to the growing financial, physical and emotional toll on families facing this disease,” said Keith Fargo, Ph.D., director of scientific programs and outreach for the Alzheimer’s Association, in a statement. “Soaring prevalence, rising mortality rates and lack of an effective treatment all lead to enormous costs to society. Alzheimer’s is a burden that’s only going to get worse. We must continue to attack Alzheimer’s through a multidimensional approach that advances research while also improving support for people with the disease and their caregivers,” he said.

Adds Fargo, “Discoveries in science mean fewer people are dying at an early age from heart disease, cancer and other diseases,” said Fargo. “Similar scientific breakthroughs are needed for Alzheimer’s disease, and will only be achieved by making it a national health care priority and increasing funding for research that can one day lead to early detection, better treatments and ultimately a cure.”

2018 Alzheimer’s Facts and Figures

New findings from the 88-page report on March 20, 2017 reveal the growing burden on 16.3 million caregivers providing 18.4 billion hours of care valued at over $ 232 billion to 5.7 million people with the devastating mental disorder. By 2050, the report projects that the number of persons with Alzheimer’s and other dementias will rise to nearly 14 million, with the total cost of care skyrocketing to more than $1.1 trillion.

Between 2000 and 2015 deaths from health disease nationwide decreased by 11 percent but deaths from Alzheimer’s disease have increased by 123 percent, says the new data in the report, noting that one out of three seniors dies with Alzheimer’s or another dementia. It even kills more than breast cancer and prostate cancer combined. In Rhode Island in 2015, the number of deaths from Alzheimer’s disease was 453, making the devastating brain disorder the 5th leading cause of death in the state.

In 2017, 53,000 Rhode Island caregivers provided an estimated 61 million hours of unpaid physical and emotional care and financial support – a contribution to the nation valued at $768 million dollars. The difficulties associated with providing this level of care are estimated to have resulted in $45 million in additional healthcare costs for Alzheimer’s and other dementia caregivers in 2017.

State Updates Battle Plan Against Alzheimer’s Disease

“The Alzheimer’s Association’s most recent report about Alzheimer’s Disease in Rhode Island illustrates the need to take swift action in updating our State Plan to ensure Rhode Island is prepared to provide the necessary resources to families, caregivers and patients who are struggling with the disease,” says Lt. Governor McKee,

McKee adds that the updated State Plan will be a blueprint for how Rhode Island will continue to address the growing Alzheimer’s crisis. “It will create the infrastructure necessary to build programs and services for the growing number of Rhode Islanders with the disease. The updated Plan will also outline steps the state must take to improve services for people with Alzheimer’s and their families. After the update is complete, my Alzheimer’s Executive Board will seek legislative and regulatory changes to carry out the recommendations of the Plan and ensure that it is more than just a document,” he says.

“One of the many types of caregivers benefiting from AARP’s caregiving advocacy in Rhode Island are family members who care for those with Alzheimer’s,” said AARP Rhode Island State Director Kathleen Connell. “They are among the army of 10 million wives, husbands, sons and daughters nationwide. The majority are women and according to researchers, especially when it comes to dementia and Alzheimer’s care. Approximately 40 percent of those caregivers say they have no other options or choices, and a third say they provide care 24/7.

“The latest report indicates what we already know,” Connell added. “This will continue to be rising challenge in Rhode Island as our population ages. The disease will place more stress on our Medicaid-funded nursing home capacity, which should make this a concern for taxpayers. There is a strong case for increasing research funding so that someday we may reverse the tide.

“Our Web site, http://www.aarp.org, provides abundant resources for these dedicated caregivers. AARP in states across the nation, including Rhode Island, have worked to pass legislation that provides paid respite for caregivers who have jobs as well as caregiving obligations. We have supported the Alzheimer’s Association here in Rhode Island for many years and, last year, a small team of AARP volunteers participated in the Alzheimer’s Walk. Joined by others, they are gearing up for this year’s walk.”

Increased Research Funding Needed Now

Donna McGowan, Alzheimer’s Association, RI Chapter Executive Director, says that the 2018 Alzheimer’s Disease Facts and Figures report should send a very clear message that Alzheimer’s disease is an issue that policy makers cannot ignore. “This is an urgent public health crisis that must be addressed. Early detection and diagnosis of the disease leads to better planning, avoiding preventable hospitalizations, and over all a better quality of life for the patient and the caregiver,” says McGowan.

McGowan warns that the health care system is not ready to handle the increased cost and number of individuals expected to develop Alzheimer’s disease in the coming years. “With a vigorous National Plan in place to address the Alzheimer’s crisis, and annual budget guidance for Congress, it is essential that the federal government continue its commitment to the fight against Alzheimer’s by increasing funding for Alzheimer’s research,” adds McGowan.

Rhode Island Congressman David Cicilline sees the need for increased funding for direct services for those afflicted with Alzheimer’s disease. He voted for H.R.1625, the omnibus spending bill that increases funding for the National Institute of Health’s Alzheimer’s research by $414 million. And two years ago, Cicilline worked to pass H.R.1559, “The HOPE for Alzheimer’s Act,” which President Obama signed into law to expand Medicare coverage for Alzheimer’s treatment.

If Cicilline succeeds to get the Republican-controlled Congress to have a vote on H.Res.160, his bill to reestablish the House Select Committee on Aging, it will allow House lawmakers to hear expert testimony and make new policy recommendations to improve the delivery of care to those afflicted with Alzheimer’s and to assist caregivers, too.

For details, go to http://www.alz.org/facts.

Report: Cognitive-Simulating Activities Good for Your Brain’s Health

Published in Woonsocket Call on August 6, 2017

Don’t expect playing “brain games” to have the long-term brain health benefits oftentimes reported in newspapers. According to a statement released last month by the Global Council on Brain Health (GCBH), the scientific evidence supporting the benefits of “brain games” is at best “weak to non-existent.” But, the researchers say you can engage in many stimulating activities to help sharpen your brain as you age.

GCBH’s latest statement on “Cognitive Stimulating Activities” follows earlier reports issued by this independent organization created by AARP, advocating on behalf of its 38 million members with the support of Age UK, one the United Kingdom largest charities advocating for seniors. Previous areas included: “The Brain Body Connection;” The Brain Sleep Connection;” and “The Brain and Social Connectedness.”

The 25-page GCBH report, released on July 25, says that while many find “brain games” to be fun and engaging activities, oftentimes the claims made by companies touting the game’s cognitive benefits are exaggerated. The researchers noted that there are many ways to support and maintain your memory, reasoning skills, and ability to focus, such as engaging in formal or informal educational activities, learning a new language, engaging in work or leisure activities that are mentally challenging, and connecting socially with others.

Keeping Mentally Sharp

The report debunks “brain health” myths, too. Contrary to the many stories told about the brain as we age, the GCBH finds that a person can learn new things, no matter their age. Getting dementia is not an inevitable consequence of growing older. Older persons can learn a second language. And, people should not expect to forget things as they age.

“The GCBH recommends people incorporate cognitively stimulating activities into their lifestyles to help maintain their brain health as they age,” said Marilyn Albert, Ph.D., GCBH Chair, and Professor of Neurology and Director of the Division of Cognitive Neuroscience at Johns Hopkins University in Baltimore, Maryland. “The sooner you start the better, because what you do now may make you less susceptible to disease-related brain changes later in life.”

“We know that the desire to stay mentally sharp is the number one concern for older adults,” said Sarah Lock, AARP Senior Vice President for Policy, and GCBH Executive Director. “Seeking out brain-stimulating activities is a powerful way for a person to positively influence their brain health as they age.”

GCBH pulled 13 independent health care professionals and experts together, who work in the area of brain health-related to cognitive functioning, to examine “Cognitively Stimulating Activities.” This group crafted the report’s consensus statement and recommendations after a close examination of well-designed randomized scientific studies published in peer review journals and studies replicated by other scientists.

Taking Control of Your Brain Health

The report concluded that people have control and influence over their brain changes throughout their lifespan. People can maintain their memory, cognitive thinking, attention and reasoning skills as they age by doing brain-stimulating activities. There is sufficient evidence that brain-stimulating activities are beneficial to staying mentally sharp over your lifespan

The researchers found through their literature review that training on a specific cognitive ability such as memory may improve that specific ability, but scientific evidence suggests you need to continue to apply that training to maintain or improve the ability over time.

The researchers also found that there is insufficient evidence that getting better at “brain games” will improve a person’s overall functioning in everyday life. Maintaining or improving your brain health is tied to the activity being “novel, highly engaging, mentally changing and enjoyable.”

The GCBH report suggested that just by learning a new skill, practicing tai-chi, learning photography, even investigating their family history, you can stimulate their brain and challenge the way they think, improving “brain health.” Also, social engagement and having a purpose in life, like “volunteering as a companion and mentoring others in your community,” can be mentally stimulating and improve your “brain health.”

But, the researchers say don’t forget physical activity, such as “dancing and tennis.” because the mental engagement and physical exercise can mentally benefit you, too.

The GCBH, founded in 2015, is an independent international group of scientists, health professionals, scholars and policy experts working on brain health issues. Convened by AARP with support from Age UK, the goal of the GCBH is to review the current scientific evidence and provide recommendations for people so that they can maintain and improve their brain health.

The full GCBH recommendations can be found here: http://www.globalcouncilonbrainhealth.org.

Yes, routinely challenging your brain can lead to improved “brain health. As the old adage says, “Use it or lose it.”

Samaritans Celebrate Their Fortieth Birthday

Published in Woonsocket Call on January 22, 2017

In 2001, Denise Panichas took the temporary job as executive director of The Samaritans of Rhode Island, only expecting to stay at the helm for six week. Looking back over the last 16 years the Woonsocket resident clearly sees the hook that has kept her in her very demanding job.

“After my arrival people I knew, from all walks of life, came up to me sharing their personal stories of losing a loved one to suicide or being a caregiver to a person with physical or behavioral problems,” says Panichas. “My decision to stay in my temporary position for just one week, turned into two weeks and then time just quickly flew by,” she says, noting that her empathy grew daily with each encounter with Rhode Islanders who suffered the tragic loss of a loved one.

Surviving the Financial Storm

Running a small statewide nonprofit is not as easy as one thinks, notes Panichas, as she reflected on the uncontrollable obstacles she had to overcome to keep The Samaritans, the state’s only nonprofit group exclusively dedicated to suicide prevention and education, financially afloat.

Panichas watched her donations dry up as the America’s economy spiraled out of control during the 2008 financial crisis, some calling it the nation’s worst the 1930’s Great Depression. Before that, at the state-level, The Samaritans along with many of Rhode Island’s nonprofits, lost funding when the United Way of Rhode Island eliminated member agencies, cutting assistance to many nonprofit groups. “The Samaritans lost over $50,000 from these cuts,” says Panichas, stressing that that downsizing and redirected fundraising efforts to target individual contributors and special event fundraisers (“Cross the Bridge to Hope” at the Pell Bridge Run) brought in needed funds into the nonprofit’s coffers to man the hotlines and its grief support group.

Today, 17 percent of The Samaritan’s funding comes from state and local grants, the rest coming from foundation, individual, corporate and special event contributions. Eighty one percent of its fundraising dollars is allocated to program, she says.

But, Panichas now sees better times for The Samaritans as she begins organizing events and programs that will take place in the upcoming months to celebrate the 40th Anniversary of The Samaritans. “In February, we are planning to release the details about the free programs and special events that will serve as our fundraisers,” she says.

Panichas and her board of 12 community leaders, from six Rhode Island communities and nearby Massachusetts, are also in discussion with the Preservation Society of Pawtucket to purchase the Baker-Hanley House, one of the City’s oldest houses, on Park Place, to serve as its first owned headquarters. The agency is planning a “Peace Garden” at the side of the historic structure to allow visitors to mediate and reflect on loved ones they have lost through suicide. .

Over forty years, The Samaritans have worked hard to bring the topic of suicide out of the closet and into public discussion, say Meredith Hampton, president of The Samaritan’s who has served on its board for over 15 years. “We have persevered and gained public support who have rallied behind our efforts,” she says.

Like Panichas, Hampton, a Cranston resident who serves as senior project manager for Norwood, Massachusetts-based Cramer Production Company, a marketing and communications firm, is thrilled that her nonprofit is celebrating its ruby anniversary of providing programs and services to the Rhode Island community. Hampton notes that owning a building will “put a face to the organization” and she expects the capital campaign to be announced in a couple of months.

Reaching out to Rhode Island’s Lonely

“Feeling low with nowhere to turn” noted songwriter Bill Withers says is a public service announcement regularly played, there is a place to call – The Samaritans – where trained volunteers “are there to listen.” Incorporated in 1977, the Pawtucket-based nonprofit program is dedicated to reducing the occurrence of suicide by befriending the despairing and lonely throughout the state’s 39 cities and towns.

Since the inception, The Samaritans has received more than 550,000 calls and trained more 1,355 volunteers to answer its confidential and anonymous Hotline/Listening Lines.

With the first Samaritan branch started in England in 1953, independent Samaritan branches can now be found in more than 40 countries of the world. “Samaritans, can I help you?” is quietly spoken into the phone across the world in a multilingual chorus of voices,” notes its web site.

The communication-based program teaches volunteers to effectively listen to people who are in crisis, says Panichas, noting that conversations are free, confidential and, most importantly, anonymous.

A rigorous 21-hour training program teaches volunteers to listen to callers without expressing personal judgments or opinions. Panichas said that the listening techniques called “befriending,” calls for 90 percent listening and 10 percent talking.
“Suicide is considered a missed opportunity in prevention,” says Panichas. She stresses, “If you are doing all the talking there is a very chance that you will miss what is really bothering the hopeless caller.”

Panichas noted in 2016 more than 5,491 calls were logged into The Samaritans’ Listening Line, a great resource for caregivers and older Rhode Islanders. She estimates that 997 came from seniors.

In 2016, The Samaritans hosted over 108,305 visitors to its website, many going to caregiver information. The nonprofit’s website received 1,487,691 hits and 233,336 pages were viewed. Panichas believes that the increased website visits are due to the “growing problem of suicide and our nonprofit group’s effective use of social media.”

Other services include a peer-to-peer grief Safe Place Support Group for those left behind by suicide as well as community education programs.

The Samaritans can be the gateway to care or a “compassionate nonjudgmental voice on the other end of the line,” Panichas notes. “It doesn’t matter what your problem is, be it depression, suicidal thoughts, seeking resources for mental health services in the community or being lonely or just needing to talk, our volunteers are there to listen.”

Rhode Island’s Art Community Supports Program and Services

In December 2011, The Samaritans began a social venture, by relocating to the City of Pawtucket’s 307 acre Arts & Entertainment District. According to Panichas, a built out professional gallery allowed her to open the Forget-Me-Not Gallery and Community Education Center. Through networking and partnerships with Rhode Island’s fine arts and crafts community, “we are able to foster hope, inspiration and commemoration of the lives of our loved ones who have fallen victim to suicide,” she says.

“Every piece of art sold or every gift bought through our gift shop provides needed funded for our programs and also contributes to Rhode Island’s state artistic small business economy,” says Panichas.

Eric Auger of Pawtucket and co-owner of Ten31 Productions also in Pawtucket, volunteers his time and talent in curating gallery shows throughout the year, says Panichas, noting that there have been more than two dozen exhibits, performances and education programs since 2011.

At the Forget-Me-Not Gallery, no sales taxes are charged on one-of-a-kind pieces of art work. The gallery also is a retail site for Rhode Island-based Alex and Ani jewelry and other giftware.

For those seeking to financially support the programs of The Samaritans, its Gallery and Education Center is available to rent for special events, meetings and other types of occasions. For information on gallery rental, call the Samaritans business line at 401-721-5220; or go to http://www.samaritansri.org.

Need to Talk? Call a volunteer at The Samaritans. Call 401.272.4044 or toll free in RI (1-800) 365-4044.

For persons interested in more information about suicide emergencies, The Samaritans website, http://www.samaritansri.org, has an emergency checklist as well as information by city and town including Blackstone Valley communities from Pawtucket to Woonsocket.

Does Exercise Aid Brain Health?

The Debate’s Yet to be Decided

Published in Woonsocket Call on August 31, 2016

According to AARP’s latest health aging survey findings, age 40 and over respondents who regularly exercise rate their brain health significantly higher than non-exercisers. They also cite improvements in their memory, ability to: learn new things, managing stress, and even making decisions. On the other hand, the findings reveal an overwhelming majority of these respondents see the benefits of exercise, but only 34 percent are meeting the Global Council on Brain Health’s (GCBH) recommended 150 minutes of moderate to vigorous exercise per week.

These findings in the 37 page Survey on Physical Activity report, conducted by GfK for AARP, directly align with AARP’s Staying Sharp program, a digital platform that promotes brain health though holistic advice supported by science.

“With Staying Sharp, we sought to empower consumers with the tools needed to create a holistically brain healthy environment for themselves—along with a way to track and measure their progress,” said Craig Fontenot, VP of Value Creation. “The results of this survey only further validate the advice suggested on the platform and give us confidence that we’re providing our members with helpful, impactful information.”

The AARP survey findings, released on July 26, found that more than half (56 percent) of the age 40 and over respondents say that they get some form of exercise each week. However, only about a third (34 percent) of these individuals actually achieve the recommended 2 ½ hours of moderate to vigorous activity each week. There was little difference in reported amounts of exercise by age or gender.

The AARP online survey, with a represented sample of 1,530 Americans age 40 and over, found that walking is the most common form of physical exercise reported with 53 percent of the age 40 and respondents saying that they walk for exercise. A smaller percentage is engaging in more vigorous activity such as strength training/weight training (15 percent) or running/jogging (8 percent).

According to the survey’s findings, most of the age 40 and over respondents see the benefits to engaging in physical activity and do not find it particularly unpleasant or difficult. For example, three quarters believe exercise would improve their health, physical fitness, and quality of life.

Having willpower, enjoying exercise, identification as an “exerciser,” lack of enjoyment and feeling like you have the energy to exercise or lack money to exercise are the key factors that differentiate exercisers from non-exercisers, the researchers say.

The study found that the largest share of non-exercisers are “contemplators” in that they see the benefits and are considering taking up exercise (34 percent). About one-quarter (24 percent) are considered “non-believers” and see no need for exercise and were satisfied being sedentary. However, two in ten (19 percent) are “preparers” and say they have a firm plan to begin exercising in the near future.

Finally, the most common leisure activity that age 40 and over respondents would give up if they were to engage in exercise is watching TV/streaming movies (65%).

Removing the Barriers to Exercise

Colin Milner, CEO at the Vancouver, BC-based International Council on Active Aging, says, “These findings demonstrates the amazing and ongoing benefits of regular exercise. Our challenge, to get more people to actually move. By doing so the country and millions of individuals would improve their physical and mental health,” he notes.

Adds Milner, “The most important thing is to remember is that our bodies and brains were meant to be used. If we fail to do so they will cease to perform at the level we need or desire, and that is detrimental to our overall health and well-being.”

“Part of our challenge [to not exercising] is to remove the barriers that prevent us from leading an engaged life. A recommendation would be to list out the reasons you are not exercising or eating well, why you are feeling stressed or are not socially engaged, then set out to replace these with reasons to exercise and eat well, to be stress free and socially engaged. Once you have done this consider what steps you need to take to make this a reality,” he says. ICAA’s Webpage, “Welcome Back to Fitness” (http://icaa.cc/welcomeback.htm) gives the basics to help people begin exercising.

An avid squash player, Richard W. Besdine, MD, Professor of Medicine and Brown University’s Director, Division of Geriatrics and Palliative Medicine, preaches the importance of physical activity to all his colleagues and friends. “There are a large number of research studies documenting that exercise is good for all organs in your body,” he says, adding that that regular exercise can also reduce cancer rates, control diabetes, improve one’s emotional health and even reduce depression.

When asked about AARP’s survey findings about the impact of exercise and brain health, Besdine says he applauds the survey’s objectives of examining the relationship between physical exercise and brain health, but its findings are self-reported at best, not empirically derived.

Besdine points out that there is a growing body of studies that empirically study the relationship between exercise and brain health and findings indicate a positive impact on brain functioning. People who exercise are less likely to be cognitively impaired and those who are mildly impaired may even slow or stop the progression of their mental disorder, he says.

“Although AARP’s survey is very interesting it is very limited because it is self-report and cross-sectional, says Deborah Blacker, MD, ScD, Director of the Gerontology Research Unit at Massachusetts General Hospital who is also a Professor of Psychiatry at Harvard Medical School.

AlzRisk, part of the AlzForum, a website that reports the latest scientific findings on the advancement of diagnostics and treatments for Alzheimer’s disease, posts a scientific review of 16 scientific articles reporting on the relationship of exercise habits to the later development of Alzheimer’s disease. Blacker, AlzRisk’s leader, says that this more solid body of evidence suggests that exercise may play a modest role in protecting a person from Alzheimer’s disease, but further scientific research is required.

Like Besdine, Blacker still sees the positive benefits of exercise even if the scientific data is still coming in. “We know that physical exercise is good for preventing cardiovascular disease and diabetes. If it may also help to prevent cognitive decline, for me that is an even better reason to exercise,” she says.

The Bottom Line

“Staying physically active is one of the best things that someone can do for their physical health and mental health. Physical activity can help you lose weight, lower your blood pressure, prevent depression, and, especially for older adults, promote memory and help you think clearly,” said Nicole Alexander-Scott, MD, MPH, Director of the Rhode Island Department of Health. “We are working hard to make sure that people from every zip code throughout Rhode Island have access to our state’s wonderful parks, beaches, and other natural resources and are getting the amount of physical activity they need to live long, full, productive lives.”

The Growing Incidence of Alzheimer’s

Published in Pawtucket Times on April 26, 2016

While Congress and states are nation grappling with how to put the brakes to one of the largest public health crises in recent times, the escalating Alzheimer’s disease (AD) epidemic, the Chicago-based Alzheimer’s Association releases its annual snap shot detailing statistics on the impact of Alzheimer’s and dementia on caregivers and health care costs..

According to the 2016 Alzheimer’s disease Facts and Figures, released on March 30, 2016, this year nearly 16 million Alzheimer’s caregivers will provide 18 billion hours of unpaid care to 5.4 million afflicted with this devastating disorder. That care had an estimated value of $221.3 billion, says the report.

But that’s not all, this recently released report notes that two out of three people believe that Medicare will help them over costly nursing facility costs. Sorry it won’t. AD also has a direct impact on a caregiver’s pocketbook, too, the researchers found. More than one-third of those surveyed say they were forced by caregiving duties to reduce their hours at work or just quit their job entirely. As a result of these actions their income dropped by $15,000 compared to the previous year. Eleven percent of caregivers were forced to cut back on spending for their children’s education in order to provide support.

The 79 page Alzheimer’s Association report notes that both physical, emotional and financial support required by a person with AD may ultimately deprive family and friend care givers basic necessities, such as food, transportation and medical care. The Facts and Figures report reveals that these caregivers were 28 percent more likely to eat less or go hungry while contributing care to someone with AD, and one-fifth even sacrificed their own medical care by cutting back on doctor visits. Overall, nearly half of the caregivers say they cut back on their own expenses to afford dementia-related care for their family member or friend.

“The devastating emotional and physical effects of caring for a person with Alzheimer’s disease has been well-studied,” said Beth Kallmyer, MSW, Vice President of Constituent Services for the Alzheimer’s Association. “However, this new report shows, for the first time, the enormous personal financial sacrifices that millions of care contributors must make every day. These sacrifices jeopardize the financial security of individuals and families, as well as their access to basic needs and health care.”

This year’s Facts and Figures report found that 13 percent of family or friend caregivers sold personal belongings, such as a car, to help pay for costs related to dementia, while nearly half tapped into savings or retirement funds. On average, caregivers, many of whom do not live with the person they’re caring for, spent more than $5,000 a year of their own money to care for someone with AD; however, amounts varied with many spending tens of thousands of dollars per year.
Incidents of AD is Fast Growing

The Facts and Figures report says that out of the 5.4 million (of all ages) afflicted with AD, an estimated 5.2 million are age 65 and over. Yes, one in nine people having the cognitive disorder. Approximately 200,000, having early onset AD, are under age 65.

Also, the recently released Facts and Figures report warns that we are truly in the midst of an AD epidemic as the baby boomers grow older. By 2050, researchers say that someone in the United States will develop AD every 33 seconds. Without a medical breakthroughs to prevent or cure, the age 65 and over population with AD, the incidence is expected to nearly triple, from 5.2 million to a projected 13.8 million. Some say may be even as high as 16 million. It’s the only disease among the top 10 causes of death in America that cannot be prevented, cured or even slowed. .

Additionally, this year’s Facts and Figure report notes that AD is officially listed as the sixth-leading cause of death in this country. It is the fifth-leading cause of death for people age 65 and older. With the graying of America, AD will become a more common cause of death. At age 70, 61 percent of those with AD are expected to die before the age of 80 compared with 30 percent of people without the cognitive disorder — a rate twice as high, says the report.

The Typical Care Giver

The Facts and Figures report puts the face on a typical caregiver. Approximately two-thirds of caregivers are women, and 34 percent are age 65 or older. Forty one percent have a household income of $50,000 or less.

AD takes a devastating toll on the health of caregivers, says the Facts and Figures report. Nearly 60 percent of those taking care of loved ones with Alzheimer’s and dementia report that their emotional stress being high or very high. About 40 percent suffer from depression. One in five care givers cut back on their own physician visits because of their caregiving responsibilities. And, among caregivers, 74 percent report they are “somewhat” to “very” concerned about maintaining their own health since becoming a caregiver.

A Huge Cost on the Health Care System

The report’s researchers warn that the AD epidemic might just bankrupt the nation’s Medicare program. In 2016, total payments for health care, long-term care and hospice are estimated to be $236 billion for people with Alzheimer’s and other dementias, with just under half of the costs paid by Medicare. Nearly one in every five Medicare dollars is spent on people with Alzheimer’s and other dementias. In 2050, it will be one in every three dollars

Medicare and Medicaid are expected to cover $160 billion, or 68 percent, of the total health care and long-term care payments for people with Alzheimer’s disease and other dementias.

Seeing a huge rise in AD over the last two years, federal and state officials are gearing up to strategize a battle to fight the impending epidemic.

A Call to Action

Yes, the AD epidemic is here, right in Rhode Island. Everyone is personally touched by either caring for a family member with the cognitive disorder or knows someone who is a caregiver or afflicted.

Following the efforts of Congress to create a national strategic plan to address the rapidly escalating AD crisis and to coordinate resources across federal agencies, the Rhode Island General Assembly passed a joint resolution enacted into law to direct the Lt. Governor’s Long Term Care Coordinating Council (LTCCC) to be the vehicle to develop a state plan to address this growing public health crisis in the Ocean State. Ultimately, for over a year former Lt. Governor Elizabeth Roberts along with LTCCC members, former Division of Elderly Affairs Director Catherine Taylor, the state Chapter of the Alzheimer’s Association, universities and health care organizations with the public input gleaned from 8 listening events hammered out the 122 page battle plan with over 30 pages of recommendations.

In 2016, Lt. Governor Daniel J. McKee has picked up the ball and convened a meeting of the Executive Board on Alzheimer’s Disease and Related Disorders, consisting of researchers, advocates, clinicians and caregivers, to begin efforts to implement recommendations from the State’s Alzheimer’s Plan. The group will determine which recommendations are outdated.

With a rising population of Rhode Islander’s with AD, state policy makers must act swiftly and lose no more time in addressing this terrible disease and public health issue.

Comic Robin Williams’ Death Puts Spotlight on Depression, Suicide

Published in Pawtucket Times, August 15, 2014

Last Monday evening, millions of Americans were shocked to hear that 63-year- old Robin Williams died from an apparent suicide. While it was well-known that he had a history of severe depression and years of alcohol and drug addiction, we were stunned by the unexpected tragic news. publically, Williams had it all, fame, fortune, loyal friends, and fans in every corner of the globe. But like millions of Americans he suffered in silence trying to slay his personal demons when he went into substance abuse treatment.

The sudden death of this Oscar-winning actor, recognized as America’s comic genius, squarely puts the spotlight on depression, a mental illness that commonly afflicts tens of millions of Americans.

DDepression Becomes a Public Conversation

Within the first 48 hours of Williams’ suicide The Samaritans of Rhode Island saw an increase in calls from people concerned about loved ones and friends, says Executive Director Denise Panichas, who expects to also see an increase in visits to her Pawtucket-based nonprofit’s website. Last year, its website received more than 50,000 visitors.

Panichas says, “William’s death reinforces the fact that suicide knows no boundaries, it being a relentless demon afflicting both rich or poor, and those having access to therapy or medical care and those not having it.

According to the Woonsocket resident, William’s suicide has raised the awareness of suicide prevention in a way that millions of dollars in public health announcements could never have done. “William’s movies as well as his dedication to community service resonate with multiple generations, says Panichas, stressing that his six plus decades had value “which will live on.”

Williams substance abuse problems also highlights the need for more awareness as to how addictions can be a risk factor for depression and suicide, states Panichas, who observes that throughout the country, in ever city and town, budgets for substance abuse treatment are being decimated, she adds.

“Promoting wellness and preventing addictions will always be a big challenge but we must do more if we want to see a decrease in suicides,” says Panichas.

Panichas expects the death of Williams, an internationally acclaimed movie star, will have an impact on fundraising for suicide prevention or addiction and depression prevention programs. She has seen an increase in donations from Rhode Islanders as well as from around the country. .

“One donor gave a donation in memory of “Mork”. The donations coming in may be small but every one counts toward keeping our programs available to the public,” says Panichas, noting that over the years public funding has “been drying up.” The Samaritans of RI is using more creative fundraising structures, like crowdfunding (www.crowdrise.com/samaritansri2014) and other social venture sites to create new revenue streams for her nonprofit, she adds.

An Illness That Can Affect Anyone

Lisa B. Shea, MD, Medical Director of Providence-based Butler Hospital, Providence, learned of William’s suicide by a CNN alert on her IPhone. To the board- certified psychiatrist who serves as a clinical associate professor at Brown University’s Alpbert Medical School, “it was tragic but preventable.”

Shea, a practicing psychiatrist for 20 years, notes that people who have suicidal thoughts, like Williams, are struggling with mental health disorders. “Their thinking can get very dark and narrow and they believe they have no options,” she says, oftentimes feeling like a burden to others. “It does not matter who you are mental illness can strike any one regardless of their wealth and fame,” she says.

According to Shea, the public’s interest in William’s tragic death sheds light on the fact that people can get help and it begins with taking a positive first step. “People with suicidal thoughts, who feel “intensely tortured and can not see any way out of their situation, can benefit from supportive therapeutic relationships, medications, and getting support from family and friends who can push them into getting professional help,” she says.

Shea calls on Congress and Rhode Island state lawmakers to positively respond to the William’s suicide by providing increased funding to create access to treatment and prevention programs and to support mental health research.

Finally, Shea says that there are a number of tell-tale signs of a person expressing hopelessness who may be thinking of ending their life. They include statements made by someone that others are better off if he or she were not around; excessive use of alcohol and/or drugs; not taking care of yourself; and giving away personal items. When these occur, talk to the person telling them that you care about them and are concerned for their well-being.

Adds Melinda Kulish, Ph.D., a Clinical Psychologist/Clinical Neuropsychologist and Instructor of Psychology at Harvard Medical School, “There are also times when depression is not easily recognizable. Some people who are depressed experience it most acutely when by themselves but can appear fine, even quite happy, when they are with other people.”

Kulish explains that, for various reasons, some people feel the need to make others happy. Cheering others up or making others laugh makes them also feel happy.

“But, if that person is suffering from depression, the happiness is fleeting – the laughter ends and they once again feel empty and sad. The cheering up of others is a fix that is OUTSIDE, not inside of them.

“And drugs and alcohol can make them feel better for a time. The high always ends, and when alone, they feel empty and even more depressed,” says Kulish. “There’s really good research to suggest that talking about traumatic and upsetting events leads to much healthier responses. The old idea, ‘I’m just not going to talk about it so it’ll go away’ doesn’t work.”

“It’s a myth that if you ask a person if they are suicidal you will put that idea in their heads,” says Shea.

Feeling Low, a Place to Call

When this happens, “feeling low with nowhere to turn” as noted singer songwriter Bill Withers once said in a public service announcement, there is a place to call – The Samaritans of Rhode Island – where trained volunteers “are there to listen.” Incorporated in 1977, the Pawtucket-based nonprofit program is dedicated to reducing the occurrence of suicide by befriending the desperate and lonely throughout the state’s 39 cities and towns.

Since the inception, The Samaritans has received more than 500,000 calls and trained more 1,380 volunteers to answer its confidential and anonymous Hotline/Listening Lines.

With the first Samaritan branch started in England in 1953, chapters can now be found in more than 40 countries of the world. “Samaritans, can I help you?” is quietly spoken into the phone across the world in a multilingual chorus of voices,” notes its website.

Executive Director Panichas, notes that the communication-based program teaches volunteers to effectively listen to people who are in crisis. Conversations are free, confidential and, most importantly, anonymous.

A rigorous 21-hour training program teaches volunteers to listen to callers without expressing personal judgments or opinions. Panichas said that the listening techniques called “befriending,” calls for 90 percent listening and 10 percent talking. Panichas noted The Samaritans of Rhode Island Listening Line is also a much needed resources for caregivers and older Rhode Islanders.

Other services include a peer-to-peer grief Safe Place Support Group for those left behind by suicide as well as community education programs.

In 2014, The Samaritans of Rhode Island received more than 4,000 calls and hosted more than 50,000 visitors to its website.

The Samaritans of Rhode Island can be the gateway to care or a “compassionate nonjudgmental voice on the other end of the line,” Panichas notes. “It doesn’t matter what your problem is, be it depression, suicidal thoughts, seeking resources for mental health services in the community or being lonely or just needing to talk, our volunteers are there to listen.”

For persons interested in more information about suicide emergencies, The Samaritans website,http://www.samaritansri.org, has an emergency checklist as well as information by city and town including Blackstone Valley communities from Pawtucket to Woonsocket.

For those seeking to financially support the programs of The Samaritans of Rhode Island, its Art Gallery and Education Center is available to rent for special events, meetings and other types of occasions. For information on gallery rental, call the Samaritans business line at 401-721-5220; or go tohttp://www.samaritansri.org.

Need to Talk? Call a volunteer at The Samaritans. Call 401.272.4044 or toll-free in RI (1-800) 365-4044.

For mental health resources, go to http://www.butler.org.

Herb Weiss, LRI ’12 is a Pawtucket-based freelance writer who covers health care, aging, and medical issues. He can be contacted at hweissri@aol.com.