Experts Say Isolation and Loneliness Impacting More Older Americans

Published in Woonsocket Call on April 30, 2017

Sarah Hosseini, a blogger on Scary Mommy, a website bringing entertainment and information to millennial mothers, penned a touching story about Marleen Brooks, a California resident, who came home to find a heartbreaking hand-written note from Wanda, her 90-year-old neighbor, asking her to be friends.

Wanda wrote: “Would you consider to become my friend. I’m 90 years old – live alone. All my friends have passed away. I’m so lonesome and scared. Please I pray for someone.”

According to Hosseini’s blog posting, Brooks shared this note with KTVU News Anchor Frank Somerville, who posted it on his Facebook page. She responded to the posting by saying, “Came home to this note from a lady that lives down the street from me. Makes my heart sad, but on the bright side it looks like I will be getting a new friend.”

That evening Brooks visited her new friend, bearing a gift of cupcakes. After the visit, she wrote to Somerville describing this initial visit (which was posted on his Facebook page), says Hosseini. In this update posting, Brooks observed, “She’s such as sweet lady! And she was over the moon when we came over.” Brooks reported what Wanda said during the impromptu get together: “I hope you didn’t think I was stupid for writing you, but I had to do something. Thank you so much for coming over. I’ve lived here for 50 years and don’t know any of my neighbors.”

Wanda shared with her new acquaintance that she is on oxygen has congestive heart failure, osteoporosis and other age-related ailments, and her two surviving sons do not live by her,” noted Hosseini’s blog posting.

Zeroing in on a Growing Societal Problem

Wanda’s isolation and loneliness is not a rare occurrence. It happens every day throughout the nation. The U.S. Senate Special Committee on Aging recently put a spotlight on the growing number of Americans who are socially isolated and lonely, like Wanda, and expert witnesses detailed the negative consequences of this tragic societal problem.

In Room 403 of the Dirksen Senate Office Building, U.S. Senators Susan Collins and Bob Casey, the Chairman and Ranking Member of the Senate Aging Committee, held a morning hearing on April 27, 2017, “Aging Without Community: The Consequences of Isolation and Loneliness.”

he Senate Aging panel hearing (lasting almost two hours), the first in a two-part series, took a close look at the mental and physical health effects of social isolation and loneliness. The next hearing will explore ways to reconnect older people to their communities.

“The consequences of isolation and loneliness are severe: negative health outcomes, higher health care costs, and even death. The root problem is one that we can solve by helping seniors keep connected with communities,” said Senator Collins in her opening statement. “Just as we did when we made a national commitment to cut smoking rates in this country, we should explore approaches to reducing isolation and loneliness. Each has a real impact on the health and well-being of our seniors,” noted the Maine Republican Senator.

Adds, Senator Bob Casey, “Older Americans are vital to the prosperity and well-being of our nation.” The Democratic Senator said, “Our work on the Aging Committee to ensure that we all remain connected to community as we age is important to maintaining that vitality. It is for that reason that we, as a federal government, need to sustain and improve our investments in programs that help seniors stay connected — from Meals on Wheels to rural broadband to transportation services.”

When approached for her thoughts about the Senate Aging panel, Nancy LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer said, “We know that social isolation and loneliness has severe negative effects on older Americans and we’re pleased the US Senate Committee on Aging held a hearing on this important issue. As they explore solutions for social isolation and loneliness amongst older Americans, AARP looks forward to working with them on these issues in 2017.”

Senator Sheldon Whitehouse says, “When seniors get involved, the community benefits from their valuable contributions. And the personal connections seniors make engaging in the community can help them stay healthy and productive.” Whitehouse, who sits on the Senate Aging panel, will work to protect funding for senior centers and programs that Rhode Island seniors rely on to stay connected, like Meals on Wheels and Senior Corps.”

Social Isolation is a “Silent Killer”

Speaking before the U.S. Senate Special Committee on Aging today, social work professor Lenard W. Kaye, DSW, PhD, urged lawmakers to support programs that help older adults stay connected to their communities.

Kaye serves as director of the University of Maine Center on Aging. Joining three other experts, he reported to the committee that social isolation is a “silent killer” — due to placing people at higher risk for a variety of poor health outcomes — and he warned that more Americans are living in isolation than ever before.

“The prevalence may be as high as 43 percent among community dwelling older adults,” Kaye said. “And the risk is high as well for caregivers of older adults given that caregiving can be a very isolating experience.”

Kaye’s testimony also highlighted the state of current research in solving the problem of social isolation among older adults.

“Due to the various life events that can trigger social isolation, from death of a significant other, to loss of transportation to health decline, effective interventions will need to be diverse and they will need to be tailored to the personal circumstances of the isolated individual,” he said.

Kaye added that there is still significant progress to be made in determining what works for helping to reduce social isolation. Lack of rigor in studies of interventions aimed at reducing loneliness can make it difficult to evaluate some of these strategies.

In Pima County, 46 percent of nearly 2,300 seniors surveyed in its 2016 community needs assessment cited social isolation as a significant concern of those living alone, said W. Mark Clark, president of the Pima Council on Aging.

In his testimony, Clark says, “Changes to mobility, cognitive ability or health status can cause an individual to hold back from previously enjoyed social activities. Older adults in rural areas who can no longer driver are at incredible risk of physical and social isolation unless transportation options are available.”

“While aging at home is cited as a top priority by a majority of older people, and doing so has both emotional and economic benefits, aging in place at home can also lead to isolation,” said Clark, noting that connections to the community wane as one gets older due to less opportunities to build new social networks.

In her testimony, Julianne Holt-Lunstad, a psychology researcher at Brigham Young University, estimated that over 8 million seniors are affected by isolation and social disconnect is increasing.

Holt-Lunstad told the Senators that research shows that social isolation and loneliness is as dangerous as being obese, as risky as smoking up to 15 cigarettes per day. and associated with higher rates of heart disease, a weakened immune system, anxiety, dementia, including Alzheimer’s disease and nursing facility admissions.

Finally, Witness Rick Creech, who was born with cerebral palsy, shared to the Senate Aging panel how disabilities can isolate a person. He described how an alternative communication (AAC) device, costing $10,000, a van concerted for a powered wheel chair passenger and smart home equipment to help him grow a “productive, independent adult.”

Meals on Wheels Program Vital Program for Isolated Seniors

It was clear to Senate Aging panel members and to expert witnesses that local Meals on Wheels programs can bring good nutrition and companionship to older American’s reducing social isolation and loneliness. Over two years ago, a Brown University study confirmed another benefit of visitors regularly knocking on the doors of seniors in need: a significant reduction in their feelings of loneliness.

“This continues to build the body of evidence that home-delivered meals provide more than nutrition and food security,” said study lead author Kali Thomas, assistant professor of health services, policy and practice in the Brown University School of Public Health and a researcher at the Providence Veterans Affairs Medical Center.

Thomas, a former Meal on Wheels volunteer said that the study is one of few to rigorously examine the long-presumed psychological benefits of home-delivered meal service. She believes it is the first randomized, controlled trial to assess the effect on loneliness, which has been linked by many studies to a greater risk for medical problems, health care utilization, and mortality.

“In a time when resources are being further constrained and demand is increasing, it is important that we have evidence that guides decision-making in terms of what services to provide and how best to provide them,” Thomas said.

Senator Susan Collins, chair of the U.S. Select Senate Committee on Aging, sees Meals on Wheels as policy strategy to address the growing number of isolated seniors and their loneliness. At the Senate Aging panel, Collins said, “For many, Meals on Wheels is not just about food – it’s about social sustenance, also. Seniors look forward to greeting the driver with a bit of conversation.” And the Republican Senator called for adequate funding to the nationwide Meals on Wheels network, comprising 5,000 local community-based programs. President Trump’s proposed cuts to Meals on Wheels were, “pennywise and pound foolish because in the end they’re going to cause more hospitalizations, more nursing home admissions, and poor health outcomes.”

Like Brooks, we should reach out to our older isolated neighbors in our community. A simple gesture like this can have a lasting, positive impact on both parties.

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Trump Budget Proposal Makes Draconian Cuts to Aging Programs

Published in Woonsocket Call on March 19, 2017

Since his inauguration, GOP President Trump/s controversial and surprising Cabinet picks, some who have even called for the elimination of federal agencies that they were appointed to oversee, has sent a chilling message to the nation. That is business as usual is over inside the Washington Beltway, especially as to how federal dollars will be spent. The release of Trump’s first budget proposal, for fiscal year 2018, reveals draconian cuts throughout the federal government, this causing alarm among aging advocacy groups.

Trump Slashes Funding for Aging Programs and Services

James Firman, President and CEO, of the Washington, D.C.-based National Council on Aging (NCOA), notes Trump’s 62 page $.15 trillion budget proposal to remake the nation’s federal agencies and the programs they provide eliminates the Senior Community Service Employment Program (SCSEP), which provides job training and placement for adults 55 and over who have limited incomes and are trying to make ends meet. “Last year under SCSEP, 70,000 older adults received on-the-job training while providing nearly 36 million hours of staff support to 30,000 organizations, he says, noting that the value of this work exceeded $800 million, or nearly twice the program’s appropriations.

Trump’s budget proposal also zeros out the Low-Income Home Energy Assistance Program (LIHEAP), which provides assistance to low-income households to meet the costs of electricity, heating, and cooling, says Firman, noting that about a third of the nearly 7 million households receiving LIHEAP benefits include an older adult aged 60 or older.

Finally, Trump’s budget proposal eliminates the Corporation for National and Community Service (CNCS), which funds volunteer programs that serve distressed communities and vulnerable population, says Firman, noting that three Senior Corps programs (the Foster Grandparent Program, Senior Companion Program, and Retired Senior Volunteer Program (RSVP), will lose funding. “Together, these programs provide the nation with approximately 96 million hours of service, with a value of $2.1 billion,” he says.

“While the President’s budget blueprint does not cut Social Security Administration (SSA) funding (unlike the drastic reductions in non-defense discretionary spending), the 0.2% increase for SSA does little to solve serious customer service deficiencies for Social Security beneficiaries,” says Max Richtman, President and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare (NCPSSM). “Seven years ago, the SSA’s budget was cut by 10% (after adjusting for inflation), just as waves of Baby Boomers were beginning to retire and place a strain on the agency’s resources,” he says.

Richtman noted that while the numbers of Social Security beneficiaries were increasing, SSA was forced to implement a hiring freeze in 2016 and was not able pay its workers overtime. As a result, hold times on the SSA toll-free customer service number are now an average 15 minutes, more than 60 SSA field offices around the country have been shuttered, and the average wait time for a disability hearing has climbed up to 590 days.

Richtman points out that one million people are awaiting their scheduled disability hearing. “The disability case backlog and customer service will only get worse under the flat operating budget proposed by the President. To make up for previous cuts and restore vital services, the National Committee supports a 7% increase in the SSA’s operating budget,” he says.

NCPSSM’s Richtman warns that Trump’s “skinny budget” may keep millions of vulnerable seniors from participating in the Meals on Wheels program. As Meals on Wheels America has pointed out, Trump’s budget blueprint eliminates the U.S. Department of Human Development’s (HUD) Community Services Block Grant and Community Development Block Grant (CDBG), on which some local Meals on Wheels programs rely on to deliver nutritious meals, safety checks, and friendly visits to seniors who need these services. (The President’s budget blueprint does not mention the Older Americans Act, which provides 35 percent of Meals on Wheels funding nationally.)

Richtman calls on President Trump to ride along with a Meals on Wheels delivery van and see for himself how seniors thrive on the meals they receive and the much-needed human interaction that comes with the food. “Maybe then he would move to protect – rather than cut – this vital program for our nation’s seniors,” he says.

Budget Proposal Puts Food Delivery Program on Budgetary Chopping Block

Trump’s elimination of HUD’s CDBG program in his proposed budget proposal will drastically impact many Meals on Wheels programs across the nation, but, fortunately Meals on Wheels of RI (MOWRI) will not be hit as hard, says Heather Amaral, executive director of Meals on Wheels of RI. But, Rhode Island’s only non-profit home-delivered meal program, will be indirectly impacted by Trumps CDBG cuts, she worries, noting that other programs that support her work receive these HUD funds, specifically, community centers that house our Capital City Café sites or local drop-off sites for the Home Delivered program. The Senior Community Service Employment Program that provides staff for several of our Café sites is also slated for elimination in President Trump’s “Skinny Budget.”

Amaral also is concerned about Trump cutting the U.S. Department of Health and Human Services’ budget by 18 percent. “Our Older Americans Act Title III funding flows through this department. It is safe to assume that this significant cut will result in a reduction of our funding—funding that has remained at stagnant for over 10 years,” she says.

“It is impossible to predict any service cuts until a final federal budget is approved and any cuts to MOWRI are known. Any funding reductions will have a negative impact on her nonprofit agency’s ability to keep up with the increased demand of Rhode Island’s growing senior population,” says Amaral.

“Our programs directly address issues that are critical to Rhode Island’s vulnerable homebound seniors,” she says, noting that last year, MOWRI delivered 345,262 meals to over 2,560 homebound residents.

Last Thursday, White House budget director Mick Mulvaney defended the Trump budget proposal cuts to the widely popular Meals on Wheels program. He told reporters that the program “sounds great” but is “not showing any results.”

Amaral counters by saying that research is providing the tremendous benefits of participating in the meals and wheels program — for seniors, homebound, family members, municipalities and the Rhode Island

The Brown University “More than a Meal” Report (published 2015), a randomized, controlled study of Meals on Wheels Programs across the country, reported that those who received daily-delivered meals experienced the greatest improvements in health and quality of life indicators,” says Amaral. The most vulnerable of our recipients, those who live alone, were more likely to report decreases in worry about being able to remain in home and improvements in feelings of isolation and loneliness, she noted.

Meanwhile, a U.S. Administration on Aging (AoA) Study, published in September 2105, found that those receiving daily-delivered meals are more likely to report improvements in mental and physical health, reductions in feelings of isolation and anxiety about being able to remain at home, and lower rates of hospitalization and falls, adds Amaral.

“In that same report, AoA statistics show that a home delivered meal program can deliver a year’s worth of meals to a senior for the same cost as one day in the hospital, or one week in a nursing home, notes Amaral.

Speaking at the Hubert Humphrey Building dedication in Washington, D.C. on November 1, 1977, former U.S. Vice President (1965-69) Hubert Humphrey stated “the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life; the sick, the needy and the handicapped.” A quick read of the Trump’s budget proposal revealing huge cuts for domestic programs, it’s clear to many that his Administration has failed it’s test.

If you want to learn more about MOWRI, sign up for meals, volunteer or donate, please visit http://www.rimeals.org or call 401-351-6700.

How the Election Impacts Social Security

Published in Woonsocket Call on July 24, 2016

On the final night of the Republican National Convention (RNC) an average of 32 million Americans tuned in to watch Donald J. Trump, a New York Real Estate Developer, author, television personality and now politician, formally accepted the GOP nomination for President of the United States.

After he delivered his July 21 speech, reporters, political commentators, and even postings trending on twitter called Trump’s hour and 15 minute speech (4,400 words) “dark” because of its stark tone and content. This GOP presidential candidate’s speech was even referred to as being the longest acceptance speech in history since 1972.

Before more than 2,400 delegates Trump, 70, pledged to be the nation’s law and order president who would crack down on crime and violence. America first would be Trump’s mantra during the negotiation of international trade deals and the existing NAFTA trade accord would be renegotiated.

Trump also called for defending the nation’s borders against illegal immigrants and giving parents more choice in choosing schools for their children. And to the forgotten men and woman across the country who were laid-off because of President Obama’s mishandling of the economy Trump promised to be their voice. Syrian refugees would be vetted and only those individuals who “will support our values and love our people” will be admitted, he said.

Trump Ignores Social Security in Speech

Aging advocates say that Trump’s acceptance speech was short on details when it can to domestic policy, specifically Social Security and Medicare. But, you won’t need tea leaves to read how a future Trump Administration will change the way the nation supports its retirees. .

According to Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM), the choice of Governor Mike Pence as Trump’s running mate should send “a very clear message to America’s seniors that their priorities will hold little weight in a Trump administration.” While Trump has promised on the campaign trail that he won’t cut Social Security and Medicare.

During his 12 years serving as a U.S. Congressman, Pence consistently voted in favor of GOP legislative efforts to cut benefits in Social Security, Medicare and Medicaid, says Richtman, charging that Trump’s vice presidential running mate is one of a few Congressional lawmakers that has a strong “anti-seniors voting record.”

Richtman says that “Mike Pence was one of Congress’ biggest proponents of privatization. He supports cutting Social Security benefits by raising the retirement age, reducing the COLA, means-testing and turning Medicare into “CouponCare.” As he told CNN, ‘I’m an all of the above guy. I think we need to look at everything that’s on the menu,’ and the record shows he has done just that by supporting every form of Social Security, Medicare and Medicaid benefit cut proposed in the past decade.”

While Trump has promised not to cut Social Security benefits on his year-long campaign trail, he continues to surround himself with advisors who are “polar opposite” of his positions says Richtman. “They say actions speak louder than words — Donald Trump’s choice of Mike Pence as his Vice-Presidential running mate will speak volumes to American seniors,” he adds.

Political Experts Weigh in

Darrell M. West, Ph.D., Vice President and Director of Governance Studies at the Brookings Institution, says that “Trump is on record as saying he does not want to cut Social Security so that is considerably different from most Republican leaders, who support benefit reductions as a way to balance its books. This probably is the reason the [GOP] platform is vague on Social Security. The party could not reconcile Trump’s view on not cutting benefits with the party’s general view that cuts are needed. That left them with a reference to market solutions without explaining what that meant.”

“Party leaders have said they want to raise the retirement age for people under age 50. That issue certainly would be on the issue in a Trump presidency although it is not clear how he views that issue. But there would be significant support in a GOP-run Congress for doing that and cutting the benefits of future retirees,” adds West.

West believes that “Democrats have a very good chance of recapturing control of the Senate. If that happens, that will allow them to block benefit reductions or raising the retirement age, he says.

Wendy Schiller, professor and chair, Department of Political Science at Brown University, warns that talking about changing Social Security can be risky and this “involves a depth of knowledge about entitlement financing that eludes most political candidates especially those without any political experience.”

The Brown professor of politics does not see Trump tackling this issue in any meaningful way in the campaign and she does not believe it will be a priority for him or the GOP if he wins. “Recall George W. Bush tried to reform Social Security immediately after he won reelection in 2004 – by late January 2005 it was dead on arrival in Congress,” she says.

“Overall I am not sure the GOP leadership in the Congress has fully processed what a Trump presidency would look like in terms of policy or what his priorities might be. It is unclear to me that they will align closely and getting anything through Congress these days is nearly impossible, no matter who sits in the Oval Office,” she adds.

Stark Differences in Platforms to Fix Social Security

On Friday, the released Democratic Platform released reveal a stark difference as how to the Democratic and Republican parties will fix the ailing Social Security program. The GOP platform. Although current retirees and those close to retirement will receive their benefits, changes are looming with a Trump administration and a Republican-controlled Congress. For younger generations all benefit cut options to be put on the table, opposing the lifting of the payroll tax cap and sees privatization of Social Security as a way for older American’s to create wealth for use in retirement. On the other hand, the Democratic Party platform calls for a strengthening and expansion of the existing Social Security program. The Democrats oppose any attempts to “cut, privatize or weaken” Social Security, and calls for lifting the payroll tax and exploring a new COLA formula.

NCPSSM’s Richtman notes “ It’s also very telling that while the GOP buried their cuts and privatization plans for Social Security under the Platform’s Government Reform heading, the Democrats addressed Social Security, as they should, as part of their plan to restore economic security for average Americans. That’s been Social Security’s fundamental role for more than 80 years — providing an economic lifeline impacting the lives of virtually every American family.”

As AARP’s John Hishta noted in his July 22 blog, even though the “political spotlight was not on Social Security” at the RNC in Cleveland, delegates, rank-and-file politicians and even political operatives that he talked with clearly understand the programs importance to retirees and younger generations.

“If political leaders fail to act, future retirees could lose up to $10,000 a year. All beneficiaries could face a nearly 25 percent cut in their benefit,” warns Hishta. .

Hishta tells his blog readers that “AARP’s Take a Stand campaign left the RNC with renewed determination to make updating Social Security a bigger part of the presidential debate.” He pledges to continue pushing for strengthening and expanding the nation’s Social Security program at next week’s Democratic National Convention in Philadelphia and until the November presidential elections.

To keep informed about Social Security discussion during this presidential campaign go to http://takeastand.aarp.org/,

Aging Report is “Rhode Map” for Change

Published on June 27, 2016 in Pawtucket Times

Next year look for the policy debate in the Rhode Island General Assembly to heat with Governor Dan McKee’s Aging in Community Subcommittee of the Long Term Care Coordinating Council (LTCCC) release of a sixty page report in June documenting the sky rocketing growth of the state’s older population and identifying strategies to allow these individuals to age in place and stay in their communities.

The Aging in Community Subcommittee was mandated by the enactment of the Aging in Community Act of 2014, sponsored by Senate Majority Whip Mary Ellen Goodwin and Representatives Christopher Blazejewski and Eileen Naughton. The Subcommittee, chaired by Maureen Maigret, Vice Chair of the Long Term Care Coordinating Council, and former Director of the Division of Elderly Affairs, staff from Rhode Island College, Brown University and the University of Rhode Island, representatives from state agencies, members of the senior community, and senior service providers.

According to Maigret, it has taken almost 18 months to gather data, host focus groups and to write the “Aging in Community” report. The report provides demographic data snapshot on the state’s older population and also inventories current services and resources. It also identifies challenges faced by older Rhode Islanders and recommends strategies to promote successful aging in community in these nine issue areas.

Maigret believes that this report may take the most comprehensive look at what aging programs and services are available to assist older Rhode Islanders age in place in their communities and it identifies what programs and services are lacking. “The State Plan on Aging does have some data and actions planned but does not comprehensively cover all the domains covered in the “Aging in Community” report,” she says.

A Demographic Snap Shot

In 2010, the report notes that over 152,000 Rhode Islanders were age 65, predicting that this number will sky rocket to 247,000 in 2030. By 2025, Rhode Island will be considered to be a “Super Aging” state where 20 percent of its population will be over age 65. The report noted that two years ago the population of New Shoreham, Little Compton, North Smithfield, North Providence and Tiverton had already reached “Super Aging” status.

The report added that 42 percent of over age 65 household incomes amounted to less than $30,000. Only 49 percent of the retirees have non Social Security retirement income. Fifty two percent of the older renters and 39 percent of the home owners were financially burdened with covering housing costs. Poverty levels for older Rhode Islander vary, from 7 percent in Bristol County to 18 percent in Providence County.

The LTCCC report notes that even with lower incomes older Rhode Islanders have a major impact on the state’s economy. They bring in over $2.9 billion dollars from Social Security pensions and $281 million in taxes into the state’s economy. Older workers account for 33,750 jobs throughout all job sectors.

Rhode Island’s retirees provide an estimated $ 149 million by volunteering and an estimated $ 2 billion in providing caregiving services to family and friends.

A Spotlight on Priority Recommendations

The Subcommittee’s findings were the result of interviews held with aging service providers, an examination of age-friendly best practices in other states and ten focus groups conducted with older Rhode Islander from across the state.

The focus groups attendees gave the Subcommittee valuable information. They stressed that Senior Centers were “highly valued.” Many expressed financial concerns for their current situation and into the future. Attendees were very concerned about the lack of transportation and lack of affordable housing. State customer service employees were viewed by many as “unfriendly.”

Dozens of strategies were listed in the LTCCC report for state policy makers to consider to better assist older Rhode Islanders to successfully age in their community in these nine issue areas: Information and Communication, Community Engagement, Transportation, Economic Security, Food Security and Nutrition, Housing, Supports at Home, Healthcare Access and Open Spaces/Public Buildings

The LTCCC report identifies priority strategies including the restoring of senior center funding based on a population-based formula and continuing RIPTA’s no-fare bus pass program for low income seniors and persons with disabilities. It also calls for increase payments for homecare and for restoring state funding for Elder Respite.

Maigret says that creating a coalition of aging groups to “build an age-friendly Rhode Island” is the next step to take. Businesses can also become “age friendly” and better understand the economic value of older Rhode Islanders bring to the state and its educational institutions, she says.

Political Will Required to Implement LTCCC Report Strategies

There must be a political will to implement the strategies of the LTCCC report, says Maigret, starting with the state’s top elected official. “Governor Raimondo’s proposed budget had added $600,000 in funding for senior centers but the Rhode Island General Assembly removed it,” she said, noting that the decrease in funding got caught up in the negativity surrounding Community Service grants. “We were fortunate the 2017 budget will still have $400,000 in funding for senior centers,” she says.

“Rhode Island’s older adult population contributes a great deal socially, economically, and intellectually to our communities. Ensuring that those Rhode Islanders who desire to age-in-place are able to do so only enriches our society,” said Governor Raimondo. “I’m pleased that Director Fogarty, and members of his senior staff, serve and work with the Long Term Care Coordinating Council and the Subcommittee on Aging in Community. The insight they gain from service with these committees helps to shape State policy and programs related to services for seniors.

“I applaud the members of the Subcommittee for their dedication to creating a clear, comprehensive report on aging that can be a catalyst for change in our state. Their work recognizes that Rhode Island’s older population is growing dramatically and that we must direct public policy to help them remain active and in their homes,” said Lt. Governor McKee. I look forward to supporting the strategies detailed in the Subcommittee’s report to help build stronger, healthier communities for all Rhode Islanders.”

Finally, House Speaker Nicholas Mattiello, also says that the Subcommittee report’s recommendations will also be studied closely next legislative session. “I will be reviewing the findings of the report in greater detail and I will confer with Representatives Chris Blazejewski and Eileen Naughton, who sponsored and advocated for the Aging in Community Act of 2014. Our older population in Rhode Island is a growing one and it is important that we continue to listen to their needs and be responsive. I commend the work of the subcommittee, as well as all those who participated in the focus groups. I would anticipate that any policy and financial recommendations will be fully analyzed by the members of the General Assembly in the 2017 session.”

The LTCCC’s “Aging in Community” report gives our policy makers a road map in reconfiguring the state’s fragmented aging programs and services. With the Governor, House Speaker and Senate President on board, we might just see legislative changes in the next years that might just be what we need to keep people at home and active in their community. Lawmakers must not act penny-wise and pound foolish when considering legislative fixes.

Both the executive summary and the full Subcommittee “Aging in Community” report are available on the Lieutenant Governor’s website at: http://www.ltgov.ri.gov and the general assembly website at: http://www.rilin.state.ri.us/Pages/Reports.aspx.

Slater Mill Showcases Classic Rock ‘n’ Roll Flick  

Published in the Woonsocket Call on October 11, 2015

When planning the 2nd Annual S.A.M. Fest, in conjunction with this years Pawtucket Arts Festival, Slater Mill’s Executive Director, Lori Urso scheduled a showing of Jim Wolpaw’s “Complex World.” Urso, also a professional musician, knew featuring the film at her event in August was a great way to both promote a local Providence filmmaker and give homage to The Young Adults, a popular rock band playing at the nonprofit’s weekend festival, too.

Rediscovering a Classic Film at S.A.M. Fest

On Aug. 30, more than 80 people gathered early evening at Hodgson Rotary Park to watch on a big outdoor screen the 81-minute offbeat cult rock ‘n’ roll comedy filmed at Providence’s Lupo’s Heartbreak Hotel. While the film attracted the curious, many adoring and loyal fans of The Young Adults came to check out the flick, too, says Urso.

The Complex World captures one night at Lupo’s Heartbreak Hotel, with its zany plot involving terrorists, political conspiracy, 100 pounds of explosives in the bar’s basement and drugs, with music from iconic Providence bands such as the Young Adults, NRBQ and Roomful of Blues. The film had a brief two-month run in a Boston and one week in New York City, and it garnered good reviews. However, a distribution deal with Hemdale, a major film distributor that released “The Terminator” and the “Last Emperor,” fell through, ending up in a lawsuit. Even though Wolpaw won his case and a small settlement, the legal battle sealed the film’s fate. Over the years, the filmmaker’s DVDs have been sold on a website, and the last public showing was in 2010, for two days at the Providence-based Cable Car to raise money for a local charity.

Urso, 51, remembers being an extra during the 1987 film shoot, “a biker chick hanging out in the bar’s parking lot” at 79 Washington St.  “Quite a few people that I knew showed up to be extras that night. I’m glad I was able to be part of it,” she said.

Rudy Cheeks one of the founders of Young Adults and co-writer of the Phillip & Jorge column published in “Motiff Magazine,” was in attendance during the S.A.M. Fest screening, and he observed people of all ages in attendance, many of whom watched the film for the first time.

Even though the film was produced about 25 years ago, “it’s held up pretty well over the years,” says Cheeks. “The strongest part of the film was its ‘mise en scène,’ the capturing of the inside atmosphere of the bar.”

Adds, Rick Bellaire, Chair and Archive Director of Pawtucket-based Rhode Island Music Hall of Fame, the Wolpaw’s Indie film produced outside of the major film studio system, is a great Rock and Roll documentary.  “It was a snap shot of what was happening in the Rhode Island music scene at the time the film was shot,” he says.

The Making of a Classic Film

While it took about two-and-a-half months to shoot the film in 1987, it took more than two years to bring “Complex World” to the screen of the Cable Car Theatre in 1990, says Wolpaw, noting that it ran for a record four months. The veteran filmmaker, who was nominated for an Academy Award for a 1985 documentary, was brought into this film project by Rich Lupo, the owner of Lupo’s Heartbreak Hotel, who just happened to be his roommate at Brown University and later a bartender and manager at the Providence bar.

In 1970, when both young men graduated from Brown University they shared their dreams. Lupo planned to open up a bar with music while Wolpaw wanted to become a filmmaker.  Wolpaw agreed to use Lupo’s bar in film if he opened on up.  “I never would have believed at that time we would both end up at that place,” says Lupo.

According to Wolpaw, the efforts to create and fund a film began a year before the bar was going to be torn down to make way for condos. The film was to use Lupo’s as a basis for the movie to “explain the spirit of the bar,” he said, noting that it would be shot like a documentary film.

Lupo invested the most to produce the film, but with increased costs, other friends chipped in, said Wolpaw. The unique film stood out among films that were produced in Hollywood, he said, “noting it was not the typical movie.”

Two years of editing and reshoots would later result in the final film, says Wolpaw, noting that over the years and even at the Slater Mill screening he “had trouble watching it.” Shooting the film like a documentary just did not work for the plot, he said, but it captured an early era of the Providence music scene.

Even after more than two decades since being released, orders for “Complex World” keep trickling in, says Wolpaw, who has worked as an adjunct film professor at Emerson College in Boston, the University of Rhode Island and the Rhode Island School of Design. He is pleasantly surprised that orders come in from such faraway places as British Columbia and France.

A Prolific Filmmaker  

Besides his Classic “Complex World,” Wolpaw is known for innovative approaches in considering artists and issues in the arts, and he has an impressive number of films under his belt:  “Cobra Snake for a Necktie” (Showtime 1980), a portrait of rock ‘n’ roll legend Bo Diddley; “Loaded Gun: Life, and Death, and Dickinson” (PBS 2003, INPUT 2004), a quirky look at poet Emily Dickinson that was chosen by “The Library Journal” for its list of Best Poetry Films; and “First Face: The Buck Starts Here” (PBS 2011), an accounting of the dollar bill portrait of George Washington.

Even at 67, Wolpaw, who has won awards at more than a dozen film festivals worldwide, has not slowed down. He is still working on three projects, a film about Cleveland poet and activist Daniel Thomson, one detailing the history of Rhode Island’s Ladd Center and a fictional narrative film about poet Dickinson. Hopefully, they will have a long shelf life and audience like “Complex World.”

“Complex Word” can capture viewers who wish to relive their experiences at Lupo’s, and purchases of the DVD benefit the Gloria Gemma Foundation and Advocates in Action. For details, go to www.complexworldthemovie.com.

 

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Palliative Care Can Provide Comfort to Dying Residents

Published in Woonsocket Call on May 10, 2015

           A recently published study, by Brown University researchers, takes a look at end-of-life care in America’s nursing facilities, seeking to answer the question, is knowledge and access to information on palliative associated with a reduced likelihood of aggressive end-of-life treatment?

Brown researchers say when a nursing facility resident is dying, oftentimes aggressive interventions like inserting a feeding tube or sending the patient to the emergency room can futilely worsen, rather than relieve, their distress. While palliative care can pull resources together in a facility to provide comfort at the end of a resident’s life, the knowledge of it varies among nursing directors.  A new large national study found that the more nursing directors knew about palliative care, the lower the likelihood that their patients would experience aggressive end-of-life care.

Susan C. Miller, professor (research) of health services, policy and practice in the Brown University School of Public Health and lead author of the study in the Journal of Palliative Medicine, published March 16, 2015, worked with colleagues to survey nursing directors at more than 1,900 nursing facilities across the nation between July 2009 and June 2010.  The researchers hoped to learn more about their knowledge of palliative care and their facility’s implementation of key palliative care practices.

Knowledge Is Power

According to the findings of the Brown study, the first nationally representative sample of palliative care familiarity at nursing homes, more than one in five of the surveyed directors had little or no basic palliative care knowledge, although 43 percent were fully versed.

“While the Institute of Medicine has called for greater access to skilled palliative care across settings, the fact that one in five U.S. nursing home directors of nursing had very limited palliative care knowledge demonstrates the magnitude of the challenge in many nursing homes,” Miller said. “Improvement is needed as are efforts to facilitate this improvement, including increased Medicare/Medicaid surveyor oversight of nursing home palliative care and quality indicators reflecting provision of high-quality palliative care,” she said, noting that besides quizzing the directors the researchers also analyzed Medicare data on the 58,876 residents who died during the period to identify the type of treatments they experienced when they were dying.

When researchers analyzed palliative care knowledge together with treatment at end of life, they found that the more directors knew about basic palliative care, the lower likelihood that nursing facility residents would experience feeding tube insertion, injections, restraints, suctioning, and emergency room or other hospital trips. Meanwhile, residents in higher-knowledge facilities also had a higher likelihood of having a documented six-month prognosis.

The study shows only an association between palliative care knowledge and less aggressive end-of-life care, the authors say, noting that knowledge leads to improved care, but it could also be that at nursing facilities with better care in general, there is also greater knowledge.  But if there is a causal relationship, then it could benefit thousands of nursing facilities residents every year for their nursing home caregivers to learn more about palliative care, the authors conclude.

Progress in Providing End-of-Life Care

Virginia M. Burke, J.D. President and CEO of the non-profit Rhode Island Health Care Association, said, “We were gratified that the authors found that most of the nursing directors who responded to their survey gave correct answers on all (43% of respondents) or most (36%of respondents) of the “knowledge” questions on palliative care.  We were also gratified to see that the number of hospitalizations during the last thirty days of life has declined significantly over the past ten years, as has the number of individuals who receive tube feedings during their last thirty days.  The need for continued progress is clear.”

Burke, representing three-quarters of Rhode Island’s skilled nursing and rehabilitation centers, adds, “It is not at all surprising that greater understanding of palliative care leads to better application of palliative care.”

The states’s nursing facilities are committed to providing person-centered end of life care, says Burke, noting that according to the National Palliative Care Research Center, Rhode Island’s hospitals are among the top performers for palliative care.  “We suspect that our state’s nursing facilities are as well.  We would be very interested in state specific results in order to see any areas where we can improve.”

Says spokesperson Director Michael Raia, of Rhode Island’s Health & Human Services Agency, “We need to provide the right care in the right place at the right time for all patients.”

When it comes to nursing facilities, Raia calls for reversing the payment incentives so that facilities are rewarded for providing better quality care and having better patient outcomes.  He notes that the Reinventing Medicaid Act of 2015 reinvests nursing home reimbursement rate savings into newly created incentive pools for nursing homes and long-term care providers that reward facilities for providing better quality care, including higher quality palliative care.

Bringing Resources to Families

With caregiving one of AARP’s most important issues, it’s no surprise that the organization provides a great deal of guidance on palliative care, stressing that “it involves organizations and professionals coming together to meet a person’s needs both in terms of pain management, along with emotional and spiritual perspectives,” said AARP State Director Kathleen Connell.

Connell says that “It’s is truly a team effort in which nursing home staff become key players. The resources are important to patient with chronic and terminal issues. Their families need help, too. So it is important any time we learn more about ways we can address this very important healthcare need.”

Adds Connell, “In Rhode Island, I’m confident that we have nursing homes that are dedicated to easing the difficulty of this particularly stressful stage of life. They give patients and their families enormous comfort. We certainly applaud their compassion and hope the report is helpful anywhere it identifies a need for improvement,” adds Connell.

AARP’s Caregiving Resource Center (http://www.aarp.org/home-family/caregiving/) includes an End of Life section. Check out a specific palliative care resource at  http://assets.aarp.org/external_sites/caregiving/multimedia/EG_PalliativeCare.html

To read the Brown Palliative Care Study go to http://online.liebertpub.com/doi/abs/10.1089/jpm.2014.0393.

Herb Weiss, LRI ’12 is a Pawtucket writer covering aging, health care and medical issues.  He can be reached at hweissri@aol.com.

Study Shows Meal Deliveries Positively Benefit Seniors

Published in Woonsocket Call on March 22, 2015

In 2013, Dr. Kali Thomas, an assistant professor at Brown University’s Center for Gerontology and Healthcare Research, published a study that found home delivered meals can keep persons age 60 and older at home, allowing them to age in place.  The study’s data also indicated that some states would experience cost savings if they expanded meals on wheels because that could delay a Medicaid recipient’s entry into costly nursing home care.

The “More Than a Meal” pilot research study, conducted by Thomas, was released on March 2, 2015 the Alexandria, Virginia-based Meals on Wheels America, the oldest and largest national group representing over 5,000 community-based senior nutrition programs. The gerontologist found benefits far beyond basic nutrition identified by her earlier 2013 study — health and psychological benefits, too, particularly for those seniors who live alone.

Details of Groundbreaking Research Study

Thomas, contracted by Meals on Wheels America with funding provided by AARP Foundation, designed and executed the 15-week pilot study, involving over 600 older participants, in eight sites around the country, including the Ocean State.  Study participants either received personally delivered fresh meals daily, or weekly bulk deliveries of frozen meals, or just simply remained on a waiting list.

The Brown University researcher found those living alone who received meals showed statistically significant reductions in feelings of isolation, an effect that was greater if they received meals daily rather than weekly.  They also felt significantly less lonely, were less worried about staying in their homes, and said they felt safer. Those also receiving meals experienced fewer falls and hospitalizations.

Thomas said that based on her personal experience as a driver for Meals on Wheels of Rhode Island and as the family member of a meals recipient (her 98-year old grandmother), she was not at all surprised to see the positive benefits she observed anecdotally emerge as significant in a rigorous research study.

Elle Hollander, President and CEO on Wheels America, notes that her members have “faced tough choices forced by limited funding, rising costs, unprecedented demand and need, and increasingly for-profit competition.”  Hollander says, “We now have the research-backed evidence that confirms what we’ve all know for decades anecdotally through personal experience: that Meals on Wheels does in fact deliver so much more than just a meal.”

AARP State Director Kathleen Connell agrees.  “It really has been no secret that home-delivered meals are a critical for the older population, as well as the disabled. With  Kali Thomas’s earlier Brown data released in 2012 in our award-winning senior hunger documentary Hungry in the West End, the newest research reinforces what Thomas said in film: the nutritional benefits and relief from food preparation allows people to live in their homes longer and to stay healthier. And so, there are long term healthcare benefits as well as savings to the state if the investment in home-delivered meals delays someone’s transition from independence or home-based care into a Medicaid-supported nursing facility.”

A Call for More State Funding

Heather Amaral, Executive Director of Meals on Wheels of Rhode Island agrees with the benefits of visiting volunteers to the recipients, but stressing that the volunteer benefits, too, from the bond that develops. “There are many studies that show volunteering is good for your health and spirit, she says.

Amaral expresses pride that Rhode Island was selected as one of eight pilot sites in the study.  “This study proves what we’ve observed through the years—Meals on Wheels deliveries keeps people out of nursing homes and in their own homes longer,” she says.

According to Amaral, in 2014 Meals on Wheels of Rhode Island’s Home Delivered Meals program provided 316,524 meals to 2,298 individuals.  Over the years she has seen federal funding remain stagnant, while state funding has declined.  Last year’s budget allocated $200,000 to Meals on Wheels, down from $530,000 that was allocated by the General Assembly in 2006.   But, Governor Raimondo’s submitted budget does reinstate $ 330,000 more in funding, if approved by the Rhode Island General Assembly, she says.

Clearly, Governor Gina Raimondo recognizes the importance of Meals on Wheels as she begins to reshape Rhode Island’s long-term care continuum.  The Governor states, “Programs like Meals on Wheels are important investments. These programs are one of the strategies in our toolbox to keep people healthy and in their own homes. Particularly as we work to reinvent Medicaid to support better health outcomes and provide better value to taxpayers, we will continue to support programs like Meals on Wheels that help our most vulnerable seniors stay in their homes and in the community.”

The Rhode Island General Assembly must not be penny-wise and pound foolish.  Support the Governor’s budget to ratchet up funding for Meals on Wheels.  It is a sound policy move to put the breaks to spiraling Medicaid costs, by making the system more efficient and rooting out fraud and waste.   We must balance the State’s limited budget funds to keep older Rhode Islanders at home as long as possible.  But, if nursing home care is need, the Rhode Island General Assembly must allocate the necessary Medicaid funding to provide efficiently delivered quality of care.

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