Efforts to Revise State Alzheimer’s Plan are in Full Swing

Published in Woonsocket Call on February 25, 2018

By Herb Weiss

Lt. Governor Dan McKee is gearing up Rhode Island’s fight against the skyrocketing incidence of Alzheimer’s disease, called by some as one of the ‘biggest epidemics in medical history.’ Last Wednesday, he announced $30,000 in grants secured by his office and the Rhode Island chapter of the Alzheimer’s Association to hire a consultant to update the state’s five-year plan on Alzheimer’s Disease and Related Disorders. Tufts Health Plan Foundation and the Rhode Island Foundation each pledged $15,000 to support the rewriting of the initial State Plan.

Updating the State’s Alzheimer’s Plan

The updated State Plan, to be created by 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, will provide state lawmakers with a road map for the state, municipalities and the health care system, to confront the continuing Alzheimer’s crisis. It will take a look at the current impact of Alzheimer’s disease on a growing number of Rhode Islanders and outlines what steps the state must take (legislatively and regulatory) to improve dementia-capable programs and services for people with Alzheimer’s and their family caregivers.

Lt. Governor McKee and the Executive Board of the Alzheimer’s Disease and Related Disorders, a working group of comprised of distinguished researchers, advocates, clinicians and caregivers, are now beginning their efforts to meet their deadline by the end of 2018 of having a completed state plan to submit to the Rhode Island General Assembly.

With financial support provided by the Rhode Island Foundation and Tufts Health Plan Foundation, the Alzheimer’s Association, Rhode Island Chapter, as fiscal agent, can now hire a consultant to assist in updating the initial state-five-year plan approved by the Rhode Island General Assembly in 2013. Once the updated report is completed and approved by the Rhode Island General Assembly, the Executive Board can 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.

“Rhode Island has been a national leader in 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 momentum in the fight against Alzheimer’s,” said Lt. Governor McKee.

“A Living Document”

“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,” says Donna McGowan, Executive Director of the Alzheimer’s Association, Rhode Island Chapter.

“Communities have greater interest in age-friendly initiatives. There’s a growing understanding of the critical role older people play. They are an asset to community, and their voices and insights are invaluable to the public discourse on what communities need,” said Nora Moreno Cargie, vice president, corporate citizenship for Tufts Health Plan and president of its Foundation.

“A coordinated, strategic approach to Alzheimer’s will lead to better outcomes and healthier lives. Working with generous donors, we’re proud to partner with Tufts to fund this crucial work,” said Jenny Pereira, the Rhode Island Foundation’s vice president of grant programs.

Put Older Woman, Older Veterans on the Radar Screen

The updated state plan must address the growing needs of older woman and the state’s aging veterans population.

Maureen Maigret, Vice Chair of the Long Term Care Coordinating Council and Chair of its Aging in Community Subcommittee, suggests zero in on the special needs of older woman. “Alzheimer’s disease and related dementias is of special concern for older women as the they are more likely to suffer from the debilitating disease due to greater longevity, more likely to need long term care services and supports and are more often than men to be caregivers either unpaid or paid of persons with Alzheimer’s disease. The Aging in Community Subcommittee of the LTCCC has several pieces of legislation to strengthen support for caregivers and to enhance home and community based services,” says Maigret.

Last year, the USAgainstAlzheimer’s, (UsA2), released the issue brief, “Veterans and Alzheimer’s Meeting the Crisis Head on,” with data indicating that many older veterans will face a unique risk factor for Alzheimer’s as a direct result of their military career.

“Forty nine percent of those aging veterans age 65 ((WW2, Korea, Vietnam and even younger veterans, from the Iraq and Afghanistan conflicts in the coming decades), are at greater risk for Alzheimer’s compared to 15 percent of nonveterans over age 65,” say the authors of the issue brief.

UsA2’s issue brief pulled together research findings released by the U.S. Department of Veteran’s Affairs (VA). On study estimates that more than 750,000 older veterans have Alzheimer’s disease and other dementias, another noting that the number of enrollee with Alzheimer’s grew 166 percent from roughly 145,000 in 2004 to 385,000 in 2014.

The minority communities are at even greater risk for Alzheimer’s and minority veterans are predicted to increase from 23.2 percent of the total veteran population in 2017 to 32.8 percent in 2037, says a cited VA study.

The issue brief also cited one study findings that indicated that older veterans who have suffered a traumatic brain injury (TBI) are 60 percent are more likely to develop dementia, Twenty-two percent of all combat wounds in Afghanistan and Iraq were brain injuries, nearly double the rate seen during Vietnam – increasing these younger veterans’ lifetime Alzheimer’s risk.

The Rhode Island Foundation and the Tufts Health Plan Foundation grant funding was key to the Lt. Governor McKee being able to update its state’s plan to battle Alzheimer’s disease. It provides state policy makers with a roadmap o effectively utilize state resources and dollars to provide care for those afflicted with debilitating cognitive disorder. It is money well spent.

The Alzheimer’s Association will shortly issue a Request for Proposal (RFP) seeking a research consultant to assist in revising and updating e the State Plan. For details about the RFP of the State’s Alzheimer’s Plan, email Michelle La France at mlafrance@alz.org.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, healthcare and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

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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.

Aggressive Scams Popping Up All Around the Ocean State

Published in Woonsocket Call on November 25, 2015

On Thursday morning, Mary Smith (not her real name) received a phone call from Sergeant Bradley from the Washington County Sheriff’s Office claiming she had missed jury duty and because so, there was a warrant issued for her arrest. Concerned, the older woman asked the man, who identified himself Sergeant Bradley, what she needed to do to fix the problem. She was instructed to go to a local CVS, purchase a pre paid debit card in the amount of $300 and to meet him in the parking lot of the Washington County Courthouse.

Thinking quick, Mary reported the troubling call to her local police. Like many older Rhode islanders, she had been a target of an aggressive scam now sweeping through the Ocean State, called the “jury duty scam.”

According to the Attorney General’s Office, in the latest rendition of the scam, an individual is calling Rhode Islanders claiming there is a warrant out for their arrest for failure to appear for jury duty. The individual, identifying himself as “Sergeant Bradley,” from either the “Washington County Sheriff’s Office,” the “South County Sheriff’s Office,” or the “Newport County Sheriff’s Office.” The caller ID shows the individual is calling from the 401 area code.

Here’s the scam

“Sergeant Bradley” tells the people he calls that they will be charged with a felony for failure to appear for jury duty and will then be held at the ACI for 30 days, after which they will be brought before Judge Suttell.

In order to avoid being arrested the scammer urges the individual to make an immediate payment using a pre-paid debit card. Mary did not fall for this old scam. It has been reported that at least one person paid more than $900 before they realized they were tricked.

Attorney General Peter Kilmartin calls on anyone receiving a similar phone call or threat to contact either the Rhode Island State Police to report the incident. Kilmartin says, “The individual making these phone calls has just enough information to make themselves sound legitimate.” This information, however, is readily available on the Internet to anyone with access to a computer, he notes.

“It is very important for anyone who receives a similar phone call to write down as much information as possible, don’t provide any personal information to the individual over the telephone, do not pay any money, hang up, and contact the State Police,” adds Kilmartin.

The state’s Office of Attorney General provides the following details about judicial process to keep Rhode Islanders from becoming a victim of the “jury duty scam.”
• Neither the Jury Commissioner nor the Rhode Island Sheriff’s Department makes telephone calls to prospective jurors threatening arrest or demanding that a fine be paid or a bond posted. If a juror who has been legitimately summoned in writing fails to appear, the Jury Commissioner will attempt to make contact and arrange to reschedule his or her service.

• Sheriffs in Rhode Island are a division of the Rhode Island Department of Public Safety and primarily work with the Courts. Unlike most other states, Rhode Island does not have sheriff departments based in counties. Each city and town has its own local police department.

Constant Vigilance Key to Fighting Scams

According to the U.S. Federal Trade Commission list of top consumer fraud complaints last year, more than 6,200 Rhode Island residents were victims of imposter scams.

“These latest Rhode Island scams underscored the need for constant vigilance,” observed AARP Rhode Island State Director Kathleen Connell. “We like to remind people that when people hear about a scam, the first reaction often is ‘I’d never fall for that.’ Well, maybe that’s because you just read about it in the news. People need to remember that they are most susceptible to the fresh scam no one is talking about that comes out of the blue.”

AARP’s Fraud Watch Network, Connell said, is one way to keep current. If you register for the free service you can receive alerts via smart phone or your computer when a new scam surfaces. You also can report a scam going around your neighborhood that is shared across the network, she added. If you’re not connected to the Internet, you can receive alerts and tips via a quarterly newsletter mailed to homes (Lean more and sign up at http://www.fraudwatchnetwork.org).

“Identity theft and fraud costs seniors billions of dollars nationally – in most cases, money that has been set aside for retirement, “Connell noted. “Impersonating police officers, federal agents or financial service companies, scammers use their “authority” to scare a person into paying them. Or, they pretend to be a friend or loved one in trouble who needs money.

“We’re committed to fighting back,” Connell declared, noting that one recent effort was a “reverse boiler room” operation.

In September, Connell and AARP Rhode Island volunteers Alan Neville of Cumberland and Carlo Gamba of West Greenwich met up in Boston with more than 50 others. Borrowing a favorite tactic the con artists’ playbook, AARP Fraud Watch Network staff and volunteers from New England and New York operated their own telemarketing boiler room. Instead of hearing from scammers, local residents received tips and information on how to protect themselves from imposter scams.

Strong Connections Protect Seniors from Scams

“Friends and family are key partners in protecting senior citizens from financial exploitation,” remarked Elderly Affairs Director Charles Fogarty. “Isolation is a major reason that people get victimized, so ensuring that senior citizens living in the community have strong connections to family and friends helps to protect them from scams and exploitation.”

The Department of Elderly Affairs (DEA) monitors fraud and scam reports from a number of sources, and distributes those notices to a network of approximately 500 partners in the community. If the victim of a scam is referred to DEA, they immediately contact the Attorney General’s Consumer Protection Unit. DEA does not investigate instances of scams perpetrated by strangers, but does investigate financial exploitation of an older adult by family or acquaintances.

Unpaid Caregiver Care Saves State Money

Published in Woonsocket Call on July 26, 2015

With the graying of state’s population, Ocean State caregivers provided 124 million hours of care—worth an estimated 1.78 billion —to their parents, spouses, partners, and other adult loved ones in 2013, according to a new AARP Policy Institute’s report.  The total estimated economic value of uncompensated care provided by the nation’s family caregivers surpassed total Medicaid spending ($449 billion), and nearly equaled the annual sales ($469 billion) of the four largest U.S. tech companies combined (Apple, Hewlett Packard, IBM, and Microsoft) in 2013, says the 25 page report.

AARP’s report, Valuing the Invaluable: 2015 Update, noted that family caregiving for relatives or close friends with chronic, disabling, or serious health problems – so they can remain in their home – is nearly universal today.  In 2013, about 134,000 family caregivers in Rhode Island helped another adult loved one carry out daily activities (such as bathing or dressing, preparing meals, administering medications, driving to doctor visits, and paying bills), says the report issued on July 16.

Log on to AARP Rhode Island’s caregiving Web page (www.aarp.org/ricaregiving) to download the report as well as access information on recent caregiver legislation passed by the General Assembly and other resources: www.aarp.org/ricaregiving.

The Difficulty of Caregiving

The AARP report detailed how caregiving can impact a person’s job, finances and even their health, says the researchers.   More than half (55%) of family caregivers report being overwhelmed by the amount of care their family member needs, says the report.  Nearly 4 in 10 (38%) family caregivers report a moderate (20%) to high degree (18%) of financial strain as a result of providing care. In 2014, the majority (60%) of family caregivers had full- or part-time jobs, placing competing demands on the caregivers’ time.

According to AARP Rhode Island State Director Kathleen Connell, AARP’s study on caregiving affirms the state’s record as a trailblazer in the field of caregiving. In 2013, Rhode Island became just the third state to enact paid family leave, which is known as Temporary Caregiver Insurance (TCI). Also in 2013, Rhode Island enacted the Family Caregivers Support Act, which requires a family caregiver to receive an assessment,” she said.

Connell said that this year the Ocean State remained in the forefront of helping caregivers with passage of the Caregiver Advise, Record, Enable (CARE) Act, which calls for hospitals to provide instruction to designated caregivers. Additionally, Rhode Island became the 42nd state to enact the Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act. In Rhode Island, a court-appointed guardian can make important decisions across state lines.

“This new report, however, does demonstrate that we need and can do more to assist the many caregivers in our state,” said Connell. “Some of the ways we can help family caregivers include continuing efforts to improve workplace flexibility, respite care, tax credits and home care services,” she says.

Adds Charles Fogarty, Director of the state’s Division of Elderly Affairs (DEA), “This study demonstrates that the backbone of long-term services and supports are family members and informal caregivers.  Quantifying the hours and economic value of caregiving provided by Rhode Island families and informal caregivers raises public awareness of the impact these services have upon Rhode Island’s health system and economy.  It is clear that there is a significant need to support caregivers who, at a cost to their own health and economic well-being, work to keep their family members in the community.”

DEA works with the state’s Aging Disability and Resource Centers and local nonprofits and agencies such as the RI Chapter of the Alzheimer’s Association, Office of Catholic Charities of the Diocese of Providence, local YMCAs and Adult Day Care programs, to provide programming, support groups and information to Rhode Island’s caregivers, according to Fogarty.  “Rhode Island also requires that a caregiver assessment be conducted when a recipient of Medicaid-funded Home and Community Based Services has a caregiver providing support in the home,” he says.

Improving State Support for Caregiving

            Although Maureen Maigret, policy consultant for the Senior Agenda Coalition of Rhode Island acknowledges Rhode Island as being a leader with progressive laws on the books supporting caregivers, specifically the Temporary Caregiver Insurance Program, more work needs to be done.

Maigret calls for better dissemination of information to caregivers about what services and programs are available.  “In this day and age we should have a robust Rhode Island specific internet site that offers caregiving information about state specific resources,” she says, noting that too often caregivers “just do not know where to turn to find out about programs like DEA’s co-pay program.”  This program pays a share of the cost for home care and adult day care for low-income persons whose incomes are too high to meet Medicaid eligibility.

          Rhode Island also falls short in providing subsidies to caregivers of frail low income elderly to keep them out of costly nursing homes, says Maigret, noting that the program’s funding was cut by 50 percent in 2008, creating waiting lists which have occurred over the years, It’s “short sided” to not allocate adequate resources to this program. The average annual cost of $ 1,200 per family for the caregiver subsidy program can keep a person from going on Medicaid, at far greater expense to Rhode Island taxpayers, she says.

          This AARP report must not sit on a dusty shelf.  It gives an early warning to Congress and to local lawmakers.  As Americans [and Rhode Islanders} live longer and have fewer children, fewer family members will be available for caregiving duties. Researchers say that the ratio of potential family caregivers to the growing number of older people has already begun a steep decline. In 2010, there were 7.2 potential family caregivers for every person age 80 and older. By 2030, that ratio will fall sharply to 4 to 1, and is projected to drop further to 3 to 1 in 2050.

With less caregivers in the trenches providing unpaid care to keep their loved one at home, the state will have to step in to provide these programs and services – for a huge price tag to taxpayers.  State lawmakers must not be penny wise and pound foolish when it comes to caregiver programs.  Funding should not be slashed in future budgets, rather increases might just make political sense especially to tax payers.

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

DEA’s Grimaldi Hangs Up His Spurs

Published in Pawtucket Times, January 25, 2015

With 40 years in state government under his belt, including 29 years at Elderly Affairs, Larry Grimaldi begins to move into his next stage of life, publicly announcing his retirement earlier this week. The retirement date, Feb. 6, is set in stone, his papers to personnel filed.

Sixty-five year old Grimaldi, who currently serves as Chief, Program Development at the state’s Division of Elderly Affairs (DEA), looks forward to his retirement next month, but with “mixed emotions.” While the North Providence resident is satisfied with his professional accomplishments over his career, in retirement “there is an anticipation of the unknown.” It’s not an uncommon experience for those planning to “hang up their spurs” after successful careers, he says.

Once retired, “I will take a little time to breathe and look around for things I just might want to do,” says Grimaldi, noting that first on his short list is to drive across the country in April with his wife, Katherine, in a small SUV. Not a bad decision with lower gas prices.

Grimaldi has no regrets as to how his career at DEA panned out. “It was marvelous,” he tells this columnist.

Throughout the Years

After graduating from the University of Rhode Island in 1970 with a Bachelors degree in Journalism, Grimaldi worked for Providence-based companies Davol Rubber Company as a Quality Control Inspector and, three years later as a technical writer at BIF Industries. But he would leave the private sector to work as a Revenue Officer for the state’s Division of Taxation from 1975 to 1986.

A job advertisement for the position of Communications Coordinator at the state’s Department of Elderly Affairs (now a Division within the Department of Human Services) would catch Grimaldi’s attention. He jumped at the chance to apply. “It would really allow me the opportunity to put my college education and communication skills to good use,” he remembers.

Grimaldi learned a lot about the state’s aging network, honing his communication skills and building relationships. The late William Speck took him under his wing, teaching him the art of disseminating information to seniors and their caregivers, elected officials, and to the aging network, too.

According to Grimaldi, the statewide DEA information and public outreach campaign for the roll-out of the Medicare Part D program in 2006 received an Innovations in Health Care Award from RI Quality Partners (the federally designated Medicare Quality Improvement Organization for Rhode Island).

Putting his writing skills to good use, for over 27 years Grimaldi penned over 600 “Rhode Island Senior Beat” columns that appeared in many of the state’s daily and weekly newspapers. Since last year, the prolific writer produced over 60 weekly columns, “Taking Charge,” that appeared in the Providence Journal.

Grimaldi is also responsible for producing the nationally acclaimed ‘Senior Journal’ on the state’s public access cable. Since he took the helm as DEA’s information officer, more than 620 programs have been broadcast. Over 75 older volunteers have “lent their ideas, time, talent, and unique perspective” to this effort, he says, noting that this November the show celebrated 25 years on the air.

In 2012, DEA’s cable show received the “Volunteers Matter Award” from the Washington-based National Association of State Units on Aging and Disabilities, says Grimaldi, noting that it was one of three programs recognized at that conference that year.

During his DEA career, Grimaldi was responsible for providing an estimated 300 monthly trainings to the state’s Information and Referral Specialists and professionals in the aging network. He brought DEA’s greetings and information to United Way and the POINT (Aging and Disability Resource Center for Rhode Island) events and to local health fairs and expos.
As his final retirement day approaches on February 6, 2015, Grimaldi says that he will miss his DEA relationships and those in the aging network that have developed over the years. “They are exceptionally dedicated people,” he says, noting that they now have to do more work with less resources.

Colleagues Say Their Goodbys

Grimaldi “has been the face of DEA for decades,” says DEA Director Charles Fogarty. “He is a warm, caring, and energetic man who has a real passion for helping older Rhode Islanders live full and productive lives. To thousands of seniors over the years he became a trusted friend on matters they cared about most. He really represents the best in public service in Rhode Island,” notes the newly appointed DEA Director.

Former DEA Director Corinne Calise Russo, who now serves as Deputy Director of the state’s Department of Human Services, describes Grimaldi as the “consummate professional.” He is a “great trainer with exceptionally strong people skills,” says the Warwick resident who was former director at the North Providence-based Salvatore Mancini Senior Center.

According to Russo, Grimaldi was key to getting DEA’s widely used pocket manual out to the public on a timely manner each year. “He was actually like a one person production line for this manual, compiling information, ensuring accuracy, and designing it, even negotiating with the printer for a good price and product. It is a “wonderful resource for families, physician offices, community partners and elected officials”, she says.

Susan Sweet, a passionate advocate for older Rhode islanders, says that Grimaldi “fulfilled his responsibilities admirably because he took those responsibilities seriously. He has been the information guru at DEA. Nothing could be more important”

His columns provided accurate information and guidance to older persons, people with disabilities, their families and the general public, Sweet says, giving “trustworthy and helpful tips and thoughtful advice with a cheerful lilt and a timely presence.”

Paula Parker, LCSW, Assistant Director at DEA, agrees with Sweet’s assessment of Grimaldi’s writing skills. “I have been awed by his commitment to accurate, current and effective communication about aging issues for both the public community and for his colleagues at DEA and other state agencies”, she says. “I think that Larry’s most impressive skill is his ability to re-frame complex issues (such as Medicare Part D, Social Security retirement benefits, and other governmental programs) in language that is clear, concise and understandable to most people”, adds Parker.

Grimaldi certainly earned his spurs serving under eight DEA Directors. He has earned the right to hang them up.

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

Report: Alzheimer’s Poses Greater Risk for Older Women than Men

Published in Pawtucket Times, May 11, 2014

According to the Alzheimer’s Association 2014 Alzheimer’s disease Facts and Figures report released last Month, a woman’s estimated lifetime risk of developing Alzheimer’s at age 65 is 1 in 6, compared with nearly 1 in 11 for a man. As real a concern as breast cancer is to women’s health, women age 60 and over are about twice as likely to develop Alzheimer’s over the rest of their lives as they are to develop breast cancer, says the this years’ report.

The Facts and Figures report, an official report of the Alzheimer’s Association, the world’s leading voluntary health organization in Alzheimer’s care, support and research, is a comprehensive compilation of national statistics and information on Alzheimer’s disease and related dementias. The 75 page report conveys the impact of Alzheimer’s on individuals, families, government and the nation’s health care system. Since its 2007 inaugural release, the detailed report has become the most cited source covering the broad spectrum of Alzheimer’s issues.

“Through our role in the development of The Shriver Report: A Woman’s Nation Takes on Alzheimer’s in 2010, in conjunction with Maria Shriver, we know that women are the epicenter of Alzheimer’s disease, representing majority of both people with the disease and Alzheimer’s caregivers. The recently released Alzheimer’s Association Facts and Figures examines the impact of this unbalanced burden,” said Angela Geiger, chief strategy officer of the Alzheimer’s Association. “Well-deserved investments in breast cancer and other leading causes of death such as heart disease, stroke and HIV/AIDS have resulted in substantial decreases in death. Geiger calls for comparable investments in research to reach the same levels of successfully preventing and treating Alzheimer’s as the other leading causes of death.

Adding to women’s Alzheimer’s burden, there are 2.5 times as many women as men providing intensive “on- duty” care 24 hours for someone living with Alzheimer’s disease, says the report, also noting that among caregivers who feel isolated, women are much more likely than men to link isolation with feeling depressed (17 percent of women verse. 2 percent of men).

Also noted in the 2014 Alzheimer’s’ Facts and Figures report released on March 19, 2014, the strain of caring for someone with Alzheimer’s is also felt in the nation’s workplace, too. Among caregivers who have been employed while they were also care giving, 20 percent of women verse. 3 percent of men went from working full-time to working part-time while acting as a caregiver. The report also noted that 18 percent of women versus. 11 percent of men took a leave of absence while 11 percent of women verses 5 percent of men gave up work entirely. Finally, 10 percent of women verse 5 percent of men lost job benefits.

Far Reaching Fiscal Human Impact of Alzheimer’s

Meanwhile the Alzheimer’s Association Facts and Figures report noted that there are more than 5 million Americans living with this devastating disorder, including 3.2 million women and 200,000 people under the age of 65 with younger-onset Alzheimer’s disease (see my May 9, 2013 Commentary). However, Alzheimer’s has far-reaching effects by impacting entire families. Also, it was reported that there are currently 15.5 million caregivers providing 17.7 billion hours of unpaid care throughout the nation, often severely impacting their own health. The physical and emotional impact of dementia care giving resulted in an estimated $9.3 billion in increased healthcare costs for Alzheimer’s caregivers in 2013.

The total national cost of caring for people with Alzheimer’s and other dementias is projected to reach $214 billion this year, says the 2014 Facts and Figures report, not including unpaid care giving by family and friends valued at more than $220 billion. In 2014, the cost to Medicare and Medicaid of caring for those with Alzheimer’s and other dementias will reach a combined $150 billion with Medicare spending nearly $1 in every $5 on people with Alzheimer’s or another dementia.

The Facts and Figures report predicts the cost numbers to soar as the baby boomers continue to enter the age of greatest risk for Alzheimer’s disease. Unless something is done to change the course of the devastating disorder, there could be as many as 16 million Americans living with Alzheimer’s in 2050, at a cost of $1.2 trillion (in current dollars) to the nation. This dramatic rise includes a 500 percent increase in combined Medicare and Medicaid spending and a 400 percent increase in out-of-pocket spending.

The country’s first-ever National Plan to Address Alzheimer’s disease has a goal of preventing and effectively treating Alzheimer’s disease by 2025. Ensuring strong implementation of the National Alzheimer’s Plan, including adequately funding Alzheimer’s research, is the best way to avoid these staggering human and financial tolls.

Lack of Understanding of the Alzheimer’s’ Disease

“Despite being the nation’s biggest health threat, Alzheimer’s disease is still largely misunderstood. Everyone with a brain — male or female, family history or not — is at risk for Alzheimer’s,” said Geiger. “Age is the greatest risk factor for Alzheimer’s, and America is aging. As a nation, we must band together to protect our greatest asset, our brains.”

In 2010, the Alzheimer’s Association in partnership with Maria Shriver and The Shriver Report conducted a groundbreaking poll with the goal of exploring the compelling connection between Alzheimer’s disease and women. Data from that poll were published in The Shriver Report: A Woman’s Nation Takes on Alzheimer’s, which also included essays and reflections that gave personal perspectives to the poll’s numbers. For the first time, that report revealed not only the striking impact of the disease on individual lives, but also its especially strong effects on women — women living with the disease, as well as women who are caregivers, relatives, friends and loved ones of those directly affected.

Realizing the impact Alzheimer’s has on women — and the impact women can have when they work together — the Alzheimer’s Association is launching a national initiative this spring highlighting the power of women in the fight against this disease. To join the movement, visit http://www.alz.org/mybrain.

Maureen Maigret, policy consultant for the Senior Agenda Coalition of Rhode Island and Coordinator of the Rhode Island Older Woman’s Policy Group, concurs with the findings of the Alzheimer’s disease Facts and Figures report. She calls for the education of elected officials on the facts about Alzheimer’s disease and its greater prevalence among women. “It is clearly a tragedy for the women effected with the disease, and can be devastating for their caregivers, mostly daughters, trying to keep them at home,” she says.

Maigret says that Alzheimer’s disease and other dementias at the state level have tremendous implications for this state’s budget. “Data show that in Rhode Island, about three-quarters of persons in nursing homes paid for by Medicaid are older women. An overwhelming number of them have some cognitive decline or dementia, she notes.

“We must do more to ensure that quality long-term care is available for persons with dementia and that robust caregiver support services are in place for the many families dealing with parents, spouses and other loved ones suffering from this disease,” says Maigret, stressing that government funding on research must also be greatly increased in the hopes of finding a cure or ways to prevent its onset.

Director Catherine Taylor, of the state’s Division of Elderly Affairs, believes that the Alzheimer’s’ Association’s released 2014 Facts and Figures report, about a woman’s lifetime risk of developing the devastating cognitive disorder verses breast cancer “really help us understand, in stark terms, what a public health crisis Alzheimer’s disease is, especially for women.”

Taylor notes that the Ocean State is in the implementation phase of its State Plan on Alzheimer’s disease and Related Dementias (see my November 13, 2013 commentary), where state officials are working to improve information, care and supports for every family that confronts Alzheimer’s disease. “The work will continue until there’s a cure,” she says.

“It’s important to note that new research findings also indicates that up to half of the cases of Alzheimer’s disease may be linked to risk factors “within our control,” states Taylor, adding that reducing the risk of developing Alzheimer’s disease may be a simple as eating a healthy diet, staying active, learning new skills, and maintaining maintain strong connections with family, friends and community.

For those concerned about their risk of developing Alzheimer’s disease, join Prevent AD, Rhode Island’s Alzheimer’s disease Prevention Registry. Prevent AD volunteers will learn about prevention studies for which they may be qualified to participate in, as well as the latest news on brain health. For more information, call (401) 444-0789.

The full text of the Alzheimer’s Association 2014 Facts and Figures can be viewed at http://www.alz.org/downloads/facts_figures_2014.pdf. The full report also appeared in the March 2014 issue of Alzheimer’s & Dementia: the Journal of the Alzheimer’s Association (Volume 10, Issue 2).

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.

Senior Centers, Not Just a Place to Play Bingo

Published February 1, 2013, Pawtucket Times

Today’s senior centers are not the places our parents once visited to knit or play bingo. Established in the 1980s by the U.S. Administration on Aging, the centers programming has slowly evolved to encompass activities that encourage healthy aging and wellness, says Mary Lou Moran, who oversees Pawtucket’s Leon A. Mathieu Senior Center. Established in 1980, last year over 15,000 clients took advantage of programs and social services offered, or to eat a nutritious meal, she notes.

At Rhode Island’s 47 Senior Centers, “We are now looking at the whole person, the body, mind and spirit,” notes Moran, a former Program Coordinator who now serves as Director of Senior Services. “It is very important that we encourage individuals to live independently and safely in their communities.”

At the Leon Mathieu Senior Center, health screenings, specifically taking blood pressure readings, are performed by nursing students from Rhode Island College and URI Pharmacy students, notes Moran. “Proper nutritional counseling is a very big deal, too,” she adds, noting that a nutritionist is available to provide individual counseling.

Through the Eyes of Clients

Linda Slade discovered the Leon Mathieu Senior Center after retiring from working in retail for over 38 years. Initially, attending a few exercise activities in October 2010, she was forced to stop attending, taking care of her terminally ill husband. After his passing she came back four months later “to just be with people again.”

Slade, initially had misconceptions about Pawtucket’s Senior Center. “I was a young sixty-two and not really sure what to expect,” she said, expecting to be surrounded by very old people. That first visit totally changed her mind, seeing younger people. Besides knitting, playing cards or cribbage, the Pawtucket resident participates regularly in arthritis class, stretch exercises and Tai Chi.

Before attending the Senior Center’s exercise classes, Slade’s son had given her a gym membership. “Basically I was intimated to go because of the younger people,” she says. Now Slade is more comfortable working up a sweat with her Senior Center exercise companions.

According to Slade, the City’s Senior Center offers something [activities] for everyone, her involvement even gave her an opportunity to develop new social bonds. “I had a work family that I truly adored, but now I adore my Senior Center family, too” she said. Just like the fictional bar, Cheers, Slade knows everyone’s name in all her activity groups.

“Going bonkers” and feeling a need to get out of her home propelled Nancy Connor, 79, a former Secretary to the CEO of Citizens bank, to the doors of the Leon Mathieu Senior Center. Aortic valve surgery forced the Pawtucket resident into an early retirement in her early seventies from a job she loved and found intellectually challenging.

Once the Pawtucket widow, who lives with her companion, Mave, a 60 pound Royal Standard Poodle, found the Leon Mathieu Senior Center in the Yellow Page Directory, she went to see what it was all about. She’s been going daily ever since.

The Grand Dame of the Literary Circle

Like Slade, before attending, Connor had a misconception about Senior Centers, thinking that she would see “a bunch of old people doddering along.” Now the enthusiastic participant has found out that this was not the case.

According to Connor, not as many men come into the Center. “We really do outnumber them,” she quips, noting that they “usually appear out of thin air when there is a high-low jack game.

Walking with a cane keeps Connor from exercising but she hopes to some day explore the Chinese practice of Tai Chi. However, she gets activity involved in other pursuits. Never published, she took up writing, participating in the Book and Drama Clubs, and now considers herself the “Grandma Moses” of the Senior Center’s literary circle.

Meanwhile, Connor and a few other older participants meet monthly with third year Brown Medical students to teach them the art of speaking to the “geriatric crowd,” she says. At Friday coffee hours, invited guests come into the Senior Center’s large activity room to entertain, teach or educate, she says. If a cancellation happens, she’s drafted to play piano for the crowd in the activity room.

Like in Senior Centers across the Ocean State, every day Connor can eat lunch, only paying a minimal fee. “It is wonderful stuff, from soup to nuts,” she remarks.

A Medical Model

Jill Anderson, Executive Director of Senior Services Inc., a private nonprofit corporation established in 1975, manages the Woonsocket Senior Center. Each day over 100 clients (around 500 annually) participate in exercise activities and health and wellness programs at her site. A day care program in her building handles 35 people who have limitations in their daily living.

Reflecting its medical model philosophy, the Woonsocket Senior Center’s registered nurse, who also serves as the Wellness Director, counsels people on how to change behaviors to maintain better health. Health screening, including blood pressure checks, diabetic and bone density testing are also part of a Wellness program.

About 20 retired volunteers regularly help out each day serving lunch and assisting staff, notes Anderson. “These individuals create a friendly atmosphere for the new clients, making sure they don’t sit by themselves.”

Although many of Rhode Island’s Senior Centers have an annual membership fee or charge registration fees to participate in activities, Anderson’s nonprofit does not. “We just ask people to make a voluntary weekly contribution of one dollar to fill the gap that fundraising, grants and memorials don’t cover.”

Like in many other Senior Centers, computer courses in a computer lab is offered, says Anderson. “We would like to do more with computers, maybe we can some day offer both Intermediate and Advanced computer classes, too,” she adds, because the older clients are interested in embracing new technology, like I-pads, and smart phones.

“A Benefits Councilor also is on site to identify benefits and programs our clients are entitled to receive, states Anderson, this ultimately helping to lower the cost of supplemental Medicare plans, and make other economies.

Pumping Weights

Robert Rock, Director East Providence Senior Center, on Waterman Ave., provides all the typical exercise programs that Senior Centers offer. But through a $96,000 grant received from the U.S. Administration on Aging, his Senior Center now houses the only fitness center in the Ocean State.

“The [fitness] program promotes attitude change and development of appropriate exercise skills and reduces the risks of a sedentary lifestyle. It also improves the quality of life for our senior population,” Rock says.

According to Rock, a client can gain privileges to using the fitness room for a very minimal fee of $40 for single membership, $60 for couples. Equipment includes three treadmills, two recumbent bikes, an elliptical stepper, hand weights and six dual weight machines. Other features include a matted floor, mirrored walls, water, stereo, and cable TV.

Rock notes that 90 percent of the 258 people, mostly in their 60s, are taking advantage of this fitness center room, an attachment to the Senior Center. “They come to work out and then leave,” he says, noting that the oldest, a 91-year old man comes to work out three days a week.

Rock believes that once aging baby boomers come to us for the fitness room, they will choose to come back for other programs and services offered by his Senior Center.

Walking is also an important exercise, too, says Rock. Many clients take advantage of using the Senior Center’s half mile walking track.

Finally, Rock adds that the East Providence Senior Center is also a Rhode Island state-certified site for diabetes education. Both classes and individual counseling are offered.

In conclusion…

Starting in church basements, many as small social clubs, the passage of the Older Americans Act in 1965, propelled Senior Centers into a key provider in the nation’s long term care continuum of care.

Today, 11,000 senior centers serve one million older adults every day. In Rhode Island, 47 agencies, serving 208,000 persons, are geographically spread out from Westerly to Woonsocket and from Foster to Tiverton. Some are managed by municipalities, others by nonprofit groups. While catering to serving the state’s burgeoning elderly population, some have expanded their mission to offer programs for young and middle age adults.

While the average age is age 75, many of Rhode Island’s Senior Centers are adjusting their programming and services to attract the state’s aging baby boomers by focusing on health and wellness, recreation and life long learning.

According to Rhode Island’s Division of Elderly
Affairs (DEA), over 14 percent of Rhode Island’s population is age 65 and over. By 2030, its projected to grow to over 21 percent. Rhode Island’s senior centers are a key provider to keep the aging baby boomers, healthy, independent and at home.

Yes, today’s Senior Centers are not your parent’s bingo hall, as some mistakenly believe. Why not visit your local senior center you may even be surprised with what you find. Call DEA for a complete listing of the state’s senior centers at 401/462-3000.

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