2050 and the Caregiver Dilemma

Published in the Woonsocket Call on April 22, 2018

The year 2030 marks an important demographic turning point in U.S. history according to the U.S. Census Bureau’s 2017 National Population Projections, released last month. By 2030, older people are projected to outnumber children. In the next twenty years, when these aging baby boomers enter their 80s, who will provide informal caregiving to them.

Almost three years earlier, in a July 2015 report, “Valuing the Invaluable: 2015 Update Undeniable Progress, but Big Gaps Remain,” the AARP Public Policy Institute warned that fewer family members will be around to assist older people with caregiving needs.

According to AARP’s 25-page report, coauthored by Susan C. Reinhard, Lynn Friss Feinberg, Rita Choula, and Ari Houser, 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.

Family caregivers assisting relatives or close friends afflicted with chronic, disabling, or serious illness, to carry out daily activities (such as bathing or dressing, preparing meals, administering medications, driving to doctor visits, and paying bills), are key to keeping these individuals in their homes and out of costly nursing facilities. What is the impact on care of aging baby boomers when family caregivers no longer provide assistance in daily activities?

“In 2013, about 40 million family caregivers in the United States provided an estimated 37 billion hours of care to an adult with limitations in daily activities. The estimated economic value of their unpaid contributions was approximately $470 billion in 2013, up from an estimated $450 billion in 2009,” notes AARP’s caregiver report. What will be the impact on the nation’s health care system without family caregivers providing informal care?

The Census Bureau’s 2017 National Population Projections, again puts the spot light on the decreasing caregiver ratio over the next decades identified by the AARP Policy Institute, one that must be planned for and addressed by Congress, federal and state policy makers.

Who Will Take Care of Aging Baby Boomers?

With the expansion in the size of the older population, 1 in every 5 United States residents will be retirement age. Who will provide informal caregiving in our nation with a larger adult population and less children to serve as caregivers?

“The aging of baby boomers means that within just a couple decades, older people are projected to outnumber children for the first time in U.S. history,” said Jonathan Vespa, a demographer with the U.S. Census Bureau. “By 2035, there will be 78.0 million people 65 years and older compared to 76.4 million under the age of 18.”

The 2030s are projected to be a transformative decade for the U.S. population, says the 2017 statistical projections – the population is expected to grow at a slower pace, age considerably and become more racially and ethnically diverse. The nation’s median age is expected to grow from age 38 today to age 43 by 2060.

The Census Bureau also observed that that as the population ages, the ratio of older adults to working-age adults, also known as the old-age dependency ratio, is projected to rise. By 2020, there will be about three-and-a-half working-age adults for every retirement-age person. By 2060, that ratio will fall to just two-and-a-half working-age adults for every retirement-age person.

Real Challenges Face Congress as the Nation Ages

Jean Accius, Ph.D., AARP Policy Institute’s Vice President, Independent Living, Long-Term Services and Supports, says, “The recent Census report highlights the sense of urgency to develop innovative solutions that will support our growing older adult population at a time when there will likely be fewer family caregivers available to help. The challenges that face us are real, but they are not insurmountable. In fact, this is an opportunity if we begin now to lay the foundation for a better system of family support for the future. The enactment of the RAISE (Recognize, Assist, Include, Support and Engage) Family Caregivers Act, which would create a strategy for supporting family caregivers, is a great path forward.”

Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare, gives his take on the Census Bureau’s 2017 statistical projections, too.

“Despite how cataclysmic this may sound, the rising number of older people due to the aging of baby boomers is no surprise and has been predicted for many years. This is why the Social Security system was changed in 1983 to prepare for this eventuality. Under current law, full benefits will continue to be paid through 2034 and we are confident that Congress will make the necessary changes, such as raising the wage cap, to ensure that full benefits continue to be made well into the future,” says Richtman.

Richtman calls informal caregiving “a critical part of a care plan” that enhances an older person’s well-being. “While there currently are programs such as the Medicaid Waiver that will pay family members who provide caregiving support more can be done to incentivize caregiving so that loss of personal income and Social Security work credits are not barriers to enlisting the help of younger individuals to provide informal support services,” he says.

Adds Richtman, the Medicare and Medicaid benefits which reimburse for the home-based services and skilled nursing care “will be unduly strained ”as the diagnosed cases of Alzheimer’s disease skyrockets with the growing boomer population. He calls on Congress to “immediately provide adequate research funding to the National Institutes of Health to accelerate finding a cure in order to save these programs and lower the burdens on family caregivers and the healthcare system. “

Finally, AARP Rhode Island State Director Kathleen Connell, says “Our aging population represents challenges on many, many fronts, including healthcare, housing, Social Security, Medicare and, of course, caregiving. It would be nice to think everything would take care of itself if there were more younger people than older people. But that misses the point entirely. The needs of older Americans are a challenge to all Americans, if for no other reason than most of us end up with multiple late in life needs. And too many reach that point without savings to cover those needs.”

“It’s worth noting, by the way, that many of the solutions will come from people 50 and older — many of whom will work longer in their lives to improve the lives of older Americans. We need to stop looking through the lens of ‘old people’ being the problem and instead encourage and empower older Americans to take greater control over their lives as they help others,” says Connell.

“Congress needs to focus on common sense solutions to assure families that Social Security and Medicare are protected. The healthcare industry needs to face the medical challenges. And at the state and local level, we must focus on home and community-based health services,” adds Connell.

For details about the Census Bureau’s 2017 statistical projections, co to http://www.census.gov/newsroom/press-releases/2018/cb18-41-population-projections.html.

For more information about AARP’s July 2015 caregiver report, go to http://www.aarp.org/content/dam/aarp/ppi/2015/valuing-the-invaluable-2015-update-new.pdf.

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

Published in the Woonsocket Call on March 25, 2018

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

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

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

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

2018 Alzheimer’s Facts and Figures

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

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

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

State Updates Battle Plan Against Alzheimer’s Disease

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

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

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

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

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

Increased Research Funding Needed Now

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

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

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

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

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

Pets Can Bring You Health, Happiness

Published in the Woonsocket Call on February 4, 2018

My newly adopted three-month old chocolate lab, Molly, keeps me on my toes. Literally. My daily walks around the block and playing ball in the back yard equal over eight thousand steps calculated by my Fitbit App. Being a pet owner I can certainly vouch for research findings published over the years that indicate that older adults who also are pet owners benefit from the regular exercise and bonds they form with their companion animal.

The Positives of Owning a Pet

According to Dr. William Truesdale, owner of Seekonk, Massachusetts Central Avenue Veterinary Hospital, “having a companion animal can greatly improve your life. Of course you should always choose the right pet based upon your lifestyle and activity levels,” says the veterinarian who has practiced for over 43 years.

“Studies have demonstrated that having a pet in the home can actually lower a child’s likelihood of developing related allergies or asthma. Children exposed early on to animals tend to develop stronger immune systems overall (as published in the Journal of Allergies and Clinical Immunology),” says Truesdale.

“The Centers for Disease Control and Prevention (CDC) have conducted heart related studies on people who have pets. The finding showed that pet owners exhibit decreased blood pressure, cholesterol and triglyceride levels. All of which can ultimately minimize their risk for having a heart attack,” adds Dr. Truesdale, noting that people affected by depression, loneliness or PTSD may find that a companion animal may greatly improve their overall mood.

“As a dog owner myself and knowing so many people who find companionship and just plain fun as a pet owner, I can attest to the many benefits,” said AARP RI State Director Kathleen Connell. “While not for everyone, there is an abundance of evidence supporting this. I have heard so many stories about pets in senior living centers and even service pets that provide furry contact for patients in nursing homes and hospitals I know they can do so much to brighten a day. And when you are on Facebook, you almost expect to see friends’ proud dog and cat pictures.

“When it comes to dogs, they need walking. Anything that gets older people up and out of the house is a good thing, even if it requires carrying a supply of clean-up bags. Bending and stretching is exercise, you know. In addition, there inevitably is increased social interaction as people meet and make new pet-owner on the sidewalks and at dog parks. It’s all good.”

Pet-Friendly Policies Abound in Health Care Settings

Dr. Karl Steinberg, a San Diego-based hospice and nursing home medical director and Chief Medical Officer for Mariner Health Central, has seen the positive impact of pets in patient care settings. For over twenty years the long-term care geriatrician has taken his own dogs with him to nursing homes, assisted living facilities and on house calls to hospice patients almost every day. ”It generates a lot of happiness,” says Steinberg.

Steinberg sees first-hand on a daily basis the joy they bring to the residents, even those with severe dementia. “It slows down the day a little bit, because when you walk past a room and someone shouts, ‘Oh! A dog!’, you can’t just walk on down the hall. You stop and share the unconditional love, and it’s so worth it.,” says the geriatrician and hospice physician

For years, Administrator Hugh Hall has brought Bella, a Labrador Retriever, to visit residents of the West Warwick-based West View Nursing and Rehabilitation. Bella is considered “an important member” of the Rehabilitation staff of the 120 bed skilled nursing facility,” says Hall, noting the 8-year old canine is utilized by therapists to assist and motivate patients in their recovery.

“Residents love the ability to ability to interact and hold or cuddle with Bella and visiting pets,” observes Hall, noting that his dog is the “official greeter” at the facility’s main entrance. “The residents get to pet her and reminisce about their pets of the past and this memory is warm and happy,” he says.

Mike, a 12 -year old Labrador often makes the “rounds” with Geriatrician David A. Smith, MAD, CMD, at facilities in Central Texas. His pet’s impact on residents is very positive and improves the quality of his rapport with residents enabling him to get “better history and better compliance from them” he says.

“In a meta-analysis of non-pharmacologic therapies for behavioral problems in Nursing Home Residents with dementia, pet therapy was one of only a small number of interventions that showed statistical benefit,” says Smith, who is a past president of AMA: The Society for Post-Acute and Long-Term Care Medicine.

Smith warns that there is a downside in owning a pet. Frail adults may trip over a pet. Elders may age out of the ability to care for a pet, placing an additional burden on a caregiver who must care for the pet. Plans need to be in place for the placement of a pet in case of a move to an assisted living facility or if an owner passes away.

Life-Like Pets Can Also Bring Benefits to Older Adults

But, for those who find taking care of a living pet taxing because of deceased mobility or memory loss, Hasbro, Inc., has created a new realistic pet, an animatronic cat with soft fur, soothing purrs, and pleasant meows and a barking dog, especially designed to bring companionship to older adults.

In 2015, the Joy For All Companion Pets brand, featuring the animatronic cat, was Hasbro’s first foray into products designed specifically for older adults. In addition to captivating older adults, Joy For All Companion Pets can help enhance the interaction between caregivers and their loved ones by incorporating lighthearted fun, joy, and laughter into time spent together.

In 2016, Hasbro’s the JOY FOR ALL Companion Pet brand included a lifelike pup that sounds, and feels like a real dog; when the pup’s “owner” speaks, it looks toward him/her and reacts with realistic puppy sounds. That year the Pawtucket-based toy company collaborated with Meals on Wheels America to fight senior isolation and loneliness, which affects one in four seniors across the country. Hasbro donated $100,000 to Meals on Wheels America and provided JOY FOR ALL Companion Pets to local Meals on Wheels programs across the country in order to provide comfort and companionship to the nation’s most vulnerable citizens.

“Aging loved ones and their caregivers have been thrilled with the Companion Pet Cats, and we are inspired by their positive feedback and personal stories,” said Ted Fischer, vice president of business development at Hasbro in a statement announcing the new life-like product. “The Cat delivers a unique way for all generations to connect deeply through interaction and play, but dog lovers continually asked when we planned to add a dog to the line. We are truly excited for the new JOY FOR ALL product – the Companion Pet Pup – to bring even more lighthearted fun and laughter to seniors and their families.”

“We heard from seniors across the country that companionship was important to their happiness. Many live alone, miss having a pet, or are no longer able to care for a pet,” said Fischer. “While it’s not a replacement for a pet, the Joy For All Companion Pet Cat is a life-like alternative that can provide the joy and companionship of owning a real pet, without the often cumbersome responsibilities,” he says.

The Joy For All Companion products are available for purchase on JoyForAll.com.

Congress Passes RAISE Family Care Givers Act

Published in the Woonsocket Call on January 14, 2018

With the dust finally settling after the heated partisan battles over the dismantling President Obama’s landmark Obamacare and later reforming the nation’s tax code, Congressional Democrats and Republicans put political and philosophical differences aside to overwhelming pass by voice vote the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act of 2017.

The RAISE Family Caregivers Act of 2017, introduced in the U.S. Senate by Senators Susan Collins (R-ME) and Tammy Baldwin (D-WI), was passed on January 8, 2017. Two months earlier a House companion measure (H.R. 3759), introduced by Reps. Gregg Harper (R-MS) and Kathy Castor (D-FL), was passed. At press time, the legislation now heads to the President’s desk to be signed into law.

The caregiver legislation would direct the U.S. Secretary of Health and Human Services to develop and sustain a strategy to recognize and support family caregivers across the nation. This bipartisan legislation has been endorsed by more than 60 aging and disability organizations, including AARP, the Alzheimer’s Association, the National Committee to Preserve Social Security and Medicare, the Elizabeth Dole Foundation, the Michael J. Fox Foundation, and the Arc.

Universal Praise for Congressional Passage

Congress clearly understands that caregiving is not a partisan issue but a life experience for millions of Americans.Yes, everyone at some time in their life may take on the role of caregiver for parents, spouses, children and adults with disabilities, or personally know caregivers.

According to AARP’s Public Policy Institute, there are 40 million family caregivers in the United States who provided an estimated $470 billion in uncompensated long-term care in 2013. In the Ocean State at any time during the year, an estimated 134,000 Rhode Island family caregiver step up to provide 124 million hours of care for an aging parent or loved one, most often helping them to live independently in their own homes.

“Family caregivers play an essential role in our communities by dedicating time and attention and making countless personal and financial sacrifices to care for their loved ones,” said Sen. Collins upon the Senate bills passage. “I am delighted that our bipartisan legislation to develop a coordinated strategic plan to leverage our resources, promote best practices, and expand services and training available to caregivers will now become law,” adds the Maine Senator, who chairs the Senate Special Committee on Aging.

Senator Sheldon Whitehouse sees the value of the RAISE Family Caregivers and its impact to Rhode Island caregivers. “The passage of the bipartisan RAISE Family Caregivers Act is an important first step toward easing the burden on the caregivers who mean the world to the family members they care for.” says the Rhode Island Senator who serves on the Senate Special Committee on Aging.

“Family caregivers play a key role in supporting their loved ones in Rhode Island and throughout the nation. adds Democratic Policy and Communications Committee Co-Chair David N. Cicilline. “The RAISE Family Caregivers Act ensures that family caregivers have the support and the resources they need to do their jobs safely and effectively. As a co-sponsor of H.R. 3759, I made sure my colleagues understood that this bill needed to become law as soon as possible, and I am glad that it passed both Chambers without objection. Now I urge President Trump to sign it and allow this important law to take effect”

“Thanks to the efforts of bipartisan Senate and House champions—Senators Collins and Baldwin and Representatives Harper and Castor—the RAISE Family Caregivers Act will help address the challenges family caregivers face,” said AARP Chief Advocacy & Engagement Officer Nancy A. LeaMond, in a statement. “Family caregivers are the backbone of our care system in America. We need to make it easier for them to coordinate care for their loved ones, get information and resources, and take a break so they can rest and recharge,” she says.

According to LeaMond, family caregivers take on a range of tasks including managing medications, helping with bathing and dressing, preparing and feeding meals, arranging transportation, and handling financial and legal matters. She estimates that the unpaid care that family caregivers provide helps delay or prevent costly nursing home care, which is often paid for by Medicaid.

What’s in the RAISE Family Caregiver Act?

The RAISE Family Caregivers Act directs the Secretary of Health and Human Services to develop and update a national strategy to support family caregivers. The legislation would also create a Family Caregiving Advisory Council comprised of relevant Federal agencies and non-federal members, also including family caregivers, older adults with long-term care needs, individuals with disabilities, employers, health and social service providers, advocacy organizations engaged in family caregiving, state and local officials, and others with expertise in family caregiving.

The newly established Advisory Council (meetings open to the public) would be charged with making recommendations to the Secretary. The strategy would be updated to reflect new developments. The Advisory Council’s initial report would include an initial inventory and assessment of federally funded caregiver efforts that would be incorporated into the initial strategy. The strategy would then identify recommended actions that government, providers, communities, and others could take to support family caregivers.

The development of the initial strategy would take up to 18 months, followed by updates of the strategy biennially. The bill would improve the collection and sharing of information, including information related to evidence-based or promising practices and innovative models regarding family caregiving; better coordinate, assess, maximize the effectiveness, and avoid unnecessary duplication of existing federal government activities to recognize and support family caregivers. The strategy and work around it could help support and inform state and local efforts to support family caregivers, promoting greater adoption of person- and family-centered care in all health and Long-Term Service and Support (LTSS) settings, with the person and the family caregiver (as appropriate) at the center of care teams

In addition to requiring the development of a strategy to support the nation’s family caregivers, the bill also establishes an advisory body that will bring together stakeholders from the private and public sectors to make recommendations that communities, providers, government, and others are taking and may take to help make the big responsibilities of caregiving a little bit easier.

The activities under the bill would be funded from existing funding appropriated for the Department of Health and Human Services. No new funding is authorized and it would sunset in five years.

Calls for More Caregiver Assistance

“In Rhode Island, we’re working hard at staying ahead on legislation supporting caregivers,” said AARP Rhode Island State Director Kathleen Connell. “We passed temporary caregiver insurance, which covers thousands of working caregivers with salary protection much like TDI (Temporary Disability Insurance). Earned-paid sick leave fills in a gap that caregiver TDI may not cover in emergency situations. The AARP-back CARE Act now requires hospitals, upon admitting patients, identify a designated caregiver, inform that person on discharge and provide training for at-home medical tasks. We have passed legislation making it easier for caregivers to modify their homes. And just this month, the state opened applications for a grant program we fought for in the current budget that provides up to $5,000 in hard cash for caregivers who make qualifying home improvements.” (Download a grant application at http://www.aarp.org/ricaregiving)

“We cannot stop here,” added Connell. “And the RAISE Act keeps the need for ongoing strategic planning and smart policymaking on the front burner. The numbers demand escalating action that will improve conditions not just for people who need care, but their family caregivers as well. But it is very important to emphasize that all taxpayers benefit when someone with chronic illness or aging disabilities can stay in their homes, rather than move into Medicaid-supported nursing homes. We all win when we support caregivers.”

NOTE: “The Rhode Island Chapter of the Alzheimer’s Association has a commitment to assisting caregivers navigate the various challenges of caring for someone living with Alzheimer’s and other related dementias,” says Donna McGowan, Executive Director of the Alzheimer’s Association, RI Chapter. Call 1-800-272-3900 for details about caregiver and provider services (including confidential support, information, and referrals to local resources via access to a 24/7 Helpline, care consultation, caregiver support groups, education programs for families, and online information (www.alz.org/ri ).

Zarlengo Earns AARP Rhode Island’s Most Prestigious Volunteer Award

Published in Pawtucket Times on December 18, 2017

“To Serve and Not be Served” – Dr. Ethel Percy Andrus

AARP Rhode Island recognizes its own, Phil Zarlengo, for his decades of serving the state’s and the nation’s seniors. Over 130 family and fellow AARP Rhode Island members gathered at the Warwick Country Club at a luncheon ceremony to recognize his remarkable service to America’s largest aging advocacy group.

AARP top national officials (Joan R. Ruff, Chair of the AARP National Board of Directors, Kelly Clark, AARP Eastern Region Vice-president and Megan Hookley, AARP Vice President, Volunteerism & Services), came bringing their greetings.

Last week, Zarlengo, 71, a resident of Jamestown for over 30 years, became the 16th recipient AARP Rhode Island Ethel Percy Andrus Award for Community Service — the nonprofit group’s most prestigious and visible state volunteer award for community service.

Every year, Andrus Award recipients across the nation are chosen for their ability to enhance the lives of AARP members and prospective members, improve the community in or for which the work was performed, and inspire others to volunteer.

An Easy Pick

Zarlengo, a native of Chicopee, Massachusetts, was nominated for the Rhode Island Chapter’s prestigious award by Alan Neville, a retired executive in the financial services sector who now serves as AARP Rhode Island state president. “It was a very easy to pick Zarlengo,,” says Neville, acknowledging that “working with him has been a great privilege for me.”

“He is dedicated to public service and I consider him to be an authentic leader,” says Neville.

“As I have gotten to know him, I have come to appreciate the depth and breadth of Phil’s knowledge and experience,” says Neville, echoing many at the December 10 award ceremony who observed that the former teacher and school administrator’s volunteer efforts extend far beyond AARP to countless other regional and national groups and span decades of giving back to his community.

Zarlengo’s professional and educational credentials are impressive. He has a bachelor’s degree in Social Science from UMASS Amherst, an MA in History from Brown University, a doctorate in Management & Evaluation from the University of Connecticut and a Public Affairs Certificate from Tufts University.

Zarlengo Brings a lot to the Plate

A quick glance at his bio reveals his love for education. Zarlengo was Executive Director of Brown University’s National Education Research Lab, where he developed new models for teacher and school program evaluations disseminated across the nation. As an administrator in the Rhode Island Department of Education and the Providence School Department he monitored state and local programs for special population children. Currently, he is CEO of his own management consulting firm that evaluates and helps improve innovative school programs for low achieving students in urban schools, and is a member of the ACE Charter School Board of Directors.

Zarlengo’s award “acts as a symbol to the public that we can all work together for positive social change,” AARP Rhode Island State Director Kathleen Connell told the attending. “AARP has long valued the spirit of volunteerism and the important contributions volunteers make to their communities, neighbors, and the programs they serve,” she said.

Connell considered Zarlengo a guiding light to AARP Rhode Island when he was asked to assist in organizing the first AARP Rhode Island state office in Providence. She had reached out to her former boss after working with him at Brown to serve as the aging advocacy group’s first volunteer state president.

“His advice on elderly and elderly issues was invaluable and his commitment extraordinary,” Connell says, stressing that Zarlengo “helped to put our office on the map early on, and in recognition of his work he moved swiftly on to his position on the National Board.”

Zarlengo eventually put his energies at the national level by serving on AARP National Board and Board Chair before stepping down in 2012. During his 14 years of volunteer service, he has been an energetic defender of Social Security and Medicare and a strong voice in improving healthcare quality and access for all. Since he left his national position three years ago, he still remains active in AARP in many roles, including AARP’s designee on the U.S. Federal Emergency Management Agency, with a focus on helping older Americans prepare for natural disasters. He works closely with AARP Rhode Island’s legislative committee, bringing his understanding of complex national aging policy issues to the General Assembly when they are considering legislation impacting older Rhode Islanders.

“Nonetheless, he never left our fold, offering counsel and assistance whenever asked – and often when we didn’t ask. That’s Phil’s style and everyone who has ever worked with him here has benefited from his vision, wisdom and his warm enthusiasm,” says Connell.

Top AARP Volunteer Comes to Rhode Island

The award was presented by Joan Ruff, current AARP National Board Chair, who has worked as a executive, human resources consultant and attorney. “You have left more than a legacy of service for those of us who have followed in your footsteps,” she said, before presenting the award.

“Your instinct to emphasize the value of state offices and engines for positive social change and to focus on what we now call engaging locally was spot on. You made the case that the more engaged our membership is with AARP the more likely they are to get involved, to renew their commitment and to tell friends and family members about the value of the work we do,” noted Ruff.

“To Zarlengo’s surprise, Huff also conveyed a letter from AARP CEO Jo Ann Jenkins, which read in part, “Having previously served as AARP Rhode Island’s State President, as a national board member for six years and as AARP Board Chair for two years, you know as well as anyone the high level of commitment and dedication this honor represents.

“As a former state president, you were always thinking about how to make the states and national office work more closely together and how to make AARP a stronger presence in local communities across the country.

“You were instrumental in pushing for the integration of the states into AARP’s strategy development and in making AARP more of a local presence across the country. As president of AARP Foundation at the time, I was energized by your support for The Drive to End Hunger and our efforts in financial services,” Jenkins wrote.

“When AARP decided to bring Experience Corps into the AARP family of programs, you saw the benefit of serving all generations to help strengthen our communities. And, as AARP’s representative to the Federal Emergency Management Agency (FEMA), you spearheaded AARP’s relief efforts in communities hit by natural disasters, leaving a legacy we continue to build on today.

Accolades, Accolades, Accolades

Dr. Reid Appleby, 38, ophthalmologist in East Greenwich who has known Zarlengo for over 48 years, calls him “a wonderful man who is dedicated to society and a friend to everyone he ever met.” It is very appropriate that he receive this prestigious award at this point in his life, says Appleby.

“It’s incredibly important to recognize his work,” says Senator Dawn Euer, representing Newport and Jamestown, noting that she had heard stories about his impact on the state’s aging policy. “It’s valuable for organizations like AARP to recognize their volunteers working to address aging issues that have an impact on the state and nation,” she said, noting that her legislative district has the highest concentration of AARP members in the Ocean State.

Senator Louis P. Dipalma, representing Little Compton, Middletown, Newport, Tiverton, was not surprised that Zarlengo was receiving AARP’s most prestigious award because “his record is impressive.”

According to Dipalma, you need more people like Zarlengo with their extensive knowledge of Social Security and Medicare with such trying times at the federal level with a GOP Congress looking to cut these programs.

When accepting his recognition, an overwhelmed Zarlengo stated that he was not ready to hang up his spurs and there was still much work to do with Congress targeting Social Security and Medicare for cuts. “ AARP has given me the opportunity to grow, to contribute, to learn and to enjoy – at a very exciting time – when the older population is rapidly increasing – you know today nationally we have surpassed the 50 million mark of seniors age 65 and over and we’re well on our way to reaching 83 million by 2080.”

AARP’ Zarlengo and tens of thousands of committed AARP volunteers throughout the nation will be there “to serve and not be served.”

Zarlengo resides in Jamestown with his wife Charlotte. They are parents of, Nancy Gilbert (who resides in Wellesley, Mass., with her husband Michael) and are grandparents of Jeffrey, Elizabeth and Abigail.

New Report Charges that States Disfranchise Older Voters

Published in Woonsocket Call on November 11, 2017

Since 1948, Wisconsin resident Christine Krucki had voted in every presidential election, but effectively lost her right to vote when her state enacted a voter ID law in 2011. An old Illinois photo ID and proof of her residence in Wisconsin was just not good enough to allow her to cast a vote.

Krucki did not have a birth certificate and was forced to purchase one for $20. However, her last name on the document did not match her current last name, changed when she married. She then paid $15 dollars for a copy of her marriage certificate , but that document listed her list name differently than her birth name, as she was adopted a different name after moving in with her stepsister when she was in her early 20s. Changing her name on the Illinois marriage certificate to match her birth certificate to solve the problem would cost between $ 150 and
$ 300.

The obstacles Krucki faced when attempting to exercise her right to vote are encountered by millions of older Americans when they attempt to vote. With the 2018 mid-term elections less than a year away, two U.S. Senators release a report detailing Krucki’s problem at the polls, and notes how suppressive state laws and inaccessible voting locations disenfranchise older voters.

Pushing Older Voters Away from the Polls

Senators Bob Casey (D-PA), Ranking Member of the Special Committee on Aging, and Amy Klobuchar (D-MN), Ranking Member of the Committee on Rules and Administration’s 15 page report, “Barriers to Voting for Older Americans: How States are Making it Harder for Seniors to Vote,” finds that strict voter identification (ID) laws, closure of voting locations, inaccessible polling places and limits on early voting and absentee ballots are preventing seniors and people with disabilities from casting votes.

“The right to vote is one of the fundamental pillars of American democracy. But, that right is under threat for millions of older Americans and individuals with disabilities across the nation,” stated Sen. Bob Casey in a statement announcing the report’s release. “This report brings awareness to the unique challenges that seniors face in exercising their constitutional right. We must work to ensure that all Americans have equal access to the voting booth.”

“The right to vote is the foundation of our democracy, but exercising that right is becoming harder and harder for many Americans, especially our seniors,” add Sen. Klobuchar, noting that long lines, inaccessible polling places, and strict voter ID laws have become barriers to voting for older Americans. “This important report shines a light on the hardships these voters face and proposes common sense solutions to make voting easier for everyone. We need to do more to restore Americans’ confidence in our political system. Our first step should be making it easier for their voices to be heard on Election Day,” he says.

The report, released on Nov. 2, also includes new information from the U.S. Government Accountability Office (GAO), which found that only 17 percent of the polling places it examined during the 2016 election were fully accessible. Most polling places GAO examined had one or more impediments from parking to the voting area and had accessible voting stations that could impede private and independent voting.

According to the report, suppressive voting laws and issues of accessibility affect tens of millions of older Americans and people with disabilities. In the 2016 election, 30 percent of the voters were between the ages of 50 and 64-years-old and 13 percent were 65 and older. Sixteen million (11.5 percent) of the 139 million votes were cast by people with disabilities. As the baby boomer population continues to age, these restrictions and barriers are likely to adversely impact more Americans.

In order to protect the voting rights of older voters and persons with disabilities, the report calls on Congress to ensure the full authorization and empowerment of all federal voting laws, which will make polling places accessible to older voters. Access to polls can also be increased by allowing opportunities for accessible early voting and absentee voting. Finally, it calls on limiting restrictions on voting and ensure that election laws fully consider the needs and abilities of older Americans.

Reflections from Rhode Island

“The depth of this issue varies from state to state,” says AARP State Director Kathleen Connell, who herself is a former Rhode Island Secretary of State. “I believe that older Rhode Islanders are well protected here, but we must be vigilant. Older Rhode Islanders are traditionally the most engaged voting group. Their voices are important and should not be silenced in any way.”

“I would add, however, that deliberate voter suppression is a threat to voters of all ages and the implications are as serious as they are obvious.

“When Voter ID legislation was passed in Rhode Island, we worked with then Secretary of State Ralph Mollis to set up photo booths to create ID cards for voters who did not have proper photo IDs. It was well received, but transportation was identified as a barrier to reaching some potential voters. Fortunately there were other remedies in place and, I have to say, no one contacted us saying they were prohibited from voting.”

Adds, Secretary of State Nellie Gorbea, this report presents a troubling situation across our country. The right to vote is sacred. I have spent the past three years modernizing our elections so that we can engage and empower all Rhode Islanders. Civic participation at all age levels is critical to our success as a state. I will continue to work to remove barriers so that eligible Rhode Islanders can have easier access to the ballot.”

Joe Graziano, Gorbea’s Communication Coordinator, notes that the GAO findings cited in this “Barriers to Voting” report is based on Council on State Governments research that his Department did not have a chance to review. “While it is not called “early voting”, Rhode Island does have an emergency mail ballot period that allows Rhode Islanders to cast their ballot ahead of Election Day without an excuse, says Graziano, noting that older voters have been able to use this system, in fact, 45 percent of the emergency mail ballots cast last year were by Rhode Islanders 65 and older.

Graziano admits that the GAO report shines a light on some of the barriers to voting across the nation. “Secretary Gorbea agrees that access to voting is critical and has successfully strived to improve it in the last three years including the introduction of online voter registration, automatic voter registration and the implementation of new, easier to use elections technologies (voting machines and ePoll books). Additionally, she has redesigned the ballot and the voter information guide to make them easier to read and understand. She also introduced legislation to update and expand opportunities for early, in-person voting,” he says.

“As a way to mitigate the negative impact of the photo ID requirement for voting, the Rhode Island Department of State has made sure that free photo Voter IDs are available to people in the communities where they live,” says Graziano, noting that last year alone, the Secretary of State staff held 51 events at senior centers and retirement facilities to ensure that eligible, older voters had proper voter identification, were introduced to new voting technologies and had any of their elections related questions answered by our Elections Division staff.

Looking to the upcoming General Assembly Session, Graziano says that Secretary Gorbea will once again introduce legislation for early in-person voting. “The legislation would eliminate the need for emergency mail ballots by allowing voters to cast their ballot at their local city or town hall, up to 20 days prior to an election, including the Saturday and Sunday prior to Election Day,” he says.

For more details about the Senate voting obstacle report, go to http://www.aging.senate.gov/imo/media/doc/Voting%20Rights%20Report.pdf.

Report Links Improved Brain Health to Sleep

Published in Pawtucket Times on January 16, 2017

Seven to eight hours of sleep per day may be key to maintaining your brain health as you age, says a newly released consensus report issued the Global Council on Brain Health (GCBH). The report’s recommendations, hammered out by scientists, health professionals, scholars and policy experts working on brain health issues at meeting convened by AARP with support of Age UK, in Toronto, Canada in late July 2016 Toronto, translates the scientific research evidence compiled on sleep and brain health into actionable recommendations for the public.

An AARP consumer survey released this month [in conjunction with GCBH’s report] found that 99 percent of age 50-plus respondents believe that their sleep is crucial to brain health, but over four in 10 (43 percent) say they don’t get enough sleep during the night. More than half (about 54 percent) say they tend to wake up too early in the morning and just can’t get back to sleep.

As to sleep habits, the adult respondents say that the most frequently cited activity that they engage in within an hour of bedtime are watching television and browsing the web. One-third keep a phone or electronic device by their bed. Nearly 88 percent of the adults think a cool bedroom temperature is effective in helping people sleep. Yet only two in five (41 percent) keep their room between 60 and 67 degrees. Finally, the most common reason people walk up during the night is to use the bathroom.

“Although sleep problems are a huge issue with older adults, it’s unfortunate the importance of sleep is often not taken seriously by health care professionals,” said Sarah Lock, AARP Senior Vice President for Policy, and GCBH Executive Director. “It’s normal for sleep to change as we age, but poor quality sleep is not normal. Our experts share [in GCBH’s report] the steps people can take to help maintain their brain health through better sleep habits,” said Lock, in a statement released with the report.

Sleep Vital to Brain Health

The new GCBH recommendations cover a wide range of sleep-related issues, including common factors that can disrupt sleep, symptoms of potential sleep disorders, and prescription medications and over-the-counter (OTC) sleep aids. The consensus report is jam-packed with tips from experts, from detailing ways to help a person fall asleep or even stay asleep, when to seek professional help for a possible sleep disorder, and the pros and cons of taking a quick nap.

Based on the scientific evidence, the GCBH report says that sleep is vital to brain health, including cognitive function, and sleeping on average 7-8 hours each day is related to better brain and physical health in older people.

The 16-page GCBH consensus report notes that the sleep-wake cycle is influenced by many different factors. A regular sleep-wake schedule is tied to better sleep and better brain health. Regular exposure to light and physical activity supports good sleep, says the report.

According to the GCBH report, people, at any age, can change their behavior to improve their sleep. Persistent, excessive daytime sleepiness is not a normal part of aging. Sleep disorders become more common with age, but can often be successfully treated. People with chronic inadequate sleep are at higher risk for and experience more severe health problems, including dementia, depression, heart disease, obesity and cancer.

“A 2015 consensus statement of the American Academy of Sleep Medicine and the Sleep Research Society mirrors the recently released GCBH report recommending that a person sleep at least 7 hours per night, notes Dr. Katherine M. Sharkey, MD, PhD, FAASM, Associate Professor of Medicine and Psychiatry and Human Behavior who also serves as Assistant Dean for Women in Medicine and Science. “Seven to eight hours seems to be a ‘sweet spot’ for sleep duration,” she says, noting that several studies indicate that sleeping too little or too much can increase risk of mortality.

More Sleep Not Always Better

Sharkey says that individuals with insomnia sometimes use a strategy of spending more time in bed, with the idea that if they give themselves more opportunity to sleep, they will get more sleep and feel better, but this can actually make sleep worse. “One of the most commonly used behavioral treatments for insomnia is sleep restriction, where patients work with their sleep clinician to decrease their time in bed to a time very close to the actual amount of sleep they are getting,” she says, noting that this deepens their sleep.

Sleep apnea, a medical disorder where the throat closes off during sleep, resulting in decreased oxygen levels, can reduce the quality of sleep and is often associated with stroke and other cardiovascular diseases, says Sharkey. While sleep apnea is often associated with men (24 percent), it also affects nine percent of woman and this gender gap narrows in older age, she notes.

Many older adults who were diagnosed with sleep apnea many years ago often times did not pursue medical treatment because the older CPAP devices were bulky and uncomfortable, says Sharkey, who acknowledges that this technology is much better today.

“We know how many questions adults have about how much sleep is enough, and the role that sleep plays in brain health and cognitive function,” said Marilyn Albert, Ph.D., GCBH Chair, Professor of Neurology and Director of the Division of Cognitive Neuroscience at Johns Hopkins University in Baltimore, Maryland. “This [GCBH] report answers a lot of these questions and we hope it will be a valuable source of information for people,” she says.

Simple Tips to Better Sleep

Getting a goodnights sleep may be as easy as following these tips detailed in the 16-page GCBH report.

Consider getting up at the same time every day, seven days a week. Restrict fluids and food three hours before going to bed to help avoid disrupting your sleep to use the bathroom. Avoid using OTC medications for sleep because they can have negative side-effects, including disrupted sleep quality and impaired cognitive functioning.
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The GCBH report notes that dietary supplements such as melatonin may have benefits for some people, but scientific evidence on their effectiveness is inconclusive. Be particularly cautious of melatonin use with dementia patients.

Naps are not always a cure to enhancing your sleep. Avoid long naps; if you must nap, limit to 30 minutes in the early afternoon.

“There has been such a steady stream of revealing brain-health reports that it would seem people would change their habits accordingly,” said AARP Rhode Island State Director Kathleen Connell. “Taking active steps is what’s important – and the earlier the better,” she added.

“The personal benefits are obvious, but we should be aware of the cost savings that better brain health can produce. If people in their
50s get on board, the impact on healthcare costs and a reduced burden of caregiving 20 years down the road could be significant,” Connell added. “At the very least, those savings could help cover other rising costs. We owe it to ourselves and to each other to assess and improve aspects of diet and exercise. And we should not overlook the importance of sleep.”

The full GCBH recommendations can be found here: http://www.globalcouncilonbrainhealth.org. The 2016 AARP Sleep and Brain Health Survey can be found here: http://www.aarp.org/sleepandbrainhealth.